STRESS AND STRESS MANAGEMENT AMONG NURSING STUDENTS OF

THESELECTED SCHOOLS IN ZAMBOANGA CITY

A THESIS PROPOSAL

Presented to the Faculty of Bachelor of Science in Nursing Program

Pilar College of Zamboanga City, Incorporated

In Partial Fulfillment of the Requirements for the Degree of

Bachelor of Science in Nursing

By

BOONE, MERHANA T.
GUTIERREZ, CHRISTINE MAY K.
HAYUDINI, NICKA CASSANDRA G.
KUNNANG, SHEENA L.
NAPOLEREYES, JAMIE D.P.
SARAJI, SURWINA S.

OCTOBER 2019
 CHAPTER 1

INTRODUCTION

Background of the Study

Students at the college level experience high level of stress, related to worry about
successes, availability of time, engagement in patient care. As a psychosocial
phenomenon, stress affects students’ academic achievement and well being. There are
many sources of stress among nursing students, which can be related to academic
workload, many assignments, and expose to a new setting. The rate and level of stress is
an alarm among students in different academic fields. Nursing students practice long
hours of study and inadequate time for other activities. In addition, spending a substantial
time in the clinical areas, with the heavy responsibility of being accountable for patient.
Moreover, financial burden, struggling to manage time and using high-tech machines are
all additional stressors in many cases.

Clinical practice in nursing is essential to train students to be professional nurses

through applying academic skills in practice. Students generally undertake basic courses
for clinical practice from the beginning of the educational program, thus face this great
escalation in addition to the general burdens of managing academic activities, which are
inherently stressful. The stress can be related to the short time to study and spend many
hours in clinical setting such as hospitals and health centers. Some student cannot cope
with stressors because students do not have the suitable study plan. In general, student
cannot eradicate the stress but they can reduce it, so coping is an element that helps to
preserve psychosocial needs. Many studies found that nursing students have high levels
of stress compared with other students. Coping strategies to manage stress through social
care can positively reduce levels of stress and promote health.

In the Philippines, nursing schools started in the age of 18 years old. These
students faced with some patient care responsibilities for which they lack the prerequisite
of professional knowledge and skills. This is the cause to stress. A publication on stress
by the University of New York [Retrieved March 14, 2016] buttresses the notion that,
extreme levels of stress can hinder studies effectiveness and lead to poor academic
performance and attrition. It goes on to affirm that, students who experienced stressful
life events also reported worse health outcomes and reduced quality of life.AlsoThe
World Health Organization (WHO) estimated that stress-related disorders will be one of
the leading causes of disability by the year 2020. Nursing schools are now recognized as
stressful environment that often exert a negative effect on the academic performances and
psychological well-being of the students. (https://www.researchgate.net)

The researchers main objective is to ascertain or identify the extent to which

stress affects students’ academic success, health and general lifestyle, as well as to
inquire and bring to light measures to counteract the effects of existing stress in students.
The researchers believes that this study may be beneficial in designing an accurate
management package including organize social skills and fast trainings, stress reducing
methods, and counselling techniques to overcome the stress among Nursing Students in
the selected schools of ZamboangaCity.This may also encourage the faculty and staff to
work in cooperation with the students to improve capabilities.

STATEMENT OF THE PROBLEM

This study will aim to identify thestress and stress management among Nursing
Students of the selected schools in Zamboanga City. Specifically, the study will answer
the following questions:

1. Which factors most often cause stress among nursing students of the selected
schools in Zamboanga City as to:
 Academic Stressor
 Clinical Stressor
 Personal Stressor
 Social Stressor?

2. To what extent do stress affects the quality of performance among the nursing
students as to:
 Academic
 Clinical
  Personal
 Social?

3. What are the stress management strategies adopted by the nursing student as to:
 Academic
 Clinical
 Personal
 Social?

4. Is there a significant differences in the stress and stress Management among

Nursing Students of the selected Schools in Zamboanga City when respondents
are grouped according to:
 Age
 Gender
 Ethnicity and type of school?

