STRESS MANAGEMENT PERFORMED BY THE LEVEL III NURSING STUDENTS OF NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY WITH REGARDS TO THEIR CLINICAL DUTIES: BASIS FOR A PROPOSED
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STRESS MANAGEMENT PERFORMED BY THE LEVEL III NURSING STUDENTS OF NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY WITH R...
Description
STRESS MANAGEMENT PERFORMED BY THE LEVEL III NURSING STUDENTS OF NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY WITH REGARDS TO THEIR CLINICAL DUTIES: BASIS FOR A PROPOSED EFFECTIVE QUALITY NURSING CARE
An Undergraduate Thesis Presented to the Faculty of the College of Nursing Nueva Ecija University of Science and Technology
In Partial Fulfillment of the Requirements for the Subject Research I
1
By:
Danica Paula Bianca D. Castillo Mark Anthony S. Castillo Gerly P. Carrasco Jayson A. Cardenas Alona Joy G. Mandia
April 2009
APPROVAL SHEET This thesis entitled “Stress Management Performed by the Level III Nursing Students of Nueva Ecija University of Science and Technology with regards to a
Proposed
Effective
Quality
their Clinical Duties: Basis for Nursing
Care”
prepared
and 2
submitted by Danica Paula Bianca D. Castillo, Mark Anthony S. Castillo, Gerly P. Carrasco, Jayson A. Cardenas and Alona Joy G. Mandia in partial fulfillment of the requirements for the degree of Bachelor of Science in Nursing has been examined for oral examination.
ZENAIDA A. VILLARIAZA Ph.D Adviser
Accepted
and
approved
in
partial
fulfillment
of
the
requirements for the degree of Bachelor of Science in Nursing.
EPPIE D.C. BUGARIN RM, RN, MAN Dean, College of Nursing
STRESS MANAGEMENT PERFORMED BY THE LEVEL III NURSING STUDENTS OF NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY WITH REGARDS TO THEIR CLINICAL DUTIES: BASIS FOR A PROPOSED EFFECTIVE QUALITY NURSING CARE THESIS ABSTRACT 3
This study is all about the “Stress Management Performed by the Level III Nursing Students with Regards to their Clinical Duties: Basis for a Proposed Effective Quality Nursing Care”. The
descriptive
method
of
research
was
utilized
and
the
questionnaire serves as the principal data gathering instrument. There are 267 respondents who fill up the survey questionnaire. The results of the questionnaire were tabulated and interpreted from which the findings and conclusion were drawn. Summary of the findings The
following
are
the summary of findings of the study
based from all the data presented, analyzed and interpreted in chapter IV. 1. Majority of the respondents are in 19 years of age. 2. Majority of the respondents are female. 3.
The
researchers
different
stressors
used
sixteen (16) items to enumerate
encountered
by
the
level
III
the
nursing
students with regards to their clinical duties namely: Doing bedside care to the patient with weighted mean equivalent to 3.60 was interpreted as “Often”; Finishing charting on time with weighted mean equivalent to 3.89 was interpreted as “Often”; Handling too many patients with weighted mean equivalent to 3.67 was
interpreted
as
“Often”;
Preparation
and
submission
of 4
requirements interpreted
with as
weighted
“Often”;
mean
equivalent
Patients
with
to
serious
3.67 cases
was with
weighted mean equivalent to 3.62 was interpreted as “Often”; Lack of hospital facilities and equipments with weighted mean equivalent to 3.43 was interpreted as “Often”; with
the
patients
interpreted with
as
weighted
“Sometimes”;
with
Relationship
weighted mean equivalent to 2.94
was
“Sometimes”; Relationship with the co-students mean
equivalent
Relationship
with
to
3.01
was
the
Clinical
interpreted Instructor
as with
weighted mean equivalent to 2.97 was interpreted as “Sometimes”; Relationship with the staff nurse with weighted mean equivalent to 3.01 was interpreted as “Sometimes”; Relationship with the physicians with weighted mean equivalent to 2.79 was interpreted as
“Sometimes”;
Relationship
with
the
patient’s
family,
relatives and visitors with weighted mean equivalent to 2.99 was interpreted as “Sometimes”;
Recognition of some evident changes
concerning patient’s symptoms with weighted mean equivalent to 3.29 was interpreted as “Sometimes”; Mixed cases of patients due to
lack
of
rooms
with
weighted
mean
equivalent
to
3.31
was
interpreted as “Sometimes”; Unfamiliar healthcare setting in the hospital with weighted mean equivalent to 3.21 was interpreted as
“Sometimes”;
And
lastly
wrong
procedure
performed
to
the
patients with a weighted mean equivalent to 3.01 was interpreted
5
as “Sometimes” also with the total average mean of 3.28 was interpreted as “Sometimes”. 4.
The
researchers
used
thirty
(30)
items
to
determine
the
different stress management performed by the respondents with regards to their clinical duties namely: Thinking positive and being confident in whatever you do with weighted mean equivalent to 4.23 was interpreted as “Always”; Taking time to rest and relax with weighted mean equivalent to 3.78 was interpreted as “Often”; Spending time with your love ones with weighted mean equivalent to 3.84 was interpreted as “Often”; Praying to God with
weighted
“Always”;
mean
equivalent
Watching
movies
and
to
4.66
programs
was on
interpreted television
as with
weighted mean equivalent to 3.71 was interpreted as “Often”; Daydreaming
with
weighted
mean
equivalent
to
2.98
was
interpreted as “Sometimes”; Listening to music, singing,
and
dancing with weighted mean equivalent to 3.73 were interpreted as “Often”; Enjoying pleasurable activities with weighted mean equivalent to 3.31 was interpreted as “Sometimes”; Knowing your limits and stick to them with weighted mean equivalent to 3.85 was interpreted as “Often”; Engaging into sports with weighted mean equivalent to 3.31 was interpreted as “Sometimes”; Simply stay at the corner of your room and crying with weighted mean equivalent favorite
to foods
2.27
was
with
interpreted
weighted
mean
as
“Seldom”;
equivalent
Eating to
3.88
your was 6
interpreted as “Often”; Using the internet and playing online games with weighted mean equivalent to 3.89 was interpreted as “Often”;
Calling
friends,
etc...
or
texting
with
your
weighted
family
mean
members,
equivalent
relatives,
to
3.90
was
interpreted as “Often”; Making yourself busy by doing household chores with weighted mean equivalent to 3.28 was interpreted as “Sometimes”; Ignoring the problem with weighted mean equivalent to 3.33 was interpreted as “Sometimes”; Getting angry and having mood
swings
with
weighted
mean
equivalent
to
2.86
was
interpreted as “Sometimes”; Laughing at it with weighted mean equivalent
to
3.79
assistance
to
the
was
interpreted
Clinical
as
“Often”;
Instructor
with
Asking
weighted
for mean
equivalent to 3.67 was interpreted as “Often”; Verbalization of feelings to fellow students with weighted mean equivalent to 3.64 was interpreted as “Often” ;Reasoning out or answering back with
weighted
“Sometimes”;
mean
equivalent
to
it
challenge
Taking
as
a
3.29
were with
interpreted weighted
as
mean
equivalent to 3.86 was interpreted as “Often”; Limiting your contact to the source of stress with weighted mean equivalent to 3.42
was
equivalent
interpreted to
2.67
as was
“Often”;
Cursing
interpreted
as
with
weighted
“Sometimes”;
mean
Drinking
alcoholic beverages and smoking with weighted mean equivalent to 2.18
was
interpreted
as
“Seldom”;
Taking
medication
as
a
reliever with weighted mean equivalent to 2.42 was interpreted 7
as
“Seldom”;
Doing
physical
exercise
with
weighted
mean
equivalent to 3.09 was interpreted as “Sometimes”; Accepting the reality
that
sometimes
it
merely
happens
with
weighted
mean
equivalent to 3.81 was interpreted as “Often”; Sleeping with weighted mean equivalent to 3.75 was interpreted as “Often”; Managing your time better with weighted mean equivalent to 3.99 was interpreted as “Often”; With the total average mean of 3.48 was interpreted as “Often”. Conclusions: Based on the findings of the study, the researchers arrived at the following conclusions: 1.
