FACTORS AFFECTING STUDENT NURSE’S ABILITY TO PROVIDE

HOLISTIC CARE

BACHELOR OF SCIENCE IN NURSING

IBANEZ, CHEZKA KLEAH

JAVAR, MARIA NICHOLE

PESCO, FRANCYS YUMARIE

April 2024
FACTORS AFCTING STUDENT NURSE’S ABILITY TO PROVIDE

HOLISTIC CARE

An Undergraduate Thesis Presented to the Faculty

of North Valley College Foundation Incorporated

Lanao, Kidapawan City, in Partial Fulfillment

of the Requirements for the Degree

BACHELOR OF SCIENCE IN NURSING

IBANEZ, CHEZKA KLEAH

JAVAR, MARIA NICHOLE

PESCO, FRANCYS YUMARIE

April 2024

TABLE OF CONTENTS
 Preliminaries

Title Page i

Table of Contents ii

CHAPTER 1

INTRODUCTION
Background of the Study 4
Review of Literature 6
Theoretical Framework 13
Research Objectives 16
Scope and Limitation 17
Definition of Terms 18

CHAPTER 2

METHODOLOGY

Introduction 20
Research Design 22
Research Locale and Participant 23
Research Instrument 24
Data Gathering Procedure 25
Data Analysis 27
Trustworthiness of the study 28
Ethical Considerations 30

CHAPTER III
RESULTS AND DISCUSSION

Factors that affects student nurses ability

to provide holistic care

CHAPTER IV
IMPLICATIONS AND CONCLUDING REMARKS
Implication for Practice
Implication for Future Research
Concluding Remarks

REFERENCES

APPENDICES
A – RF5
B – Permission Letters
C – Research Instrument
D – Transcribed data
E - Data Reduction and Categorization

APPENDICES
 A. Informed Consent
B. Survey Questionnaire

CHAPTER 1

INTRODUCTION

Background of the Study

Nurses’ competence is based on the knowledge and skill taught to them.

(Manninen,1998). Therefore, clinical education is considered to be an essential

and integral part of the nursing education program (Aghamohammadi-

Kalkhoran, Karimollahi, and Abdi,2011). Since nursing is a performance-based

profession, clinical learning environments play an important role in the

acquisition of professional abilities and train the nursing students to enter the

nursing profession and become a registered nurse ( Jonsen, Melender, and

Hilli, 2013).The unpredictable nature of the clinical training environment can

create some problems for nursing students ( Newton and McKenna, 2007).

The challenges and problems the students are faced with in the clinical

learning environment prevents them from effective learning and growth. As a

result, the growth and development of their skills will be influenced (Nahas,
1998).

Holistic care is a comprehensive model of caring. Previous studies have

shown that most nurses do not apply this method. Examining the effective

factors in nurses’ provision of holistic care can help with enhancing it. Studying

these factors from the point of view of nurses will generate real and meaningful

concepts and can help to extend this method of caring. The results of the study

show that the educational system, working environment, and motivational

factors are major factors in providing holistic care. However, the findings reveal

that these factors are not appropriate enough in Iran to lead to holistic care,

and Iranian nurses tend to stick to their routine duties and satisfy patient's

clinical needs only. Earlier studies conducted in other countries—e.g.

Strindberg (2007), King (2006), Henderson (2002), Olive (2003)—have

attested to the importance of the above-mentioned factors in the provision of

holistic care, hence the need for closer attention to the compatibility of the

educational system with the idea of holistic care, revision of the contents and

methods of education, and modification of the conditions at work in order to

encourage holistic care. Purposive sampling was used to select 14 participants

with abundant information. Three of the nurses selected were male and the

others were female. The participants were selected from various wards

[intensive care unit (ICU), emergency, general wards] in university hospitals in

the Iranian cities of Tabriz, Uremia, Ardebil, and Tehran.

Several studies have been conducted on the factors affecting student

nurses' ability to provide holistic care. For example, a study conducted in the

United States found that nursing students reported a lack of confidence and

knowledge in providing spiritual care (Taylor et al., 2017). The purpose of the

study was to explore registered nurses’ (RNs) perceptions of their spiritual care
competence (SCC), preparedness, and barriers to providing spiritual care and

frequency of provision of spiritual care. This online survey was completed by

391 RNs enrolled in post licensure programs at a public state university in

South Eastern United States. Another study conducted by (Usher et al., 2015;

Wolff et al., 2010) about the variety of factors contributes to novice nurses’

ability to provide appropriate care in acute situations. The participants are first

year nurses of Australia 17 novice nurses were interviewed in this qualitative

study. To address this issue, it is important to describe factors in nursing

education and first year of practice that enable nurses to provide appropriate

care in acute situations. Results suggest that a variety of factors contribute to

novice nurses’ ability to provide appropriate care in acute situations.

Experience of acute situations and the integration of theory and practice are

pivotal in acquiring skills to provide appropriate care.

Despite the various studies conducted on the topic, there is still a gap in

research on the factors affecting student nurses' ability to provide holistic care.

Even there was a conducted study in international countries there is a need to

explore this topic further specially in our country the Philippines to identify the

specific factors that affect student nurses' ability to provide holistic care and

how these factors can be addressed to improve their competence.

The study on the factors affecting student nurses' ability to provide

holistic care is essential in addressing the gaps in knowledge and practice in

nursing care. It can provide insights into the specific factors that affect student

nurses' ability to provide holistic care and can guide the development of

strategies to address these factors. Ultimately, this study can contribute to

improving the quality of nursing care and the overall well-being of patients.
 Review of Literature

This section presented the review of related literature which guides the

researchers to conduct this study. This section includes related literature on holistic

care, factors affecting the ability to provide holistic care, and perceptions about the

factors affecting holistic care.

Holistic care

Holistic care is a nebulous and subjective concept. (Bullington, and

Fagerberg , 2013) In general, it describes approaches and interventions that are

meant to satisfy a patient's physical, mental, emotional, and spiritual needs.

However, this definition is not comprehensive, and research demonstrates

that the concept of holistic care is frequently used by nurses in a variety of

contexts without any clear knowledge of what is meant by it. (Bullington , and

Fagerberg , 2013). Thus, the meaning of the concept of holistic care often

remains unclear and ambiguous and usually incorrectly understood. ( McEvoy ,

Duffy, 2007) Most often, “holistic care” is viewed with disapproval and

condemned as unspecialized, unscientific, wasteful, and time-consuming.

(Bullington and Fagerberg, 2013)

 In general, the literature suggests that the meaning of “holistic care”

remains ambiguous and any in-depth studies toward a definition of it are rare.

Having a concreate definition of holistic care enables nurses to identify

therapeutic potentials when caring for patients. (McEvoy, Duffy, 2008) thereby

increasing nurses' knowledge, helping to develop a framework for holistic

nursing. (Filej, Kaucic, 2013) In addition, a comprehensive understanding of

holistic care will facilitate professional autonomy and enable them to consider

patients' needs in a more systematic and scientific way.(Baldacchino, 2008)

Furthermore, a clear conceptual definition of holistic care will provide a

concensus on its meaning therby facilitating its application in nursing practice,

research, education, and theory development. Therefore, the aim of this study

was to conduct a concept analysis of holistic care using an integrative approach

facilitated by the hybrid approach.

Factors Affecting Ability to provide Holistic Care

Patient’s Attitude

Patient-student relationship is just as important as patient-doctor

relationship. Patients are considered the cornerstone in medical education and

essential for the acquisition and development of clinical skills in the performance

of their tasks, represented by history taking and clinical examination culminating

in the performance of procedures and development of management plans.

(British Medical Association MES. 2016)

Patients’ right to accept or refuse the involvement of medical students is a

challenging issue which could interfere with medical education. Addressing

patients’ attitudes towards medical students’ involvement and highlighting

factors that affect their acceptance of this involvement are critical(Abdulghani,

Al-Rukban, Ahmad, 2008)

Variation in the patients’ acceptance and comfort level towards medical

students’ involvement in their care are attributable to numerous factors including

patients’ sociocultural and educational levels as well as the kind of students’

involvement.[Sayed-Hassan, Bashour, Koudsi, 2012]. For example, patients’

comfort level towards involving medical students in performing less invasive

examination and minor procedures was consistently high across different

specialties in the US;[Isaacson, Neides, Mayer, Nottingham, 2014]

 However, in Kuwait and Ethiopia,more than half the patients refused that

kind of involvement. (Temesgen, 2013). Male and female students’ attire could

be a significant contributing factor in patients’ acceptance and comfort in having

medical students involved in their care. Although it has been reported that

general appearance of medical students affected cooperation of patients,the

impact of specific traditional attire worn by medical students has not been well

documented, especially in a country like Saudi Arabia where some medical

students and physicians wear traditional attire when seeing their patients.

(Junod, Sommer, Louis, Nendaz, 2015)

Communication Anxiety

Communication is a dynamic and very complex process that requires the

sender of the message to be aware of the barriers and possible limitations that

may prevent the information from being conveyed and understood by the

receiver of the message (Wimmers, Stuber,2016). Thus, effective communication

requires not only mastering the sending, understanding, and monitoring of the

information , but also properly handling both emotional and social aspects, which

requires a high degree of empathy as well as assertiveness and active listening,

among other skills .( Transl, Behav, 2017). Effective communication in the field

of nursing management is an essential tool that facilitates organizational

processes, minimizes conflict management that can lead to unhealthy work

environments, and increases the quality of care ( Nery, 2020)

 However, anxiety is more commonly understood as a complex and

unpleasant emotion that is expressed by a feeling of fear and emotional tension,

accompanied by an important array of somatic symptoms (Nurs. Manag. 2020). If

the situation that generates such anxiety extends over time or is of great

intensity, it can generate emotional changes that may lead to pathological

manifestations in the individual. Situations that generate a state of high stress,

anxiety, and even depression in nurses lead to both physical and psychological

exhaustion. (Int. J. Community Based Nurs. Midwifery. 2016)

Moreover, they negatively influence nurses’ perception of others’ needs,

rendering them less capable of understanding them and generating “compassion

fatigue” (Ment. Illn. 2018), diminish nurses’ adaptability to change , and reduce

and hinder their ability to convey information in an efficient manner (Educ.

Couns. 2019)

The effect of stress-generating situations also affects communication skills,

resulting in a bad organizational climate ( Front. Psychol. 2015). This can

generate hostility toward the work environment and authoritarian behaviors that

can even derive in humiliating treatment of nurses by their superiors, causing a

loss of confidence among professionals, with a significant impact on

communication (Nurs. Manag. 2014).

Time constraints and workload

Nursing students experience high levels of stress due to significant

workload, relatively inflexible curriculum, competitive atmosphere between peers

(Lee, Lim, 2017) ,which inevitably lead to burnout. As a result, burnout causes

psychological and physical problems (weakness, insomnia), emotional problems

(anxiety, depression), attitude problems (hostility, apathy, distrust), and

behavioral problems (aggression, nervousness) (De la Fuente, Vargas, San

Luis, Garcia, Canadas, Emilia, 2015)

Student Nurses’ health and well-being are affected by these stresses and

demands of their work, and in turn, their well-being affects their work, including

increasing the risk of medical errors and compromising patient safety and care

(Melnyk et al., 2018). Student Nurses are coping with unrealistic workloads;

insufficient resources and protective equipment; risk of infection; stigma directed

at health care workers; and the mental, emotional, and moral burdens of caring

for patients with a new and unpredictable disease (Shechter et al., 2020; Squires

et al., 2020). Nurses are accustomed to setting aside their own needs and fears

to care for people and take on the burdens and stresses of families and

communities (Epstein and Delgado, 2010). However, if nurses are not supported

in maintaining their physical, emotional, and mental well-being and integrity, their

ability to serve and support patients, families, and communities will be

compromised (e.g., McClelland et al., 2018).

In Canada, nursing students had higher levels of depression, anxiety, and stress
compared to other students (Cheung, Wong, et al., 2016) , and similarly in Korea,

nursing students experienced higher levels of depression, anxiety, and stress

compared to other major students (Hwang, Kim, Shin SJ, 2016)

Additionally, compared to other major students, medical school and

nursing students experienced higher levels of burnout due to the complex

curriculum and pressure for professional performance (Ling, Qin, Shen, 2014) .

Altogether, these evidence show that nursing students frequently experience

psychological and emotional problems such as academic exhaustion, stress,

depression, and anxiety during their four years of completing their degree.

Limited Knowledge

Most of the nursing bachelor programs require students to complete an

internship or a practicum course to gain practical experience and integrate all the

learned clinical skills in order to complete their nursing degrees. This experience

is considered a transition from academic education to a professional career (Staff

Writers, 2020). Pre-licensure nursing students might have a preparation-to-

practice gap due to a lack of deep clinical learning that exacerbates a crisis in

their clinical competencies. This is coupled with a lack of confidence and

restricted clinical judgment that may affect their ability to work in a complex field

such as acute care settings (Kavanagh and Szweda, 2017).

 Therefore, preceptors had to adopt innovative clinical teaching

approaches to prepare the students for working efficiently in such acute care

setting and minimize their anxiety (Colleran and Toronto, 2017, Sihotang et al.,

2017). Scenario-Based Learning (SBL) is one of the modern and creative

teaching methods that has been increasingly incorporated into the existing

nursing curricula (Colleran and Toronto, 2017). A clinical scenario is a plan of an

expected and a potential course of events for simulated clinical experience (Lioce

et al., 2020).

Moreover, the design entails the desired fidelity, decisions about

equipment, learner role assignments, simulation flow, predetermined facilitator

responses to participants’ interventions and briefing/debriefing strategies (Jeffries

et al., 2015). Besides, the theory emphasized that the simulation experience, the

fourth element, should be interactive, learner-centered, experiential and

collaborative. Regarding the facilitator and educational strategies, Jeffries

emphasized that the SBL is a dynamic interaction between facilitator and

participants, where the facilitator responds to the emerging needs of participants

during the simulation experience and adjusting the educational strategies

accordingly. The sixth core element is concerned with the outcomes for the

participant, patient and system as a whole (Jeffries et al., 2015, Cowperthwait,

2020).
Theoretical Framework

The study pertaining to the factors affecting student nurse’s ability to to

provide holistic care is anchored on the nursing theory of Jean Watson’s

Philosophy and Science of Caring. Watson's theory emphasizes the

importance of providing holistic care that considers the patient's physical,

emotional, psychological, and spiritual needs. The theory posits that nursing

care should be based on the nurse's ability to establish a caring relationship

with the patient, promoting healing, and enhancing the patient's overall well-

being.

The model of Watson's Philosophy and Science of Caring provides a

theoretical basis for understanding the concept of holistic care in nursing. It

emphasizes the importance of treating the patient as a whole person, rather

than just addressing their physical symptoms. The theory also highlights the

importance of the nurse's caring consciousness and the use of caring

interventions in providing comprehensive care.

In summary, the theory of Jean Watson is relevant to the study for it will

help the researches provide a valuable framework for understanding and

studying the factors that influence student nurses' ability to provide holistic

care. It emphasizes the importance of holistic care, caring relationships, caritas

processes, self-care, and contextual considerations, all of which are relevant to

exploring the factors affecting student nurses' ability to provide holistic care.
 In addition to the first theory, is the self-efficacy, developed by Albert

Bandura, is highly relevant to the study of factors affecting student nurses'

ability to provide holistic care.