HYPOTHESIS

There is no significant difference on the levels of stress and stress management

among Nursing Students in the selected schools in Zamboanga City when respondents are
grouped according to age, gender and ethnicity and type of school.

SIGNIFICANCE OF THE STUDY

The result of this study will greatly benefit the following:

 Students
The researches believes that this study will provide both a better
understanding of stress and its effect. The main objectives of the study is
 to help nursing students overcome stress by introducing them to a new
stress management techniques that they can put into practice. Also, this
will help the nursing students enhance well being and help improve
academic-life balance. The present research work will guide the nursing
students in preventing too much stress that may lead to a serious health
problem like depression.

 Instructors
The researches aim to foster excellence in education by
empowering instructors in improving stress management skills in order to
teach more effectively and help students. Effectively managing stress often
leads to improved health also. Most importantly, stress management will
give them a sense of control which leads to enhance their self esteem, less
likehood of depression and an overall improvement in quality of life.

 Program
This study will help nursing program by providingmanagement
techniques and methods to lessen or eliminate the stress experiencing by
the nursing students in the selected schools.
5

SCOPE AND DELIMITATION OF THE STUDY

The study will focus on the stress and stress management among nursing students
of the selected schools in Zamboanga City. The variables of this study will be the
Academic, Clinical, Personal and Social stressors of the nursing students. The
respondents of this study will be Schools A, B and C where Bachelor of science in
nursing is available. The researches will gather data by using questionnaires related to
stress which will given to the fourth year nursing students in the selected school in
Zamboanga City. The researchers choose the fourth year students because this level
encounter more stress because of the numerous requirements to pass. The main purpose
of this research is to identify the causes of the stress that student nurses encounter and to
propose possible solutions or management strategies.

THEORETICAL FRAMEWORK

The research will be anchored on the Theory of Hans Selye (1907–82) in 1936was
the first to give a scientific explanation for biological stress. He explained the stress
model based on physiology and psychobiology as General Adaptation Syndrome (GAS).
He explained about hypothalamic-pituitary-adrenal axis (HPA axis) system which
prepares the body to cope with stress.

He also explained about a local adaptation syndrome which refers to the

inflammatory response and repair processes occur at the local site of tissue injury as in
small, topical injuries, such as contact dermatitis which may lead to GAS if the local
injury is severe enough.

He introduced the idea that the stress response could result in positive or negative
outcomes based on cognitive interpretations of the physical symptoms or physiological
experience. In this way, stress could be experienced as eustress
6
(positive) or dystress (negative). However, he always considered stress to be a
physiologically based construct or response. Gradually, other researchers expanded the
thinking on stress to include and involve psychological concepts earlier in the stress
model.

CONCEPTUAL FRAMEWORK
 SUBJECT OF THE INDEPENDENT DEPENDENT
STUDY VARIABLES VARIABLES

Nursing students in the Stress management as to: Study will provide:

selected school:

 SCHOOL A 1. Academic Stressor  Knowledge

2. Clinical Stressor
 SCHOOL B  Prevention
3. Personal Stressor
 SCHOOL C 4. Social Stressor  Awareness
 Management
 Skills

DEFINITION OF TERMS

The following terms will be defined conceptually and operationally for the
understanding of the others.

Academic Stressor. It refers to the mental distress with respect to some anticipated
frustration associated with academic failure. or even unawareness to the possibility of
such failure.
Clinical Stressor.It refer to the body's reaction to any change that requires an adjustment
or response. The body reacts to these changes with physical, mental, and emotional
responses.

Nursing Students.There are the students in a post-secondary educational program that

leads to certification and licensing to practice nursing, usually as part of a program
administered by a nursing school. The title 'nursing student' usually applies to
students enrolled in an RN or practical nurse program.

Personal Stressor. This refers to the events or conditions that occur in a person's life that
may adversely impact on the individual's or their family's health or wellbeing.