That
the
level
III
charting
on
time”
as
nursing the
students
greatest
consider
stressors
“Finishing they
have
encountered with regards to their clinical duties and the least one is the relationship with the physicians. Meanwhile, the rest of the stressors show that they can also affect the respondents somehow. 2. That the level III nursing students consider praying to God and thinking positive as the number one stress management they usually performed when they feel stress. While simply staying at the corner of the room and crying followed by drinking alcoholic beverages and smoking does not play much role.
8
3.
The
result
practice
in
of
the
study
rendering
stands
effective
benefit
quality
to
the
nursing
nursing
care.
The
identification of the possible cause and effect of stressors on the
level
III
nursing
students
will
provide
them
adequate
academic and clinical knowledge on stress. This study will serve as a guide to them on how to manage their stress with regards to their clinical duties. This will also provide information to the Clinical
Instructors,
healthcare
team
in
the
hospital,
and
school administrators on how they can help the students upon dealing
with
competent
stress
enough
in
properly
in
different
order
clinical
for
students
area
and
to
to
be
render
quality and effective nursing care to the patients. Recommendations: After the conclusions were drawn, the researchers of the study hereby recommended that: 1.
The students must develop not only their nursing skills but
also their ability on handling problems. 2.
The students must learn how to rest and relax.
3.
The
students
also
need
to
develop
their
good
working
relationship to others especially with the patients to avoid pro 4.
Proper
utilization
of
coping
mechanism
will
help
the
9
nursing students to manage their stress and be competent enough in different clinical area. blems that lead to create stressor. 5.
The Clinical Instructors must support their students all
the time to establish a harmonious and professional relationship with them and guide them in rendering quality nursing care to the patient. 6.
Doctors
and
Clinical
Instructors
as
well
as
the
staff
nurses should be invited at times as a resource person during ward
class
and
case
presentation
to
give
them
a
sense
of
recognition thereby improving good working relationship in the clinical area. 7.
The proper approach and continuous support of the staff
nurse and other healthcare provider must be present to help the students
cope
and
deal
with the possible problems that they
might encounter in the clinical area. 8.
Discussion for the most practical adaptation to prevent the
existence of excessive amount of stress in the individual should be
conducted
and
if
found
to
be
already
existed,
the
most
possible activities should be given to decrease the strength of stressors that could affect on physiological, psychological and behavioral make up of the individual. 10
9.
The college of nursing should conduct seminar workshops and
trainings
that
will
further
develop
the
student
ability
and
capacity to cope up with stress. 10.
The
future
junior
nursing
students
must
be
properly
equipped with enough knowledge in nursing for them to become confident. Hence, improper coping with stress will be lessened and prevented. 11.
Conducting
sample
frame
another should
study be
using
more
considered
to
variable arrive
and at
bigger a
more
comprehensive and meaningful conclusion.
ACKNOWLEDGMENT This
work
is
an
outcome
of
the
writers’
struggles
and
hardships for the completion of their college degree. This is to 11
express the writers’ grateful appreciation to all the people whose assistance helped them accomplish this study: Sincerest
and
profound
gratitude
is
extended
to
their
professor Zenaida A. Villariaza Ph. D. for her all out support and for her unselfish dedication as an educator, persistence and encouragement; To Mrs. Maura Usita their critic, for providing direction in
writing
the
study
and
for
painstakingly
editing
their
manuscript; To the librarians of the Nueva Ecija University of Science and Technology and Wesleyan University of the Philippines, for their
assistance
and
benevolent
response
on
the
researchers’
request to avail the rich resources in their library; To the students who serve as their respondents, for their willingness and cooperation during the conduct of this research; To all their esteemed friends, brothers and sisters, for their prayers and moments they have shared with the researchers which are worthy to treasure and cherish; To patience
their and
most
loving
undying
parents,
support
and
for their love and care, aspirations
to
give
the
researchers a brighter future; and 12
Most
and
foremost,
the
researchers
offer
praises
and
thanksgiving to our Almighty God, for lavishly equipping the researchers
with
divine
support
and
guidance,
knowledge,
and
skills. The Researchers
DEDICATION
13
With heartily
love
and
sincerity,
dedicated
to
the
this
humble
people
piece
whose
of
work
contribution
is is
significant in making this study a reality. To our mentors, for the great effort they have exerted in molding us to become well rounded and competent students of this institution. To our families, friends and fellow students, for their cooperation for the completion of this work and for their moral support
which
inspired
us
in
making
things
possible
and
in
pursuing our ambition. Above
all,
to
Almighty
God
who
continually
showers
His
infinite wisdom, blessings, and skills to the researchers.
Danica Mark Gerly Jayson Alona TABLE OF CONTENTS 14
CONTENTS
PAGE
TITLE PAGE
i
APPROVAL SHEET
ii
THESIS ABSTRACT
iii
ACKNOWLEDGEMENT
xi
DEDICATION
xiii
TABLE OF CONTENTS
xiv
LIST OF TABLES
xvi
LIST OF FIGURES
xvi
CHAPTER I: PROBLEM AND ITS SETTINGS Introduction …………………………………………………………………………………………………………1 Statement of the Problem …………………………………………………………………………5 Scope and Delimitation ………………………………………………………………………………6 Significance of the Study ………………………………………………………………………7 Definition of Terms ………………………………………………………………………………………9 CHAPTER II: THEORETICAL ORIENTATION AND REVIEW OF RELATED LITERATURES AND STUDIES
Theoretical Orientation ……………………………………………………………………………11 Conceptual
Framework
……………………………………………………………………………………12
Research Paradigm ……………………………………………………………………………………………13 Foreign Literature …………………………………………………………………………………………14 Local Literature ………………………………………………………………………………………………18 Foreign Studies …………………………………………………………………………………………………19 Local Studies ………………………………………………………………………………………………………20 Justification of the Studies
……………………………………………………………21 15
CHAPTER III: RESEARCH METHODOLOGY Method of Research …………………………………………………………………………………………22 Research Instruments ……………………………………………………………………………………23 Sources of Data …………………………………………………………………………………………………24 Statistical Treatment of Data ……………………………………………………………24 CHAPTER IV: PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA
Interpretation of the Study …………………………………………………………………27 CHAPTER V: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS Summary Findings ………………………………………………………………………………………………36 Conclusions ……………………………………………………………………………………………………………40 Recommendations …………………………………………………………………………………………………41 BIBLIOGRAPHY
APPENDICES
A. Sample Letter to the Dean B. Sample Letter to the Level III Coordinator C. Sample Letter to the Respondents D. Sample Questionnaires E. Table Presentations CURRICULUM VITAE
16
TABLE 1.1 1.2
2 3 1
LIST OF TABLES TITLE Distribution of Respondents According to Age Distribution of Respondents According to Gender Stressors of Level III Nursing Students Stress Management Performed By the Level III Nursing Students FIGURE Research Paradigm
PAGE 27 28 29 31 13
CHAPTER I THE PROBLEM AND ITS SETTING
17
Introduction Throughout
its
distinguished
history,
nursing
has
had
a
significant effect on people’s lives. As rapid change continuous to transform the profession of nursing and healthcare delivery system
with
broader
which
it
opportunities
is to
indicately influence
linked, human
nurses
embrace
well-being.
