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CHAPTER 1
INTRODUCTION
Globally,
nurses
had
normal
experience
of
being
times
when
events
conspire
and
the
bodys
stress
has
been
defined
as
barrier
to
concentration,
in
managing
their
time
and
study
and
may
lead
to
with
clinical
duties,
makes
it
impossible
for
these
most
common
decisions,
stressors
continuous
are
time
changes
and
pressures,
economic
workload,
mistakes
making
at
work
grades,
long
hours
of
studying,
another
stressor
among
stress
is
important
for
nursing
students
since
to
save
lives
and
studying
hard
to
become
future
stressors
that
cause
them
to
become
stressed.
If
they
let
stressors
they
encounter,
collaborate
with
their
lives
people
outside
and
the
pursue
job,
supportive
supporting
relationships
fellow
nurses
with
and
and
continuous
quizzes
everyday
are
some
of
the
going
out
with
friends
and
taking
the
time
for
leisure
activities.
Based on the above premise, this study was conducted to
determine how levels of stress and stress management techniques
are
utilized
by
student
nurses
of
Saint
Gabriel
College
of
Nursing.
STATEMENT OF THE PROBLEM
This study was conducted to determine the levels of stress
and stress management techniques utilized by student nurses of
Saint Gabriel College of Nursing.
Specifically it will have the following objectives:
1. To
find
nurses
out
such
the
as
demographic
age,
gender,
profile
year
of
student
level,
marital
and number
of subjects
2. To assess the level of stress among student nurses
of Saint Gabriel College of Nursing.
3. To
identify
the
stress
management
techniques
THEORETICAL FRAMEWORK:
has
theories.
some
Roy
characteristics
borrowed
and
of
expanded
stress
on
and
theories
interaction
from
other,
own
respond
with
standard
of
ordinary
the
range
adaptive
of
stimuli
response.
to
Stress
which
can
for
Roy
this
study,
stress
refers
to
the
physiological
and
CONCEPTUAL PARDIGM:
The conceptual framework shows the relationship between the
independent
and
dependent
variables.
In
this
study,
the
variable
intervening
are
variable
the
are
stress
the
management
personal
while the
techniques.
characteristics
of
The
the
Independent Variable
Dependent Variable
LEVELS OF STRESS
High
Moderate
Low
STRESS MANAGEMENT
TECHNIQUES
Moderator Variable
PERSONAL
CHARACTERISTICS
E.g. Age
Gender
Year level
Marital status
Residence
Allowance per week
Number of subjects
Hours of Sleep
Figure
1:
Figure
1:
The
Schematic
Diagram
showing
the
NULL HYPOTHESIS:
There is no significant difference between stress and stress
management techniques utilized by student nurses of Saint Gabriel
College.
ASSUMPTION:
All nursing students experience stress.
SCOPE AND LIMITATIONS
The study was focused on describing the relationship
between the levels of stress and stress management techniques
utilized by regular Bachelor of Science in Nursing Students,
enrolled
in
the
Saint
Gabriel
College.
Data
which
will
be
This study will benefit those nursing students who have been
experiencing stress under their academic/clinical program. The
result
of
this
study
will
help
them
identify
the
causes
of
Clinical Instructors
This study will set as a guide for instructors in planning
activities and strategies that would help students in controlling
and avoiding stress when involved in the academic or clinical
field.
School Administrators
The study will serve as a basis to encourage them to
support and approve school activities which will benefit the
students well-being.
Guidance Counsel
This study will serve as a basis for guidance counselors to
develop activities or programs for those students to release
their tension on stress and help them relieve the symptoms of it.
Future Researchers
For future researchers, this study will benefit as a source
or reference for your future outputs and will provide information
10
about
the
levels
of
stress
and
stress
management
techniques
DEFINITION OF TERMS:
The following terms are defined for clarity:
Level of stress refers to the severity of the manifested
physical or mental tension resulting from factors that alter an
existing equilibrium (Mosby, 2009).
In this study, this refers to the state or condition of
restrictions, demand, or constraints of nursing students. This
will be measured by a 30 items questionnaire by Dangan (2006)
which is modified by the researchers about manifestations of
stress and scores will be categorized as 0 for (never) did not
experience;
this
study
stress
refers
to
the
feeling
that
is
11
Management
set
of
techniques
and
programs
lives
by
analyzing
the
specific
stressors
and
taking
practicing;
for
rarely
practicing
for
sometimes
12
CHAPTER II
REVIEW OF RELATED LITERATURE
This chapter presents the literatures reviewed, which may be
utilized in defining the methodology and/or interpretation of
data. Literature reviewed includes local and foreign books, local
and foreign researches, articles, and internet materials.
13
Local Literature:
Coping with Stress
For licesned Apruebo, Roxel, A. The Science of Psychology,
1st Edition. Philippines: Educational Publishing House Inc. 2009.
Process of Stress Stressful events may occur as sudden,
unexpected, potentially life-threatening experiences or traumas
qualify as catastrophic events, such as physical or sexual
assault, military combat, natural disasters, explosions, plane
crashes and accidents fall into this category. Life changes and
strains include marital separation, illness in the family,
difficulties at work, moving to a new place, and other
circumstances that create demand with which people must adjust.
