COPING MECHANISM TO ACADEMIC STRESS AMONG NURSING

STUDENTS OF PHINMA SAINT JUDE COLLEGE DURING

A Research Proposal Presented to the Faculty of Nursing,

In partial fulfillment for the requirements in Bachelor of Science in Nursing,

1st Semester SY 2021-2022

Submitted by:

Bautista,, Sydney.
Herbito, Junaly
Manday, Mark Vince
Pacolor, Honey

April 2022

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 APPROVAL SHEET

This research paper entitled “COPING MECHANISM TO ACADEMIC STRESS

AMONG NURSING STUDENTS OF PHINMA SAINT JUDE COLLEGE

DURING COVID-19 PANDEMICS.Y 2021-2022”. Prepared and submotted by

Honey Pauline M. Pacolor, Sydney B. Bautista, Junaly B. Herbito, and Mark Vince C.

Manday, in partial fullfillment of the requirements for the degree of Bachelor of

Science in Nursing has been examined and hereby recommended for approval and

acceptance.

ELMER C. PEREZ, RN, MSN, MAN, PhD

Research Adviser

Accept and approved in partial fulfillment of the requirements for the degree of

Bachelor of Science in Nursing.

______________________
Jejomar D. Quiroz, RN, MAN
Dean of College of Allied Health

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ACKNOWLEDGEMENT

III
ABSTRACT

IV
 Table of Content

Title Page --------------------------------------------------------------------------- I

Approval Sheet -------------------------------------------------------------------- III

Acknowledgement ----------------------------------------------------------------- IV

Abstract -------------------------------------------------------------------------- V

Table of Contents ----------------------------------------------------------------- VI

List of Tables --------------------------------------------------------------------- VIII

List of Appendices --------------------------------------------------------------- IX

I. CHAPTER

Introduction ----------------------------------------------------------------------- 1

Theoretical Framework --------------------------------------------------------- 3

Research Paradigm ------------------------------------------------------------- 4

Statement of the Problem ---------------------------------------------------- 6

Hypothesis ------------------------------------------------------------------------- 6

Significance of the Study ---------------------------------------------------- 7

Scope and Delimitation ------------------------------------------------------- 7

Definition of Terms ------------------------------------------------------------ 8

II. CHAPTER

Review Related Literature ------------------------------------------------- 9

III. CHAPTER

Research Method -------------------------------------------------------------- 29

Population frame and Sampling Scheme --------------------------------- 29

Description of the Respondents -------------------------------------------- 30

Research Instrument ---------------------------------------------------------- 30

V
Data Gathering Procedures ----------------------------------------------- 31

Statistical Treatment od Data ------------------------------------------------ 31

VI
LIST OF TABLES

VII
LIST OF APPENDICES

VIII
LIST OF FIGURES

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 CHAPTER I

THE PROBLEM AND ITS BACKGROUND

Introduction

Academic stress has been reported to be the most common mental state that

medical students experience during their training period (Ramli et al. 2018). It is on

the rise among them probably due to increasing course requirements (Ramli et

al. 2018; Drolet and Rodgers 2010). Kumaraswamy (2013) observed that the issues

known to precipitate academic stress were excessive assignments, peer competition,

examinations and problems related to time management. University students, for the

life phase they are going through, also have to deal with many other stresses such as

detachment from the family, building of self-identity and issues concerning

adolescence period and those in relation to student-workers. The stress of the medical

student is also connected to the relationship with the patient in the clinical period.

Coping mechanisms are the ways people employ to cope with painful or difficult

emotions when they are stressed or traumatized. Coping methods can help people

cope with difficult situations while also maintaining their emotional health.

Furthermore, coping techniques can be classified as either active or avoidant.

Active coping techniques usually involve being aware of the stressor and making

active efforts to lessen it. Avoidant coping techniques, on the other hand, involve

ignoring or avoiding the situation in some way. Effective coping skills can often

aid in the improvement of mental and emotional health. People who can use

constructive coping techniques to cope with stressful or traumatic experiences

(and the long-term effects these episodes may have) are less likely to develop

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anxiety, depression, or other mental health issues as a result of painful or

challenging events.

This is a scenario which even college students face. Most students struggle with their

academic preparation on a regular basis. Many students find college to be a stressful

experience as they adjust to new academic and social surroundings. Certain factors,

such as stress coping skills, are thought to help some pupils achieve academic

success. Coping skills are factors that determine how a person responds to a task and

how well they succeed (Pajares, 2002).

College can be a very stressful period in the lives of most students; however,

some students cope with stress better than others. Many students who are able to

handle stress well have effective stress coping skills. When college students are facing

stressful life events, they typically use many kinds of coping strategies to deal with

them. They use various coping strategies simultaneously, and strategies are also likely

to change over time, depending on the effectiveness of the applied strategy. Aun et.al

(2011) opined that coping skills improve class attendance, participation, persistence

even when faced with setbacks or failure in general, and arm them with stronger more

resilient self who can lead to a much more positive learning experience. Similarly,

academic coping strategies helped undergraduate students to perform in their

academic through academic coping strategies factors i.e. approach, avoidance, and

social support (Sullivan, 2010). In addition, academic coping strategies was also

design to help undergraduate students to cope their life those that include physical

well-being, emotional, spiritual, and psychological well-being (Yasin & Dzulkifli,

2009). Normally, emotional coping strategy is usually practiced in the first year of

undergraduate students while in later years the trend is changing towards cognitive,

confrontive and painful problem solving (Mahajan, 2010). Stemming from these

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perspectives, this study therefore explored how nursing student of PHINMA- Saint

Jude College of Manila SY: 2021-2022 cope with academic related stress.