Today,
nurses bring knowledge, leadership, spirit, and vital expertise to
expanding
roles
responsibility, evolve,
and
underlying
that
afford
rewards. all
is
increase
However,
participation,
nursing
time-honored,
continuous
fervent
and
to
profound
commitment to caring. This
profession
requires academic and clinical training.
The clinical duties that the nursing students have to undergo are an integral part of the course. Related Learning Experiences (RLE) is required in the nursing curriculum. The RLE training is necessary to all nursing students in order that their clinical exposure becomes an in-depth experience, meaningful and early appreciated
when
they
are
in
actual
hospital
situation.
Any
nursing student who does not undergo sufficient clinical duties maybe
considered
ill
prepared
to
undergo
further
hospital
training and may fail miserably in the major nursing course. Every nursing student needs to be given sufficient duties in
the
different
hospital
wards/
areas
as
well
as
in
the 18
different types of hospital services in order to broaden his/her learning experiences while undergoing his or her RLE program. It is in this respect where the clinical duties plays a vital role in the development of proper skills, attitudes, and behavior among
nursing
students
so that when they graduate, take
the
board examination and become professional nurses in the future their conducts and work ethics will be greatly influenced by what they have experienced during clinical duties. As the nursing profession continuously emerges, there is always a question on how a healthcare provider renders service to humanity. Many things that someone is experiencing can give rise to what kind of nurse he/she could be. As these nursing students undergo clinical duties, they will meet some kinds of stressors that produce discomfort and irritation conducive to stress
that
learning
if
not
experiences
given and
because stress interferes
proper their
attention future
may
affect
professional
their
practice
with learning. It is in this context
that the study is focused to help the nursing students identify some stressors during their clinical duties and to recommend possible solutions on how to manage this stress most importantly. Stress is our body’s response to changes in our life. Since life involves constant change (ranging from changing locations from home to work each morning to adapting to major life changes 19
like marriage, divorce, or death of a love one), there is no avoiding stress. This is why our goal isn’t to eliminate all stress, but to get rid of unnecessary stress, and effectively manage the rest. Some common causes of stress that many nurses are
experiencing
are
increasing
the
severity
of
clients’
illnesses, adjusting to various work shifts, being expected to assume
responsibilities
for
which
one
is
not
prepared,
and
inadequate support from supervisors and peers. There
are
different
types
of
stress
that
range
from
Eustress, which is a positive and exciting form of stress, to Chronic Stress, which has been linked to many serious health issues, and is the type of negative stress most often mentioned in the news. While we want to manage or eliminate the negative types of stress, we also want to keep positive forms of stress in our lives to help us remain vital and alive. Stress affects us in different ways, not all of which are negative. In fact, the stress of an exciting life can actually serve as a good motivator and keep things interesting. However, when stress levels get too intense, people will experience its negative
effect.
Some
of
it
are
headaches,
irritability
and
‘fuzzy thinking’. These effects are evident that we’re under too much stress. However, not everybody who is under stress will experience these specific symptoms. 20
We all feel overwhelmed from time to time; that is normal. It
is
virtually
impossible
to
eliminate
times
when
events
conspire and the body’s stress response is triggered, but there are ways that we can quickly reverse our body’s reaction to stress, like buffering the damage to our health and keeping our thinking clear so we can more deal effectively with what’s going on in the moment. It may seem that there is nothing we can do about our stress level. However, we have a lot more control than we might think. In fact, the simple realization that we are in control of our
life
is
the
foundation
of
stress
management.
Managing stress is all about taking charge of our thoughts, our emotions, our schedule, our environment, and our problems. The
ultimate
goal
is
a
balanced
life,
with
time
for
work,
relationships, relaxation, and fun – plus the resilience to hold on under pressure and to meet challenges head on. There are many ways to manage unhealthy stress in our life. The key to stress reduction is identifying strategies that work for us. As we begin to understand more about how stress affects us, we will develop our own ideas to help relieve the tension. Because
each
person
is
unique,
some
of
these
stress
management strategies will be more helpful for you than others, and
some
will
be
new
skills
that
require
practice
to
be 21
effective. Think about learning to ride a bicycle. There was a time when this was a new skill and felt very unnatural and awkward.
You
probably
needed
help
at
first
but
with
some
coaching, practice, and stress management, cycling or any other skill, becomes easier and more effective. Statement of the Problem This study was conducted to analyze the “Stress management performed University
by
the
of
level
Science
III and
nursing
students
Technology
with
of
Nueva
Regards
to
Ecija their
Clinical Duties: Basis for a Proposed Effective Quality Nursing Care”. Specifically,
this
study
aims
to
answer
the
following
questions: 1. How may the profile of the level III nursing students of Nueva Ecija University of Science and Technology be described in terms of the following: 1.1 age 1.2 gender
2. What are the different stressors encountered by the level III nursing students of Nueva Ecija University of Science and Technology with regards to their clinical duties? 22
3. What are the different stress management performed by the respondents with regards to their clinical duties? 4. What are the implications of this study to nursing practice in rendering effective quality nursing care? Scope and Delimitation This study was entitled “Stress Management Performed by the Level III Nursing Students of Nueva Ecija University of Science and Technology with regards to their Clinical Duties: Basis for a Proposed Effective Quality Nursing Care”. The primary focus of this study was directed toward the different stress management that the third year nursing students usually utilized and performed to alleviate their stress and to render effective quality nursing care to their patients. The data however were limited from those gathered from the nursing
students
Technology
as
from
Nueva
respondents
Ecija of
the
University study
of
during
Science the
and
second
semester of school year 2008-2009. Significance of the Study The
researchers
believe
in
the
merits
of
the
study
especially to the following:
23
the
researchers,
conducting
this
kind
of
study
brought
a
learning experience for them. It handed them the pulse of the major
level
III
nursing
students
when
it
comes
to
stress
management they performed with regards to their clinical duties, which was hardly known without survey. the nursing students, who may acquire greater insights of the stressors,
problems
and
challenges
they
may
encounter
all
throughout their clinical performances which is part of their chosen career. This knowledge will give them better and wider perspective about their profession and aid them in enhancing their coping abilities and self-confidence. the
Clinical
Instructors,
the
findings
may
provide
them
understanding why nursing students behave like they do. This study will also provide them hints of what remedial measures they need to institute to lessen the learning difficulties of their students while undergoing clinical exposure. Further, it will eventually help them to build a better relationship with the students, promote educational growth, and improve human and public relations with the identified clinical area of operation. the school administrators and faculty, who may help to work out solutions and course of action that will improve the students’ performance and to lessen their burden in their clinical duties while on the learning process. It also gives them the chance to 24
improve the quality of nursing education for the benefit of the students and the institution as well. the parents, this study will gives insights to the parents about the stressors encountered by their siblings and to prepare them nor
strengthen
them
by
means
of
giving
emotional
and
moral
supports in ways that may help them how to face and manage their stress during their clinical duties. The patients, who are the recipients of the healthcare service given by the nursing students. the
future
researchers,
this
study
can
serve
as
reference
material to those students who will conduct exactly the same or related studies.
Definition of Terms To convey clearly the meaning of the words used in this study, the researchers defined the terms used operationally, as follows: Clinical Area. This pertains to the hospital setting wherein the nursing students apply and practice what they have learned in terms of rendering or applying nursing care and focusing on the holistic being of the patient. 25
Clinical
Instructors.
These
refer
to
persons
who
impart
knowledge to the students. Clinical
Duties.
students
in
These
different
refer to the exposure of the nursing hospital
wards/areas
as
well
as
in
different types of hospital services in order to broaden his/her learning
experiences
while
undergoing
the
Related
Learning
Experience program. Coping. This refers to the adaptation to stress events. Management. This refers to the act or art of managing the whole system of care and treatment of a sick individual. Nursing Students. These refer to the students enrolled in the College
of
Nursing
in
Nueva Ecija University of Science
and
Technology. Nueva
Ecija
University
of Science and Technology.