Firstly, it tackles about the Beliefs in Personal Capabilities: Self-efficacy

theory focuses on individuals' beliefs in their own capabilities to successfully

perform specific tasks and achieve desired outcomes. In the context of student

nurses' ability to provide holistic care, self-efficacy beliefs play a crucial role. By

studying factors that influence self-efficacy beliefs, such as educational

experiences, clinical exposure, and feedback, we can gain insights into how

these factors impact student nurses' confidence in their ability to deliver holistic

care.

Second, the Influence on Motivation and Effort: Self-efficacy beliefs

influence motivation and effort. When student nurses have high self-efficacy

beliefs, they are more likely to feel motivated to learn, engage in caring

behaviors, and put in the effort required to provide holistic care. Conversely,

low self-efficacy beliefs may lead to decreased motivation and effort. By

studying factors that affect self-efficacy, we can explore how these factors

influence student nurses' motivation and effort in providing holistic care.

Another idea about the theory is the Skill Development and

Performance: Self- efficacy beliefs impact skill development and performance.

Student nurses with high self-efficacy beliefs are more likely to actively seek
out opportunities to acquire and refine their skills in holistic care. They are also

more likely to persist in the face of challenges and setbacks. By understanding

the factors that influence self-efficacy beliefs, we can gain insights into how

these factors affect student nurses' skill development and performance in

providing holistic care.

In addition, Emotional Well-being: Self-efficacy beliefs can impact

emotional well-being. Student nurses with high self-efficacy beliefs tend to

experience less anxiety, stress, and burnout, as they have confidence in their

ability to handle the demands of holistic care. By studying factors that influence

self-efficacy beliefs, we can explore how these factors impact student nurses'

emotional well-being and their ability to provide holistic care effectively

Lastly, the Self-Regulation and Goal Setting: Self-efficacy theory

emphasizes the importance of self-regulation and goal setting in achieving

desired outcomes. By understanding the factors that influence self-efficacy

beliefs, we can explore how these factors impact student nurses' ability to set

goals, monitor their progress, and adjust their strategies in providing holistic

care.

Moreover, the theory of self-efficacy provides a valuable framework for

studying factors that affect student nurses' ability to provide holistic care. It

highlights the importance of beliefs in personal capabilities, motivation, skill

development and performance, emotional well-being, and self-regulation. By

understanding and addressing factors that influence self-efficacy beliefs, we

can support student nurses in developing the confidence and skills needed to

provide holistic care effectively.

Research Objectives

This study specifically aims to determine the factors affecting student

nurse's ability to provide holistic care.

Scope and Limitation

The study will focus on the factors affecting student nurse's ability to

provide holistic care. A total of 10 respondents will be selected from selected

2nd year 3rd year and 4th year nursing students of North Valley College

Foundation Inc. will serve as the respondents of the study. The participants to

be recruited must have already been exposed in the hospital setting. This study

focused on the current nursing students enrolled in the second semester of the

present school year 2023-2024. The study will be conducted from January to

April of 2024.

Therefore, the study may not cover all factors that affect student nurse's

ability to provide holistic care due to the vast range of potential factors

involved. The study's findings may be influenced by the subjective experiences

and perceptions of the participants, which can vary. The timeframe may be

limited to a specific period, and changes in factors affecting student nurse's

ability to provide holistic care over time may not be fully captured. The study's

implementation may be subject to logistical constraints, such as limited access

to participants or resources, which may affect the depth and breadth of data

collected.
 Definition of Terms:

The following terms are operationally defined according to their use in the study:

Ability – refers to the skills of the student nurses to perform procedures in clinical setting.

Experience and Exposure - refers to the clinical rotations provided to student nurses to

practice their competence.

Factors –refers to the circumstance that affects the ability of student nurses to provide

holistic care.

Holistic Care – refers to the care includes the well-being of the whole person.

Knowledge– refers to the information gained by the student nurses from their clinical

duties.

Student Nurse –refers to a person enrolled in nursing program who practiced their skills in

clinical exposure.
 CHAPTER 2

METHODOLOGY

Introduction:

The primary component of this chapter will include a detailed explanation

of the research design, research locale and participants, research instrument,

data gathering procedure and data analysis. It outlines the steps taken to

conduct the study, including the specific procedures used to measure variables,

gather data and analyze the results. The chapter also discusses the reliability

and validity of the research through the ethical considerations involved in the

study.

Research Design

The study will employ a qualitative research design to explore the

factors affecting student nurses' ability to provide holistic care. Qualitative

research is focused on understanding and describing the population, situation,

or phenomenon being studied, rather than explaining causality or making

predictions (Gall, Gall & Borg, 2007). This design is appropriate for gaining in-

depth insights and understanding the perspectives and experiences of student

nurses in relation to holistic care.

 The researchers have chosen a qualitative research design for several

reasons. Firstly, qualitative research allows for the collection of rich and

detailed data that can provide a comprehensive understanding of the factors

influencing student nurses' ability to provide holistic care. Through qualitative

methods such as interviews or focus groups, the researchers can capture the

narratives and experiences of the participants, enabling a deeper exploration of

their perspectives.
Research Locale and Participant

The study will be conducted in North Valley College Foundation Incorporated

which offers student nurse education or Bachelor of Science in Nursing, located in

Brgy. Lanao, Kidapawan City, North Cotabato.

A total of 10 respondents will be selected from selected 2nd year 3 rd year and

4th year nursing students of North Valley College Foundation Inc. The criteria for

participant selection will include:

a) Student nurses enrolled the second semester of the school year 2023-2024

b) must be in 2nd year, 3rd year or 4th year level.

c) must have already been exposed in the hospital setting

d) and has willingness to participate in the study

The participant of the study will be determined with the use of purposive

sampling technique or also known as purposive and selective sampling. According to

Statistic Solution (2021), purposeful sampling is a sampling technique that qualitative

researcher use to recruit participants who can provide in-depth and detailed

information about the phenomenon under investigation.

 Research Instrument

Qualitative Interview Guide Questions

The qualitative interview guide questions will be utilized to gather in-depth and rich data

through semi-structured interviews to determine the factors affecting the student nurses

ability to provide holistic care.

In gathering data, the researchers will utilize an interview guide with self-

constructed questions as an instrument to collect in-depth information for the study.

The self-constructed interview guide will be validated by experts to ensure validity of the

research output. The questions will be composed of two (2) main questions and probing

questions. The main questions are to answer the research questions and probing

questions are to ask for more details and often a follow-up question to help clarify a

point or to understand the point of the participants.

The interview guide consists of open-ended questions that allow participants to

provide detailed responses and elaborate on their thoughts. The questions are

designed to be flexible, allowing the interviewer to probe further based on the

participant's responses and to explore different aspects of the research topic. This

research instrument is particularly useful when studying subjective phenomena,

exploring social constructs, or investigating personal opinions and attitudes.

Data Gathering Procedure

The researchers will be guided by the following guidelines in conducting the

data gathering:

Step 1: Approval and Permission

The researcher will seek approval from the relevant authorities or the school

administration. Once approved, the researcher will seek permission from the

participants, explaining the purpose of the study and the expected outcomes. The

researcher will ensure that the participants understand the study and their

participation is voluntary.

Step 2: Recruitment of Participants

The researcher will recruit participants who are student nurses in 2 nd to 4th year

level from North Valley College Foundation Incorporated. The researcher will use

purposive sampling to select participants who have completed their clinical rotation in

various healthcare settings.

Step 3: Conduct of Interview

The researcher will conduct an interview to gather data from the participants.

The interview will be conducted in a conducive and private setting, and the

participants will be informed of the purpose of the discussions. The researcher

will facilitate the discussions using a set of open-ended questions related to the

factors affecting student nurses' ability to provide holistic care. The interview will be

audio-recorded to ensure the accuracy of the data collected.

Step 4: Data Collection

The researcher will collect data from the interview using audio recordings and

field notes. The researcher will ensure that the data collected is accurate and

complete. The researcher will also ensure the participants' anonymity and

confidentiality are maintained throughout the data collection process.

Step 5: Data Analysis

The researcher will use a content analysis method to analyze the data

collected from the interview. The researcher will transcribe the audio recordings and

categorize the data into themes and sub-themes. The researcher will interpret the

findings and identify factors affecting student nurses' ability to provide holistic care.
Data Analysis

Analyzing data from In-depth Interviews and focus group discussions can be

challenging. Colaizzi’s (1978) distinctive seven-step process provides a rigorous

analysis, with each step staying close to the data. The end result is a concise yet all-

encompassing description of the phenomenon under study, validated by the participants

who created it. The method will depend upon rich first-person accounts of experience;

these may come from face-to-face interviews, but can also be obtained in multiple other

ways; written narratives, blogs, research diaries, online interviews, and so on. The

stages are illustrated in the table below:

Table 1. Steps in Colaizzi’s descriptive phenomenological method

Step Description

1. Familiarization The researcher familiarizes him or

herself with the data, by reading through

all the participant accounts several

times.

2. Identifying significant statements The researcher identifies all the

statements in the accounts that are of

direct relevance to the phenomenon

under investigation.

3. Formulating meanings The researcher identifies meanings

relevant to the phenomenon that arise

from a careful consideration of the

 significant statements. The researcher

must reflexively “bracket” his or her per-

suppositions to stick closely to the

phenomenon as experienced (though

Colaizzi recognizes that complete

bracketing is never possible).

4. Clustering themes The researcher clusters the identified

meanings into themes that are common

across all accounts. Again, bracketing of

per-suppositions is crucial, especially to

avoid any potential influence of existing

history.

5. Developing an exhaustive The researcher writes full and inclusive

description description of the phenomenon,
incorporating all the themes produced in
step 4.
6. Producing the fundamental structure The researcher condenses the
exhaustive description down to a short,
dense statement that captures just
those aspects deemed to be essential to
the structure of the phenomenon.
7. Seeking verification of the The researcher returns the fundamental
fundamental structure structure statement to all participants (or
sometimes a sub-sample in larger
studies) to ask whether it captures their
experience. He or she may go back and
modify earlier steps in the analysis in
 light of this feedback.

Trustworthiness of the Study

The principles of trustworthiness are relevant to the study, it ensure the reliability

of the study’s findings and prioritizing trustworthiness, researchers can instill confidence

in the study's findings on factors affecting student nurses' ability to provide holistic care.

This enhances the study's impact and utility in informing nursing education, practice,

and policy-making.

Trustworthiness or rigor of a study refers to the degree of confidence in data,

interpretation, and methods used to ensure the quality of a study (Pilot & Beck, 2014).

In each study, researchers should establish the protocols and procedures necessary for

a study to be considered worthy of consideration by readers (Amankwaa, 2016).

Although most experts agree trustworthiness is necessary, debates have been waged in

the literature as to what constitutes trustworthiness (Leung, 2015).

Credibility: Credibility refers to the believability and trustworthiness of the

study findings. According to Lincoln and Guba (1985), credibility can be established

by ensuring that the research is conducted with rigor and that the findings accurately

reflect the participants' perspectives. In this study, credibility will be achieved by using

a rigorous data collection process, such as conducting focus group discussions and

online survey interviews, and ensuring that the participants' voices are accurately
represented in the analysis and interpretation of the data. Researchers will apply

credibility in their study by employing rigorous research design, transparent

methodology, and systematic data analysis. This involves clearly defining research

questions, using appropriate data collection methods, and ensuring the reliability and

validity of measurements.

Confirmability: Confirmability refers to the objectivity and neutrality of the

research findings. According to Lincoln and Guba (1985), confirmability can be

achieved by ensuring that the data collection and analysis process is transparent and

well- documented. In this study, confirmability will be established by maintaining an

audit trail of the research process, documenting the decisions made during data

collection and analysis, and seeking input from other researchers or experts to

validate the findings. This will enhance the reliability and objectivity of the study

findings. Researchers will apply conformability in their study by promoting consistency

and neutrality throughout the research process. This involves maintaining

transparency in data collection, analysis, and interpretation.

Transferability: Transferability refers to the extent to which the findings can be

applied to other settings or contexts. In qualitative research, transferability is not about

generalizability but rather about providing enough information for readers to determine

the applicability of the findings to their own context. To enhance transferability, the

researcher will provide a detailed description of the research context, participants'

characteristics, and the research procedures. This will allow readers to assess the

similarities and differences between their own context and the study context, thus

making informed decisions about the applicability of the findings. Researchers can

enhance transferability in their study by providing detailed and context-specific

information about the research design, methodology, and findings. This involves

clearly describing the study's setting, participants, and demographics.

Dependability: Dependability refers to the consistency and stability of the

research findings over time. According to Lincoln and Guba (1985), dependability

can be achieved by ensuring that the research process is well-documented, and the

procedures are clearly described and replicable. In this study, dependability will be

established by maintaining a detailed record of the research process, including the

recruitment process, data collection methods, and data analysis procedures. The

researcher will also engage in peer debriefing, where other researchers or experts will

review the research process and findings to ensure consistency and reliability.

Researchers can enhance dependability in their study by implementing robust and

consistent research practices. This involves thoroughly documenting the research

process, including clear descriptions of the research design, data collection methods,

and analysis procedures. Consistency in applying these methods throughout the

study ensures dependability

Ethical Considerations

The principles of ethical considerations are highly relevant to the study of factors

affecting student nurses' ability to provide holistic care so researchers can conduct a

study responsibly and respectfully, ultimately contributing to the advancement of nursing

knowledge and practice while upholding the well-being of the participants.

Informed Consent. Informed consent is an essential courtesy when

conducting research or studies. It provides individuals with the necessary information,

freedom, and flexibility to fully participate in alignment with the research objectives

while ensuring accuracy and reliability. For this particular study, participants will be

provided with informed consent.

To safe guard confidentiality and protect their information, respondents will not

be identified or disclosed by their real names. Instead, they will be assigned

pseudonyms solely for research purposes, with the assurance of meticulous care

from the researchers. This approach aims to foster a trusting relationship between the

researchers and the participants.

Voluntary Participation. Voluntary participation is not required. Selected

respondents always had the opportunity to decline participation. You have the right to

stop and refuse to answer any reasonable question by researcher.

This study will provide relevant information to respondents before conducting

the survey. These are questions that give you the opportunity to choose whether to

answer, refuse, or be forced to stop completing the questionnaire completed by the

researcher.

Do no harm. This study adheres to the fundamental principles of ethics,

whereby the well-being and protection of individuals involved in the study are of

utmost importance. Furthermore, it emphasizes the concept of fairness, with

researchers responsibly addressing matters such as potential benefits and risks

associated with the research.

The researchers will take all necessary measures to ensure that respondents

are not harmed, either physically or psychologically. The primary objective of this

research is to uncover new information that can be beneficial to society, while

ensuring that individuals are not exposed to any detrimental information that could

jeopardize their lives.

Confidentiality. In the context of research, confidentiality is contractual. An

agreement was reached between respondents and researchers regarding non-

disclosure of the following information: This was confirmed through surveys and

interviews. It also empowers researchers, ensuring strict storage of information that

can never be made public. It spreads to other people.

This study used all the data the researchers could obtain, regardless of

availability. Information before and after the exam must be kept strictly

confidential. With all respondents. Reliable information related to this study must not

be disclosed to others. Without prior confirmation from the owner and participating

researchers.
 Anonymity. Ensuring the anonymity of information collected from research

participants means that the project does not collect identifying information from

individuals or that the project cannot link an individual's responses to the participant's

identity.