Theoretical Framework

Stress is considered as one of the principle causes of human performance failure.

Stress arises when individuals perceive that they cannot adequately cope with the

demands being placed on them or with threats to their well-being (Lazarus, 1966).

There are clear inter-individual and intra-individual differences in the way that we

react to stress (Lazarus, 2000), and a subjective interpretation of stress likely explains

this. As such, stress is best conceptualized as a process involving a dynamic

interaction between the person and the environment (Lazarus, 1999). Lazarus and

Folkman’s (1984) seminal work on stress describes how humans constantly evaluate

what is happening to them, a process known as cognitive appraisal. Cognitive

appraisal involves determining the extent to which environmental stressors are

harmful, threatening, or challenging (Lazarus, 1966). The process of cognitively

appraising harm, threat, and challenge happens in two stages. First, in primary

appraisal, the person evaluates whether he or she has anything at stake in this

encounter. In the context of performance, social evaluation, monetary incentives, or

collective goals may be at stake. Next, in secondary appraisals the person evaluates

what, if anything, can be done to overcome these demands, prevent harm, or to

improve the prospects for benefit.. In their ‘Ways of Coping Questionnaire’ (WOCQ;

cf. Folkman and Lazarus 1988, Lazarus 1991), Lazarus and co-workers distinguish

eight groups of coping strategies: Confrontive coping (taking action and confronting

the problem), seeking social support (seeking informational and emotional support),

planful problem-solving (planning to solve the problem), and positive reappraisal

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(creating a positive meaning and focus on personal growth) constitute the active

coping strategies. Meanwhile, distancing (expecting that the problem solves itself -

involves emotional detachment), self-controlling (making efforts to regulate feelings

and actions), accepting responsibility (accepting one's own role in the problem), and

escape-avoidance (trying to avoid the problem by wishful thinking and behavioral

efforts) comprise the passive coping mechanism. The problem with this conception

and, as a consequence, the measurement of coping is that these categories are only

loosely related to the two basic coping functions.

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Figure 1. Research Paradigm

This study use of a paradigm to find out the Coping mechanism to academic stress

among nursing students of PHINMA St Jude College during COVID-19 Pandemic

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 Input Process Output

Demographic profile
of respondent in terms
of:
 sex
 academic
program and
 year level •Survey Proposed coping
Questionnaires mechanism on
Academic stress •Collection of Survey
among nursing academic stress of
Questionnaire nursing student of
students in terms of: •Data Tabulation
 intra-individual College of Allied
•Statistical Health Science’s
 inter-individual Treatment; and
and •Data Analysis and
 environmental Interpretation
stressors

Coping mechanism of
the respondent in
terms of:
 Planful- problem
solving
 Distancing and
 Self-controlling.

The research paradigm of this study implies the IPO model or the system

approach The demographic profile of the students, such as sex, academic program,

and year level, is included in the input. As well as the respondents' stress levels in

terms of relevant, irrelevant, and threatening information. Allied health students used

planful-problem solving, distancing, and self-control as coping strategies. The

researchers used a survey questionnaire to collect data from the participants in

Process. The data tabulation will be assessed for statistical treatment after the survey

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questionnaire is collected, and the data analysis and interpretation will be the final

step. A proposed coping mechanism on academic stresswill be the end result

Statement of the Problem

This is study aim to determine the coping mechanism of nursing students to

academic stress. Specifically, it intended to answer the following questions:

1. What is the demographic profile of the respondents in terms of:

1.1. age;

1.2. sex; and

1.3. year level?

2. What are the academic stresses among nursing students of PHINMA St. Jude

College in terms of;

2.1 Intra-individual;
2.2 Inter-individual; and
2.3 Environmental Stressors?

3. What are the coping-mechanisms among nursing student of the PHINMA-Saint

Jude College in terms of:

3.1 Planful- problem solving;

3.2 Distancing; and

3.3 Self-controlling?

4. Is there a significant relationship between the respondents’ coping mechanisms in

academic stress and their demographic profile?

5. Based on the findings, what are coping mechanisms on academic stress that may be

proposed?

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Hypothesis

There is no significant relationship between the respondents’ coping mechanisms on

academic stress and their demographic profile.

Significance of the Study

The researchers believe that this study will not only yield data that will be helpful

to the students, more so to the following group of people:

College of Allied Health and Sciences (CAHS): The College of Allied Health

Sciences is involved in enhancing and improving the quality of life for people

everywhere by discovering, teaching and applying knowledge related to health

sciences. The findings of this study will give data to the college of allied health and

sciences about the common academic stressors and different coping mechanisms that

nursing students underwent during the times of pandemic.

Center for Student Development and Leadership (CSDL): This study will

give knowledge to the center for student development and leadership about different

coping mechanism and academic stressors. Since CSDL’s role is to provide guidance

and counselling to the students this research might give them some important

information that may be helpful to them that can widen their knowledge about

student’s academic stressors especially during these times of pandemic.

SSP Adviser: This study will benefit the student success program adviser since

their role is to look over the students and record their future plans. Having knowledge

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about student’s academic stressors and coping mechanism might be helpful for them

in creating programs that will deal with these kinds of situations.