Chronic stressors continue over a long period of time like living
due to adverse economic conditions, residing in a high-crime
neighborhood, being the victim of discrimination, and even
enduring years of job pressures. Daily hassles involve
irritations, heavy traffics, pressures, and annoyances that may
not be major stressors by themselves but such effects aggravate
to become significant. This frustration of daily commuting in
heavy traffic can become so intense for some drivers display a
pattern of aggression. People reactions to stressful events or
stressors, such as catastrophic events, life changes and strains,
chronic stressors, and daily hassles are contributing components
14
The
is masaya,
which
is
really
more
of
an
externalized
wakes
are
notorious
for
its
merry-making,
but
that,
friends
Philippines
can
to
overcome
also
be
stress,
social
counterproductive
pressures
in
with
way
the
the
we
15
situations
stress
abdominal
by
complaining
pains,
accompanied
about
by
recurring
dizziness,
headaches,
nausea,
or
fatigue.
16
abused
drugs
are
metaphetamines,
which
are
uppers
or
said
Filipinos
have
their
own
natural
coping
said
after
some
being
mental
treated.
patients
Of
could
course,
for
function
example,
normally
a
bank
17
He further states
Rena Lawrence have done extensive study in the area of stress and
burnout in nursing. A recent article by these authors reads as
follows:
Common
stressors
for
nurses
are
environmental
18
lead
to
burnout
stressor,(1980:912).
faster
Smyth
than
in
any
her
other
single
book, Surviving
adds
final
dimension,
Disillusionment
and
burnout
19
Scheduling:
20
21
22
23
24
25
put the body on high alert. The adrenal glands do not attempt to
distinguish between negative or positive excitement. Once the
crisis is over, the excess hormones need to be dissipated out of
the bloodstream. This is where exercise plays a critical role.
Regular physical activity helps to burn these extra chemicals so
your body can return to normal. Imagine their buildup if you tend
to live in a period of stress day in and day out. In addition to
its positive impact on stress, physical activity provides us with
numerous other benefits, including better resistance to illness,
stronger bones, more energy and stronger muscles. What activity
is best? The best form of exercise is the one you enjoy and find
the most convenient. These are the two biggest reasons why most
of us fail to be consistent in following an exercise program.
First, we either lose interest in the activity because we dont
really get a lot of satisfaction out of doing it. I have had
beginning lessons in almost every sport two or three times for
some.
26
27
28
29
30
31
32
al.
Fundamentals
of
Nursing,
7th
Edition.
the
person
responds
to
faces
stressors,
responses
are
referred
to
as
be
coping
broadly
stressors.
Internal
stressors
originate
within
33
at
predictable
times
throughout
an
individuals
life.
prevent
or
reduce
stress.
Situational
stressors
are
spiritual
consequences.
Usually
the
effects
are
mixed,
Selye
(1956-1976)
defined
stress
as
the
non-specific
response of the body to any kind of demand made upon it. Schafer
(2000)
defined
stress
as
the
arousal
of
mind
and
body
in
34
often
than
not,
not
really
stress.
According
to
the
bad
tummy
or
feeling
sick,
back
pain,
trembling,
change
our
mental
status
such
as
feelings
of
panic
or
35
lacking
confidence,
and
not
wanting
to
socialize.
Thats why this article sited 5 Save Your Soul Strategies: a.)
Cognitive
Behavioral
Therapy
(CBT),
b.)
Stress
management
have
1997,
1999;
identied
Timmins
specic
and
academic
Kaliszer,
and
2002a;
clinical
Tully,
stressors
academic
stressors
for
students in their nal year and these include not being treated
as an adult learner, confusing assignment guidelines and the
amount
of
self
directed
learning
(Hamill,
1995),
nancial
36
skills,
negative
attitudes
of
ward
staff
and
extracurricular
factors
rather
than
from
the
educational
37
course
of
training.
Accordingly,
there
is
need
of
(Lazarus
and
Folkman,
1984).
Now
considered
period,
there
is
little
consensus
within
the
data
(Begley and Glacken, 2004; Lees and Ellis, 1990; Randle, 2003;
Sasat et al.,
2002). Different aspects of self-esteem (social, personal and
general) in nursing students were investigated across three years
of nurse training programmes in two countries and no relationship
38
evidence.
Randle
(2003)found
that
although
the
fallen
to
the
point
that
95%
of
the
students
perceived
the
end
of
their
education
programme,
although
their
39
(http://www.foxbusiness.com/personal-finance/2011/03/31/stresscollege-causes-combat/#ixzz2MvQeL4NX)
College Stress
Its no secret that many college students spend most of
their time on campus stressed out. Balancing classes, tests,
projects, extra-curricular activities and work is enough to make
anyone feel overwhelmed, especially with final exams right around
the corner.
College life has become a lot more competitive--its much
harder to get into schools, its gotten a lot more expensive,
says Elizabeth Scott, stress management expert. There are a lot
of things that are factors that have made society more stressful,
and that really translates to college life as well.