In this study, confidentiality includes non-disclosure of legal information.

Research information. This study provides all respondents with: To test this, a

fictitious name was created in the form of a research experiment. Provides variables

without leaking information to the general public.

CHAPTER III

RESULTS AND DISCUSSION

 This chapter presents the results and discussion on factors affecting student

nurse’s ability to provide holistic care. These are interpreted and analyzed to get

a clear view of the information that we gathered using the interview guide

question.

Factors affecting student nurse’s ability to provide holistic care

The factors affecting student nurse’s ability to provide holistic care are

described in themes such as: patient’s attitude, enormous number of patient, first

timer, struggling to balance academic and clinical exposure, language barrier,

limited knowledge and self-adjustment.

Patient’s attitude

Patient attitude can significantly impact student nurses’ ability to provide holistic

care in a hospital setting. Dealing with a demanding, uncooperative, or verbally

aggressive patient can be emotionally draining, lowering the student nurses' confidence

and focus. This can make it challenging for them to establish trust and communication

with other patients, hindering their ability to deliver personalized compassionate care.

One of the participants shared how patients attitude can affect their provision of

holistic care to patients.

Amm… Ang factor lang saakin is sometimes ahm… possible din sa

patient attitude siya which is toxic ( Amm... The only factor for me is
sometimes ahm... it is also possible with the patient's attitude which is
toxic)
 Additionally, another student nurses express that it is hard to their part to provide

holistic care when they have limited knowledge because they can’t communicate well to

the patient and they don’t know how to approach the patient, provide comfort because

the patient don’t like student nurses.

Kay if pwede tong sa example mo, ano po, sa patient’s attitude pud, then
sa mga limited knowledge pud. Kay kung sa patient’s attitude, kay feel ko
lang hindi ko, hindi ko ma, ay hindi ko knows. Hindi ko, ano, like, paano
mag-approach sa patient na may attitude. Like, hindi ko makita ang words
kung paano siya i-comfort, paano siya i-assure na, amo sa kay syempre,
may patient na hindi gusto siya yung student nurses, nga mag-care sa
ilaha. So, hindi ko sure if mahatag ko ang assurance na ginapangita nila, if
ever, nga, mag-attitude sila towards me. ( Because if it is possible in your
example, what is it, in the patient’s attitude as well, then in those with
limited knowledge as well. As for the patient’s attitude, I just feel that I
don’t know, I don’t know. I don’t, what, like, how to approach the patient
with attitude. Like, I can’t find the words on how to comfort him, how to
assure him that, of course, there is a patient who doesn’t like the student
nurses, so take care of them. So, I’m not sure if I can give the assurance
they are looking for, if ever, they will have an attitude towards me.)
P3L1O5-110

Other participant stated that they have difficulties in providing care when the

watcher is not comfortable if the student nurses handle their patient and it is

challenging in their part when the patient will get angry and it causes to the student

nurse to blame their self.

Then sunod kay attitude sa patient og watcher kay may times jud hindi
maiwasan na mag toxic sila then makasabot man ko pero syempre masakitan
pud so tendency makakulba og maka down pag makigan ka sa patient, pero sa
mga una raman nako tu na duty kay first time man tapos karun kada exposure
man gud ma enhance man akoang communication skills maong the rest sa mga
duty nako hantud karun kay okay kaayo attitude sa mga naging patient ko pati ila
 watcher,( Then next to the attitude towards the patient and the watcher, because
there are times when they can't avoid being toxic, then I understand, but of
course it hurts too, so there is a tendency to get nervous and sad when a patient
scolds you, but I only experienced that during my first duties, and then now every
exposure I enhanced my communication skills so that the rest of my duty until
now is that my patients attitude is good as well as their watchers)

Along with the other participants, one of the student nurses struggling to provide

holistic care because they felt that the patient is not comfortable when they take vital

sign.

Ang mga na experience nako during duty is and pakaattitude sa pasyente

kanang sige ka ug balik sa ilang room para lang mag vital sign kay mafeel nako
na murag lain na ilang panan-aw nila sa imuha so as a studemt nurse need nato
ug taas na pasensya ug dapat confident ka. (What I have experienced during
duty is the attitude to the patient that you go ahead and go back to some room
just to take vital signs because I feel like they have different views on the patient
so as a student nurse we need a lot of patience and you must be confident.)
P12L474-476

In addition, other participant stated that they can’t communicate well to the

patient and it is challenging to their part to provide holistic care when patient is not

cooperating.

Encountering patients with challenging attitudes for example ano lisud kaayo sila
intindihon naa man guy patients usahay maldita lisud kaayo sila I approach naa puy dili
makipag cooperate if naay question ( Encountering patients with challenging attitudes
for example they are difficult to understand, there are patient usually cursed it's difficult
to approach and there’s some patient do not cooperate when there is a question)
 Furthermore, based on the results. Student nurses have difficulty in providing

care to because of their attitude, This results support to Arkan et. Al (2017) study

revealing that nurses have a big effect, both good and bad, on how nursing students

learn during their clinical training.

Enormous Number of Patient

When there are too many patients, student nurses may struggle to provide

comprehensive care. The large workload can make it hard for them to give each patient

the individual attention needed. They may focus more on completing tasks rather than

understanding the whole person. This can make it difficult to create personalized care

plans that address the patient’s physical, emotional, and social needs.

One of the participants shared that it is hard for them to provide holistic care

when there are too many patients, student nurses may not know who to prioritize. The

large number of patients can make it challenging for them to decide which ones need

their attention the most.

Tapos usually sa karami ng patient talaga na hindi mo na talaga alam

anong gagawin mo tapos ( Then usually there are so many patients you really
don’t know what to do after)

Furthermore, based on the result the student nurses affect their ability to provide
holistic care in a hospital setting with an enormous number of patients, student nurses

may face significant challenges. The increased workload can lead to stress, fatigue, and

difficulty in providing quality care. This results support to Aliafsari’s (2016) study stated

that high workloads and limited time were reportedly some of the factors that were

impacting the communication abilities of student nurses.

First Timer

If you are a first timer in doing the procedures, you need guidance from the nurses or CI

to learn and not make mistakes in what to do. As a nursing student who's first-time performing a

procedure can be an overwhelming experience. It's natural to feel nervous and unsure about

what to expect. Balancing time, studying and providing hands-on patient care is crucial for

healthcare professional development. If you don't really know anything about the procedures,

learn from watching videos or practice so that you have an idea when it comes to using or doing

what kind of procedure should be done. One of the participants shared their thoughts about their

first time in doing a procedure:

Yung first time mo nga gawin yung procedure na unknown ka pa talaga kaya
mag tala-tala ka gud. ( Doing a procedure for the first time, you might get really flustered
or overwhelmed.) P1L16-19

According to, Maria Jocelyn B. Natividad (2020) students’ anxiety rises during their first

clinical exposure which as they may question their ability and experienced a lack of confidence

as they adjust themselves in the clinical learning environment. The Nursing College must

emphasize comprehensive orientation before students' exposure to clinical practice.

Struggling to balance academic and clinical exposure

Challenges in healthcare-related fields are common among students. Managing your

time is essential for balancing your academic and duty commitments as a nursing student. In

order to balance academic and clinical exposure, we need to make a plan of what should be

done first so that it is not difficult when duties come or in making requirements. Doing school

work such as assignments, making requirements and the rotation of duties in different hospitals

affects students and causes a burden to both academic and clinical exposure. One of the

participants shared their thoughts about their struggles on balancing the academic and clinical

exposure:

Base sa akoang mga experience during hospital duties, kanang mga factors nga
kabalo jud ko nga naka affect sa akoang pag provide ug holistic care sa mga naging
patients ko kay una stress, stress kay tungod and schedule sa duty gina send sa group
chat mga one week before man pero para sa akoa kulang sya kay may klase paman
plus naa pay mga requirements so dagdag pressure ug stress tapos makawala pud sa
focus kaya kis a apektado pud akoang time management. (Based on my experiences
during hospital duties, there are factors that I don't know that have affected me in
providing holistic care to my patients, first stress, stress due to duty and schedule are
sent to the group chat for about one week before but for me it is lacking because there
are classes plus there are requirements so there is more pressure and stress and then I
can lose focus so my time management is also affected)

Nursing is both a science and an art and requires students to develop sound scientific

foundations for artful application. The at times binary nature of how the way in which the

knowledge and skills of nursing are delivered in higher education can be difficult for students to

comprehend initially and synchronise for practice and can lead to feelings of being

overwhelmed, withdrawal or failure. This paper culminates in suggestions for creative

approaches to grit development. Daniel Terry (2020)

 Therefore, the struggle between academic and clinical exposure is a concern for

students for some reason they cannot keep up with it, but there are also other students who are

able to balance academic and clinical exposure. It depends on your ability to do well and

balance your time in doing tasks.

Language Barrier

Good communication is essential in medical environment. Language obstacles

may make it more difficult for the student nurse and the patient to communicate, which

could result in miscommunication and misinterpretations. Building a trustworthy rapport

with patients is crucial to delivering all-encompassing treatment. One of the participants,

shared their inability to understand the patient's concerns and preferences due to the

language barrier may make it difficult for the student nurse to build rapport.

So, ang mga naka-ano sa akon is first ang language barrier kay
paryas sa akon is illonggo ko tapos ma-assign ko dire sa Kidapawan ti bisaya man sila
mabudlayan gud ko mag-approach. (So, first is language barrier for example like me, I
am an ilonggi and I was assigned in Kidapawan and they speak bisaya, I don’t know
how to approach them.) P5L191-194

In addition, because they do not speak the same language as the patient, some

students are reluctant to engage in conversation. One participant described how she

was unable to interact with her patient because of the language barrier and how she

had to ask her classmate to translate the patient's intentions.

Also experiencing communication anxiety during my 1st exposure

as a student nurse nag struggle jud kog communicate because I can't speak bisaya
before need pa nakog interpreter. (Also, experiencing communication anxiety during my
1st exposure as a student nurse, I struggle to communicate because I can’t speak
bisaya before and I need an interpreter.) P13L514-516
 In order to meet a patient's requirements and enable student nurses to do their

share of intervention, communication in the medical sector is crucial. However, a lack of

understanding between the parties might be a barrier. This results supports to Azra,

Sana, Firdous, & Noreen (2023) study entitled assessment of language barriers among

nursing students for effective communication. It shows study have demonstrated that

language problems can hinder nurses' capacity to successfully communicate with their

patients, teachers and colleagues in any location. A significant number of students were

concerned about language barriers. This can hinder the delivery of appropriate, timely,

safe, and effective care and skills to fulfill the desired requirements. Nursing students

can improve their learning abilities affected by language barriers by gaining a better

understanding of these communication skills and developing appropriate strategies to

overcome them. As a result, language barriers have a great impact on healthcare

delivery.

Limited knowledge

Insufficient understanding can considerably affect a student nurse's capacity

to offer patients comprehensive care. The student nurse may find it difficult to

meet the patient's varied requirements if they lack a thorough understanding of

medical illnesses, therapies, and the interaction of physical, emotional, and social

components in patient care. This may result in less than ideal care, missing

crucial facets of the patient's health, and even a possible decline in the standard

of care as a whole.
 One of the participants shared how limited knowledge can affect their

provision of holistic care to patients during their rotational duty.

Kung kulang kog knowledge kay ang mahitabo hindi na nako ma

provide ang holistic care sa patient ko kay gamay lang bal an ko sa mga interventions
or management nga priority sa akoa nga patient.(If I lack knowledge, I will not be able to
provide holistic care to my patient because I have little knowledge of the interventions
and management.) P9L3658-360

Additionally, another student nurse expressed how challenging it would be on

their part to respond to certain question of a patient if they are not knowledgable about

the medications, procedures and interventions applicable for the patients condition.

So, essentially, yung knowledge ko, zero talaga kasi wala talaga
akong idea kung ano yun. So, naka-apekto siya sa akoa yung kakulangan ng
knowledge is I don’t know how to respond If na ay mag-ask na patients ako with regard
silang sakit. Like, ma’am, Ngano diay na ing-ani? Tapos ako na maternal lang akong
nabalan, dili kaayo nako matubag ug tarong, So, kato, medyo challenging jud siya.
(Essentially, my knowledge is zero, it would affect to me in a way I don’t know how to
respond to their questions and I find it quite challenging.) P7L271-277

Another participant narrated the impact of return demonstration on the

knowledge of student nurses during the rotational duty.

Ang mga nakakaapekto para sa akin na nakakaapekto sa ating

duties is yung limitasyon ng ating mga kaalaman halimbawa ay depende kung
nadaanan na natin ito as nagawa nating return demonstration ah kasi di lahat ng bagay
na experience na mismong setting nga hospital ay napag-aralan natin so isa yun sa
makakapekto yung knowledge about sa procedure or about sa mga ginagawa natin.
(The things that affect our duties are the limitations of our knowledge, it depends on
whether we have been through it in return demonstration, That is one of the things that
will affect the knowledge about the procedure or about we do.) P15L570-574
 Furthermore, based on the result student nurses may find it difficult to provide

holistic care to patients if their knowledge in a certain procedure is insufficient. This

would result in student nurses to doubting their capability. This result supports to

Rudberg’s (2022) study revealing a solid theoretical education before entering clinical

training offered students possibilities for reflecting on evidenced-based practice in

clinical settings.

Self-adjustment

A patient’s physical, emotional, social, and spiritual needs are all taken into

account when providing holistic care. It may be difficult for a student nurse to offer

comprehensive care if they are unable to self-adjust and respond to changing

circumstances and patient needs.

Student nurses who are assigned to rotational duty will definitely experience

tension and anxiety, particularly if the clinical instructions are stringent, the patient does

not treat you well, and there are numerous patients allocated to the student nurse. On

your first day of work, it's difficult to adjust; you still need to figure out the best flow to

work efficiently. The participant stated:

Next, is yung mga adjustment natin kasi 1st mga estudyante pa

tayo so Hindi pa natin alam yung environment pagdating sa mismong trabaho na for
example na may mga hindi natin alam na ganun pala ang ugali ng mga tao may time na
masyado silang irritable may mga tao din na mas marunong pa sa atin, kaya minsan
kailangan nating makisama yun yung mga bagay na nakakapekto para sa akin. (Next, is
our adjustments because firstly we are still students so we don't know the environment
when it comes to the work itself, for example there are people we don't know, people's
behavior is like that, there are times when they are too irritable, there are people also
more knowledgeable than us, so sometimes we have to get along, those are the things
that would affect for me.) P15L570-578

Based on the result, student nurses are overburdened since not all information is

taught in school, leaving them ignorant of certain topics when on duty. In hospital

settings, there are situations that you have to handle on your own. As a result,

sometimes they lack the confidence to perform their role while on duty, which makes it

harder for them to adjust to the healthcare setting and alters their ability to offer holistic

care. This result supports to Tiwari, Prabhu, & Ansuya (2020) study about the

adjustment and self-esteem among novice B.S. nursing students, shows that find it

challenging to keep up with the circumstances occurring at the hospital, but they have

responded appropriately.
 CHAPTER IV

IMPLICATION AND CONCLUDING REMARKS

This chapter represents the implication and concluding remarks related to the

study.

