A Thesis Presented to The Faculty of the College of Nursing Liceo de Cagayan University
In Partial Fulfillment of the Requirements for the Degree Bachelor in Science in Nursing by Kimberly Ann G. Dolero Aiza Mae B. Fernando Charmaine T. Gallano Maria Elaine Angelica Ghan Aryan F. Mabelin Krysslyn C. Navarro
July 2014 2
ABSTRACT This study aimed to determine the types of stress experienced by 3 rd year nursing students and to find out their preferred stress management in dealing with the different day to day hassles and problems that they experience being a nursing student. This study was anchored by the theory of Hans Selye which is about the General Adaptation Syndrome and for the Stress Management that they commonly utilize; the 12 S of the Department of Health is reinforced. Qualitative type of research was used and questionnaires to gather data. A total of 30 students were the respondents of the study. Stress in students are classified according to academics, financial, interpersonal and intrapersonal and based on the results, it has been noted that problems in academics greatly poses much higher risk of stress among students. Stress management that students commonly use are sounds and songs, social, smile, spirituality and others. The entire data and analysis showed that students have problems in their academics and have inappropriate stress management because they dont practice time management and good study habits thats why they tend to have problems in their academics especially 3 rd year Nursing students since they have their Major subjects doubled and this level is said to be the waterloo of Nursing.
KEYWORDS: Stress, Management, Third Year, Nursing Students
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CHAPTER 1 THE PROBLEM AND RESEARCH DESIGN INTRODUCTION Stress is inevitable and is evident nowadays. It is a state produced by a change in environment perceived as challenging, threatening or damaging to a persons balance and equilibrium (Lippincott, 2008).Stress is experienced by everyone everyday and one must adapt in order to overcome it in every circumstance. It is any change that one must adapt to, ranging from the negative extreme of actual physical danger to exhilaration of falling in love or achieving some long desired success (Public Health Nursing in the Philippines, 2006). Lazarus and Folkman (1984) defined stress as a whole spectrum of factors (stimulus, response, cognitive appraisal of threat, coping styles, psychological defenses and the social mileu) and by that, we experience stress all the time and there is no question about that. It's a well known fact by now that stress isn't good for the body. While the argument can be made that some stress is healthy in motivating us and adding the needed pressure to get things done, there is no arguing the fact that stress has a negative impact on the body (Theories Behind Stress, online) Being stressed then also affects our health. We may not have a disease but as stress worsens and stays in us for a long period of time it might lead to an illness and worsens if not managed and that alone proves that stress is not a unique problem to the 4
21st Century and up to now. According to Selye, human kind has suffered stress starting from the dawn of human evolution and up to now (1976). College stress is an even a more complex problem. Students in college have experienced stress all their school and day to day life. To students currently attending college, tons of requirements, activities, other problems and conflicts makes all of them stressful and tends to frustrate them conversely. Stress is one of the factors that influence students in their performance at school or in their day to day experiences (Sawatzky 1998). Even in professionals and normal people, stress is felt. But in the contrary, we all can have the ability to combat stress. Stress management are popping everywhere and we are not all blinded by that. Hence, there are tendencies that we dont know how to use and utilize it. As nursing students, we can say that we had encountered stress always especially on our routine day to day schooling and add it up with other additional problems coming our way. With the difficult lectures and tiring duty days, it has been always our complain that we are stressed and thats because of all those activities that our course demands on us. Nursing is a demanding course and by that, due to our curiosity, we had come up to a study that explains really the types of stress experienced by junior years in college, because in some instances, and as what we have observed, many had flunked their subjects and had really difficulties when it comes to catching up with lectures especially on major ones. 5
This study aimed to determine the different stress experienced by third year students only and what is the underlying reason why some of them failed their major subjects or had poor performance in class or had incurred many extensions. And also, we had this study to know the preferred stress management of Nursing students and how it plays a great role in relieving their stress. CONCEPTUAL FRAMEWORK The study focused on the theory of Hans Selye about stress. Selye initially proposed a triadic model as the basis for the stress-response pattern. Selye viewed stress as the common factor of all adaptive reactions in the body and complete freedom from stress as death (Selye, 1974). Selye (1976) labeled GAS (General Adaptation Syndrome), because agents are produced by having a general effect on portions of the body and adapts mostly on mechanisms that is stimulated and rely on manifestations that are dependent to each other. The stressors then that college students experience nowadays really cause anxiety and depression on them, instead stress results from the interaction between stressors and the individuals perception and reaction to those stressors ( Romano, 1992). According to a journal about Stress in College, college workload is involved than in high school and being in college, parents and teachers are in less control with them. With challenging classes, busy schedules, difficult exams and scholarly college 6