Selected Schools.These refers to schools that admits students on the basis of some sort of
selection criteria, usually academic. The term may have different connotations in
different systems and is the opposite of a comprehensive school, which accepts all
students, regardless of aptitude.

Stress.It refers totension exerted on a material object; a state of mental or emotional

strain or tension resulting from adverse or very demanding circumstances.

Stress Management.It consists of making changes to your life if you are in a constant
stressful situation, preventing stress by practicing self-care and relaxation
and managing your response to stressful situations when they do occur.

Social Stressor.It refers to a situation which threatens one's relationships, esteem, or

sense of belonging within a dyad, group, or larger social context. Social stress can
emerge in a number of situations.
 9

CHAPTER 2

RELATED LITERATURE AND STUDY

According to Lazarus &Folkman (1984), stress is a mental or physical

phenomenon formed through one’s cognitive appraisal of the stimulation and is a result
of one’s interaction with the environment. The existence of stress depends on the
existence of the stressor.According to Feng (1992) and Volpe (2000) defined stressor as
anything that challenges any individual’s adaptability or stimulates an individual’s body
or mentality. Stress can be caused by environmental factors, psychological factors,
biological factors, and social factors. It can be negative or positive to an individual,
depending on the strength and persistence of the stress, the individual’s personality,
cognitive appraisal of the stress and social support.

A literature search was performed using key terms of stress, college student stress,
Millennial, mature college with a focus on research in nursing student stress since 2009.
Only articles in English were selected. Databases searched included CINAHL, Proust,
PubMed, student stress, student nurse education, student nurse clinical education.

It demonstrated changes over time in the areas of nursing student stress evaluated
by researchers. Past researchers evaluated student nurses in regard to stress in the clinical
setting and the developmental phase of the students (Beck &Srivastava, 1991).

Additional stress may come from a continually changing clinical environment.

Students need some time to develop a working relationship with a new clinical advisor,
settle into a new environment, become familiar with the
10
routines and norms on the new clinical area, and become acquainted with friendly
supportive floor staff to develop a sense of belonging.

In addition to stress related to courses, examinations, and clinical experiences,

perceptions of faculty attitudes can cause anxiety for students. When students perceive
that their faculty care about student success, stress levels are decreased. Conversely,
students become more stressed when they perceive that a faculty member is not being
objective or fair.

Additionally, students are more stressed when they perceive that a faculty member
is disorganized or not knowledgeable about the content (Torregosa, Ynalvez, & Morin,
2015). Nursing faculty should be aware of how they communicate with students, striving
to convey a positive and caring attitude.

Nursing curricula are stressful and tend to cause anxiety for many students. It often
seems as if nursing students are just stressed in general.
 Stress, according to Buhler (1993), Queen and Queen (2004), and Brock and Grady
(2002), the body is non-specific response to stressors in the environment. Lyles (2005)
concurred and reported stress is the mental and physical wear and tear that we experience
as we live our lives. In no more than hundredth of a millisecond, the individual prepares
themselves for fight or flight.

Stress is a natural part of life and will be induced in both good and bad situations.
Coping is essentially the way people manage those life conditions that are stressful.
Stress and coping can be considered to be reciprocals of each other (Lyles, 2005). When
the coping behavior is effective, the level of stress tends to be low or on the decline.
However, if the individual has ineffective coping skills, there is a tendency for stress to
be high or continue to increase (Lazarus, 1999; Queen & Queen, 2004).

11

Nursing students are prone to stress due to the transitional nature of college life.
High levels of stress are believed to affect student’s health and academic functions.
Students are subjected to different kinds of stressors such as the pressure of academics
with an obligation to succeed, an uncertain future and difficulties of integrating into the
system. Thus, they are exposed to stress leading to its effects their life and also may
compromise learning during these due to stress reactions. Methods to reduce student
stress often include effective time management, social support, positive reappraisal, and
engagement in leisure pursuits.