Nursing Faculty Members: The part of the faculty members is to teach nursing

students nursing education programs. The findings of this research will give

knowledge to the faculty members on how they will provide assistance and make

interventions for students in terms of coping their school related problems.

The Students: The role of the students in the educational system is to learn what

they are being taught but somehow a barrier might emerge during the process of

learning of the students. Examples of barriers are academic stressors. This research is

a great help for nursing students for who developed coping mechanisms to overcome

academic stressor to improve their mental health especially during this Covid-19

pandemic.

Parents: Parents role to their children while studying is to provide guidance,

assistance and support in attaining their maximum potential in academics. This

research is made with the aim to provide crucial information and knowledge to the

parents on how they will maintain a well mental being of their children and can be

part of the solutions towards the performance of their children in the future.

Future Researchers: The findings may serve as basis and as inputs if and when

there will be other researcher to do the same research. Future researchers may benefit

from this research since their role is provide answer to an unanswered research studies

and this research might be a great help for them.

Scope and Delimitation of the Study

The scope of this study will be focusing on the coping mechanisms of Nursing

Students of PHINMA Saint Jude College to academic stress. This is study will be

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limited to only nursing students of PHINMA Saint Jude College and may not include

other courses due to limited resources and time frame. The primary subjects of this

study will consist of certain number of nursing students from first year to fourth year.

The respondents will be limited of 80 nursing students of PHINMA Saint Jude

College School Year 2021-2022. This research will be using 3groups instead of 8

groups of coping strategies that Lazaruz and Folkman distinguish, which is planful

problem-solving, distancing and self-controlling. This research is design to have

thorough knowledge in coping mechanism of nursing students in dealing with

academic stressors. This selection of the respondents does not cover all the nursing

students of PHINMA Saint Jude College due to limited resources and boundaries of

geographical location of the respondents where the researcher carry out

investigations.

Definition of Terms

For the purpose of clarification, the important terms used in this study have

been defined:

Academic Stress: According to One Future Collective (2018), Academic stress

involves mental distress regarding anticipated academic challenges or failure or even

the fear of the possibility of academic failure. In this study, it refers to the tension,

biological and psychological relating to the amount of work and pressure given by

academic life as perceived by the Nursing Students.

Coping Mechanism: According to Folkman and Lazarus (2012), it is defined as

constantly changing cognitive and behavioral efforts to manage specific external or

internal demands that are appraised as taxing. In this study, it can be associated to the

methods of Nursing Student’s in coping with there stress on academic.

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 COVID-19: According to WHO (2021). Coronavirus disease (COVID-19) is

an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the

virus will experience mild to moderate respiratory illness and recover without

requiring special treatment. However, some will become seriously ill and require

medical attention. In this study, it refers to the experience of Nursing Student during

this Covid-19 pandemic that will cause stress in academic as well.

Distancing: According to Psychology (2017). It describes cognitive efforts to

detach oneself and to minimize the significance of the situation. In this study, In this

study, this is part of three groups or methods of coping mechanisms that will be

proposed for academic stress.

Environmental Stressor: According to R. Guski, In International encyclopedia

of the social & Behavioral Science (2001). Environmental stressors are usually

considered to fall into one of four distinct classes: cataclysmic events, stressful life

events, daily hassles, and ambient stressors. In this study, it refers to the external

stressors that may affect the academic.

Intra-individual: According to Lucy in To My Tutor Psychology (2013), intra-

individual are observed within the same person when they are assessed at different

times or in different situations. In this study , it consists on academic stress cause that

may affect of Nursing Students.

Inter-individual: According to Lucy in To My Tutor Psychology (2013), inter-

individual are observed between people when they are assessed at different times or in

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different situations. It consists on academic stress cause that may affect of Nursing

Students.

Nursing Students: According to lawinsider (2010), Students who enrolled in the

College of Nursing in pursuit of a BSN or Graduate degree, including registered

nurses (RN), students taking courses via distance education, special students, or

individuals in post-graduate study, either alone or in combination with any other

degree. In this study, its refers to those who enrolled in the nursing school of

PHINMA Saint Jude College to participate in research on a proposed coping

mechanism for academic stress.

PHINMA- Saint Jude College: According to Wikipedia (2021). PHINMA – St.

Jude College is a college of nursing in the city of Manila in the Philippines. It was

founded in 1968, although a clinic had existed on the site since 1950. The terms was

used in the study as it locus where the respondent came from.

Planful Problem-Solving: According to Psychology Today (2017), Panful

Problem Solving is coping through analysis and planning to resolve the situation . In

this study, this is part of three groups or methods of coping mechanisms that will be

proposed for academic stress.

Self- Controlling: According to Kendra in Very Well Mind (2022) self-control is

desirable ones, and achieve long-term goals. Research has shown that possessing self-control can be

important for health and well-being. In this study, this is part of three groups or methods of

coping mechanisms that will be proposed for academic stress.

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 CHAPTER II

REVIEW RELATED LITERATURE

Coping Mechanism

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Coping mechanism

Coping is an activity that a person does to seek and apply solutions when

stressful situations or problems emerge because of stressors. Primarily, the term

"coping" is more associated with "reactive coping" because in general, we see coping

as a response to a stressor. However, there is also another type of coping the

“proactive coping" wherein the coping response is aimed at preventing a possible

encounter with a future stressor.