demands, many students may it be new or returnees find themselves studying at long tiring sleepless nights. But when there is stress, management is then the counterpart. Since all of us have a unique response to stress, different kinds of solutions are used to manage it. If we cant avoid it, we can still manage it though, but it is not applicable to everyone in every circumstance so experimentation is needed with various strategies and techniques. We must focus on something that makes us calm and in control (Stress Management, online) Many stress management techniques popped everywhere and its up to all of us on what stress management fits all of us. An example would be the program of the DOH which is about the 12 S. It talks about the 12 Stress management techniques in order to lessen stress among individuals. According to the book entitled Public Health Nursing in the Philippines (Cuevas,2006), stress management is a largely learnable skill. Everybody can learn to effectively handle stress even when pressures persist. The following are then the stress management techniques that can be used to manage stress. First would be spirituality wherein it signifies the meaning of mans relationship with God. Meditation is in relation with spirituality because it relaxes the mind and spirit. Next is Self-awareness which means getting to know more ones self and being vigilant to ones feeling. Scheduling or time management refers to managing time in a way that getting things done is made through a stipulated time frame to achieve desired results. Siesta comes next wherein it relaxes and the mind and body muscles. Stretching also is a form of relaxing the muscles and it improves health as well. Sensation Techniques relieve stress by 7
soothing away stress and freeing tensed muscles from a stressful and tiring day while sports, gives the body the exercise the body needs and socials, enables an individual to boost confidence and develop skills when it comes to mingling with other people. Sounds and songs provide expression of thoughts and feelings among teenagers through listening. Speak to me is designed to form a mutual support system to verbalize feelings in a more clear way through speaking to release emotions. Stress debriefing is evident on persons who have experienced accidents or trauma that needs counselling. And lastly is smile, which is an expression of pleasure and gratitude. All of these are the programs of the government and it aims to lessen stress may it be physically, psychologically and some may be behavioural. And by that we can say that stress in the overall is being presented to intertwine every single detail that it is causing exhaustion to students. Appropriate management is needed and it all depends on us on what management are we going to use.
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Research Flow
Figure 1. A Schematic Diagram showing the relationship of Stress Experienced by 3 rd
Year Nursing Students in relation to their preferred Stress Management
Stress experienced by 3 rd Year Nursing Students
Preferred Stress Management 9
OBJECTIVES OF THE STUDY This study aimed to (1) determine the types of stress experienced by third year nursing students and to (2) determine their preferred stress management. SIGNIFICANCE OF THE STUDY The following persons will benefit from the findings of this study: NURSING STUDENTS. The results of this study will help them to be aware of stress and to help them manage it in their lives as students. PARENTS OF NURSING STUDENTS. The findings of the study will enable the parents to understand the different changes that they observe in their sons and daughters due to the different demands of the course yielding stressful events in the lives of their children. This will also equip them with alleviating factors on how to lessen the stressful feelings that their children is experiencing. DEAN, LEVEL COORDINATORS AND FACULTY OF THE COLLEGE OF NURSING. The results of the study would provide additional information to further reinforce students and also his/her constituents on how to deal with stress of students and provide management utilizing the programs of the government. Moreover, the results will provide interventions to students on how to up with stress and find ways on how to handle them especially those who have failing grades in their major subjects or those who have family and other problems. FUTURE RESEARCHERS. The findings and conclusions that will be taken from this study would later on serve as a basis for future researchers on how to further 10
manage stress felt by nursing students especially on their junior years or not only for them but for other year level as well. SCOPE AND LIMITATION OF THE STUDY The study focused more on 3 rd Year Nursing students since they have the most busy schedule in all of the year levels of the College of Nursing and majority of the students failed the major subjects they are taking. The study is limited to 3 rd Year Nursing students who had taken both their lecture and RLE. Nursing students of Liceo de Cagayan University who are officially enrolled in the 2 nd semester of the School Year 2013-2014 are the focus on this study. Regarding the type of stress they experienced, their input is then interpreted into 4 categories which is interpersonal, intrapersonal, financial and academic stress. Then for the stress management, the scope is the 12 S of DOH and some additional stress management is only optional for them to answer. DEFINITION OF TERMS To provide reference and for better understanding of the words used in this study, they are defined to mean as follows: Stress is a specific response by the body to a stimulus, as fear or pain, that disturbs or interferes with the normal physiological equilibrium of an organism. Academics , the scholarly activities of a school or university as classroom studies or research project more emphasis on academics and less on athletics. 11
Interpersonal Relationship is the relationship between individuals. Spirituality is a state or quality of being spiritual. It is strong faith and belief to one God or any spiritual symbol. Self-awareness means knowing self more and being sensitive to the inner self and its relationship to others. Scheduling or time management refers to managing time in a way that getting things done is made through a stipulated time frame to achieve desired results Siesta relaxes the mind and body muscles by taking a short nap or break toincrease productivity. Stretching are body movements that relaxes muscles and improves blood circulation. It can be done anytime that requires no equipment. Sensation Techniques is the use of touch to communicate with others in order to alleviate pain or transfer positive aura to provide comfort. Sports enables the muscles in the body to work and encourages camaraderie and participation on activities that may both benefit the health and well-being of a person. It also gives the body the exercise it badly needs. Socials enables a person to mingle with others company or to develop interpersonal relationship. Sounds and Songs provide expression of thoughts and feelings through listening. 12
Speak to me is designed to form a mutual support system to verbalize feelings in a more clear way through speaking to release emotions Stress Debriefing Stress debriefing is evident on persons who have experienced accidents or trauma that needs counselling. Smile is an expression of pleasure and gratitude.