Stress can also have diverse sequential durations, such as acute and chronic stress.
According to Oxington, (2005), chronic stress includes stress that is not short term.
Health concerns, lingering problems and financial difficulties may be sources of chronic
stress. Acute stress on the other hand is caused by a reaction to a short-lived, urgent
threat. This threat can either be real or perceived (Violanti, 1983)
 Nursing students suffer from high levels of stress related to academic assignments
in addition to clinical skills training. As a psychosocial phenomenon, stress affects
students’ academic achievement and wellbeing.

However, there are a variety of ways to promote stress reduction, both formally
and informally, throughout nursing programs. Nursing faculty should be cognizant of the
stress experienced by their students and encourage activities to mitigate stress and foster
success.

Coping mechanisms help students deal with the challenges arising from stress.
Aims: To illustrate the level of stress and common stressors among nursing students; to
describe the difference in stress level related to demographic data; and to identify coping
mechanisms used by nursing students.
12

If health is considered as a dynamic equilibrium, stress is part of it (Lyles, 2005).

There is no health without interaction with other people and with the environment. Only
excesses of stress are pathological (Lyles, 2005).

Some stress is therefore normal and necessary, at work and outside it. But if stress
is intense, continuous or repeated, if a person is unable to cope, or if support is lacking,
stress then becomes a negative phenomenon which can lead to physical illness and
psychological disorders (Lyles, 2005).

Therefore, according to Brock and Grady (2002), Buhler (1993), Lyles (2005), and
Queen and Queen (2004) not all tension is necessarily bad or unhealthy. The negative or
unhealthy stress is referred to as distress and the stress that is considered positive and
healthy is known as eustress.

Techniques identified included healthy attitudes, proper nutrition, exercise,

relaxation/sleeping/taking breaks, meeting the source of stress head on, set
limit/goals/priorities, increase qualifications/skills, and building a strong family life.
However, only seventeen percent of the respondents felt the responsibility for stress
management lies with the individual rather than the organization (Crampton, et al, 2005).

Stress is harmful, that stress should be avoided, that the higher up in the
organization, the greater stress, that stress is a male dominated phenomenon, that
superintendents experience excessive stress, and that there is only one right way to cope
with stress (Gates &Gmelch, 1998). The realities, according to Gates and Gmelch (1998)
and Lyles (2005) are that some stress is positive and necessary.Stress is a way of life and
is an important step in rising to the challenges of a leadership position.

Stress has been defined and described by many researchers (Lazarus

13
&DeLongis, 1983; Oxington, 2005; Sapolsky, 2004; Selye, 1956; Storch&Panzerella,
1996). Sapolsky defined stress in his book, Why Zebras Don’t Get Ulcers (2004) : “A
stressor is anything in the outside world that knocks you out of homeostatic balance and
the stress response is what your body does to re-establish homeostasis”
In the lives of most individuals stress has been identified as a constant condition.
Stress affects the life and functioning and therefore there has been an importance of stress
as a research topic (Abdollahi, 2002).

Academic stressors among students have long been researched on, and researchers
have identified stressors as too many assignments, competition with other students,
failures, lack of pocket money (Fairbrother and Warn, 2003)poor relationships with
other students or lecturers, family or problems at home.

Clinical Stressors They also experience stress in clinical area pressure in

procedure performance, fear of committing a mistake, time pressure, dealing with
different and difficult patients. Lack of experience, fear of making mistakes, discomfort
at being evaluated by faculty members, worrying about giving patients the wrong
information or medication and concern about possibly harming a patient are just a
few of the stressors for student nurse.

Personal stressorsare events or conditions that occur in a person's life that may
adversely impact on the individual's or their family's health or wellbeing. A stressor may
occur directly, such as personally experiencing a serious illness, or indirectly, such as
having a family member with a serious illness.

Social stressorsAspects of the work itself can be stressful, namely work overload
and role-based factors such as lack of power, role ambiguity, and role
14
conflict. Threats to career development and achievement, including threat of
redundancy, being undervalued and unclear promotion prospects are stressful.