Although there are different living stressors and bad impacts of stress which

severely affect one’s life, there are also ways on how to relieve and manage it. Worry

prevention is one of the ways on how to manage stress and negate its possible effects

on psychological and physiological state of a human. There are steps on how to easily

handle stress, which can diminish its undesirable effects in every person. According to

Melgosa (2006), the first thing to do is to analyze the significance of the worry,

whether it is of importance or not. After this, if the stress is constructive, review for

possible solutions that can resolve the worries. On the other hand, if it is a destructive

one, forget it and move on. Look on the other way around, on its positive corner,

because through this, stress can be minimized. If there is no other way to change a

certain circumstance, the best thing to do is to accept and make further understanding

about it. Lastly, do not worry about what happened in the past or what may happen in

the future; rather, think about the present time, since the present is more essential and

relevant

Coping mechanism plays a significant part to overcome or reduce the stress

experienced by individuals. (Adler & Park 2003) stated that appropriate and effective

coping may buffer the effect of stressful circumstances on physical and mental health

of individual. Study indicated that university students are more stressful than those

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individuals at any other stages of their life (Kumar & Bhukar, 2013). These stressful

students were also found to be more likely to be engaged in negative activities such as

binge drinking, eating junk foods and not exercising regularly (Ostwald & Riddock,

2007). Certain students find it difficult to cope with the stress that they experience and

tend to lag behind while some other students see it as a challenge for them to work

hard. Coping is seen as a stabilizing factor that may support an individual in

psychosocial adaptation during stressful situations (Bamuhair et al., 2015).And

Mechanism it is a process, technique, or system for achieving a result. It can also be

defined as fundamental processes involved in or responsible for an action, reaction, or

other natural ( Merriam-Webster Dictionary, 2018). Using the correct coping style

effectively will help students in reducing their stress level (Yusoff, 2010).

According to the study of Semel Institute for Neuroscience and Human

Behavior (2011). There are many coping styles that people use, and some may prove

to be more effective than others, depending on the nature of the stressful situation and

the person who is employing them. Ineffective coping mechanisms, also referred to as

maladaptive coping, may also be applied to stressful events or internal conflict, often

unconsciously. Maladaptive coping mechanisms are counterproductive. The research

showed there are positive and negative responses to coping  (Howard & Medway,

2004).Communicating and seeking help from others along with problem-solving,

taking action and seeking support are positive ways adolescents deal with stressors.

Coping involves a control of engagement responses to change the source of stress or

one’s emotional reaction (Jaser et al., 2005). And included that coping is an effort to

manage specific external and internal demands of stress (Sontag and Graber 2010).

Planful Problem-Solving

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 According to Psychology Today (2017), Panful Problem Solving is coping

through analysis and planning to resolve the situation . It describes deliberate

problem-focused efforts to alter the situation, coupled with an analytic approach to

solving the problem. An individual will identify the main cause of the problem,

clarify the desired outcome and brainstorm possible solutions to combat the problem,

rationally evaluate and seek information to solve the problems and choose the best

problem-solving alternatives. Such an individual is courageous enough to implement

the selected solution, reflect on whether the preferred solution has managed to solve

the problem effectively, and revise the plan if needed.

Distancing

According to Psychology (2017). Distancing is where you detach yourself from

the situation and try to minimize its significance. It describes cognitive efforts to

detach oneself and to minimize the significance of the situation. Again, this strategy is

only effective in the short run, since it does not deal with the root of the problem.

Some distancing strategies include joking around and having a sense of humor,

intellectual discussion, socializing, and spending time with sweethearts. Hence,

avoidant coping may initially be perceived as an appropriate reaction to stress, but it

is mostly utilized by individuals who perceive stress as uncontrollable, and therefore,

according to Kariv and Heiman (2005), this technique is associated with poor

adjustment to life.

Self-Controlling

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 Self-Control helps people to cope with new challenges and to gain a balanced life.

It describes efforts to regulate one's feelings and actions. It is a robust predictor of a

student’s level of academic success (Mansfield et al., 2004). A self-controlled person

is healthy emotionally and is generally better at handling stress because of the ability

to accept reality and because of the openness to criticism and comments. An

individual who is self-controlled has the belief that it is necessary to control one’s

emotions to become a healthier person, and so exercises restraint on his or her own

compulsive or addictive behavior. When feeling stressed, some may feel relief by

crying, or some may jot down their feelings in a diary.

Academic Stress

Stress is undoubtedly a part of students’ lives and it may impact their ways of

coping with the demands of university life. Their daily responsibilities involve

numerous challenges which lead to stress. Results from various studies carried out

thus far show a clear increase in mental health problems among students. As some of

them indicate, there is also an urgent need to assess the impact of the current

pandemic on students’ mental health and wellbeing , which legitimizes carrying out

such studies in various countries, including Poland.

Academic Stress among students have long been researched on, and researchers have

identified stressors as too many assignments, competitions with other students,

failures and poor relationships with other students or lecturers. Academic problems

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have been reported to be most common source of stress for students. The stress and

coping concept is the most popular study approach, also explaining the mechanisms

mediating between personality and disease. Currently, the transactional model of

stress by Lazarus and Folkman is employed increasingly frequently. It posits mutual

interactions between people and their environment. The perception of stress is a

subjective and variable phenomenon. Particular attention is paid to the processes of

coping with stress, which decide the positive and negative impact of stress on the

individual. Using different strategies of coping with stress involves mobilizing

cognitive and behavioral resources to meet the demands which are subjectively

perceived as surpassing personal capabilities.