CHAPTER 2 REVIEW OF LITERATURE AND STUDIES This chapter discusses some relevant literature and studies on the different stress experienced by nursing students. The studies from various nations supplements new insights regarding the study and will serve as a guide and framework of the study. Foreign Literature Suzanne C. Kobasa et al. (1985) believed that stressful events fire up challenges in life and hardiness serves as a buffer system. This theory, serves as a perceptive buffer and adds a third element in the stimulus-response. Greenberg (2008) explained that in order to avoid stress, social support theory is needed to provide a perceptive buffer that can turn available support systems to resources that can be used to fill-in gaps.
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J.C. Overholser, W.H. Norman and I.W. Miller (1990) perceived that stress are results of inability of the person to dissolve the threat of stressors and it is due to lack of social support systems and resources. Melluci (2004) cited that psychosomatic illness is also a result of stress. It is brought about by psychological and emotional distress that cause a feeling of unusuality and problem in the normal functioning of the body. Furthermore, stress can lead to poor coping mechanisms such as alcohol or drug use, lack of care for oneself or one's health, poor exercising routines, and poor nutrition. According to Lazarus and Folkman, (1984), stress will depend upon the person's personality, beliefs and general experience. A person who is seriously ill and has no clear information might draw hope from this ambiguity, believing that they will get well.. Foreign Studies The (American Institute of Stress, online) listed staggering 50 symptoms of stress. Some of these include frequent headaches, teeth grinding, heartburn or other stomach problems, insomnia, nightmares, depression, mood swings, social withdrawal, irritability, diarrhea or constipation, frequent illness or infection, feelings of being overloaded and overwhelmed, and at worst suicidal thoughts. In all, stress impacts the brain, digestive track, lungs, heart, mouth (dryness and ulcers), hair (hair loss), muscles (various pains, tics, and twitches), reproductive organs, and the skin. Rahe (2000) had a reliability testing done in 1970 to predict illness using a stress scale. The scale was given to 2,500 US sailors and they were asked on their previous 14
six months life events. Results showed that life events are related to development of stress. Stress management is effective for preventing behaviours such as smoking, unhealthy eating habits, sedentary lifestyle choices to name a few-, behaviours that serve as risk factors for the majority of the disease and disorders. Non- pharmacological and pharmacological stress management are emphasized, but as Nursing students, non-pharmacological stress management is encouraged.(Health Science Journal, 2011). A study on college students who are stressed showed a positive relationship between study conditions and mental stress. Other precipitating factors may occur but the most dominant factor is about the mental stressed experienced by students rather than the other types of stress that they encounter. (Hong Ji and Lei Zhang, 2011). According to a study of ( Deary and Hogston, 2003) that was done to investigate the perception and sources of stress, coping mechanisms used, and self-esteem in nursing students in their undergraduate nursing program for 3 years, four main stressors were determined and these are nursing studies, finance, family and health problems. Based on the results, there is a need to evaluate the impact of stress among students and review the curriculum together with introduction of new strategies in coping. With regard to academic stress, the most frequent stressor is the increased class workload while on environmental stressor, waiting in long lines and being placed in unfamiliar situations poses much stress.