This is
a
state university that provides advanced instructional training in arts, science and technology, education and other related fields. It also leads the leader to attain perfection at a level that
will
enable
him
to
pursue
higher
education
of
gainful
occupation. Related exposure,
Learning which
Experience. the
This
pertains
to
the
clinical
nursing students have to undergo. It
is
required to all nursing students in order for them to have an in 26
– depth and meaningful experience and easily appreciated when they are already in actual hospital situation. Stressors.
This
pertains
to
the
factors
affecting
the
performances of the nursing students.
CHAPTER II THEORETICAL ORIENTATION AND REVIEW OF RELATED LITERATURE AND STUDIES
This
chapter
presents
the
theoretical
orientation
and
review of related literature and studies by the researchers that are relevant to the present investigation. Theoretical Orientation According to Richard Lazarus and Susan Folkman(1984) stress could be thought of as resulting from an “imbalance between demands and 27
resources”
or
as
occurring
when
“pressure
exceeds
one's
perceived
ability to cope”. Stress management was developed and premised on the idea that stress is not a direct response to a stressor but rather one's resources and ability to cope mediate the stress response and are amenable to change, thus allowing stress to be controllable.
In
order
to
develop
an
effective
stress
management
programme it is first necessary to identify the factors that are central to a person controlling his/her stress, and to identify the intervention methods which effectively target these factors. Lazarus and Folkman's interpretation of stress focuses on the transaction between people and their external environment (known as the Transactional Model). The model conceptualizes stress as a result of how a stressor is appraised stressor-stress link by proposing
that
if
stressors
are
perceived
as
positive
or
challenging rather than a threat, and if the stressed person is confident that he/she possesses adequate rather than deficient coping
strategies,
stress
may
not
necessarily
follow
the
presence of a potential stressor. The model proposes that stress can
be
reduced
by
helping
stressed
people
change
their
perceptions of stressors, providing them with strategies to help them cope and improving their confide Stress is a condition in which the person responds in the normal balanced state. Most of the
concerns
extreme
and
and in
worries
most
cases,
are out
commonly of
repetitive,
proportion
to
ongoing,
the
actual 28
situation. Some of these things are relationships, work, health or family’s health and finances. Because of these worries, the person experiences very high level of stress on regular basis. Conceptual Framework Research paradigm is shown on Figure 1. This included the input, the process, and the output. The input contains the profile of the level III nursing students of Nueva Ecija University of Science and Technology,
the
different
stressors
they
encountered,
and
the
different stress management they performed to alleviate their stress. In the process, questionnaires were distributed and observations were •
•
conducted to gather pertinent information from the respondents. It “STRESS MANAGEMENT Students’ • Distribution of also included the analysis and evaluation of the gathered data and Profile Questionnaire PERFORMED BY THE information from the respondents using statistical treatment such as • Observation LEVEL III NURSING The different frequency count, percentage, average mean, weighted means, and • Analysis and stressors STUDENTS OF NUEVA evaluation using analysis. by encountered ECIJA UNIVERSITY OF statistical the level III treatment the stress AND nursing The output was consist of the findings about SCIENCE 1.Frequency students management of performed by the respondents. TECHNOLOGY WITH Count Nueva Ecija REGARDS TO THEIR 2. Percentages Research Paradigm University of 3. Average Mean CLINICAL DUTIES: Science and Input Process Output Technology with 4. Weighted Mean BASIS FOR A regards to PROPOSED EFFECTIVE their clinical QUALITY
duties. •
The
different
NURSING
CARE”
stress management performed
29 by
the respondents to
alleviate
their stress
30
Figure 1
Research paradigm used in this study is illustrated in Figure 1. It shows the steps adopted by the researchers in order to come up with the output of the study. It best describes the idea of the procedural design used by the researchers. Foreign Literature Stress is a feeling that is created when we react to particular events. It is the body's way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina, and heightened alertness.
The events that provoke stress are called stressors, and they cover a whole range of situations everything from outright physical danger to making a class presentation or taking a semester's worth of your toughest subject.
The human body responds to stressors by activating the nervous system and specific hormones. The hypothalamus signals the adrenal glands to produce more of the hormones adrenaline and cortisol and release them into the bloodstream. These hormones speed up heart rate, breathing rate, blood pressure, and metabolism. Blood vessels open wider to let more blood flow to large muscle groups, putting our 31
muscles on alert. Pupils dilate to improve vision. The liver releases some of its stored glucose to increase the body's energy. Moreover, sweat is produced to cool the body. All of these physical changes prepare
a
person
to
react
quickly
and
effectively
to
handle
the
pressure of the moment.
This natural reaction is known as the stress response. Working properly, the body's stress response enhances a person's ability to perform well under pressure. However, the stress response can also cause problems when it overreacts or fails to turn off and reset itself
properly.(
Wikipedia,
2008.
"Stress
(biological)"
http://en.wikipedia.org/wiki/Stress_(medicine))
Rebecca J. Frey(2009) said that stress in humans results from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their
well-being.
stress
responses
The
element
reflect
of
perception
differences
in
indicates
personality,
that as
human
well
as
differences in physical strength or general health. Risk factors for stress-related illnesses are a mix of personal, interpersonal, and social variables. These factors include lack or loss of control over one's physical environment, and lack or loss of social support networks. People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged (because of race, gender, educational level, or similar factors) are at greater risk
of
developing
stress-related
illnesses.
Other
risk
factors 32
include feelings of helplessness, hopelessness, extreme fear or anger, and cynicism or distrust of others.
Selye explained that stress is non specific response of the body to pay demand made upon it under ordinary circumstances, the body’s reaction to specific stimulus anticipate because of its repetitive pattern. Therefore, a person experiences pain. When the body is warm, it perspires and when it is used the body shivers. All human exhibits uniform response to stimulus because of homeostasis. When response is erotic and does not uniform to the
usual
stimulus,
reaction the
body
expected is
said
from
to
be
the in
application
stress.(“The
of
the
Nature
of
Stress” http://www.icnr.com/articles/thenatureofstress.html) Walter Cannon(2009) in the meantime said that the human body reacts either positively or negatively to a stress factor producing two kinds of possible reaction. When the human body tries
to
flee
from
stress
situation,
negative
reaction
is
exhibited. Positive reaction comes about when the body makes the principle of homeostasis apply the body to overcome stressful situation which is known as adaptation or coping. He advocated that
while
the
concepts
of
stress
is
an
absolute
fact,
its
presence and intensity reception are all relative in accordance with the physical and psychological make up of the individual. All people therefore, experience stress but the way stress is 33
present and is handled by each individual is unique for each other. A little difficulty is hardly felt by another. By understanding, we can more easily identify stress factors and their
effects
on
who
need
or
seek
healthcare.
Each
individual
is
experiencing stress, in her own particular manner. How the individual adopt or fails to adopt depend on several factors: personality and conditional make past experiences dealing with stress. It is important to remember that stress syndrome can be both positive and negative. Any change or alteration in the balance of life can
create
stress.
We
are
all
unique
individual,
we
respond
differently to various stressors. Thus, it neither does nor matter. Whether, it is positive or negative light or severe. What matter is how we developed adoptive mechanism to cope with these stressors and can be translated as the ability to withstand stress and create a life experiences that do not work against you. The implication of stress theory is by being able to withstand stress and by coping with it. Diluting it when occurs and eliminating it, you can actually affect your life. You are not programmed for premature aging. The fact is you control your own health. The quote of the journal of American Medical Association says, “Nature did not intend to grow old and ill, we were designed to die young in old age but free of disease”.