Psychological studies have found it’s more stressful than just about many othersis
the academic program—including, some studies say, medical school. The reasons why
makes sense. Like with any medical program, you have to learn a huge amount of
information fully and quickly, in addition to juggling personal/family responsibilities.
The clinical experience on top of all this, though, is what makes nursing students stand
apart. After classes, after homework and studying, after taking care of your kids or
parents or both, you have clinical, which can demand all of your mental, physical, and
emotional energy.

A descriptive cross-sectional study was carried out to determine the type of stress
and coping strategies among nursing students.

An even worse scenario could be if they stay in theirjobs, the potential for fatigue,
burnout, and depression, which might result in symptomsaffecting their physical, mental,
and emotional health (Demerouti, Bakker, Nachreiner, &
 According to Gianakos (2002), Nelson and Burke (2002), and Iwasaki, Mackay,
and Mactavish(2005) reported research results have been mixed with gender being a
predictor of copingskills for occupational stress. Women tend to exhibit independence
and resilience to copeunder work pressure; even while they risk loss of social support,
through isolation and thepossibility of internalizing failures (Bhatnagar, 1988; Long,
1989; Nelson & Burke, 2002;

Individuals must, to some extent, find methods for dealing with stress in their own
way. There is a tendency toward similarities in methods used to increase the ability to
cope with stress.

15

According to Marino (1997) the mark of a great CEO is how they cope with and
manage stress. He offered signs and signals of stress including restlessness, irritability,
prolonged fatigue, difficulty concentrating, lack of interest in recreation, anxiety,
excessive work hours, taking excessive work home, increased smoking and or drinking,
and loss of perspective.

Marino (1997) and Lyles (2005) concurred not all stress is bad; it can force positive
change, and is the basic ingredient of competition.

The key is to recognize the right balance of stress and stress management skills
needed to perform optimally. According to Sapolsky, (2004) also has explained how
anticipation of a stressful event can become a source of stress. Surprisingly, the body
reacts in the same predictable way to an actual stressing event as it would to an
anticipated stressing event (Sapolsky, 2004)

Sapolsky, (2004) also has explained how anticipation of a stressful event can
become a source of stress. Surprisingly, the body reacts in the same predictable way to an
actual stressing event as it would to an anticipated stressing event (Sapolsky, 2004).
Commonly accepted definitions of stress have also been provided by earlier researchers,
such as (Selye, 1956; and Lazarus &DeLongis, 1983)

According to Selye (1956) stress is defined as any reaction of the body to a

demand. Demands can be anything ranging from physical injury or tension to extreme
heat or cold. Stressors are either internal or external stimuli that an individual believes to
be demanding.

According to Marks (1977) people seem to find the time and energy for anything
they are highly committed to and often feel more energetic after having done it. Thus the
human resources of time and energy are flexible and because
16

of that multiple role involvement need not result in role strain.

According to Sieber (1974) went even further, arguing that being involved in
numerous roles which is also termed as, role accumulation, has many rewards. These
rewards include rights and privileges that come with the role, resource for status
enhancement and role performance, personality enrichment and ego gratification and
social security.

Schein (1970) observed that instead of treating the individual as a separate entity
against the organization it is better to consider integrating him or she into various groups
which show a pattern based on competition, cooperation or indifference towards one
another. Studying the behavioral patterns and predispositions for individual employees in
specific work groups, may be helpful in improving the functioning of an organization.
 Stress management is a practical guide for the treatment of stress. It focuses on
stress reduction for effective adjustment of people generally;people experience all kinds
of stress: physical stress, social stress, academic stress, personal stress and others.

The available research indicates that the prevalence of stress is increasing among
students studying in higher education. Issues such as student retention and student
progression are becoming increasingly important for all universities.

There are a significant number of studies that have examined stress and this paper
critically reviews that research and identifies several issues that as yet
17

have not been explored.

Based on the findings from previous studies, both stress and anxiety levels are
expected to increase for nursing students when they begin their first clinical training if
they do not receive any interventions

Nursing students in the Biofeedback Group were able to maintain the same level
of stress over the 5-week period even though they experienced more stressors and
demands from their new clinical training. Nursing students in the Control Group had a
significant increase in their stress level over the same period.