Implications for Practice

The study shows that the factors that affect student nurses ability to provide

holistic care are patient’s attitude. Enormous number of patient, first timer, struggling to

balance academic and clinical exposure, language barrier, limited knowledge and self-

adjustment.

Student nurse are facing challenges in clinical field that hinders them to provide

care to the patient. A distinct function for student nurses in the nursing field is part of

their education and training. To obtain practical experience in a range of healthcare

settings, they work under the guidance of knowledgeable nurses and lecturers. In

addition to monitoring medical processes and helping with patient care, student nurses

also take part in educational activities.

Their responsibilities include developing critical thinking and decision-making

skills, applying academic knowledge in real-world scenarios, and studying the

fundamentals of nursing. In order to give patients holistic care, student nurses also work

in tandem with other healthcare professionals. Student nurses prepare for the transition

into professional responsibilities as registered nurses upon graduation through their

academic coursework and clinical experiences. The future of healthcare and the nursing

workforce benefits from their commitment to study and to the nursing profession.

The importance of hands-on experience. While classroom learning is essential,

the true value of nursing comes from practical, real-world experience. Student nurses

should embrace every opportunity to work alongside experienced nurses, observe their

techniques, and apply what they've learned in a clinical setting. This hands-on

experience will help them develop the skills and confidence they need to become

successful nurses. In addition, Nurses must be able to communicate clearly and

effectively with patients, their families, and other healthcare professionals. This means

listening attentively, asking the right questions, and explaining medical information in a

way that is easy for patients to understand. Student nurses should practice their

communication skills, both written and verbal, to ensure they are prepared to work in a

fast-paced, high-pressure healthcare environment.

Moreover, Nursing can be a demanding and stressful profession, and it's crucial
for student nurses to learn how to manage their own well-being. This includes taking

breaks, practicing stress management techniques, and maintaining a healthy work-life

balance. By prioritizing their own mental and physical health, student nurses will be

better equipped to provide the best possible care to their patients. Patient’s attitude is

one of the factors affecting student nurses to provide holistic care, whether positive or

negative, it can significantly impact their response to treatment, adherence to

recommendations, and overall health outcomes.

Based on these theories, The Neuman Systems Model and the Orem Self-Care

Deficit Nursing Theory recognize the patient’s role in maintaining their own health and

managing their care. These theories suggest that nurses should work collaboratively

with patients, taking into account their beliefs, values, and preferences, to develop

personalized care plans that address the patient’s unique needs and concerns. By

understanding and addressing the patient’s attitude, nurses can foster a more engaged

and empowered patient, leading to better health outcomes and a more positive care

experience.

Enormous number of patients is one of the factors affecting student nurses ability

to provide holistic care, it is crucial to develop a strong foundation in patient-centered

care, even when faced with an enormous number of patients. This approach requires a

deep understanding of each individual’s unique needs, preferences, and values, and a

willingness to tailor the care plan accordingly. By placing the patient at the center of

their practice, nursing students can ensure that the care they provide is responsive,

empathetic, and tailored to the specific requirements of the patient.

 Additionally, implementing patient-centered care in high-volume settings can be

challenging, but it is essential for nursing students to develop the necessary skills and

strategies. This may involve effective communication techniques, such as active

listening, empathy, and shared decision-making. Nursing students should also learn to

navigate the complexities of the healthcare system, leveraging resources and

collaborating with the interprofessional team to ensure that each patient’s needs are

met.

However, as they progress in their nursing education, students should strive to

cultivate a deep respect for the principles of patient-centered care. This may involve

seeking out opportunities to engage with patients, understanding their diverse

backgrounds and perspectives, and continuously reflecting on their own biases and

assumptions. By embracing a patient-centered approach, nursing students can develop

the skills and mindset necessary to provide exceptional care, even in the face of an

enormous number of patients, and ultimately, contribute to the overall well-being and

satisfaction of the individuals they serve.

Mounting evidence shows that the first clinical placement, in particular, is the

most influential for nursing students. The first clinical experience can affect attitudes and

help them develop different competencies such as compassion and practical

communication skills (Andrew et al., 2009; Nejad et al., 2019). Likewise, a student's first

clinical placement is vital in the sense of belonging in their clinical placement and

nursing education (Brady et al., 2019). The clinical experience allows students to apply

theory into practice and to experience multiple humanistic experiences (Al-Anazi et al.,
2019; Atakro et al., 2019; Ramsbotham et al., 2019). The clinical experience involves

physical, psychological, emotional and organizational influences, which affects the

students' learning and motivation (Haraldseid et al., 2015; Ramsbotham et al., 2019). In

order for nursing students to gain the required qualifications for delivering high quality of

care for patients, they should develop clinical based knowledge and skills through

clinical experiences (Kalyani et al., 2019). Recent research confirms that students were

faced with identity confusion due to limited experiences in the clinical environment

(Kalyani et al., 2019). As a first time nursing student, you are embarking on a journey

that is rewarding, yet demanding. Stepping into the role of a nursing student in clinical

field for the first time can be both exciting and challenging. It aims to provide insights

into the key areas a first time nursing student should focus on navigating this journey

successfully. Effective communication is another key aspect for a first time nursing

student by building trust, understanding patients' needs, and collaborating with the

healthcare team are all clear and how we communicate to them.

Nursing educators need to use new educational strategies to actively engage

nursing students in learning activities in academic and clinical settings. Previous studies

have shown that increasing academic engagement of students could increase their

desirable academic performance and success. Recent evidence indicates that

engagement in academic-related learning activities is one of the important determinants

of students’ success in university. As a result, identifying the best teaching strategies to

sustain and promote nursing students’ engagement in academic and clinical settings

has always been a challenge for nursing educators. Hence, it is essential to provide a

set of strategies for maintaining and enhancing the academic engagement of nursing
students. Furthermore, a nursing student who's struggling to balance academic and

clinical exposure can be a common challenge for our nurses. Prioritizing tasks and

responsibilities is important for as students. This will help to improve and allowing them

to perform better in both academic and clinical exposure. With this kind of strategies

and support, student nurses can overcome this challenge and thrive in their professional

journey.

Holistic nursing care is an approach to patient care that takes into account the

physical, social, spiritual, and psychological needs of the patient. Most of the student

nurses are struggling to meet these needs because of the factors that hinder them to

perform holistic care in the healthcare settings. Based on the results, language barrier

can cause a significant effect in nursing field and this will make the nurses to be fully

aware of its effect. According to the theory of Madeliene Leinenger, transcultural

nursing, nurses emphasize the importance of diverse language skills in order to be

linguistically capable of understanding patients’ health issues and also to communicate

with colleagues This is to adequately prepare nurse graduates to cope during

transcultural nursing. Also, findings of the current study showed that nursing students

cope by being culturally competent. They do it by being aware of their own culture,

being aware there are different cultures in the context where they do clinical practice,

improve their knowledge on different cultures, being sensitive to other cultures and have

encounters with individuals from different cultures. The more nurses experience

provision of care to patients from different cultures, the more they become culturally

competent.
 In the context of knowledge, most of the student nurse admit that the procedures

and interventions in the hospital setting are not taught in school which make them

puzzled during their rotational duty. The role of professional nurses is to guide the

student and teach them the informations they need to acquire in order for them to

expand their knowledge in the clinical field. Based on Benner’s theory novice to expert,

model has been used in the nursing profession to make innovative changes in how

knowledge is acquired and developed, continuing education's rationale, and serve as a

foundation for how nurses build and improve skills based on acquiring experience

(2020). This could be interrelated to self-adjustment, a student nurse that is new to the

environment will have difficulty adjusting since there are situations which is not covered

in their responsibility. Meaning they should be more exposed specially to critical

situations and certain procedures to sharpen their judgement and skills.

Nursing students must develop a keen awareness of the challenges and

complexities involved in caring for an enormous number of patients. This realization

should inspire a sense of adaptability, resourcefulness, and a deep commitment to

providing high-quality, patient-centered care, even in the face of overwhelming demand.

Nursing students should recognize that in such high-volume settings, they must be

skilled in prioritizing care, efficiently managing their workload, and collaborating

effectively with the healthcare team to ensure that the needs of each patient are met.

With this insight, nursing students should strive to cultivate a range of essential

skills and strategies. This may include mastering triage techniques, optimizing patient
flow management, and leveraging technology to streamline processes. Equally

important is the development of strong communication and interpersonal skills, enabling

nursing students to build trust, empathy, and therapeutic relationships with their

patients, even when time and resources are limited. By embracing these principles and

continuously seeking opportunities to enhance their knowledge and abilities, nursing

students can become well-equipped to provide exceptional care in high-volume

healthcare settings, ultimately contributing to the overall well-being of the patients they

serve.

Moreover, it also found out in the study that the coping mechanisms is

prioritization, reading or watching educational videos. Nursing students learn to assess

the needs of each patient and determine the most urgent tasks. This allows them to

focus their attention and energy on the patients who require the most immediate care.

Another important coping mechanism is time management. Nursing students develop

skills to efficiently organize their workload, plan their day, and multitask effectively. This

helps them stay on top of their responsibilities and avoid feeling overwhelmed.

Additionally, nursing students rely on the support of their peers and mentors. By

sharing their experiences and seeking advice from their Clinical instructor, they can

learn strategies for managing heavy workloads and avoiding burnout. Maintaining a

positive attitude and practicing self-care, such as taking breaks and engaging in stress-

relieving activities, can also help nursing students to cope with the demands of caring

for a large number of patients.

Implication for Future Research

 The following research topics are suggested based on the findings of the study:

1. Knowledge and skills of student nurses in understanding patients attitudes.

2. Challenges of student nurses in establishing rapport to the patient.

3. Effects of language barrier to the communication skills of the patient in providing

comprehensive care.

4. Identifying knowledge gaps in nursing practice.

5. Exploring the challenges of student nurses in balancing clinical exposure and

academic performance.

6. Support systems for first-time nursing students.

Examining the correlation between the quality and quantity of clinical exposure

and nursing students' academic performance. Investigating how hands-on experience in

clinical settings influences theoretical understanding and application of knowledge.

Knowing the capacity of student nurses ability to handle the different attitudes of patient

will help them to recognize the strategies to establish rapport and gain their trust. Also,

expand the knowledge of sudent nurse in common areas of nursing practice where

knowledge may be limited or uncertain, such as emerging treatments, rare conditions,

or complex patient presentations. Lastly, acknowledging different dimensions of patient

attitudes, such as perceptions, beliefs, emotions, and behaviors towards healthcare.

Researchers suggest these topics since they are helpful to the future researchers
to acquire knowledge in their research. This will serve as a clarification and add some

information to the future researchers. It will help the researchers in dealing with patients,

exploring their skills and cognitive and the experiences will help them learn something

new.

Concluding Remarks

The ability of student nurses to provide holistic care can be significantly impacted

by several factors. Firstly, patients' attitudes and perceptions can play a crucial role, as

negative or uncooperative attitudes from patients can hinder the student nurse's ability

to establish a therapeutic relationship and provide comprehensive care. Additionally, the

enormous number of patients that student nurses may encounter during their clinical

placements can be overwhelming, making it challenging to devote the necessary time

and attention to each individual's unique needs. Furthermore, being a first-timer in the

clinical setting can lead to feelings of uncertainty and anxiety, making it difficult for

student nurses to balance their academic responsibilities with the demands of hands-on

patient care. Limited knowledge and lack of experience can also pose a significant

barrier, as student nurses may struggle to apply their theoretical knowledge to real-

world situations. Finally, language barriers, particularly in diverse healthcare settings,

can further complicate the student nurse's ability to communicate effectively with

patients and understand their needs, ultimately hindering the provision of holistic care.

The methodology presents the research design, research locale, participants,

research instrument, sampling technique, data-gathering procedure, data analysis,

trustworthiness of the study, and ethical considerations. The study utilized a qualitative
descriptive research design and purposive sampling was used to select 10 participants

who met specific criteria. An interview guide with open-ended questions was used as

the research instrument. In data gathering procedure it involved obtaining permission,

conducting in-person interviews, and ensuring confidentiality and anonymity. Thematic

analysis was employed for data analysis. This study ensured includes trustworthiness

through credibility, transferability, dependability, and conformability. Informed consent,

confidentiality, anonymity, voluntary participation, and no harm are included in ethical

considerations. Overall, this chapter provides a concise overview of the research

methodology and ethical considerations.

In gathering data, the researchers encountered some interruptions during the

interview such as loss of internet connection and network problems. Also, some of the

participants have exams and return demonstration, it was also difficult to get data

because some participants who agreed to be interviewed could no longer be contacted

while others canceled the calls. Researchers also encountered difficulty in transcribing

because some participants spoke fast and had words that were difficult to understand.

Through teamwork and patience of the researchers and explaining the purpose of the

study to the participants, the researchers interviewed ten (10) participating student

nurse from 2nd, 3rd and 4th year level as our source of data.

To future researchers, we suggest to conduct the study ahead of time and do it in

real time interview to avoid connection problems so you can also provide follow up

questions to obtain the appropriate answer needed for your data to avoid the
participants from giving long answers but the data needed is not there. It must precise

so that the researchers won’t have any difficulty in transcribing and the content data is

rich for creating themes.

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APPENDICES

APPENDIX B
Informed Consent

INFORMED CONSENT STATEMENT

“FACTORS AFFECTING STUDENT NURSE’S ABILITY TO PROVIDE

HOLISTIC CARE”

Dear Respondents,

The researchers of the Bachelor of Science in Nursing of North Valley College

Foundation, Inc. are currently working on their thesis entitled: “FACTORS AFFECTING
STUDENT NURSE’S ABILITY TO PROVIDE HOLISTIC CARE”. The purpose of this
study is to determine the perceptions of the student nurses about the barriers they
encounter in the clinical field.
The participation in this study is voluntary. Hence, we are requesting your
favorable support on this matter.

ACCEPTED AND AGREED

Name:_____________________________________ Date:________

Contact Number:_____________________________

Address:____________________________________

Signature:____________________________________

The researchers:

Chezka Kleah Ibanez

Maria Nichole E. Javar

Francys Yumarie Pesco

 APPENDIX C

Interview Guide Question

Objectives Main Question Probing questions

1. Determine the factors 1. What are the factors 1. How do patient’s

that affect student nurses you have encountered attitudes influence the

to provide holistic care. affecting student nurses competence of student

ability to provide holistic nurses?

care?
2. What is the impact of

communication anxiety

on student nurses?

3. How does limited

knowledge affect student

nurse’s ability to provide

holistic care?

4. How do student nurses

balance their time and

workload to ensure the

inclusion of holistic care

in their practice?

2. Examine the 1. What are your 1. In your own opinion,

perceptions of student perceptions about the do you think these

nurses regarding the factors affecting the barriers or factors would

factors affecting the student nurses ability to cause a problem to your

ability to provide holistic provide holistic care? competence when you

care in the clinical field. provide holistic care and

why?
.

2. What are some

effective techniques or

interventions you used to

address these factors to

improve your ability to

provide holistic care?

APPENDIX D
 TRANSCRIBED DATA

RESPONDENT 1

I: So again good noon mag conduct kami ng interview question about sa mga factors that
affects the ability of student nurse in providing holistic care so baka meron kang mga
amm.. na experience na mga factors amm I mean encounter na mga factors during sa mga
hospital duties, naka hospital duties Naman kayo ding no?