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CHAPTER 3 METHODOLOGY RESEARCH DESIGN The study falls under descriptive qualitative research design, which involves describing the characteristics of a particular individual or group in completing this study. Primary source of data is referred for the study with the use of questionnaires. Sources came from persons, personally contracted for the relevant information. The study will be conducted by the permission and approval of our class instructor, the Dean of the College of Nursing and the year level coordinator. The data collected is analyzed and interpreted. RESEARCH SETTING The study was conducted at Liceo de Cagayan University. It was founded in 1955 and has its main campus in Kauswagan Road, Cagayan de Oro City. The University is one of the fast growing and renowned institution in the city. The University is became the first and only higher education institution in Mindanao that passed the Institutional Quality Assurance through Monitoring and Evaluation (IQUAME) as Category A in teaching. CHED had also granted the University an Autonomous Status which was based on the three major criteria. Under Category A by the CHED is classified as a mature teaching institution. Mr Ferdinand Gil G. Calang, the University Quality Assurance Officer has stated that Autonomous Status attest that the University delivers quality education. 16
RESPONDENTS AND SAMPLING PROCEDURE The proposed respondents in this study were the selected 3rd year nursing students. Purposive sampling was being done among 30 female and male students who were stressed. Only those who are stressed students were selected. The 30 students were screened using the stress tool which gave a result of moderately stressed. RESEARCH INSTRUMENT The study used a researcher made questionnaire as the instrument of data collection. The first part of the questionnaire was all about the type of stress experienced by the students and they free to write what they want and what they perceived as stressful to them. The second part elicits their preferred stress management coming from the 12 S of the DOH. They are going to rank the top 5 stress management they commonly use. But before giving the questionnaire, we had first screened them to determine if they are really stressed and it yielded a result that all of the respondents that we had screened are stressed. DATA GATHERING PROCEDURE To start the data gathering, a written letter addressed to the Dean of the College of Nursing was made for her approval on the said study. Upon approval a stress tool was given to determine if they are stressed. When the tool was interpreted, those who have experienced stress were asked to sign the consent form and the actual questionnaire was then given. On the 1 st question regarding the types of stress, the 17
respondents were asked why they have chosen it as type of stress and on the second question, the researchers explained each sensation technique and they are asked to rank their 1 st to 5 th stress management. STATISTICAL TECHNIQUES The following statistical tools were used in the analysis of the data: The frequency and percentage were used in both types of stress experienced by 3 rd year nursing students and the preferred stress management and they are ranked according to what it commonly preferred to use by the students. CHAPTER IV PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA Problem 1: Types of stress experienced by Nursing Students Table 1 shows that among 45 combined results of the types of stress experienced by 3 rd Year Nursing students, 17 responses or 38% reflected that they are stressed regarding their academics, 12 responses or 27% on interpersonal, 9 responses or 20% on intrapersonal and 7 responses or 15% on financial stress. This means that academic workload, requirements, quizzes, term exams and other paper works requires great demand and time on nursing students. While financial problems yielded the least results which signifies that money problems can still be easily resolved. A study conducted on college students in China discovered that there is a relationship and correlation between study conditions and mental stress (Hong Ji and Lei Zhang ,2011). This supports the notion that academic stress is really the topmost 18
stressor that students experience. This reveals that students really had a notion that things done inside the classroom makes them stressed especially when quizzes and term exams take place. They have difficulties in compensating with the lapses they had and then the burden in them doubles when they yielded low grades.
Table 1. Objective 1: Types of Stress experienced by 3 rd Year Nursing Students TYPES OF STRESS FREQUENCY PERCENTAGE Academic
Interpersonal
Intrapersonal
Financiall 17
12
9
7 38 %
27%
20%
15% TOTAL 45 100%
Problem No. 2: Preferred stress management As shown in Table 2 , the top 5 stress management used by students according to rank are Sounds and Songs as the first, followed by Socials, Smile, Siesta and Spirituality. The least used stress management technique is stress debriefing. 19
On a study of Salamon E, Bernstein SR, Kim SA, Kim M and Stefano GB(2003), which is about The effects of auditory perception and musical preference on anxiety in naive human subjects, mainly on students, they had a result that there is a decrease in anxiety in the subjects whenever they hear their preferred genre of music as evidenced by decrease in their blood pressure and they appear to be more relaxed. They said that there is a strong relationship on reduction of stress with the music they hear and by that stress and anxiety is reduced. In addition, this confirms with the study of Cuevas (2006) that sounds and songs are more common among teenagers because it provides expression of thoughts and emotions through listening. And by that, it is of great evidence that this stress management is more popular in our respondents. Furthermore, Socials, Smile, Siesta and Spirituality also are significant also on students because by this, they divert their attention and they somewhat forget their stressful experiences at school or at duty. On the other hand, stress debriefing is most significant especially only to those who had experienced calamities or accidents that are difficult to erase and really needs psychological help thats why that is the least preferred stress management. Table 2. Preferred Stress Management 12 S OF THE DOH FREQUENCY RANK 1. Spirituality 12 5 th