With clinical training being one of the most vital components of the nursing
education, it is imperative that nurse educators continue the effort to help nursing
students manage their stress and anxiety during this important process.

The better the nursing students can manage their stress, the more successful they
can be in their clinical training.
 Ultimately, the more psychologically healthy the nursing students are, the more
likely they will flourish and graduate to become productive and contributing members of
the nursing profession.

Implication it is very important for nurse educators to help nursing students

manage their stress and anxiety in order to prevent additional problems.

Ross et al. found that nursing students who experience high stress tend to be
depressed.High stress and anxiety in nursing students also negatively affect learning and
academic performance by impeding memory, concentration, and

18

problem solving skills.

High perceived stress levels and lack of effective coping skills could be a barrier
to achieve the challenges of profession. Keeping this in mind, a study was conducted to
find out the level of stress and coping strategies used by nursing interns of National
Institute of Nursing Education, PGIMER, Chandigarh.

Students were found to cope up stress by using various coping strategies like
avoidance, transference, problem solving and optimism. It is recommended that to have
stress reduction among students, nurse educators should find out the most stressful areas
and give a serious thought to encourage the use of healthy coping strategies to improve
the productivity of students in nursing.

Skills in adaptive coping can be learned and enhanced to reduce psychological

distress and improve wellbeing. Coping effectiveness training (CET) improves people’s
skills in identifying and assessing stressful situations and in finding and using appropriate
coping strategies and social support (Folkman and others 1991, Chesney and Folkman
1994, Chesney and others 1996). Stressors that seem overwhelming are broken into their
component parts, the changeable and unchangeable aspects are identified, and coping
strategies are tailored accordingly.

Changeable and unchangeable situations require different types of coping.

Problem-focused coping includes thoughts and actions aimed at those aspects of the
specific stressful situation that are changeable, whereas emotion-focused coping includes
thoughts and actions designed to address emotional reactions to
the stressful situation, particularly aspects that are unchangeable.
.19

CHAPTER 3

RESEARCH DESIGN AND METHODOLOGY

This chapter will discuss about the research locale, research design, respondents of the
study, sampling design, research instrument, data gathering procedure and statistical
treatment.

RESEARCH LOCALE

The researchers will conduct the study in the selected schools in Zamboanga City.
These schools are coded as School A, School B, andSchool C. School A is a private
sectarian school in Zamboanga City, Philippines. It is located at R.T. lim Boulevard. The
college owned and administered by the Religious of the Virgin Mary (RVM).

School B holds approximately 20% of all college enrolment in region- lX

Western Mindanao. It has eight campuses which include in the main campus in barangay
Tetuan, City campus, Cabatangan Campus, PasonancaCampus,Vaterance Campus, High
School Campus in Cov. Alvarez St.Barangay zone-lll, PoblacionIpil,
ZamboangaSibugay. The university uses its official name in spanish and
chavacanolanguages.School B was founded on October 12, 1948 by Arturo Eustaquio,
Sr.

School C is an international co-educational day and boarding school associated

with the Episcopal Church in the Philippines. It has campuses in different locations
throughout the Philippines: School C Manila in Brgy. Mamplasan, Biñan (Main
Campus); School C Baguio, and School C Subic.

20

RESEARCH DESIGN

This study will utilize a descriptive research. According to International Journal

of Mental Health Systems volume 4.Descriptive research is defined as a research method
that the characteristics of the population or phenomenon that is being studied. In other
words, descriptive research primarily focuses on describing the nature of a demographic
segment, without focusing on “why” a certain phenomenon occurs. It “describes” the
subject of the research, without covering “why” it happens. The methods involved range
from the survey which describes the status quo, the correlation study which investigates
the relationship between variables, to developmental studies which seek to determine
changes over time.