Schafer (2000) defined stress as the “arousal of mind and body in response on the demand made upon them”. The concept of stress is important because it provides a way of understanding 34
the person as a human being who responds in totality (mind, body and spirit) to a variety of changes that takes place in daily life. Local Literature Accrding to Maraya de Jesus Chebat stress is here to stay. What people
must
do
is
to
learn
more
about
its
nature,
sources
and
alternatives so that people used the energy positively and work in the best possible way. Orlandi stated, “Your ability to tolerate stressors depends on the number of stressors in your life”. People who can handle stress use their coping mechanism, which is powerful tool to use, to analyze events objectively and observe calmly. Gather information at the state of equilibrium, understanding of what to produce the tension that helps you feel that the stress is alleviated. Miranda specified that the most effective way of managing stress are
through
relation
and
exercise
which
ironically
are
extremely
aesthetical acts which involved dynamics of the mind and body. People who are always stress survivors stay healthy throughout their lives. They consider stressful situation opportunist for growth. Foreign Studies According to Ann Marriner Tomey et. Al,(2004) Stress is a part of every student's daily life. Leaving home or commuting daily managing, finances,
living
with
roommates,
and
juggling
work,
classes,
and 35
relationships all contribute to the normal stress of being a student. In addition, it is not uncommon for students to feel stressed and anxious about wasting time, meeting high standards, or being lonely. Stress can also come from exciting or positive events. Falling in love,
preparing to study abroad,
or buying
a car
can be
just as
stressful as less-happy events. One of the most important things you can do is to recognize when your stress levels are building. The amount of stress that you can tolerate before you become distressed varies with your life situation and your age. A critical first step in coping with stress is taking stock of the stressors in your life. Whenever stress is present, your body reacts. It acts like an alarm system that prepares your body to depend yourself. A little stress is good. It helps you think faster and harder and makes you put that extra bit of effort to meet in the challenge of life. On the other hand, Lether and Woolfolk say that the relaxation is the very valuable stress management technique that can soothe the emotional
turmoil
and
suppress
problematic
psychological
arousal.
While Martin and Lefcourt, suspected humor might be worthwhile coping response. Empirical evidence to that effect has emerged only recent years. For them good humor functions as buffer to lessen the negative impact of stress. Local Studies
36
According to Calderon, people who experience a high level of stress for a long time and who cope poorly with this stress may become irritable, socially withdrawn, and emotionally unstable. They may also have difficulty concentrating and solving problems. Some people under intense and prolonged stress may start to suffer from extreme anxiety, depression or other severe emotional problems. Odrigo G. Ancheta says that, “Stress gives us energy to cope with the demanding activity of life. It is true that stress is a normal constant part of our life because it involves changes, challenges and emotions. Try to imagine life without stress. You would not have any challenges
anything
to
affect
your
emotions
and
anything
new
and
exciting. It gives as energy because it activity involves physically and emotionally. Stress might be considered as a problem because we often bear about stress in a negative light that people may only associate’s bad experiences with stress. How you perceived and handled stressors will determine whether the stress is good or bad for you. A situation that seems extremely stressful to you could leave very calm to somebody. Flores (2000) said that a person who is stressed typically less anxious thoughts and difficulty concentrating or remembering. Stress can also change outward behaviors. Teeth clenching, hand wringing, pacing, nail biting, and heavy breathing are common signs of stress. People
also
Butterflies
feel in
the
physically stomach,
different cold
hands
when and
they
feet,
are dry
stress.
mouth
and
37
increase heart rate are all physiological effects of stress that we associate with the emotion of anxiety. Justification of the Study The past study discussed in this chapter has given the researcher the concept, theories and principles that pave the way to the ideas of the
present
study
and
good
starting
point
for
the
researcher
in
assessing the stressors and the stress management performed by the respondents with regards to their clinical duties. The
review
has
enabled
the
researchers
to
have
a
better
understanding of ideas of different well known writers which resulted to broadening the researchers own thinking in relation to the present study.
CHAPTER III METHODS, PROCEDURES, AND SOURCES OF DATA
38
This
chapter
presents
the
method
of
research
used,
the
instruments, the sources of data and the procedures used in gathering of data which employed by the researchers.
Methods of Research The researchers took into consideration the present factors and current conditions of a group of persons, events or a class in finding facts
and
data
descriptive
to
method,
be
interpreted.
which
was
This
used
summary
to
includes
accomplish
in
this
the
study.
Descriptive research is a study in which bodies of data are collected, recorded
and
analyzed.
It
is
used
to
answer
questions,
satisfy
curiosity established a cause and effect relationship. Moreover, descriptive researching is the most popular approach in research. area
of
It
systematically,
interest
or
factually
situation.
and
accurately
Description,
describes analysis
an and
interpretation of conditions that exist are involved. Researchers may also deal with comparison and contrast or the discovery of existing relationship between events or groups. In addition, as this method of research was used in the study it describes
systematically
the
nursing
course
and
stress
management
performed by the level III nursing students of Nueva Ecija University of Science and Technology with regards to their clinical duties: Basis for a Proposed Effective Quality Nursing Care. The study describes also its symptoms, management or treatment and situations in which 39
stress may arise in order to obtain a factual and accurate result of the research in which student could avail. Research Instruments The researchers used the questionnaire as the primary tool in gathering data. This was made from created materials and statements that
could
followed
generate
correctly
the the
desired
result
when
given
by
direction
the
the
correspondents
researchers
for
answering. The construction of the questionnaire was preceded by intensive perusal
and
review
researchers
insights
formulated
questions
of in
related forming
based
on
literature, the
their
which
questionnaire. readings
from
provided
The
the
researchers
various
books,
manuals, journal and experiences as nursing students. The questionnaire was first drafted for the approval of their adviser and other members of the faculty who are knowledgeable on the topic. This is composed of 4 problems. Problem no. 1 involves the profile of the level III nursing student of Nueva Ecija University of Science and Technology. Problem no. 2 involves the different stressors encountered
by
the
level
III
nursing
students
of
Nueva
Ecija
University of Science and Technology with regards to their clinical duties. Problem no. 3 is the different stress management performed by the respondents. While, Problem no. 4 is the implication of the study to nursing practice in rendering effective quality nursing care. Then the final draft was reproduced for distribution to the respondents. 40
Sources of Data The researcher used the level III nursing students of Nueva Ecija University of Science and Technology as their respondents who were randomly selected from eleven sections. They were chosen using single random sampling, each number of the population has an equal chance to be included in the sample gathered. (Ymas Jr, et. al. 2006) Their
reactions,
opinions
and
suggestions
were
analyzed
and
reported. Statistical Treatment of Data After the distribution, collection and completion of distributed questionnaires, the researchers tallied the gathered data and used frequency, percentage, average mean, weighted mean, and interpretation and ranking The following statistical computations were accomplished using the following formula: For the Percentage Computation of the percentage was made using the expression: Percentage (%) = F x 100 N Where: %- Percentage 41
F- Frequency or number of response to every item or question N- Total number of respondents For the Average Mean Computation of the average mean was made using the expression: AM= F x E (DoR) Where: AM- Average mean F- Frequency used E- Numerical equivalent/ degree of response For the Weighted Mean Computation of the weighted mean was made using the expression: WM=AM N Where: WM- Weighted mean AM- Summation of the degree of response multiply frequency (F x E (DoR)) N- Total number of respondents
42
The researcher used ranking to determine the position of each variable. NUMBER VALUE
E (DoR)
4.20-5.00
5
INTERPRETATION Always
3.40-4.19
4
Often
2.60-3.39
3
1.80-2.59
2
Seldom
1.0-1.79
1
Never
Sometimes
Finally, the findings were summarized and compared with each work; conclusions were drawn, and recommendations were formulated.