In 2020, a new situation appeared which necessitates a different approach to

stress and its causal factors–the SARS-CoV-2 virus. Data published by the Johns

Hopkins University indicates that thus far, over 100 million people have become

infected with COVID-19, and around 2.5 million have died . The COVID-19 disease

affects everyone, including students, since even those who have not been infected are

subject to various restrictions which many countries have implemented to limit the

spread of the disease. The reality of the pandemic has also negatively impacted the

students’ quality of social life. Studying at a university is also a period of establishing

new relationships and intense social life. This is facilitated by the fact that young

people exhibit greater levels of extraversion and openness to experience than do older

people . Studies show that contacts with others positively influence quality of life .

Lack of regular contact with friends throughout all phases of the coronavirus

pandemic, results in loneliness, which might not be fully mitigated by regular contacts

via telephone or other means . These conclusions are supported by evidence from

studies carried out in Great Britain with participants aged between 13 and 25 years, in

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which young people reported having lost support, daily routine, social ties, and

experiencing anxiety, loneliness, and loss of motivation and aim. Higher incidence of

depression and anxiety, both during as well as after periods of social isolation, was

also confirmed . This may lead to harmful social and psychological consequences .

According to the Asian American Psychological Association (2007), suicide is

the second leading cause of death among Asian Americans aged 15-34 and has the

highest rate among aged 20-24 (12.44 per 100,000). There are estimated of 1,100

college students who commit suicide annually (Sexton-Radek, 2012). Similar study

on suicide conducted by Gunnell, Lebanan-Dalida and Redaniel (2011) in the

Philippines particularly in urban areas concluded that male rate is consistently higher

than female rate from 1984-2005. Supporting this, last 2013, two reported incidents of

physical therapy students (1st and 5th year) from different universities in the

Philippines committed suicide due to failing grades and repeated affiliation. Both of

them were suffering from depression (The Philippine Star, 2013).

Intra- individual

Efforts to understand the effects of psychosocial stressors are increasingly

focused on the role of small events and everyday problems. Daily stressors have an

immediate effect on emotional and physical functioning on the day of occurrence (eg,

Bolger & Schilling, 1991; Zautra, Afflec, Tennen, Reich & Davis, 2005), increasing

sensitivity to problems such as anxiety and increase. Depression and illness (eg,

Almeida, 2005; Cacioppo et al., 1998; Lazarus, 1999; Zautra, 2003). Responses to

stressors can vary from person to person, and from situation to situation, as both

personal resources and the environment limit or enhance the possibilities and options

for coping with everyday experiences. Given the age-related changes in personal

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resources and the environment, one may expect concomitant changes in the daily

stress process, especially in relation to the emotional response to daily stressors. Daily

stressors are events that people perceive as challenges, threats, or potential losses. B.

Interpersonal tensions and excessive demands at work and at home. The term reactive

means that a person's mood swings result from experiencing a proximal pre-stressor.

Quantifying the amount of increased negative emotion (NA) on high stress days

compared to low stress days provides a way to measure responsiveness to daily stress.

Therefore, we operationally define responsiveness to everyday stress as a covariance

or "coupling" between stress and emotion (Bolger & Schilling, 1991; Zuatra et al.,

2005). Previous studies examined cross-sections of age differences in daily stress-

emotional connections (Mroczek & Almeida, 2004; Stawski, Sliwinski, Almeida &

Smyth, 2008), but data on longitudinal changes in this relationship are limited.

Inter-individual

interpersonal variations in stress response were assessed using various

measurements . The main symptoms of increased stress responsiveness include

increased stress hormone levels and autonomic nervous system overreaction. The

mechanism of autonomic hypersensitivity to stress is associated with gene

polymorphisms, such as the alpha-adrenergic bireceptor gene. Stress-related

autonomic dysregulation is clinically important and contributes specifically to

cardiovascular disease. In many species, including rodents and humans, individual

differences in behavioral responses to aversive and threatening situations are observed

. The behavioral pattern that seems to emerge consistently is that some individuals

20
respond to challenging situations with more offensive, aggressive and impulsive

behavior, whereas others appear to avoid such situations, behaving more cautiously

and fearfully. These different coping styles have been described as proactive versus

passive/reactive, which seems to be of relevance for differences in disease

susceptibility (Ebner, K., Singewald, N., 2017)

Environmental Stressor

The human body is designed to experience stress and react to it. Stress can be

positive such as a getting a job promotion or being given greater responsibilities

keeping us alert and ready to avoid danger. Stress becomes negative ("distress") when

a person faces continuous challenges without relief or relaxation between challenges.

As a result, the person becomes overworked and stress-related tension builds. Distress

can lead to physical symptoms including headaches, upset stomach, elevated blood

pressure, chest pain, and problems sleeping. Research suggests that stress also can

bring on or worsen certain symptoms or diseases. Stress also becomes harmful when

people use alcohol, tobacco, or drugs to try to relieve their stress. Unfortunately,

instead of relieving the stress and returning the body to a relaxed state, these

substances tend to keep the body in a stressed state and cause more problems

(Bhandari, S,. 2021).