S: Oo

I: Hospital duty sa ward, OR/DR na usually yung maka affect gud sa mga ability ninyo
na makipag communicate sa mga patient, mag bigay ng mga care like kung paano niyo
sila kausapin or hmm yung mag establish gud ng rapport ganyan.

S: Oo

I: So, okay ang first question ano ang mga na experience mo during hospital duties na
nakaka apekto sayo na maka provide ng holistic care for example yung patient attitude,
communication anxiety with the patient, yung kunyari toxic ang duty, limited knowledge
about the field or assigned area.

S: amm. Ang factor lang saakin is sometimes ahm… possible din sa patient attitude siya
which is toxic tapos usually sa karami ng patient talaga na hindi mo na talaga alam anong
gagawin mo tapos Yung first time mo nga gawin yung procedure na unknown ka pa
talaga Kaya mag tala-tala ka gud.

I: So in general, patient attitude, limited knowledge tapos yung toxic duty.

S: Oo , Yeah

I: Ah. Okay. So ngayon next question paano nakaka apekto ang attitude ng pasyente sa
confidence mo sa iyong sarili.

S: hmm. Possible sya na hindi mo ma provide yung care properly sa patient mo if may
attitude sila.

I: Parang yun ang barrier para Hindi ka maka provide ng holistic care?

S: Oo. Barrier. Oo

I: Sige. So next ano Ang impact ng communication anxiety para sayo? For example
kinakabahan or di ma express yung gustong sabihin.

S: Hindi mo ma provide yung properly care towards to your patients talaga once na
meron kang social or communication anxiety.
I: So next, paano nakaka apekto ang kakulangan mo ng information patungkol sa area na
kung saan ka na naka assign?

S: Paano?

I: Kunyari limited yung knowledge mo, so paano siya nakaka apekto sayo kumbaga,
hindi mo ba ma perform ng maayos yung procedure? Kasi kinakabahan ka.

S: Hindi talaga, kasi kabahan ka talaga tapos hindi mo talaga alam gawin mo, kapag hindi
mo talaga alam kung ano gawin mo kasi usually hindi mo man alam ano yun, hindi ko pa
kasi talaga halos lahat na experience yung mga procedures kasi kaya medyo kabahan
talaga ako all the time.

I: all the time, kahit sang area?

S: Oo

I: So next paano mo na babalanse ang iyong oras at mga kinakailangan gawin sa duty
para ma sigurado na nagagampanan mo maka provide ng holistic care sa patient? So for
example kapag toxic ang duty tas marami na yung patients, so ano yung, paano mo
mabalanse yung time mo na mabigyan mo sila ng, yung ma meet mo gud yung needs ng
patients isa-isa.

S: amm. Mag prioritizing ako depende sa needs ng patient.

I: So next, ano ang perspective mo about sa mga factors na nakaka apekto sa mga
capacity ng student nurse to provide holistic care. Ano yung perception mo, ano yung
masasabi mo ganun.

S: towards holistic care?

I: yung mga factors na nakaka affect sa mga students.

S: ahmm. Kailangan lang talaga ng ano, Ka lang talaga ng more knowledge, and skills
talaga towards, tapos time management. Time management to learn tapos kailangan
hasain yung skills mo ba na properly, properly ano yung procedure para sa patient.

I: so for you, nag cacause ba siya ng burden sa student nurses, or reason ba siya para
yung hindi ka maging confident sa mga ginagawa mo .

S: Hindi Rin, Hindi rin siya kasi choice mo man kung hindi ka mag study or Hindi ay
choice mo man kung mag study ka or Hindi.

I: so para sayo, ang masasabi mo lang doon sa maga factors is?

S:amm ahh ano tawag nyan hahaha ah choice mo lang, kailangan mo lang talaga ng time
management, ah mag study tapos hasain yung skills.

I: Pero overall nakaka affect ba siya or Hindi?

S: Nakaka affect.

I: So next, Para sayo ang mga factors ba na nabanggit nag cacause ba siya ng problem sa
capacity mo or capability mo at bakit?

S: Yes, kapag hindi mo talaga alam ang gawin mo, halimbawa Hindi mo talaga alam
gawin mo sa patient mo, halimbawa if may times na may tanongin sayo tapos para saan
ito tapos kailangan mo pa mag research sa harapan ng patient mo, di mo man dapat yun
gawin. So magbalik ka muna, or ganyan maglabas ka muna sa room tapos e research mo
tapos e explain mo sa kanya kaya medyo may problem doon na part.

I: Nag cacause talaga Siya ng problem. Okay, So parang hindi ka confident makipag
communicate sa patient kasi hindi mo alam kung paano e explain ganun?

S: May times na ganyan talaga.

I: So last, Ano ano ang mga techniques or paraan na alam mo to address the factors para
mas mahasa yung ability mo na makapag provide ng holistic care? Ano ano yung mga
techniques or paraan na alam mo during the duty na nagawa mo na or gusto mong gawin
in the near future.

S: Study harder, study more and smarter and kailangan mo talaga mag practice ng mag
practice para ano yun mahasa yung skills mo and more YouTube videos.

I: Sa patients attitude ano yung mga pwedi mong gawin?

S: therapeutic communication talaga, Wala talagang. Therapeutic communication and

patience towards to your patient.

I: Then sa communication anxiety about sa self mo?

S: hmm. I can ano yun? Ako lang ano yun maka ako lang maka answer sa ano yun sa
social anxiety ko within my self na lang talaga,

I: So e enhanced mo yun or e practice.

S: Oo e enhance ko na lang talaga Siya.

I: So how about sa yung sa time and workload sa duty?

S: Time and workload? Time management

I: Sa limited knowledge?

S: study more and smarter

I: So far nasagot mo ng maayos lahat ng questions and directly, so thank you so much for
participating sa amin and also for your time. Thank you so much.

RESPONDENT 2

I: Ang thesis namin is about factors that affect student nurses’ ability to provide holistic
care. So naka ano naman kayo no naka-exposed naman kayo sa mga duties. So since
naka-exposed na kayo, ang i-ask namin is about sa factors, yung maka-affect gud sa
abilities ninyo like. Patient’s attitude, limited knowledge sa mga duties or sa procedures,
then time and workload, and lastly is yung communication anxiety.

So ang question is pwede lang ninyo ilonggo, bisaya, or any language lang. So first
question, ano ang mga na-experience mo during hospital duties na naka-affect sayo para
makaprovide ng holistic care?

S: Anong, for me lang, or pwede tong sa example mo?

I: Oo pwede tong sa mga example

S: Kay if pwede tong sa example mo, ano po, sa patient’s attitude pud, then sa mga
limited knowledge pud. Kay kung sa patient’s attitude, kay feel ko lang hindi ko, hindi ko
ma, ay hindi ko knows. Hindi ko, ano, like, paano mag-approach sa patient na may
attitude. Like, hindi ko makita ang words kung paano siya i-comfort, paano siya i-assure
na, amo sa kay syempre, may patient na hindi gusto siya yung student nurses, nga mag-
care sa ilaha. So, hindi ko sure if mahatag ko ang assurance na ginapangita nila, if ever,
nga, mag-attitude sila towards me.

I: So, how about ang sa limited knowledge?

S: Ay kato lang. Okay na.

I: So next, Paano nakaka-apekto ang attitude ng patient sa capability mo sa iyong sarili?

S: Syempre, if ever na attitude ang patient, sakoa, ma-conscious ko if paano mag-hatag

sin care, like, mahuya or maulaw kay what if hindi siya gusto sa ato, na nga doings from
me like ano so, mahuya ka, ma-apektohan ang pag-hatag mo sang holistic care, kay ma-
conscious ka sa sarili mo if tama ba ang ginahimo mo.

I: So, next. Ano ang impact ng communication anxiety para sa’yo?

S: ulit daw?

I: Ano ang impact ng communication? Communication anxiety towards you.

S: Towards me. Maka, maka, dako ang impact sa communication anxiety kay, um, dali
lang. Na mental block.

I: Sige, go lang. Take your time.

S: Communication anxiety is paano mo i-ano ang patient.

I: Mag established ka ng rapport.

S: Oo. Paano siya maka-impact sa akon.?

I: Oo

S: Okay. Kay based po sa katong, ano, patients nga, ay patient attitude. So, maka-hatag
po siya siya impact sa communication anxiety mo, like, ma- Ma-conscious ka po kung
paano mo siya i-approach, paano ka mag-hatag sing, Paano mo siya i-educate ba ang term
or paano mo siya i-communicate kung ang, nga, we need, nga, amo sina, like, Eh, basta
community anxiety kay, amo to, ma-conscious ka, paano ka mag-communicate sa iya

I: So, how about, paano nakaka-apekto ang kakulangan mo sa information patungkol sa

area na kung saan ka naka-assign? Like, sa DR, OR,

S: Paano, ano?

I: Paano nakaka-apekto. Kunwari, limited ang knowledge mo. So, paano siya nakaka-
apekto sa iyo during kapag mag-duty ka?

S: Syempre, if limited. Limited ang knowledge mo towards sa mga procedure nga

himuon. Siyempre, nang magka, ano pa, like, Dali lang. Limited ang knowledge na sa
procedure. Siyempre, kay may gamay lang pud na RD namon ba, like, wala po kami ka-
RD paano magkatong sa Tepid sponge bath, wala kami ka-RD sito. So, if ever, nahimuon
ko tong nga procedure. Siguro, mag-search ko sa Google. Tapos, ano nang, um, basta
nang, kay limited man ang knowledge mo, siyempre, hindi kakabalo kung paano, paano
himuon ng procedure. So, maka-apekto siya towards kung paano ka mag-provide. Oo,
mag-provide po sina

I: So, next. During duty ni siya, ha? Paano mo nababalansi ang iyong oras at mga
kinakailangan gawin sa duty para masigurado na nagagampanan mong makaprovide ng
holistic care sa patient. So, for example, sa, um, if may ginasugo ang CI mo. And then,
daghan kaayo patient sa ward or sa OR/DR na kailangan mong mameet ang need sa
client. So, paano mo nababalance ang time para mameet mo talaga need sa patient mo?
S: Siguro mabalance ko ang time if, if pas-pasan ko. If like, nang, ano, like, multi-task,
ana.

I: So, next. Para sa’yo, ano ang mga perceptions, opinions, or perspective mo sa mga
factors nga nabanggit?

And, ay, sa mga factors that affects the student nurse’s ability to provide holistic care?

S: Paan ko siya ma-cope up?

I: I mean, pa-ano ang mga perceptions mo about didto sa mga factors? Like, maka-affect
ba siya?

S: Oo.

I: Maka-cause ba siya sa, maka-self-confidence or self-esteem?

S: Oo. Kay, base sa ka tong mga factors, maka-affect din siya kung paano mo i-, Mag,
paano ka mag-provide sa holistic care sa patient. Kay, syempre, hindrance man gud to
siya to meet the patient’s needs pod kung, Kung kunwari, may ma-low i-mga self-esteem.
So, syempre, hindi mo mahatag ang needs sang patient if, like, huruyaon ka ana
something.

I: So, Second to the last question, for you, ang mga factors ba nga nabanggit is mag-
cause siya ng problem sa capability mo? Yes or no, then, why?

S: Yes kay, amo gani to hala. Magka cause siya sing problem kung paano ka mag
provide sang care sa patient mo if ever nga may ara ka sitong factor.

I: And ang last is, ano ang mga techniques or mga paraan na alam mo to address the
factors na mga nabanggit?

S: So, amo ni siya ang cope up?

I: So, for example, how about sa patient’s attitude? Ano ang pwede mo i- himoon?

S: Kung sa patient’s attitude, siguro, kay syempre may mga duties pa man kami.
afterwards. So, siguro, ma-cope up ko lang siya if damo na ko na agyan nga attitude na
patient. Siyempre, makabalo na ko paano sila i-assure, paano sila i-handle. So, kana lang,
siguro, need ko pa sang more experience.

I: How about sa communication anxiety? Paano mo siya ma-cope up?

S: Kato pod, need ko pa sing damo na experience. So, that makabalo ko kung paano mag-
communicate tarong sa patient.
I: And sa time or workload?

S: Ano, um, time management.

I: Limited knowledge?

S: Ala, ano ng, ano lang. Siguro, mag-ano ng advance ka mag-study sa mga procedures.

I: So, thank you so much kay nag-answeran mo sa tarong. Thank you

RESPONDENT 3

I: Good afternoon, ma’am. So, karon is magconduct kami sa study about the factors that
affect student nurses’ ability to provide holistic care. So, any opinions, perspective is
expected to be confidential among us lang sa mga nag-interview. So, ang mga questions
is same sa first interviewer and ang mga opinions is nakadepende saimo nga mga na-
experience. So, ang first question, ano ang na-experience mo during the hospital duties na
naka-affect sa’yo para makaprovide ng holistic care?

S: So, ang mga naka-ano sa akon is first ang language barrier kay paryas sa akon is
illonggo ko tapos ma-assign ko dire sa Kidapawan ti bisaya man sila mabudlayan gud ko
mag-approach. Then, ang isa is ang limited knowledge kaya hindi man gud namon na
RD, tanan, gud. So, mabudlayan pud kami.

I: So, next. Paano nakaka-affect sa’yo ang attitude ng patient sa kumpiyansa mo sa iyong
sarili?

S: For example, may mga patient mang gid na hindi gusto gud sa student nurse amo na
nga hindi sila ginapahandle. Mas, magbaba ang imo nga self-esteem kay do gina ano nila
na hindi pa takabalo maghatag ka care.

I: So, next. Ano ang impact ng communication anxiety para sa’yo?

S: umm. Ay mahuruy on man gud ko kung halimbawa mag-ano sa patient is gaduha-

duha pa ko.

I: Mahesitate na mahesitan ka pa

S:. Mahadlok pa ko mag-approach.

I: So, next. Paano nakaka-affect ang kakulangan mo sa knowledge patungkol sa area na

kung saan ka naka-assign?

S: For example, tong na-assign kami sa DR tapos hindi mo naman na-RD Kung paano
mag-deliver gud sang baby. So, pag ano namon is makulbaan kami. Halimbawa may
patient kami tapos ipa-ano gud kami tawag sina ng pabuligon gud ng mag-assist. Pa-
assist kami. So, mahadlok kami kung paano umpisahan kay hindi kami kabalo kung
anohon.

I: So, next. Paano mo nababalanse ang iyong oras at mga kinakailangan gawin sa duty
para masigurado na nagagampanan mo makaprovide ng holistic care sa patient?

S: Time management lang gid. Halimbawa, unahon mo gid tong mga need gud dapat gid
himoon then para hindi ka mag-sala.

I: Para synchronize. So, next ano ang perspective mo about sa mga factors na nakaka-
affect sa mga capabilities or abilities? Ng student nurses to provide holistic care? Para sa
imo, ano tong mga factors nga nga to? makacause ba siya ng problem? Makatabang ba
siya para ma-improve ang self?

S: Maka cause siya sang problem kay paryas satong hambal ko sa DR duty kami pero
mas maka ano pud kami nga dapat mag advance study pud kami para if ever nga isalang
kami may naman an pud kami.

I: So, next. Para sa iyo, ang mga factors ba na nabanggit is

Nagcacause ba siya ng problem sa capability mo as student nurse? Yes or no? Then why?