43
CHAPTER IV PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA
This chapter presents the data gathered in this study which has been carefully presented, analyzed, and interpreted. These data were gathered by the researchers to the two hundred sixty seven (267) junior nursing students enrolled at the College of Nursing, Nueva Ecija University of Science and Technology as of A.Y. 2008-2009. Table 1.1 Distribution of Respondents According to Age
Age 17years 18years 19years 20years 21years 22years 23years TOTAL
old old old old old old old
Frequency 2 67 152 35 6 3 2 267
Percentage 0.75% 25.09% 56.93% 13.11% 2.25% 1.12% 0.75% 100%
Rank 6 2 1 3 4 5 6 27
Table 1.1 presents the data of the respondents in terms of their age. There are 2 or 0.75% of the respondents who are 17 years old which ranked 6; 67 or 25.09% of the respondents who are
18
years
old
which
ranked
2;
152
or
56.93%
of
the
respondents who are 19 years old which ranked 1; 35 or 13.11% of the respondents who are 20 years old which ranked 3;6 or 2.25% 44
of the respondents who are 21 years old which ranked 4; 3 or 1.12% of the respondents who are 22 years old which ranked 5;2 or 0.75% of the respondents who are 23 years old and above which also ranked 6. The data indicate that the respondents are at the right age to
consider
them
as
mature
individuals
capable
of
managing
stress. It also shows that majority of the respondents are 19 years old. Table 1.2 Distribution of Respondents According to Gender
Gender
Frequency
Percentage
Rank
Male
114
42.70%
2
Female
153
57.30%
1
TOTAL
267
100%
3
Table 1.2 presents the data of the respondents in terms of their gender. There are 114 or 42.70% of the respondents who are male and 153 or 57.30% of the respondents who are female.
45
This indicates that majority of the students enrolled as nursing students are female.Wherein, they are more capable of adjusting to the stressors resulting to stress management rather than males.
Table 2 Stressors of Level III Nursing Students ITEM
STRESSORS
WM
VERBAL INTERPRETATION
RANK 5
2.1
Doing bedside care to the patient.
3.60
OFTEN
2.2
Finishing charting on time
3.89
OFTEN
1
2.3
Handling too many patients
3.67
OFTEN
2.5
2.4
Preparation and submission of requirements
3.67
OFTEN
2.5
2.5
Patient with serious cases
3.62
OFTEN
4
2.6
Lack of hospital facilities and equipments
3.43
OFTEN
6
2.7
Relationship with the patient
2.94
SOMETIMES
15
2.8
Relationship with the co-students
3.01
SOMETIMES
10.5
2.9
Relationship with Clinical Instructors
2.97
SOMETIMES
14
2.10
Relationship with staff nurses
3.01
SOMETIMES
10.5
2.11
Relationship with the physicians
2.79
SOMETIMES
16
2.12
2.99
SOMETIMES
13
3.29
SOMETIMES
8
2.14
Relationship with patient’s family, relatives, and visitors Recognition of some evident changes concerning patient’s symptoms Mixed cases of patients due to lack of room
3.31
SOMETIMES
7
2.15
Unfamiliar healthcare setting in the hospital
3.21
SOMETIMES
9
2.16
Wrong procedure performed to the patient
3.01
SOMETIMES
10.5
2.13
TOTAL WEIGHTED MEAN
3.28
SOMETIMES
Table 2.1 presents the different stressors of level III nursing students with regards to their clinical duties. Item 2.1 “Doing bedside care to the patient” got a weighted mean of 3.60, item 2.2 “Finishing charting on time” got a weighted mean of 3.89, item 2.3 “Handling too many patients” got a weighted mean 46
of 3.67, item 2.4 “Preparation and submission of requirements” got a weighted mean of 3.67, item 2.5 “Patient with serious cases”
got
a
weighted
mean
of
3.62
and
item
2.6
“Lack
of
hospital facilities and equipments” got a weighted mean of 3.43 and interpreted as “Often”. This indicates that the routine practices in the hospitals is
one
of
the
reason
for
the
nursing
students
to
be
stressed.This also indicate that a holistic approach should also maintain in dealing with patients and in treating them as a human being or as a whole with body, mind, and spirit and not just merely a person with a specific disease. With the item 2.7 “Relationship with the patient” got a weighted
mean
of
2.94,
item
2.8
“Relationship
with
the
co-
students” got a weighted mean of 3.01, item 2.9 “Relationship with the Clinical Instructors” got a weighted mean of 2.97, item 2.10 “Relationship wit the staff nurses” got a weighted mean of 3.01,
item
weighted
2.11
mean
“Relationship
of
2.79,
item
with
the
physicians”
2.12
“Relationship
got
with
a the
patient’s family, relatives and visitors” got a weighted mean of 2.99, item 2.13 “Recognition of some evident changes concerning patient’s
symptoms”
got
a
weighted
mean
of
3.29,
item
2.14
“Mixed cases of patients due to lack of rooms” got a weighted mean of 3.31, item 2.15 “Unfamiliar healthcare setting in the 47
hospital”
got
a
weighted
mean
of
3.21
and
item
2.16
“Wrong
procedure performed to the patient” got a weighted mean of 3.01 and interpreted as “Sometimes”. This
indicates
that
sometimes
dealing
with
the
hospital
personnels makes the students feel uncomfortable when they ask questions,expect satisfactory performances from them, and do not trust
the
students
own
capabilities
that’s
why
instead
of
relying on the staff nurses and even Clinical Instructor they prefer
to
rely
on
their
own.
Thus,
resulting
in
failure
to
establish harmonious and good working relationship with them. Table 3 Stress Management Performed By the Level III Nursing Students
ITEM 3.1
STRESSORS
WM
VERBAL INTERPRETATION
RANK
Thinking positive and being confident in whatever you do Taking time to rest and relax
4.23
ALWAYS
2
3.78
OFTEN
12
3.84
OFTEN
9
3.4
Spending time with your love ones.(Family, friends or even pets) Praying to God
4.66
ALWAYS
1
3.5
Watching movies and other programs on television
3.71
OFTEN
15
3.6
Day dreaming
2.98
SOMETIMES
25
3.7
Listening to music, singing and dancing
3.73
OFTEN
14
3.8
3.31
SOMETIMES
20
3.9
Enjoying pleasurable activities. (Playing instrument, reading, drawing, painting, etc.) Knowing your limits and stick to them
3.85
OFTEN
8
3.10
Engaging into sports
3.31
SOMETIMES
21
3.11
Simply stay at the corner of your own room and crying Eating your favorite foods
2.27
SELDOM
29
3.88
OFTEN
6
Using the internet (chat,friendster, facebook, etc.) and playing on line games
3.89
OFTEN
5
3.2 3.3
3.12 3.13
48
3.14
3.90
OFTEN
4
3.15
Calling and texting your family members, relatives, friends, etc. Making yourself busy by doing household chores
3.28
SOMETIMES
23
3.16
Ignoring the problem
3.33
SOMETIMES
19
3.17
Getting angry and having mood swings
2.86
SOMETIMES
26
3.18
Laughing at it
3.79
OFTEN
11
3.19
Asking for assistance to the Clinical Instructor
3.67
OFTEN
16
3.20
Verbalization of feelings to a fellow student
3.64
OFTEN
17
3.21
Reasoning out or answering back
3.29
SOMETIMES
22
3.22
Taking it as a challenge
3.86
OFTEN
7
3.23
Limiting your contact to the source of stress
3.42
OFTEN
18
3.24
Cursing
2.67
SOMETIMES
27
3.25
Drinking alcoholic beverages and smoking
2.18
SELDOM
30
3.26
Taking medication as a reliever
2.42
SELDOM
28
3.27
3.09
SOMETIMES
24
3.81
OFTEN
10
3.29
Doing physical exercises. (Jogging, running, aerobics, etc.) Accepting the reality that sometimes it merely happens Sleeping
3.75
OFTEN
13
3.30
Managing your time better
3.99
OFTEN
3
3.28
TOTAL WEIGHTED MEAN
3.48
OFTEN
Table 3.1 presents the stress management performed by the respondents
to
handle
and
alleviate
their
stress.