Covid-19

In response to the pandemic, most countries have implemented severe restrictions

in societal functioning which comprise many spheres of life: social, economic,

cultural, and educational. They led to limited interpersonal contacts, changes in the

mode of education (online teaching), and reduced economic activity. As a result, an

economic recession has affected nearly all countries (including Poland) , which

worsened the material conditions of many people (increased unemployment). This

21
significantly impacts students, as it intensifies their concerns about being able to find

or retain a job and thus support themselves during their studies and after graduation.

Essen and Owusu showed that work and studies are the most frequent causes of stress

for students . Historical data shows that previous pandemics have negatively impacted

young people’s material conditions, which had long-term consequences for their

physical and mental health as well as academic achievement. For many students,

COVID-19 has additionally complicated their current plans and changed their mode

of functioning.

More recently, Matthew H. E. M. Browning et al (2020. identified a range of

psychological consequences of the COVID-19 pandemic on students’ psychosocial

functioning. All students in the sample indicated that the pandemic impacted them

negatively, with 59% reporting a high level of psychological impact . Other studies on

the effects of the pandemic on student mental health also show greater stress, anxiety,

depression symptoms, concerns for own and one’s family’s health, reduced social

interactions, and increased concerns over academic achievements. Students try to

cope with stress, seek support from others, and prefer either negative or positive

coping strategies .

The COVID-19 situation, its rapid spread, insufficient preparation, and

significant changes in everyday functioning, including university culture, may

contribute to increased stress among students. When not managed properly, chronic

stress leads to emotional and psychosomatic consequences which manifest through

physical, cognitive, and emotional exhaustion as well as depersonalization and

lowered professional–in case of students, academic–efficiency . The consequences of

stress lower efficiency, productivity, and engagement in life activities as well as the

22
satisfaction with their results . As Adler and Park point out, effective coping with

stress might buffer the impact of stressful events on the physical and mental health,

and individuals differ with regards to the coping strategies they use Therefore, the

aims of the study were: identifying the students’ dominant strategies of coping with

stress in the pandemic situation, assessing the influence of sociodemographic factors

on the dominant coping strategies, and diagnosing differences in the students’ coping

strategies depending on expected social support and its sources.

In response to the COVID-19 pandemic, over 1,000 colleges and universities in

the United States closed their doors in March 2020. Millions of students were forced

to finish the semester via remote learning, resulting in extraordinary disruptions to

higher education in the United States (Goldstein, 2020). Although COVID-19 poses a

low risk to the health and mortality of college-aged students (Centers for Disease

Control and Prevention, 2020), the pandemic has likely resulted in stark uncertainty

and distress in this population.

One particular area of concern for students in higher education is academic

stress relating to their ability to succeed in this new environment. While enrollment in

online courses has increased over the past several years, the majority of students

remain unfamiliar with remote learning. A recent report indicates that prior to

COVID-19, only 35% of United States college students had taken one or more

courses online (D’Amato, 2020). This concerning given that one of the best predictors

of academic success in an online format is prior online course experience (Hachey et

al., 2012). This lack of experience may be compounded by challenging home

conditions, including loss of access to academic resources (e.g., computers and

internet connectivity) and distractions in the home learning environment. Indeed, the

initial research shows that at-home distractions (including disruptions from other

23
family members and additional responsibilities) are a significant challenge for college

students learning from home during COVID-19 (Son et al., 2020). Taken together,

these factors are likely to lead to significant academic stress and uncertainty.

Aside from dealing with stressors related to a potentially unfamiliar online

learning environment, students are also coping with the emotional impact of COVID-

19. Much of the initial research on the mental health consequences of COVID-19

comes from areas hardest hit at the beginning of the pandemic including countries in

Asia and Europe. This research shows that COVID-19 and its associated disruptions

have resulted in significant increases in stress, anxiety, depression, and suicidality in

college students (Husky et al., 2020; Li et al., 2020; Luo et al., 2020; Patsali et al.,

2020). More recent investigations in the United States indicate that college students

show a similar pattern in mental health and well-being to those from other regions of

the world coping with COVID-19 (e.g., Luo et al., 2020; Son et al., 2020).

Unfortunately, studies from the United States addressing these phenomena thus far

have focused on students from single institutions and have under-explored gender and

ethnic differences in COVID-19 related mental health issues. These are crucial to

investigate, particularly because men and ethnic minorities are more likely to

experience negative health outcomes after exposure to COVID-19 (Griffith, 2020),

while women and ethnic minorities are more likely to suffer negative occupational

and mental health consequences due to the pandemic (Adams-Prassl et al.,

2020; Alonzi et al., 2020; NAACP, 2020). These differences are crucial to investigate,

particularly, because the initial research suggests that women and ethnic minorities

are more likely to suffer adverse changes in their emotional well-being due to the

pandemic (Adams-Prassl et al., 2020; Alonzi et al., 2020; Rothman et al., 2020; Smith

et al., 2020; Thibaut and van Wijngaarden-Cremers, 2020). For example, using a

24
large, the geographically representative sample of United States adults, Adams-Prassl

et al. (2020) documented a significant decrease in mental health as a result of initial

COVID-19 stay-at-home orders. Of note, this decrease was entirely driven by

worsening mental health in females. Similarly, research on ethnic minority

populations suggests that the pandemic is likely to exacerbate pre-existing mental

health disparities due to significant rates of COVID-19 infection in these communities

as well as quarantine-related impediments to mental health care (Rothman et al.,

2020; Smith et al., 2020). Thus, many students (women and minority populations in

particular) are likely facing challenges to their well-being during the pandemic.