S: Maka-apekto gid siya kaya if ever nga hindi namon ano, man gud like hindi kami
kabalo pa sa procedure kay magka mahadlok kami nga maghatag ka-care then kag ano,
for example, kung sa language. So, maka-apekto gid siya kung hindi ka man kabalo ma-
establish ka rapport sa patient.

I: And then last, ano ang mga techniques or paraan na alam mo to address these factors na
nabanggit para mas mahasa ang iyong abilidad to provide holistic care?

S: For example, didto sa limited knowledge is study lang tapos research about sa mga
dapat himoon para sa mga procedure.

I: Sa communication anxiety?

S: Practice lang, like pwede ka mag istorya-istorya sa iban para mahasa ang imo nga.

I: Ang mga time and workload?.

S: Time management lang gid

I: And ang last, sa patient attitude.

S: ano lang, like wala pa abi ko kaagi pero siguro ano like taasan lang ang pasensya if
ever man nga maka-encounter.

I: okay, so thank you so much sa pag-participate. So, sorry if wala kami may mahatag ng
mga goods or something. Pero thank you sa time and thank you sa effort ng mag-answer.
And hopefully, good luck sa exam.

RESPONDENT 4

I: So, good afternoon. Mag-interview kami about sa topic namin,

Which is, the factors that affect student nurse to provide holistic care. So, ang mga factors
na actually naka-indicate sa background of the study namin is patient’s attitude, time and
workload also the communication anxiety, and the limited knowledge. So, if may mga
experiences ka pa during the duties, pwede mo rin siyang i-share sa amin.

S: Okay

I: So, first question, ano ang mga na-experience mo during hospital duties na naka-affect
sa’yo para makaprovide ng holistic care?

S: So, ang mga factors na akong na-experience during hospital duty na naka-affect,
paghatag ug holistic care is, most ang pinakauna, Jud is kanang communication sa
patient. Kay, syempre, like bago ang patient everyday and hindi ka kabalo kung paano
sila mag-handle gud ug kanang student nurse, kay naay uban na. Hindi kaayo sila open
pag nai-student nurse. So, the very first thing, Jud na ma-experience nako, na maka-
affect kung paano ko makahatag ug holistic care is paano ko makipag-communicate sa
akong patient the first day.

I: Okay. So, next question. Um, ano ang impact ng patient’s attitude sa confidence mo?

S: So, the effect of the patient’s attitude is very massive kasi pag cooperative yung patient
mo, Syempre, yung pagbibigay mo din ng patient care is tumataas din yung confidence
mo, diba? Kasi may mga patient na very supportive din sa mga ginagawa mo. So, ikaw,
parang hindi ka nagda-doubt sa mga binibigay mo. Kasi may times kasi na yung patient
mismo, pag kinakausap mo siya, Is medyo hindi sumasagot or kanang maldito gud ug
kanang trato. So, ikaw mismo, murag mag-doubt na pud ka basi pangitaan kog mali if
ever kani akong mabuhat.

I: So, next. Ano ang impact ng communication anxiety sa’yo during the duty?

S: So, the impact of communication anxiety is that dili nako matarong ug present akong
self sa patient. Kay there are times na mangunahan gyud ug pangulba especially when
you’re dealing with patients kasi yun nga yung as I’ve said before, dili ka kabalo paano
mag-react Imong patient. So, it’s very common to have a communication anxiety
especially when dealing with new patients kasi, You’re trying your best to have a proper
nurse and patient communication. So, yun medyo tumataas din pag hindi mo alam paano
yung atake at first.

I: So, next. Paano nakaka-apekto ang kakulangan ng mo ng information about sa area

kung saan ka nakasign?

S: So, naka-inexperience nako ni before since second year pa ako. So, our theory is about
maternal and child nursing. And we were exposed at a hospital in internal medicine that
specializes in yung mga CAP-MR, mga TB. So, essentially, yung knowledge ko, zero
talaga kasi wala talaga akong idea kung ano yun. So, naka-apekto siya sa akoa yung
kakulangan ng knowledge is I don’t know how to respond If na ay mag-ask na patients
ako with regard silang sakit. Like, ma’am, Ngano diay na ing-ani? Tapos ako na maternal
lang akong nabalan, dili kaayo nako matubag ug tarong, So, kato, medyo challenging jud
siya.

I: Next. Paano mo nababalanse ang iyong oras at mga kinakailangan gawin Sa duty, to
make sure na nagagampanan mong makaprovide ng holistic care.? So, for example, ani is
kanang diba daghan man ug patients And then, of course, siyempre, yung mga CI, naa
pud mga commands para sa imuha. And then, dili nimo bal'an paano ni mo siya i-handle.
So, paano mo mabalanse sa imong time para ma-meet nimo ang needs sa iyong clients
and also ma-obey nimo ang mga commands or ang mga dapat po din nga gisugo sa
imong pang-CI?

S: So, based sa like top of my head po, naman ta sa nursing ng prioritization po, di ba?
So, dara nako mabalance akong time if I know how to prioritize which action should I do
first. Kay hindi man tanan patient care nga gihatag nako is dapat katu jud ang una
buhaton. There are times na pwede nako to siya mabuhat like in its own time. Kay naay
times na ang commands sa atong CI is stat or kailangan nato buhaton sa atong patient. So,
prioritization lang po para mabalance nimo ang commands sa imong CI ug sa imong
paghatag ug holistic care.

I: So, next question. For you, ano ang perception mo or opinion about sa mga factors that
affects your capabilities as a student nurse to provide holistic care. Unsa ba sya kanang
naga-cause ba siya ng problems during sa duty or sa imong confidence.

S: So, base sa katong mga factors, kay maingon nako siya nga naga-bridge siya ug doubt
siya sa akong ability to privide care kay ang communication anxiety, lack of knowledge,
inga ana kay

Makabridge jud siyag doubt sa imong self. If ever nga, tanan man gud nga inaato, is
factors na ginaisip nimo, kay mag-stem siya sa kanang ginadoubt nnimo imong self.
Kung ginadoubt nimo imong self, magtaas din ang anxiety.

Tapos if wala kaayo kay enough knowledge, syempre mag-doubt pud ka. Kay dili baya
pwede mmali-mali ang ginahatag na information sa mga patient. So, ano Jud siya nang,
grabe jud siya maka-affect in a way na gadoubt naka saimong self,

Tapos dili naka maka-tarong ug provide ug holistic na care.

I: So, next question. For you, ang mga factors ba na nabanggit is mag-cause of problems
sa iyong capability?Yes or no, then why?

S: Yes, of course. Kasi, yung mga factors na na-mention before is, hindi naman talaga
yun mawawala, especially as a student nurse. Kasi, everyday we’re learning. Hindi
naman, binibigay lahat ng school. Kasi, we are, naga-exposed ta sa duty in order for us to
learn kung kung unsa jud ang essence sa tinood jud na nursing. Kay iba man ang theory
sa practices mo. So, wala man ginatudlo sa school kung paano jud ka mag-handle ug
patient. Kay, dili man sa school mahatag na lahi-lahi na patient jud. So, maka-affect jud
siya kay lahi na patient, lahi na background, lahi na race. So, adjustment pud siya always.

I: So, last, ano ang mga techniques or paraan na alam mo to address those factors na
nabanggit para mas mahasa mo ang iyong abilidad na makapag-provide ng holistic care?

S: So, the technique na ako ang ginagamit para makaprovide of holistic care is kanang
magbasa always. Biskan ma-inform man me beforehand kung saan amoang areas na i-
handle. So, reading is very essential basta student nurse ka and also, listening pud
saimohang CI's and sa pag during lectures. Kay madala man pud gud nimo imong na-
learn sa school pa dulong sa hospital. And ano lang, kanang, another technique is, ano
lang, ka nang be open for criticism’s gud. Kay, dili man all the time kabalo ta sa
paghahatag ug holistic care since student nurse, we’re still learning po, diba? So, it’s
very crucial to take constructive criticism as a way na mag-improve ta as a student nurse
para mas makaprovide tag holistic care para maka-avoid po tag future problems when
providing care sa atong patients.

I: So, how about sa patient’s attitude? Unsa ang mga techniques para?

S: Actually, wala siya yung one-size-fits-all po na techniques pag handle of patient’s

attitude. Kay, hindi na to matansya po kung paano jud mag-react or unsa jud ang
behavior sa isa ka-patient. So, with regards to that po ang technique ko lang is mag-
provide lang gyapon ko care, ka nang same lang sa everyone else. And if hindi siya na i-
actively accept, murag maminaw lang gud kanang active listening. Ingana lang,
paminawon lang nako kung kung sa iyang mga hinanakit o unsa ba, hindi na ko siya i-
take into heart.

I: How about sa communication anxiety?

S: So, communication anxiety, actually, hindi siya ingana kadali tagaan ug technique
kay… kulba man, jud makipag-communicate ug tao. Especially, student nurse ka. Taas
ug expectation saimoha ang patients, ang mga nurses. So, akong technique lang para sa
communication anxiety is deep breathing lang and, kung unsa akoang goal na gusto ma-
attain sa akong holistic na care is, kato lang akong i-ingon sa’kong patient.
I: How about sa time and workload?

S: So, the technique sa time and workload is, again, ganina itong prioritization and also
knowing kung asa ka dapat mag-una. Especially, itong prioritization. Kato lang.

I: So thank you so much.

S: Sige po.

I: Thank you. For answering sa mga questions.

S: Thank you.

RESPONDENT 5

I: Ano ang mga na experience mo during hospital duties na nakaapekto sayo para maka
provide nang holistic care?

S: Base sa akoang mga experience during hospital duties, kanang mga factors nga kabalo
jud ko nga naka affect sa akoang pag provide ug holistic care sa mga naging patients ko
kay una stress, stress kay tungod and schedule sa duty gina send sa group chat mga one
week before man pero para sa akoa kulang sya kay may klase paman plus naa pay mga
requirements so dagdag pressure ug stress tapos makawala pud sa focus kaya kis a
apektado pud akoang time management, then sunod kay attitude sa patient og watcher
kay may times jud hindi maiwasan na mag toxic sila then makasabot man ko pero
syempre masakitan pud so tendency makakulba og maka down pag makigan ka sa
patient, pero sa mga una raman nako tu na duty kay first time man tapos karun kada
exposure man gud ma enhance man akoang communication skills maong the rest sa mga
duty nako hantud karun kay okay kaayo attitude sa mga naging patient ko pati ila
watcher, then another factor aside pa sina kay kanang kulang ug knowledge sa isa area
kay pag holistic care man gud dapat e consider man jud nato ang patient as a whole ug
unique individual na may unique needs, preference, culture, beliefs so ang tendency lagi
kung kulang kog knowledge kay ang mahitabo hindi na nako ma provide ang holistic care
sa patient ko kay gamay lang bal an ko sa mga interventions or management nga priority
sa akoa nga patient.

I: Paano nakaapekto ang attitude nang pasyente sa kompansya mo sa iyong sarili?

S: So far tung mga past hantud sa karun nako na mga duty labi na ward kay halos ok man
ang attitude sa mga naging patient nako, kay sa ma recall nako kaisa or kaduha raman ko
naka experienced nga pangit ang attitude sa patient then katu na time syempre expected
man nako na may ana jud nga mga patient abi ko kaya ko lang dibdibon pero mao tu sya
murag na down ko ato kay gikigan man gud ko sa patient tas makataranta pud makulbaan
ka nalang tawon.

I: Ano ang impact ng communication anxiety para sayo?

S: Katung time ra apud nga naka experience ko na makigan sa pasyente nako kay maka
kulba jud nga makataranta then wala ko kabalo unsay isabat nako or unsay action nako
para ma adress tung ing ato na situation.

I: Paano nakakaapekto ang kakulangan mo sa impormasyon patungkol sa area na kung

saan ka na assign?

S: Kung about pud sa knowledge sa field or assigned area halimbawa sa ward kay
although gamy ra akoang nabal an sa isa ka procedure pero dali ra man ko maka cope up
sa mga kulang nako nga ideas kay hindi man jud lisod sa ward like paulit raman pud
maong gets na dayon pero pag abot sa mga special area like OR,DR, ER kay dra jud ko
malisodan adjust gid kay syempre baskin naga basa basa nako gamay about sa concept
kay di jud maiwasan nga makulangan gid ko sa information kay iba man gyud pag sa
actual na nga duty sa special area kay daghan gid term and procedures nga wala ko idea
so magkara kara jud ko panu startan kana nga mga procedures sa special areas.

I. Paano mo nababalanse ang iyong oras at mga kinakailangang gawin sa duty para
masigurado na nagagampanan mong makaprovide nang holistic care sa pasyente?

S: Halimbawa sina nu sa na experience nako sa ward nga duty or sa DR kay daghan

kaayu og sugo or daghan ka man gud e pang monitor like sa DR particular kaman sa VS
ana nila before kag after delivery then habang sa VS ka di pud maiwasan na need nimo
mag tabang sa ka group mo or syempre may sugo pud imong CI sa imo then ing ana pud
sa ward kay bukod sa VS taking kay naa paman iban procedure ang himuunon like mag
kuha ug blood sugar, magregulate sang IV fluid plus sugo gyapon sang CI like sa
requirements such as FDAR tas drug study pa tas charting pa so sa tanan nga na
mentioned nako kay ang wat nako para mabalance akoa nga time jud kay first unahon ko
gid ang VS sa patient paspasan jud nako pagkuha pero correct way gyapon tapos pag bal
an ko nga naay procedure nga ginapahimo kay ginahimo ko dayon then kung may time
mabilin ga regulate kog IV fluid sa patient then pag lapit na matapos ang shift gina ask ko
na ang patient sa ilahang intake og output para deretso nako sa charting then sa
requirements ginapaspasan ko pag kabalo nako sa FDAR para sa patient.

I: Ano ang perspective mo about sa factors na nakakaapekto sa mga kapabilidad ng

student nurses na maka provide nang holistic care?

S: Para sa akoa kaning mga factors maka apekto jud ni sa capability sang mga students sa
paghandle sa ilang mga patient kay mapansin ko pud na madalas mani mangyari sa iban
mga student nurses habang ga labi na ng communication anxiety kung hindi good ang
attitude sa patient then time management kay daghan man himuun sa duty so magpatung
patung kapag di mamanaged ang time then kining kulang sa knowledge samot pud ni
maka apekto sa student kay kung wala sya kabalo sa concept or wala syay idea sa isa ka
procedure pwedi jud sya makigan sa CI or patient so lisod jud sya kay madalas ning mga
factors na ma encounter og ma experience sang mga student nurses.

I. Para sayo, ang mga factors ban a nabanggit ang nagcacause ng problema sa iyong
kapabilidad at bakit?

S: Yes, pero dili man jud tanan sa katung mga factors nga nabanggit kay maka cause og
problema sa akoang capability nga maka provide ko ug holistic care sa akoang patient
kay ma addressed ko na man sya pero like sa iban factors lang like stress due to pressured
sa duty kag school works then sa kanang kulang ug adequate knowledge about sa area ug
procedure nga dapat I performed para sa patient kay kana lang jud para sa akoa maka
cause pud ug proplem kay syempre pag hindi man sapat imo knowledge hindi pud mag
gana imong skills so pwedi na hindi nimo ma met ang goal mo para sa patient which is di
mo pud ma consider og maka provide sang care sa patient holistically.