RESPONDENTS OF THE STUDY

Table 1

Summary of Respondents

N= 101
 Respondents of the study Number of Respondent

School A BSN Level4 23

School B BSN Level4 43
School C BSN Level4 35
Total of respondents 101

21

Table 1 shows the summary of the total number of respondents. There are twenty-
three (23) of BSN level 4 of School A, forty three (43) of BSN level 4 of School B and
Thirty five (35) OF BSN level 4 of School C. The table shows that there are a total of one
hundred one (101) of BSN level 4 who will be the respondents of the study.

SAMPLING DESIGN

The researchers will use total enumeration or the universal sampling design. Total
enumeration sampling is a type of purposive sampling technique that involves examining
theentire population (i.e., the total enumeration) of BSN Fourth year students that have a
particular set of characteristics specifically experience, knowledge, skills and exposure to
an event that causes behind the situation.http://dissertation.laerd.com/total-population-
sampling.php

RESEARCH INSTRUMENT
 The researchers will modify the questionnaire. Which was lifted from
https://www.scribd.com/doc/19975719/STRESS-MANAGEMENT) and
(http://repository-tnmgrmu.ac.in/35/1/jancyracheldaisy.pdf). There is no need for the
researchers to formulate and pass the survey questionnaire to the experts for the approval.
The survey questionnaire has three parts. Part 1 contains the respondent’s profile.
Part 2 contains the possible cause of stress. Part 3 contains the stress management.

22

DATA GATHERING PROCEDURE

The researchers will prepare three (3) letters. The first letter will be addressed to
the deans of the Nursing Program in the selected schools in Zamboanga City.

The purpose is to get the total population of the Bsn Level 4 and finalize the total
number of respondents. The second letter is for the Dean of the Nursing Program to ask
permission to conduct survey to the Bachelor of Science in Nursing level four (4)
students of the selected schools in Zamboanga City. The third letter is for the respondents
of the three schools where the researchers will conduct the study.

STATISTICAL TREATMENT

The following statistical tools will be used to treat the data:

1. WEIGHTED MEAN

f- represents the frequency or total response from the respondents.

n- total number of respondents.

This denotes the average response or perception of respondent or qualitative

response. In computing the arithmetic mean, the researchers will use the weighted
mean. The statistical mean is the average of measurements in a set of data.
 All gathered data were tabuled and group by variables. Then, they were
analysed, computed, organized and then qualitatively interpreted by way of
weighted mean using the formula.

23

Weighted mean =∑ fixi

N
fi= Frequency of responses
xi= Weight
N= Number of respondents

Xi represents the computed mean. ∑fixi represents the sum of product of the
option and individual frequency. And N is total number of respondents.

2. ANALYSIS OF VARIANCE

Analysis of variance, or ANOVA, is a strong statistical technique that is used to

show difference between two or more means or components through significance
tests. It also shows us a way to make multiple comparisons of several population
means. The Anova test is performed by comparing two types of variation, the
variation between the sample means, as well as the variation within each of the
samples.

SS TOTAL = ∑X2 total –N total X2 Group

SS Within = ∑X2 total - = ∑N group X2 Group

SS Between = ∑N group X-2 Group –N Total X-2 total

Mean : Square

MS Between = SS betweendf between = k-1

df between df within = N total –k
MS Within = SS within The F Ratio
df within F = MS between
MS within

24
SURVEY OF COLLEGE NURSING STUDENTS
STESSOR AND MANAGEMENT

Part l. Respondents Profile

Name: Age: □ 19 □ 20 □ 21
(Optional) □ 22 □ 23 □ 24
□25 and above

School: Sex: □ Male □ Female

Course/Year level:_________________________________________________

ETHNICITY
□ Zamboangeño □Tausug □Visayan □others (please specify) ___________

Part II. STRESSORS

Direction: Put a check (✓) on the column which best describes your response. The
columns are coded as follows.