Item
3.1
“Thinking positive and being confident in whatever you do” got a weighted
mean
of
4.23
and
item
3.4
“Praying
to
God”
got
a
weighted mean of 4.66 are interpreted as “Always”. This indicates that the rspondents believe that praying is the
most
and
above
all
the
effective
and
reliable
stress
management that they can perform because this can give us a renewed
sense
of
clarity,
purpose,
and
peace
that’s
why
we
should never loose hope because God is always with us. A sincere prayer from the heart can instantly bring soothing comfort and 49
quick stress relief. Prayer reminds us we are not really alone. Prayer can give us an immediate and deep sense of safety, and peace regardless of the external circumstances we face. With the item item 3.2 “Taking time to rest and relax” got a weighted mean of 3.78, item 3.3 “Spending time with your love ones (Family, friends, or even pets)” got a weighted mean of 3.84,
item
3.5
“Watching
movies
and
other
programs
on
television” got a weighted mean of 3.71, item 3.7 “Listening to music, singing, and dancing” got a weighted mean of 3.73, item 3.9 “Knowing your limits and stick to them” got a weighted mean of 3.85, item 3.12 “Eating your favorite foods” got a weighted mean of 3.88, the item 3.13 “Using the internet (chat, face book, friendster, etc.) and playing online games” got a weighted mean
of
3.89,
item
3.14
which
is
“Calling
and
texting
your
family members, relatives, friends, etc.” got a weighted mean of 3.90, item 3.18 “Laughing at it” got a weighted mean of 3.79, item 3.19 “Asking for assistance to the Clinical Instructor” got a weighted mean of 3.67, item 3.20 “Verbalization of feelings to fellow student” got a weighted mean of 3.64, item 3.22 “Taking it
as
a
challenge”
got
a
weighted
mean
of
3.86,
item
3.23
“Limiting your contact to the source of stress” got a weighted mean of 3.42, item 3.28 “Accepting the reality that sometimes it merely
happens”
got
a
weighted
mean
of
3.81,
item
3.29 50
“Sleeping” got a weighted mean of 3.75 and item 3.30 “Managing your time better” got a weighted mean of 3.99 and interpreted as “Often”. This
indicates
that
it
is
necessary
to
alter
one’s
attention so that stress will not be the primary of interest. With the item Item 3.6 “Daydreaming” got a weighted mean of 2.98,
item
instruments,
3.8
“Enjoying
reading
books
pleasurable or
activities
(Playing
drawing,
painting,
magazines,
etc.)” got a weighted mean of 3.31, item 3.10 “Engaging into sports” got a weighted mean of 3.31, item 3.15 “Making oneself busy by doing household chores” got a weighted mean of 3.28, item 3.16 “Ignoring the problem” got a weighted mean of 3.33, item 3.17 “Getting angry and having mood swings” got a weighted mean of 2.86, item 3.21 “Reasoning out or answering back” got a weighted mean of 3.29, item 3.24 “Cursing” got a weighted mean of
2.67
and
item
3.27
“Doing
running,
and
aerobics)”got
a
physical weighted
exercise mean
of
(jogging, 3.09
and
cursing
and
interpreted as “Sometimes”. This
indicates
that
the
respondents
do
reasoning out just to manage the stress. And lastly, item 3.11 “Simply staying at the corner of your room
and
crying”
got
a
weighted
mean
of
2.27,
item
3.25 51
“Drinking alcoholic beverages and smoking” got a weighted mean of 2.18 and item 3.26 “Taking medication as a reliever” got a weighted mean of 2.42 This
implies
and interpreted as “Seldom”.
that
the
respondents
are
mature
enough
to
adjust and manage their stress because instead of staying at the corner of the room and crying for nothing they prefer to do something to work for possible solutions. This implies also that the nursing students believe that drinking alcoholic beverages and smoking is inappropriate management for stress because it might increase the risk for illnesses instead. Implication of the Study The result of the study on the “Stress management performed by the respondents with regards to their clinical duties” stands benefit
to
the
nursing
practice.
The
identification
of
the
possible cause and effect of stressors on the level III nursing students
will
provide
them
adequate
academic
and
clinical
knowledge on stress. This study will serve as a guide to them on how
to
duties.
manage This
Instructors,
their
will
stress
also
healthcare
with
provide team
regards
to
information
in
the
their to
hospital,
clinical
the
Clinical
and
school
administrators on how they can help the students upon dealing with
stress
properly
in
order
for
students
to
be
competent
52
enough
in
different
clinical area and to render quality
and
effective nursing care to the patients.
CHAPTER V SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS
This
presents
the
summary
of
the
study,
formulated
conclusion and recommendations offered. Summary of the findings: This study is all about the “Stress Management Performed by the Level III Nursing Students with Regards to their Clinical Duties: Basis for a Proposed Effective Quality Nursing Care”. The
descriptive
method
of
research
was
utilized
and
the
questionnaire serves as the principal data gathering instrument. There are 267 respondents who fill up the survey questionnaire. The results of the questionnaire were tabulated and interpreted from which the findings and conclusion were drawn. The following are the summary of findings of the study based from all the data presented, analyzed and interpreted in chapter IV. 53
1. Majority of the respondents are in 19 years of age. 2. Majority of the respondents are female. 3.
The
researchers
different
used
stressors
sixteen (16) items to enumerate
encountered
by
the
level
III
the
nursing
students with regards to their clinical duties namely: Doing bedside care to the patient with weighted mean equivalent to 3.60 was interpreted as “Often”; Finishing charting on time with weighted mean equivalent to 3.89 was interpreted as “Often”; Handling too many patients with weighted mean equivalent to 3.67 was
interpreted
requirements interpreted
as
with as
“Often”; weighted
“Often”;
Preparation mean
Patients
and
submission
equivalent with
to
serious
3.67 cases
of was with
weighted mean equivalent to 3.62 was interpreted as “Often”; Lack of hospital facilities and equipments with weighted mean equivalent to 3.43 was interpreted as “Often”; with
the
patients
interpreted with
as
weighted
“Sometimes”;
with
Relationship
weighted mean equivalent to 2.94
was
“Sometimes”; Relationship with the co-students mean
equivalent
Relationship
with
to
3.01
was
the
Clinical
interpreted Instructor
as with
weighted mean equivalent to 2.97 was interpreted as “Sometimes”; Relationship with the staff nurse with weighted mean equivalent to 3.01 was interpreted as “Sometimes”; Relationship with the physicians with weighted mean equivalent to 2.79 was interpreted 54
as
“Sometimes”;
Relationship
with
the
patient’s
family,
relatives and visitors with weighted mean equivalent to 2.99 was interpreted as “Sometimes”;
Recognition of some evident changes
concerning patient’s symptoms with weighted mean equivalent to 3.29 was interpreted as “Sometimes”; Mixed cases of patients due to
lack
of
rooms
with
weighted
mean
equivalent
to
3.31
was
interpreted as “Sometimes”; Unfamiliar healthcare setting in the hospital with weighted mean equivalent to 3.21 was interpreted as
“Sometimes”;
And
lastly
wrong
procedure
performed
to
the
patients with a weighted mean equivalent to 3.01 was interpreted as “Sometimes” also with the total average mean of 3.28 was interpreted as “Sometimes”. 4.