I: Ano-anu ang mga paaran na alam mo to address the factors na nabanggit para mas
mahasa ang iyong abilidad na makapagbigay nang holistic care?

S: Para sa akoa ang mga ways nga kabalo ko og ginahimo nako para ma adress nako ning
mga factors nga nabanggit kay first kung about sa patient attitude kay therapeutic
communication in a way nga involved always ang active listening then dapat tone sang
boses nako kay dapat magalang para ma feel sa patient na respetado sila always ug maka
build ug rapport then sa communication anxiety kay gina practice always ang akoang
speaking or communication skills then gina boost ko akong self-confidence para pag
meet nako sa patient in actual kay confident nako baskin wala nay guide or baskin
makigan ko sa patient, then sa time pud kay manage jud ang time like kabalo ka kung
unsay dapat unahon or priority then kung kaya matapos ng mabilis ang isa ka procedure
dapat paspasan jud pero efficient way gyapon last sa limted knowledge kay pag naa juy
vacant naga basa basa gid ko sa mga notes, books, pdf even maglantaw ug youtube about
sa mga procedure nga di pa familiar sa akoa ug kung naay opportunity na ipa perform
sang CI ang isa ka procedure baskin wala pakoy idea kaayo about sito is e grab gyapon
nako dayon kay I guide man gyapon sang CI so makatuon ko actual tas pag ka next duty
kabalo na nga wala guide sa CI.

RESPONDENT 6

I: Ano ang mga na experience mo during hospital duties na nakaapekto sayo para maka
provide nang holistic care?
S: Naay mga patient na dili mag cooperate ang parent sa bata,then lisod mag kuha sang
data.

I: Paano nakaapekto ang attitude nang pasyente sa kompansya mo sa iyong sarili?

S: Ga baba akong self confidence tapos di ko maexpress o maiingon ang akoang gusto
iingon tungod kay ma atiitude ang patient

I: Ano ang impact ng communication anxiety para sayo?

S: Kina kulbaan pagka 1st day kay basin hindi approachable ang patient na ma assign sa
akoa

I: Paano nakakaapekto ang kakulangan mo sa impormasyon patungkol sa area na kung

saan ka na assign?

S: Di nako mahimo ang tama nga procedure like mag sala sala ko pagka naa na ko sa area
tas makulbaan ko pagka maga ask mag questions ang mga CI

I: Paano mo nababalanse ang iyong oras at mga kinakailangang gawin sa duty para
masigurado na nagagampanan mong makaprovide nang holistic care sa pasyente?

S:Example diri is naga take on time ng vital signs at tyaka gina obserbahan talaga ang
mga kilos nila para mapadali ang pag gawa ng naka assign sa akin na kahit busy na
babalanse ko pa din ang aking oras.

I: Ano ang perspective mo about sa factors na nakakaapekto sa mga kapabilidad ng

student nurses na maka provide nang holistic care?

S: Budlay para sakoa during duties kay kanang ang bata mag sigeg dagan dagan o
maghilak

I: Para sayo, ang mga factors ban a nabanggit ang nagcacause ng problema sa iyong
kapabilidad at bakit?

S: Hindi naman masyado kasi gina take ko sya as challenge for me to do better next time.

I: Ano-anu ang mga paaran na alam mo to address the factors na nabanggit para mas
mahasa ang iyong abilidad na makapagbigay nang holistic care?

S: Magbasa og mga books about sa procedure sometimes. Sa Patient attitude kay

storyaon storyaon lang sa hantod sa mag open up na sya or mag established rapport. Sa
communication anxiety pag mag talk ko sa patient naa jud permi ang smile wala nako
ginapakita nga nakulbaan ko then gina buhat nako kung unsay need nila or ask lang ko
nga ask para mahasa puf akong pag communicate. Then sa time or workload pag mag
take og vs gina sabay nako ang temp kag RR og o2 sat para mapadali akon task para
mabuhat pa nako ang iban nga gi assign sa ako. Sa limited knowledge magbasa og mga
books about sa procedure sometimes or mag search online kung ano ang mga buhaton if
naa ko sa OR na field or sa DR os other areas

RESPONDENT 7

I: Ano ang mga na experience mo during hospital duties na nakaapekto sayo para maka
provide nang holistic care?

S: Ang mga na experience nako during duty is ang pakaattitude sa pasyente kanang sige
ka ug balik sa ilang room para lang mag vital sign kay mafeel nako na murag lain na
ilang panan-aw nila sa imuha so as a studemt nurse need nato ug taas na pasensya ug
dapat confident ka.

I: Paano nakaapekto ang attitude nang pasyente sa kompansya mo sa iyong sarili?

S: Makaapekto ang attitude sa pasyente sa imong self-esteem kay feel nimo murag mali
ang imong ginabuhat mafeel nimo walay salig ang pasyente sa imuha pero even ingana
ang makita or maingon sa pasyente be positive, respectful and confident lang saimuhang
sarili

I: Ano ang impact ng communication anxiety para sayo?

S: Maka impact ni siya sa pag communicate mo sa mga pasyente kay feel nimo basig
magkamali ka or basig kasab-an ka sa imong CI. Makaapekto ni sa the way nimo mag
istorya basig eh judge ka nila or basig magkamali ka

I: Paano nakakaapekto ang kakulangan mo sa impormasyon patungkol sa area na kung

saan ka na assign?

S: Makaapekto ni sya sa imong performance basig magkamali ka kay kulang ka sa

impormasyon about sa imong duty

I: Paano mo nababalanse ang iyong oras at mga kinakailangang gawin sa duty para
masigurado na nagagampanan mong makaprovide nang holistic care sa pasyente?

S: Example diri is naga take on time ng vital signs at tyaka gina obserbahan talaga ang
mga kilos nila para mapadali ang pag gawa ng naka assign sa akin na kahit busy na
babalanse ko pa din ang aking oras. Para mabalanse nako ang akong oras ug kailangan
nako is dapat tapusin mo muna ang sinabi ng CI mo then proceed kana sa next task mo.

I: Ano ang perspective mo about sa factors na nakakaapekto sa mga kapabilidad ng

student nurses na maka provide nang holistic care?
S: As a student nurse makaapekto ni sya sa performance ug confidence sa amoa,
makafeel ug stress

I: Para sayo, ang mga factors ban a nabanggit ang nagcacause ng problema sa iyong
kapabilidad at bakit?

S: Opo, kay mawala ang imong self confidence, makafeel ka sang guilt ug stress sa
imong sarili

I: Ano-anu ang mga paaran na alam mo to address the factors na nabanggit para mas
mahasa ang iyong abilidad na makapagbigay nang holistic care?

S: First kay ang patients attitude be positive and confident, communication anxiety
practice lang og communications skills nimo at dapat confident ka and dapat be
respectful and kind sa mga patients natin.

RESPONDENT 8

I: Good afternoon, mag conduct kami ng research namin entitled Factors that affect
student nurses' ability to provide holistic care. We have series of questions and answer it
honestly based sa experiences mo during rotational duties.

I: 1st question po, Ano ang mga na experience mo during hospital duties na nakaapekto
sayo para maka provide nang holistic care?

S: Encountering patients with challenging attitudes for example ano lisud kaayo sila
intindihon naa man guy patients usahay maldita lisud kaayo sila I approach naa puy dili
makipag cooperate if naay question also experiencing communication anxiety during my
1st exposure as a student nurse nag struggle jud kog communicate because I can't speaker
bisaya before need pa nakog interpreter. But, facing different patient with attitudes
hightened my awareness and need lang ug deep understanding para makaprovide holistic
care even nag struggle kog communicate nila I try my best to listen and re-aasure them
while addressing their concern.

I: Next is, Paano nakaapekto ang attitude nang pasyente sa kompansya mo sa iyong
sarili?

S: Sometimes ang negative attitude jud sa patient is makababa ug self-esteem, specially

criticism and uncooperative behavior or sometimes I blame ang student nurse despite sa
effort na maka provide ug care and it made me question and doubt my abilities.

I: Ano ang impact ng communication anxiety para sayo?

S: For me, communication anxiety is one of my biggest problems. dako jud siya na
impact sa ako kay dili ko ma express or convey ug tarong ang information and address
the patient concern

I: Paano nakakaapekto ang kakulangan mo sa impormasyon patungkol sa area na kung

saan ka na assign?

S: Lack of knowledge in assigned area for example OR/DR struggle jud if dili ka
knowledgeable about sa case and most specially sa mga instruments and for ER if 1st
time magduty dili jud mawala ang kakulba lalo na ug maka encounter ug mass casual
incident.

I: Paano mo nababalanse ang iyong oras at mga kinakailangang gawin sa duty para
masigurado na nagagampanan mong makaprovide nang holistic care sa pasyente?

S: In order to balance my time on duty while ensuring holistic care, first and foremost jud
is I prioritize ang task based sa urgency and importance, for example address the patients
immediate need first, make sure lang na urgency concerns are taken care of right away
and finish every task given to me through the shift.

I: Ano ang perspective mo about sa factors na nakakaapekto sa mga kapabilidad ng

student nurses na maka provide nang holistic care?

S: For me, the difficulties that student nurse encounter during duties is dara ma determine
whether or not they are able to provide the holistic care for example ang student nurse is
lack of clinical exposure malisud jud na ug intindi paano I apply ang theory into actual
patient care situation and ofcourse the fear of making mistakes makulbaan man jud ta and
pressure specially if medically inclined ang atoang pasyente which would affect the
ability to deliver the holistic care.

I: Para sayo, ang mga factors ban a nabanggit ang nagcacause ng problema sa iyong
kapabilidad at bakit?

S: Na mention ko man na I struggle to apply theoretical framework in the hospital

exposure leading to doubts my ability na maka cause ng meeting expectation during
duties the fear of making mistakes due to the pressure and one more thing communicative
anxiety kani sila ang hinungdan na maglisud kog provide ug holistic care sa patient.

I: Ano-anu ang mga paaran na alam mo to address the factors na nabanggit para mas
mahasa ang iyong abilidad na makapagbigay nang holistic care?

S: Focus jud dapat sa communication skills deep understanding sa patient attitude and
Foster therapeutic relationship, building self confidence by practicing communication
techniques. I also focused on learning bisaya to my classmates and friends, and now I can
effectively interact with patients I've come to develop effective time management
prioritising urgency and importance. and for the limited knowledge always grab the
opportunity para makalearn specially if ipabuhat sa imo ang certain procedure pero limit
lang ang imong knowledge always remember na naay guidance sa clinical instructor
never say no just because na makulbaan ka need pud mag study to expand the knowledge
you have.

I: Thank you so much po for your time and participating in our interview.

RESPONDENT 9

I: Good morning po, naay lng miy questions about factors that affect student nurses
ability to provide holistic care.Answer the questions honestly about sa mga na experience
mo sa duty. So, Ano ang mga na experience mo during hospital duties na nakaapekto
sayo para maka provide nang holistic care?

S: Ang mga nakakaapekto para sa akin na nakakaapekto sa ating duties is yung

limitasyon ng ating mga kaalaman halimbawa ay depende kung nadaanan na natin ito as
nagawa nating return demonstration ah kasi di lahat ng bagay na experience na mismong
setting nga hospital ay napag-aralan natin so isa yun sa makakapekto yung knowledge
about sa procedure or about sa mga ginagawa natin. Next, is yung mga adjustment natin
kasi 1st mga estudyante pa tayo so Hindi pa natin alam yung environment pagdating sa
mismong trabaho na for example na may mga hindi natin alam na ganun pala ang ugali
ng mga tao may time na masyado silang irritable may mga tao din na mas marunong pa
sa atin, kaya minsan kailangan nating makisama yun yung mga bagay na nakakapekto
para sa akin.

I: Next, Paano nakaapekto ang attitude nang pasyente sa kompansya mo sa iyong sarili?

S: Depende kasi sa atin yan kung magpapaapekto tayo, pero para sa akin naman iniisip ko
nalang na limited knowledge yung may mga pasyente hindi alam yung talagang dapat
gawain ng nurse so minsan nakakapagbigay sila ng sarili nilang opinion na hindi
accurate, so pwede lang naman nating palampasin nalang yun sa kabilang tenga natin at
gawin natin yung alam natin na tama.

I: Ano ang impact ng communication anxiety para sayo?

S: Isa pa yan sa malaking nakakaapekto sa ating performance, yung kawalan ng

kompyansa natin at di natin alam paano makipag communicate sa isang tao so dapat
naman dyan sa mga ganyang bagay is mapractice lang natin yung ating sarili paano ang
tamang pag communicate sa ating kapwa or sa ating pasyente.

I: Next is, Paano nakakaapekto ang kakulangan mo sa impormasyon patungkol sa area na

kung saan ka na assign?

S: Yan malaking factor yan na talagang makakaapekto sa ating performance kasi kung
hindi natin alam ang mga procedure yung mga basic procedure pwede tayong
mapagalitan ng CI natin pwede tayong ma IR so malaki ang effect nito sa ating
performance.
I: Paano mo nababalanse ang iyong oras at mga kinakailangang gawin sa duty para
masigurado na nagagampanan mong makaprovide nang holistic care sa pasyente?

S: Uh practice tsaka time management ganyan lang naman talaga yan kailangan nating
masanay sa busy at tsaka mga pressure na naeexperience natin while dapat time
management talaga magbigay tayo ng halimbawa ng limit sa oras na ating ginagawa para
mapagkasya natin yung mga task na dapat nating makompleto.

I: Ano ang perspective mo about sa factors na nakakaapekto sa mga kapabilidad ng

student nurses na maka provide nang holistic care?

S: For my own perspective, dapat ano sufficient knowledge at tsaka sufficient self-
confidence.

I: Para sayo, ang mga factors ban a nabanggit ang nagcacause ng problema sa iyong
kapabilidad at bakit?

S: Ay kung boost self-esteem mo tsaka experience hindi siya nakakaapekto sa atin

kumbaga hindi negative ang effect niya sa atin kundi positive.

I: Ano-anu ang mga paaran na alam mo to address the factors na nabanggit para mas
mahasa ang iyong abilidad na makapagbigay nang holistic care?

S: First about sa knowledge so kabalo naman ta or alam naman natin na una sa lahat wag
tayong tamarin mag-aral or mag study so para ma provide natin yung tamang approach,
proper practices yung mga ganyan so dapat mag study talaga tayo. Next sa
communication na pud so dapat lang natin sanayin ang ating sarili paano ang tamang
pakikipag communicate sa ating pasyente para ma provide pud nato ang tamang care sa
atoang patient.

I: Okay, thank you po for answering our questions and God bless.

RESPONDENT 10

I: Good morning, magconduct po kami ng interview for our research entitled factors
affect student nurses ability to provide holistic care. Just answer the questions based sa
mga na experience mo during rotational duties maybe sa ward, OR, DR, and ER. 1 st
question, Ano ang mga na experience mo during hospital duties na nakaapekto sayo para
maka provide nang holistic care?

S: As a student nurse, in my experience ahmm…the factors na naga affect sa akoang duty

first of all ma pre-occupied ang imong mind let’s say stress personal problems, school
problems, hmm… also isa pud sa akoang factor is kanang maka distract sa akoa
kompansya sa sarili labi ng ma question and imong ginatrabaho kung tama ba ni or dili.
I: Next, Paano nakaapekto ang attitude nang pasyente sa kompansya mo sa iyong sarili?