Having stress in your life is unavoidable, but there are steps
students can take to mitigate its effects on their lives and
health.
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41
change right there, Scott says. At the same time, they have a
lot of new things they have to navigate--not just getting around
campus and living on their own, but choosing their classes,
choosing what direction they want to go in their lives and
choosing who to hang out with.
Striking a balance between school and personal life takes
discipline and strong time-management stills, something that not
every student comes equipped with as a freshman.
We have more ways to help ourselves and more ways to distract
ourselves, says Dr. Gregory Jantz , psychologist and author of
How to De-Stress Your Life. We actually create more stress
because we end up not being good time stewards.
Relationships can also be a source of stress for students. Wishywashy friends who are supportive one minute and negative and
insulting the next adds unnecessary stress, and according to
Scott, can be worse for your health than having a completely
conflicted relationship with an enemy.
Knowing who is toxic to you and safe guarding a little bit
[can] keep the stress from happening, she says. Theres going
to be conflict in every relationship at some point. Working on
conflict resolution skills and communication skills in yourself
can really help you manage the conflicts that come along.
42
Effects of Stress
A constant state of stress can affect all aspects of
students bodies: physical, mental, emotional, cognitive, and
behavioral functions can go haywire under duress.
Scott points out that stress has a profound effect on your immune
system and your state of equilibrium. Prolonged stress and
sleepless nights can compromise your health, adding another thing
for a student to stress about.
When people are stressed, they tend to not take care of
themselves as well, says Scott. They dont do healthy behaviors
like eating right, exercising and even going to the doctor as
much as they need to. Youre attacking your health on several
different fronts.
Stress can also impact relationships in your life, whether
its with friends, family, classmates or teachers. Jantz explains
that stress distorts emotions, and you may be more irritable and
defensive as a result.
If you are stressed out, you are not going to be able to
form these bonds or you're going to have problems maintaining
relationships, says Rubel.
Chronic Stress
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44
45
(http://onsopcontent.ons.org/Publications/StudentVoice/Nov04/arti
cle5.html)
Stress Management is the key during Nursing School
One important thing that I always tell my students is to
take care of them. If they cannot take care of themselves, how
will they be able to take care of the clients they encounter
throughout their nursing career? Nursing is the one profession
with the most "dropouts." Nurses change careers because of high
stress levels or "burnout," which is synonymous with total
exhaustion.
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nursing school, advice that you will fall back on throughout your
nursing career. I have had many incredible mentors throughout my
nursing career. I would not be where I am today, a clinical
instructor of holistic adult health, without these mentors. Visit
your teachers, and ask for feedback about how you are performing.
Teachers can help with developing your clinical assessment
skills. Use your health resources at school. Visit the skills
laboratory to gain competence in your nursing skills. Visit your
coordinator of learning enhancement to discuss test taking
strategies or help establish goals to reduce stress. Establish
supportive relationships with your fellow students. You can help
each other to deal with stress, encourage each other, and provide
emotional support during those stressful times in nursing school.
Do plan ahead for the holiday overload of stress. Make room
in your calendar for those important people in your life. Turn
down requests and people who make demands on your life. Get
plenty of rest and sleep during the holidays, and take care of
yourself (Davis, 2004).
(http://www.medicalnewstoday.com/releases/160265.php)
Significant Sleep Deprivation and Stress Among College Students
Stress about school and life keeps 68 percent of students
awake at night - 20 percent of them at least once a week. Stress
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Team perspective:
SYNTHESIS:
Stress
Stress as defined by Arnold Burnout as exhaustion of
physical and emotional strength. It plays a great part not only
on students but in every individuals daily living. He further
states that sustained, intense stress decreases productivity and
55
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Chapter III
Methodology
This chapter will present the research design, sampling
procedure, description of subjects and description of research
locale.
RESEARCH DESIGN
In this study, the design that was applied is the
correlational descriptive research which examines the extent of
the relationship between the levels of stress and stress
management techniques utilized by Bachelor of Science in nursing
students of Saint Gabriel College. The study will determine if
the relationship of variables will have a direct or indirect
relationship.
SAMPLING SIZE AND POPULATION
The population of regular and irregular Bachelor of Science
in nursing students from 1st year to 4th year enrolled in the
school year of 2012-2013 is 225, excluding the researcher. The
sample size will be 69.
Sample size will be computed using the Sloven Formula with
90% level of confidence where in 10% error will be used.
59
n=
N
1+ N (e)2
n=
225
Whereas:
2 = 69
1+225 ( 0.10 ) N= Population
e= Percentage of
Error
n= Sample Size
SAMPLING METHOD:
The sampling method that was utilized in this study was the
non-random sampling method. The sampling design of which will be
snowball or networking sampling design. The researcher will
gather 69 respondents from different year levels which will be 17
students from each class, approaching those students who meet the
inclusion criteria then refer to other students who meet the
criteria as well. The students of which will be respondents
should be on their free time and become available to the
researcher. There will be no manipulation or experimentation that
will be involved.
DESCRIPTION OF SUBJECTS
60