The
researchers
used
thirty
(30)
items
to
determine
the
different stress management performed by the respondents with regards to their clinical duties namely: Thinking positive and being confident in whatever you do with weighted mean equivalent to 4.23 was interpreted as “Always”; Taking time to rest and relax with weighted mean equivalent to 3.78 was interpreted as “Often”; Spending time with your love ones with weighted mean equivalent to 3.84 was interpreted as “Often”; Praying to God with
weighted
“Always”;
mean
Watching
equivalent movies
and
to
4.66
programs
was on
interpreted television
as with
weighted mean equivalent to 3.71 was interpreted as “Often”; Daydreaming
with
weighted
mean
equivalent
to
2.98
was 55
interpreted as “Sometimes”; Listening to music, singing,
and
dancing with weighted mean equivalent to 3.73 were interpreted as “Often”; Enjoying pleasurable activities with weighted mean equivalent to 3.31 was interpreted as “Sometimes”; Knowing your limits and stick to them with weighted mean equivalent to 3.85 was interpreted as “Often”; Engaging into sports with weighted mean equivalent to 3.31 was interpreted as “Sometimes”; Simply stay at the corner of your room and crying with weighted mean equivalent favorite
to
2.27
foods
was
with
interpreted
weighted
as
mean
“Seldom”;
equivalent
Eating to
3.88
your was
interpreted as “Often”; Using the internet and playing online games with weighted mean equivalent to 3.89 was interpreted as “Often”;
Calling
friends,
etc...
or
texting
with
your
weighted
family
mean
members,
equivalent
relatives,
to
3.90
was
interpreted as “Often”; Making yourself busy by doing household chores with weighted mean equivalent to 3.28 was interpreted as “Sometimes”; Ignoring the problem with weighted mean equivalent to 3.33 was interpreted as “Sometimes”; Getting angry and having mood
swings
with
weighted
mean
equivalent
to
2.86
was
interpreted as “Sometimes”; Laughing at it with weighted mean equivalent
to
3.79
assistance
to
the
was
interpreted
Clinical
as
Instructor
“Often”; with
Asking
weighted
for mean
equivalent to 3.67 was interpreted as “Often”; Verbalization of feelings to fellow students with weighted mean equivalent to 56
3.64 was interpreted as “Often” ;Reasoning out or answering back with
weighted
“Sometimes”;
mean
equivalent
to
it
challenge
Taking
as
a
3.29
were with
interpreted weighted
as
mean
equivalent to 3.86 was interpreted as “Often”; Limiting your contact to the source of stress with weighted mean equivalent to 3.42
was
interpreted
equivalent
to
2.67
as was
“Often”;
Cursing
interpreted
as
with
weighted
“Sometimes”;
mean
Drinking
alcoholic beverages and smoking with weighted mean equivalent to 2.18
was
interpreted
as
“Seldom”;
Taking
medication
as
a
reliever with weighted mean equivalent to 2.42 was interpreted as
“Seldom”;
Doing
physical
exercise
with
weighted
mean
equivalent to 3.09 was interpreted as “Sometimes”; Accepting the reality
that
sometimes
it
merely
happens
with
weighted
mean
equivalent to 3.81 was interpreted as “Often”; Sleeping with weighted mean equivalent to 3.75 was interpreted as “Often”; Managing your time better with weighted mean equivalent to 3.99 was interpreted as “Often”; With the total average mean of 3.48 was interpreted as “Often”. Conclusions: Based on the findings of the study, the researchers arrived at the following conclusions: 1.
That
the
level
III
charting
on
time”
as
nursing the
students
greatest
consider
stressors
“Finishing they
have 57
encountered with regards to their clinical duties and the least one is the relationship with the physicians. Meanwhile, the rest of the stressors show that they can also affect the respondents somehow. 2. That the level III nursing students consider praying to God and thinking positive as the number one stress management they usually performed when they feel stress. While simply staying at the corner of the room and crying followed by drinking alcoholic beverages and smoking does not play much role. 3.
The
result
practice
in
of
the
rendering
study
stands
effective
benefit
quality
to
nursing
the
nursing
care.
The
identification of the possible cause and effect of stressors on the
level
III
nursing
students
will
provide
them
adequate
academic and clinical knowledge on stress. This study will serve as a guide to them on how to manage their stress with regards to their clinical duties. This will also provide information to the Clinical
Instructors,
healthcare
team
in
the
hospital,
and
school administrators on how they can help the students upon dealing competent
with
stress
enough
in
properly different
in
order
clinical
for area
students and
to
to
be
render
quality and effective nursing care to the patients. Recommendations:
58
After the conclusions were drawn, the researchers of the study hereby recommended that: 1.
The students must develop not only their nursing skills but
also their ability on handling problems. 2.
The students must learn how to rest and relax.
3.
The
students
also
need
to
develop
their
good
working
relationship to others especially with the patients to avoid pro 4.
Proper
utilization
of
coping
mechanism
will
help
the
nursing students to manage their stress and be competent enough in different clinical area. blems that lead to create stressor. 5.
The Clinical Instructors must support their students all
the time to establish a harmonious and professional relationship with them and guide them in rendering quality nursing care to the patient. 6.
Doctors
and
Clinical
Instructors
as
well
as
the
staff
nurses should be invited at times as a resource person during ward
class
and
case
presentation
to
give
them
a
sense
of
recognition thereby improving good working relationship in the clinical area.
59
7.
The proper approach and continuous support of the staff
nurse and other healthcare provider must be present to help the students
cope
and
deal
with the possible problems that they
might encounter in the clinical area. 8.
Discussion for the most practical adaptation to prevent the
existence of excessive amount of stress in the individual should be
conducted
and
if
found
to
be
already
existed,
the
most
possible activities should be given to decrease the strength of stressors that could affect on physiological, psychological and behavioral make up of the individual. 9.
The college of nursing should conduct seminar workshops and
trainings
that
will
further
develop
the
student
ability
and
capacity to cope up with stress. 10.
The
future
junior
nursing
students
must
be
properly
equipped with enough knowledge in nursing for them to become confident. Hence, improper coping with stress will be lessened and prevented. 11.
Conducting
sample
frame
another should
study be
using
more
considered
to
variable arrive
and at
bigger a
more
comprehensive and meaningful conclusion.
60
BIBLIOGRAPHY Books •
Deborah Antai-Otong et. Al, Thomson Asian Ed. Psychiatric Nursing Book
•
Ann Marriner Tomey et. Al, Guide to Nursing Leadership and Management 7th Ed. Copy Right 2004 by Mosby, Inc.
•
Barbara Kozier MN, RN, Glenora Erb BSN, RN, Audrey Berman Ph. D., RN, MAN Funadamental of Nurszing 7th Ed.
•
Brunner and Suddart’s Textbook of Medical-Surgical Nursing Volume1 11th Ed. / (Edited by) Suzanne C.Smeltzer…( et al )
•
Stress (2008). Encyclopedia Britannica. Encyclopedia Britannica 2007 Deluxe Edition. Chicago: Encyclopedia Britannica. "Cannon, Walter Bradford." Encyclopedia Britannica from Encyclopedia Britannica 2007 Deluxe Edition. (2009) Lazarus, R.S., & Folkman, S. (1984). Stress, Appraisal and Coping. New York: Springer.
• •
Article •
[2009 Article by: Paula Ford-Martin; Rebecca J. Frey, PhD] Website
• • • •
Selye, Hans. “The Nature of Stress.” http://www.icnr.com/articles/thenatureofstress.html Wikipedia, 2008. "Stress (biological)" http://en.wikipedia.org/wiki/Stress_(medicine) Wikipedia 2009. "Walter Bradford Cannon." http://en.wikipedia.org/wiki/Walter_Bradford_Cannon en.wikipedia.org/wiki/Stress_management Undergraduate Thesis
• Stress Experiences and Coping Mechanism of Third Year Nursing Students of WUP 61
• Stress Encountered by the Level IV Student Nurses of WUP in conduct of their RLE
62
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