Emotional well-being during the times of turmoil depends on factors at both

the individual and societal level. Thus far, research on emotional well-being during

COVID-19 has focused on societal-level factors including response to situational

stressors (e.g., infection fears, constraints on physical movement, limited social

contact, and sudden lifestyle changes). What remains under-explored is how the

effects of these stressors may vary based on individual differences such as personality

traits. Neuroticism, for example, has profound implications for mental and physical

health (e.g., Lahey, 2009; Widiger and Oltmanns, 2017). Research shows that

individuals who are high in neuroticism are at increased risk for negative physical

health outcomes and the various forms of psychopathology including anxiety and

mood disorders (Tackett and Lahey, 2017). For example, a recent investigation in

Germany found that individuals with higher neuroticism attended to and worried

about the ongoing COVID-19 pandemic more than those lower on neuroticism

(Kroencke et al., 2020). Additionally, locus of control (LoC) has been shown to

predict the ability to cope with stressful life experiences (Zeidner, 1993; Lefcourt,

2013). During the SARS pandemic of 2003, having a more external LoC was

25
associated with the development of PTSD following a SARS infection (Mak et al.,

2010). Thus, it is likely that these individual differences also influence students’ well-

being during the COVID-19 pandemic.

Nurisng Student

Nursing Student

The nursing specialty consists of both theoretical and clinical courses that

reinforce and support each other. The theoretical part, conducted in classrooms

through lectures, case studies, and directive discussions, is complemented by clinical

training to provide students with opportunities to develop the knowledge, skills,

attitudes, and values taught in classrooms and labs. Furthermore, clinical training

assists students in developing clinical skills, integrating theory into practice, and

expanding their expectations of their future careers.(C. Gibbons., 2010)

Of late, clinical teaching in nursing has improved owing to advances in

technology and the changing environments of health care settings. In most nursing

programmes, clinical training begins in the first year and extends until graduation. As

clinical training accounts for the majority of the nursing curriculum, stress has been

commonly reported among nursing students, especially during the initial period.3

However, depending on how students deal with stressors, stress could have either

advantageous or disadvantageous outcomes4; while some students become more

motivated when faced with stressors, others become anxious and depressed.5 A recent

study conducted on Slovenian midwifery students reflected that the challenging nature

of the midwifery curriculum is one of the most motivating factors for students to

achieve success. Nursing students commonly experience anxiety and stress during

their initial clinical training and practice. Stress during this period can result in several

negative outcomes, such as poor academic performance, elevated burnout levels, and

26
diminished personal wellbeing.. All these are detrimental to the achievement of the

goal of training, which is to prepare competent nurses. Therefore, it is vital for clinical

teachers to be aware of the factors that may prompt increases in the level of stress

among nursing students and the adaptation techniques they utilise to overcome

stressors. There is evidence to support the idea that helping students develop positive

stress coping abilities is useful for their successful adaptation to several stressors

throughout their learning.Furthermore, a recent integrative review highlighted the

importance of recruiting representative samples to assess nursing and midwifery

students` stress and coping strategies in various institutions at specific years during

their studies including prior to their clinical practice.s. The fouryear programme is

followed by a oneyear internship. During the four years of study, students are

assigned to clinical sites to demonstrate practical knowledge of nursing skills.

Students who successfully complete the four years of study are required to complete

one year of hospital clinical training (the internship year). This year, students will

rotate between different floors and units according to their training schedule.

(Mohammed, B.,2019).

Synthesis

Based on the studies, journals, articles and guidelines that we have gathered, it

is clear to us that this research study is relevant. Especially that our department,

College of Allied Health and Science, includes the medical related courses. It will be

very beneficial for the students to know their level of awareness when it comes to

basic life support. We won’t know when this will happen, and we are not also

expecting it to happen. The important thing is when it happens, at least there’s one

person who can do it in a right way.

27
 Stress and coping research has undergone 30 years of vigorous growth. Earlier

ideas are now more fully developed and, as the chapters in this volume demonstrate

beautifully, there is a wealth of exciting new ideas to pursue. The emphasis in this

volume is on coping. Aside from the fact that coping is an inherently fascinating topic

that provides insights into the human capacity to survive both the ordinary and

extraordinary challenges of daily living, it is one of the few variables in the stress

process that lends itself to intervention. As several authors point out, a portion of our

response to stress is influenced by aspects of our biological heritage and

characteristics of the social and physical environment over which we have little or no

control. But our coping responses—what we think and what we do in response to

stress, and to a certain extent the emotions we feel—are at least potentially under our

control. Coping is thus a critical point of entry for protecting mental and physical

health from the harmful effects of stress and worthy of the time and effort the authors

of these chapters have invested over the years.

A student taking up a medical related course should know better than any of

those bystanders. It is in the field of their awaited profession, and it will be

embarrassing and shameful for them if bystanders are more knowledgeable about it.

So, as early as possible, we should start to determine their level of awareness and

when we found out that it is below average, then there’s always a room for

improvement.