Rating Scale

4 Severely Stressful (SS)

3 Moderately Stressful (MS)

2 Mildly Stressful (MS)

 1 Not at all Stressful (NAAS)

ACADEMIC STRESSOR
4 3 2 1
SS MS MS NAAS
1. Passing written examinations
2. Passing oral examinations
3. Participating in classroom discussions
4. Completing seat works
5. Submitting requirements
6. Beating requirements deadlines
7. Completing assignments
8. Searching for reference materials
9. Completing requirements
10. Passing unannounced examinations
11. Dealing with unannounced graded recitations

12. Understanding classroom discussions

13. Preparing for an examination
14. Passing a removal examination
15. Passing practical examination
16. Writing of assignments
17. Participating in extension activities
18. Attending make-up classes
19. Making sense of too many vacant periods
20. Managing too little vacant periods
21. Moving from one classroom to the other
22. Moving from one building to the other
23. Commuting to and from the school
24. Attending meetings of students organizations
25. Attending school programs

CLINICAL STRESSORS
4 3 2 1
SS MS MS NAAS
1. Doing beside care to the patient
2. Finishing charting on time
3. Too many patients to handle
4. Preparations and submission of requirements
5. Patient with infectious disease
6. Lack of hospital facilities and equipments
7. Relationship with the patient
8. Early dismissal of the clinical instructor
9. Relationship with the co-students
10. Lack of cases in the hospital
11. Relationship with the clinical instructor
12. Wrong procedure performed to the client
13. Relationship with the staff nurse
14. Unfamiliar health care setting in the hospital
15. Relationship with the physician
16. Mix cases of patients due to lack of rooms
17. Recognition of some evident changes with
regards to patient’s symptoms

PERSONAL STRESSOR
4 3 2 1
SS MS MS NAAS
1. Budgeting of allowance
2. Dealing with unexpected expenses
3. Saving money for projects
4. Handling expectation of the parents
5. Handling self-expectation
6. Dealing with family problems
7. Handling expectation of relatives
8. Handling expectation of siblings
9. Handling expectation of friends
10. Handling expectation of teachers

SOCIAL STRESSOR
4 3 2 1
SS MS MS NAAS
1. Relationship with classmates
2. Bearing with distractions in or outside the
classroom
3. Relationship with schoolmates
4. Bearing with classrooms that have poor or no
lighting
5. Relationship with dutymates
6. Bearing with over crowded classrooms
7. Relationship with the teachers
8. Bearing with classrooms that have poor or no
ventilation
9. Dealing with strict teachers
10. Bearing with noisy classrooms
11. Coping with teachers’ unfair treatment of students
12. Coping with teachers’ teaching methodologies
13. Competing with classmates

(https://www.scribd.com/doc/19975719/STRESS-MANAGEMENT)

Part III. STRESS MANAGEMENT

Read the items carefully and put a tick mark against each item on the column given on
the right side.

Rating Scale

5 Always

4Often
 3Sometimes

2Seldom

1Never

Academic Stress Management 5 4 3 2 1

1. I use a regular study habit.

2. I Study harder subjects first.

3. I don’t try to get too much of comfort ness in study

place.
4. I pay attention to subjects.

5. I Study continuously without intervals.

6. I Study from simple to complex subjects.

7. I am not aware of best time to study in a day.

8. I Practice frequent review plan

Clinical Stress Management 5 4 3 2 1

1. I prioritize all data’s immediately.

2. I gather all datas in a timely manner.

3. I try to implement one intervention after the other

according to the priority.
4. I identify all possible solutions.
5. I make a plan of action as per set goal.

Personal Stress Management 5 4 3 2 1

1. I find something good in what is happening

2. I regulate my sleep patterns well

3.I increase my strength and stamina

4.I improve my ability to concentrate

5. I enhance my self esteem and confidence

Social Stress Management 5 4 3 2 1

1. I get spiritual support.

2. I Ventilate feelings with close friends.

3. I Ventilate feelings with close family.

4. I Complain the problems to my superiors

immediately before analyzing it
5. I relax myself in my own way.

(http://repository-tnmgrmu.ac.in/35/1/jancyracheldaisy.pdf)