S: So dako pud ni siya nga ahh… makaapekto sa student nurses kay sa akoang experience
mao lagi to ma question ang imuhang ginabuhat wala silay kompansya sa imuha tungod
kay student nurse lang ka ug mawala pud akong kompyansa sa akong sarili or akong
kaugalingon.

I: Ano ang impact ng communication anxiety para sayo? (ex. Kinakabahan at di ma

express ang gusto sabihin)

S: So dako siyag impact nuh kay syempre ang communication dako siya nga role para sa
paghatag ug maayo nga care sa atong patient so pag naa tay communication anxiety dako
siya nga impact sa atoa kay dili nato, either dili ta magkasinabtanay or dili nato masabtan
ang patient ug dili pud ta masabtan sa atong patient.

I: Paano nakakaapekto ang kakulangan mo sa impormasyon patungkol sa area na kung

saan ka na assign?

S: Grabe ang ano, dili jud pwede nga limited lang ang knowledge as a student nurse kay
kinabuhi ang atong ginagunitan, kinabuhi ang atoang ginaalagaan kung mawala na siya
isa lang ka mali wala na maapektuhan ang imong pasyente and also ang atoang
kaugalingon.So, kailangan knowledgable ta as student nurses kung nay wala nabal an feel
free to ask and dili mahadlok.

I: Paano mo nababalanse ang iyong oras at mga kinakailangang gawin sa duty para
masigurado na nagagampanan mong makaprovide nang holistic care sa pasyente?

S: Katong 1st pa nga nagaduty mi grabe wala ko kabalo unsaon pag managa sa akoang
time 3-4 days mag duty and aside ana ahmm… the rest of the days naa ka sa eskwelahan
and review center so from time to time ma manage nako siya mabalance nako siya like
anay time or amo ning orasa focus ka ug maghatag pud kag time para sa imong family
and also pinaka importante maghatag pud kag time para sa imong sarili para ma refresh
ka imong utok ug lawas, maong nay time management ana nga mga butang para ma
ensure jud mo kay kung okay imong panghuna-huna and feeling sa imong kaugalingon
mas gwapo ang outcome sa paghatag ug care sa atoang patient.

I: Ano ang perspective mo about sa factors na nakakaapekto sa mga kapabilidad ng

student nurses na maka provide nang holistic care?

S: So, uhmm… ang akoang factors ha, kaya man nato, kabalo ko sa akoang kaugalingun
nga kaya nako pero ng factors jud nga makwan ko is kana gung mawad an kog trust sa
akong sarili labi na kung pagtan aw nimo sa patient murag naga duha-duha sya sa imuha
ma kwaan jud ko mawala akong kompyansa sa akong sarili kay syempre student nurse
lang gyud ta labi na kung ang patient is also in medical field like nurse or naa silay
igsuon nga nurse or mga ing ana so syempre dili tanan mabal an as a student nurse kay
naa pa ta sa practice era so kailangan nga ma question ka nila kung tama ba ni ma’am?
Tama ba ning imong ginabuhat? Dili man ing ani. So isa jud na sa factor maapektuhan
ang akong pag provide ug care sa atong patient.

I: Para sayo, ang mga factors ban a nabanggit ang nagcacause ng problema sa iyong
kapabilidad at bakit?

S:Yes, syempre gyud kay as I said maapektuhan imong paghatag ug care pati imong
pasyente pati ikaw man, mao nang ginaingun sa amoa there’s no room for mistakes sa
pag provide ug care sa sulod sa ospital kay kinabuhi gyud ang atong ginagunitan, So
ahmmm… dako siya ug factor nga makacause sa kani nga problem as a student nurse.

I: Ano-anu ang mga paaran na alam mo to address the factors na nabanggit para mas
mahasa ang iyong abilidad na makapagbigay nang holistic care?

S: Ahmmm… dili lang mag stop sa eskwelahan ang pag seek ug knowledge nuh bisan
naa ta sa balay or bisan asa man ta naa tay mga pagduha duha, you research, read even sa
pag scroll into social medias ahmm… pag seek sa mga informative videos mga questions,
makita nimo ang mga knowledge kay dili man tanan matudlo sa eskwelahan so magbasa
ka. Kung dili ka magbasa, kung gusto pud ka nga pwede pud ka magtan aw ug mga
videos, pwede ka maminaw ud mga audios so dili lang jud siya sa eskwelahan mag
stop,para mas more na knowledgeable tam as more nga effective ang atoang paghatag ug
care para sa atoang patients.
 APPENDIX E

Data Reduction and Categorization

DATA REDUCTION TABLE

RESEARCH OBJECTIVES RESPONSES/ STATEMENTS OF THE
PARTICIPANTS
Determine the factors affecting Amm… Ang factor lang saakin is
sometimes ahm… possible din sa patient
student nurse's ability to provide attitude siya which is toxic tapos usually sa
karami ng patient talaga na hindi mo na
holistic care. talaga alam anong gagawin mo tapos Yung
first time mo nga gawin yung procedure na
unknown ka pa talaga Kaya mag tala-tala
ka gud. P1L16-19

Kay if pwede tong sa example mo, ano po,

sa patient’s attitude pud, then sa mga
limited knowledge pud. Kay kung sa
patient’s attitude, kay feel ko lang hindi ko,
hindi ko ma, ay hindi ko knows. Hindi ko,
ano, like, paano mag-approach sa patient na
may attitude. Like, hindi ko makita ang
words kung paano siya i-comfort, paano
siya i-assure na, amo sa kay syempre, may
patient na hindi gusto siya yung student
nurses, nga mag-care sa ilaha. So, hindi ko
sure if mahatag ko ang assurance na
ginapangita nila, if ever, nga, mag-attitude
sila towards me. P3L1O5-110

So, ang mga naka-ano sa akon is first ang

language barrier kay paryas sa akon is
illonggo ko tapos ma-assign ko dire sa
Kidapawan ti bisaya man sila mabudlayan
gud ko mag-approach. Then, ang isa is ang
limited knowledge kaya hindi man gud
namon na RD, tanan, gud. So, mabudlayan
pud kami. P5L191-194

So, ang mga factors na akong na-

experience during hospital duty na naka-
affect, paghatag ug holistic care is, most
ang pinakauna, Jud is kanang
communication sa patient. Kay, syempre,
like bago ang patient everyday and hindi ka
kabalo kung paano sila mag-handle gud ug
kanang student nurse, kay naay uban na.
Hindi kaayo sila open pag nai-student
nurse. So, the very first thing, Jud na ma-
experience nako, na maka-affect kung
paano ko makahatag ug holistic care is
paano ko makipag-communicate sa akong
patient the first day. P7L249-254

Base sa akoang mga experience during

hospital duties, kanang mga factors nga
kabalo jud ko nga naka affect sa akoang
pag provide ug holistic care sa mga naging
patients ko kay una stress, stress kay
tungod and schedule sa duty gina send sa
group chat mga one week before man pero
para sa akoa kulang sya kay may klase
paman plus naa pay mga requirements so
dagdag pressure ug stress tapos makawala
pud sa focus kaya kis a apektado pud
akoang time management, then sunod kay
attitude sa patient og watcher kay may
times jud hindi maiwasan na mag toxic sila
then makasabot man ko pero syempre
masakitan pud so tendency makakulba og
maka down pag makigan ka sa patient, pero
sa mga una raman nako tu na duty kay first
time man tapos karun kada exposure man
gud ma enhance man akoang
communication skills maong the rest sa
mga duty nako hantud karun kay okay
kaayo attitude sa mga naging patient ko
pati ila watcher, then another factor aside
pa sina kay kanang kulang ug knowledge sa
isa area kay pag holistic care man gud
dapat e consider man jud nato ang patient
as a whole ug unique individual na may
unique needs, preference, culture, beliefs so
ang tendency lagi kung kulang kog
knowledge kay ang mahitabo hindi na nako
ma provide ang holistic care sa patient ko
kay gamay lang bal an ko sa mga
interventions or management nga priority
sa akoa nga patient. P9L346-360

Ang mga na experience nako during duty is

and pakaattitude sa pasyente kanang sige ka
ug balik sa ilang room para lang mag vital
sign kay mafeel nako na murag lain na
ilang panan-aw nila sa imuha so as a
studemt nurse need nato ug taas na
pasensya ug dapat confident ka. P12L474-
476

Encountering patients with challenging

attitudes for example ano lisud kaayo sila
intindihon naa man guy patients usahay
maldita lisud kaayo sila I approach naa puy
dili makipag cooperate if naay question
also experiencing communication anxiety
during my 1st exposure as a student nurse
nag struggle jud kog communicate because
I can't speaker bisaya before need pa nakog
interpreter. But, facing different patient
with attitudes hightened my awareness and
need lang ug deep understanding para
makaprovide holistic care even nag
struggle kog communicate nila I try my
best to listen and re-aasure them while
addressing their concern. P13L514-520

Ang mga nakakaapekto para sa akin na

nakakaapekto sa ating duties is yung
limitasyon ng ating mga kaalaman
halimbawa ay depende kung nadaanan na
natin ito as nagawa nating return
demonstration ah kasi di lahat ng bagay na
experience na mismong setting nga hospital
ay napag-aralan natin so isa yun sa
makakapekto yung knowledge about sa
procedure or about sa mga ginagawa natin.
Next, is yung mga adjustment natin kasi 1st
mga estudyante pa tayo so Hindi pa natin
alam yung environment pagdating sa
mismong trabaho na for example na may
mga hindi natin alam na ganun pala ang
ugali ng mga tao may time na masyado
silang irritable may mga tao din na mas
marunong pa sa atin, kaya minsan
kailangan nating makisama yun yung mga
bagay na nakakapekto para sa akin.

P15L570-578
DATA CATEGORIZATION TABLE
RESEARCH OBJECTIVES CATEGORIZED DATA
Determine the factors affecting Amm… Ang factor lang saakin is
sometimes ahm… possible din sa patients
student nurse's ability to provide attitude siya which is toxic. P1L16

holistic care.

then sunod kay attitude sa patient og

watcher kay may times jud hindi maiwasan
na mag toxic sila P9L351-352

Kay kung sa patient’s attitude, kay feel ko

lang hindi ko, hindi ko ma, ay hindi ko
knows. Hindi ko, ano, like, paano mag-
approach sa patient na may attitude. Like,
hindi ko makita ang words kung paano siya
i-comfort, paano siya i-assure na, amo sa
kay syempre, may patient na hindi gusto
siya yung student nurses, nga mag-care sa
ilaha. So, hindi ko sure if mahatag ko ang
assurance na ginapangita nila, if ever, nga,
mag-attitude sila towards me. P3l106-110

if ever na attitude ang patient, sakoa, ma-

conscious ko if paano mag-hatag sin care,
like, mahuya or maulaw kay what if hindi
siya gusto sa ato, na nga doings from me
like ano so, mahuya ka, ma-apektohan ang
pag-hatag mo sang holistic care, kay ma-
conscious ka sa sarili mo if tama ba ang
ginahimo mo. P3L114-117
Encountering patients with challenging
attitudes for example ano lisud kaayo sila
intindihon naa man guy patients usahay
maldita lisud kaayo sila I approach naa puy
dili makipag cooperate if naay question
P13L514-516
So, the effect of the patient’s attitude is
very massive kasi pag cooperative yung
patient mo, Syempre, yung pagbibigay mo
din ng patient care is tumataas din yung
confidence mo, diba? Kasi may mga patient
na very supportive din sa mga ginagawa
mo. So, ikaw, parang hindi ka nagda-doubt
sa mga binibigay mo. Kasi may times kasi
na yung patient mismo, pag kinakausap mo
siya, Is medyo hindi sumasagot or kanang
maldito gud ug kanang trato. So, ikaw
mismo, murag mag-doubt na pud ka basi
pangitaan kog mali if ever kani akong
mabuhat. P7L265-261

Makaapekto ang attitude sa pasyente sa

imong self-esteem kay feel nimo murag
mali ang imong ginabuhat mafeel nimo
walay salig ang pasyente sa imuha pero
even ingana ang makita or maingon sa
pasyente be positive, respectful and
confident lang saimuhang sarili P12L478-
480

Syempre, if limited. Limited ang

knowledge mo towards sa mga procedure
nga himuon. Siyempre, nang magka, ano
pa, like, Dali lang. Limited ang knowledge
na sa procedure. Siyempre, kay may gamay
lang pud na RD namon ba, like, wala po
kami ka-RD paano magkatong sa Tepid
sponge bath, wala kami ka-RD sito. So, if
ever, nahimuon ko tong nga procedure.
Siguro, mag-search ko sa Google. Tapos,
ano nang, um, basta nang, kay limited man
ang knowledge mo, siyempre, hindi
kakabalo kung paano, paano himuon ng
procedure. So, maka-apekto siya towards
kung paano ka mag-provide. P4L138-144
So, essentially, yung knowledge ko, zero
talaga kasi wala talaga akong idea kung ano
yun. So, naka-apekto siya sa akoa yung
kakulangan ng knowledge is I don’t know
how to respond If na ay mag-ask na
patients ako with regard silang sakit. Like,
ma’am, Ngano diay na ing-ani? Tapos ako
na maternal lang akong nabalan, dili kaayo
nako matubag ug tarong, So, kato, medyo
challenging jud siya.

P7L271-277
Kung kulang kog knowledge kay ang
mahitabo hindi na nako ma provide ang
holistic care sa patient ko kay gamay lang
bal an ko sa mga interventions or
management nga priority sa akoa nga
patient. P9L3658-360

Lack of knowledge in assigned area for

example OR/DR struggle jud if dili ka
knowledgeable about sa case and most
specially sa mga instruments and for ER if
1st time magduty dili jud mawala ang
kakulba lalo na ug maka encounter ug mass
casual incident.
P14L530-532

Ang mga nakakaapekto para sa akin na

nakakaapekto sa ating duties is yung
limitasyon ng ating mga kaalaman
halimbawa ay depende kung nadaanan na
natin ito as nagawa nating return
demonstration ah kasi di lahat ng bagay na
experience na mismong setting nga hospital
ay napag-aralan natin so isa yun sa
makakapekto yung knowledge about sa
procedure or about sa mga ginagawa natin.
P15L570-574

Most ang pinakauna, Jud is kanang

communication sa patient. Kay, syempre,
like bago ang patient everyday and hindi ka
kabalo kung paano sila mag-handle gud ug
kanang student nurse, kay naay uban na.
Hindi kaayo sila open pag nai-student
nurse. So, the very first thing, Jud na ma-
experience nako, na maka-affect kung
paano ko makahatag ug holistic care is
paano ko makipag-communicate sa akong
patient the first day. P7L250-254
For me, communication anxiety is one of
my biggest problems. dako jud siya na
impact sa ako kay dili ko ma express or
convey ug tarong ang information and
address the patient concern P13L526-527

Isa pa yan sa malaking nakakaapekto sa

ating performance, yung kawalan ng
kompyansa natin at di natin alam paano
makipag communicate sa isang tao so dapat
naman dyan sa mga ganyang bagay is
mapractice lang natin yung ating sarili
paano ang tamang pag communicate sa
ating kapwa or sa ating pasyente. P15L586-
589