28
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31
 CHAPTER III

METHODOLOGY

This chapter reveals the methods of research to be employed by the researcher in

conducting the study which includes the research method, population frame and

sampling scheme, descriptive of the respondents, research instrument, data gathering

procedures, and the appropriate statistical treatment of data

Research Method

This chapter concentrates on the discussion of the research method and

procedures adhered to by researcher in order to systematically answer and determine

the different coping mechanism of nursing students to academic stress. This study

used descriptive research design. In a descriptive design a researcher is solely

interested in describing the situation or case under their research study. This design

allows the researcher to provide insights into the why and how of research.

Population Frame and Sampling Scheme

32
 There are currently 329 enrolled nursing students in Saint Jude College. Out of

329 students 215 of them are first year students, 74 of them are second year students,

3rd year students are 34 and the 4th year students are only 6. The researchers will be

using slovin’s formula to get a sample that serves as representatives or the

respondents of the study. With a 90% confidence level and a 10% margin of error, the

result is 80 students, which became the participants or the sample size from the

nursing students of PHINMA Saint Jude College

The researcher uses a simple random scheme/technique to have every individual

chosen entirely by chance and each member of the population has an equal chance, or

probability, of being selected. It is also the most straightforward method of probability

sampling. Using the lottery method, the researchers will obtain the names of the 329

nursing students and randomly draw 80 names as the sample size from the box.

Simple random sampling is a type of probability sampling in which the researcher

randomly selects a subset of participants from a population.

Description of the Respondents

A total of 80 nursing students of PHINMA Saint Jude College will be selected to

become the respondents of the study. The researchers decided to choose nursing

students since they were in the same department. The respondent will also be describe

according to their demographic profile such as sex (male and female), age, and year

level (first year to fourth year)

Research Instrument

33
This is a descriptive-correlational study that determine the coping mechanisms in

academic stress during COVID-19 pandemic among nursing students. The

respondents of this study were the 50 randomly selected nursing student PHINMA-

Saint Jude Collge. The researchers will use survey questionnaires and will formulate

questions designed only for this study. The research instrument will be use in statment

of the problem number 1 is Frequency distribution to measure the demographic

profile of the respondents. In statement of the problem number 2 and 3 will be use

weighted mean to compute academic stress and coping mechanism. For the Statement

of the problem number 4 will be use correlation analysis to compute if there is

reletionship between coping mechanisms on academic stress and their demographic

profile. The questionnaires will validated by 3 selected validators, it will be sent by

the 15 respondent’s email or messenger account in the form of a google form for pilot

testing and also use Chrohn’s back alpha to measure the internal consistency. The

researchers designed the coping mechanism questionnaire with a total of 20 items.

This questionnaire is a 4-point likert scale, 1 as the lowest and 4 as the highest rating.

The student's mean assessment was interpreted as:

3.50 - 4.00 = Strongly Agree

2.50 - 3.49 = Agree

1.50 - 2.49 = Disagree

1.00- 1.49 = Strongly Disagree

Data Gathering Procedures

34
 The researchers will provide a consent letter to the research adviser, Dean of

College of Allied Health Sciences and Program Head of Department of Nursing to

conduct this study for the 80 respondents of the College of Allied Health Sciences’

students in PHINMA Saint Jude College for the school year 2021-2022. Upon the

approval of the research panel of the Title and Statement of the Problem, the student

will start collecting relevant information from books, internet, journals, articles, and

newspapers. After that, researchers will ask the registrar via email for the list of

students of a particular year level and course who are enrolled under College of Allied

Health and Sciences’ department in PHINMA Saint Jude College for the School Year

2021-2022. Then, the researchers will prepare the researcher-made survey instrument

that will assess the level of awareness in Stress event among the College of Allied

Health and Sciences’ students in PHINMA Saint Jude College for the School Year

2021-2022. It will include the demographic profile such as sex, age, year level and

course and their awareness in in terms of prevention of stress reaction occurs when

symptoms develop due to a particularly stressful event. Afterwards, the researchers

must proceed to select the random 50 respondents for this research study. The

questionnaire will be sent through the email or messenger accounts of the

respondents. This will be answered on a google form sheet. Finally, the answer

questionnaire will be the data use to tally, interpret, and analyze this research study.

Statistical Treatment of Data

Statistical treatment of data is essential to make use of the data in the right form. Raw

data collection is one aspect of any experiment. The organization of data is equally

important so that appropriate conduction can be drawn. (Siddharta Kalla, 2009)

35
 Frequency and Percentage Distribution A frequency and percentage

distribution are a display of data that specifies the percentage of observations that

exist for each data point or grouping of data points. The process of creating frequency

and percentage distribution involves identifying the total number of observations to be

presented and counting the total number of observations within each data point or

grouping of data points.

F
Formula: p= x 100
N

Where:

P= percentage

f= frequency

N= number of respondents

Weighted Mean A weighted mean is a kind of average. Instead of each data

point contributing equally to the final mean, some data points contribute more weight

the others. (Anadale,2014)

The student's mean assessment was interpreted as:

3.50 - 4.00 = Strongly Agree

2.50 - 3.49 = Agree

1.50 - 2.49 = Disagree

1.00- 1.49 = Strongly Disagree

Formula:

x=

Σ ¿¿

36
Where:

x Weighted Mean Σ ¿ ¿

f= frequencies to the given

w= Weight

n= Total number of respondent

Correlational Analysis. Used to measure the strength of the linear relationship

between two variables and compute thier assosciation, it also calculates the level of

change in one variable due to the change in the other.

37