2. Self- Awareness 4 10 th
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3. Scheduling 6 8 th
4. Siesta 16 4 th
5. Stretching 3 11 th
6. Sensation technique 4 9 th
7. Sports 8 6 th
8. Social 19 2 nd
9. Sounds and Songs 21 1 st
10. Speak to Me 7 7 th
11. Stress Debriefing 3 12 th
12. Smile 18 3 rd
FINDINGS The following findings surfaced in the course of the investigation and the results: 1. The 3 rd year students of the College of Nursing are stressed when it comes to their academic concerns. They are so pre-occupied in completing their requirements, quizzes, term exams, lectures and their loaded subjects wherein majority of it are major ones such as Medical Surgical Nursing and Psychiatric Nursing. 2. Most of the respondents preferred listening to music or sounds and songs. They also preferred socials wherein they like to socialize with other people and enjoy new company. Smiling is their way of showing positive reinforcement while Siesta or taking naps at break time energizes them even for a short period of time. Also, praying or talking to God through Spirituality gives them hope and wisdom to continue their 21
stressful day with guidance from the Lord. While stress debriefing is of the least priority stress management because they are aloof or they are not that used to talking on guidance counsellors regarding their problems. And they perceive stress debriefing as only to those who had experienced calamity or to those who experienced emotional breakdown.
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CHAPTER V SUMMARY, CONCLUSION AND RECOMMENDATIONS This chapter recapitulates the salient features as well as the revealed findings of this study. This also includes the conclusions made by the researchers based on the findings as well. Recommendations to reinforce the data are presented. SUMMARY Utilizing the descriptive research design, this study intended to determine the different types of stress experienced by 3 rd year Nursing students. The stresses included were academic, interpersonal, financial and intrapersonal. The respondents of the study are purposively selected after they have undergone the screening to determine if they are stressed and that yielded a result that they are moderately stressed. A total of 3o students were chosen who are officially enrolled in the Nursing program of Liceo de Cagayan University. The main instrument that is used to gather data from the respondents is a researcher-made questionnaire. The questionnaire has two parts. The first part seeks to know the different types of stress experienced by 3 rd year Nursing students while the second part is all about their preferred stress management coming from the 12 S of the DOH.
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CONCLUSION We conclude that 3 rd year nursing students are stressed in all aspects of their student life and they are able to compensate and fight back stress with appropriate stress management techniques with further and thorough reinforcement. RECOMMENDATION Based on the findings and conclusions, the researchers would like to recommend the following: 1. Further evaluation of the performance of their students when it comes to their grades by term for the students to know their standing in class and take measures on how to improve their grades. Also, a regular talk with students regarding proper stress management especially time management, scheduling and proper study habits. 2. While on duty, clinical instructors should schedule ahead of time activities and follow the agreed schedule unless important and emergency matters might occur. 3. Regular session with the school guidance counselor is recommended to students who have failing marks on Major subjects for them to be given proper advice and guidance. 4. Before a new topic is to be discussed in classroom setting, one song should be played or the instructors may utilize the top 5 stress management techniques. 5. For the future researchers, when they use the 12 S of the DOH, they must define what is stress debriefing and give examples. 24
BIBLIOGRAPHY A. Books Greenberg, J.S. (2008). Comprehensive Stress Management, 10th ed. NY: McGraw-Hill. Melucci, N. (2004). Psychology.Barron's Educational Series, Hauppauge, NY. Rahe RH et al. (2000). The stress and coping inventory: an educational and research instrument. Stress Medicine 16: 199-208.
Selye, H. (1976). The stress of life (Rev. ed.). New York, NY: McGraw-Hill.
Smeltzer (2008) Textbook of Medical Surgical Nursing.pp. 92-99
Cuevas(2006).Public Health Nursing in the Philippines, pp B. Journals College Student Journal; Jun99, Vol. 33 Issue 2, p312,6p, 1 chart Health Science Journal, Stress Management Techniques: evidence-based procedures that reduce stress and promote health, VOLUME 5, ISSUE 2 (2011) 25
Romano, J. L (1992).Psychoeducational interventions for stress management and well-being. Journal of Counseling and Development, 71, 199-321. Internet Sources Theories Behind Stress.(http://voices.yahoo.com/the-theories-behind-stress- physiological-effects-397474.html). Hong Ji and Lei Zhang (2011)Research on College Students Stresses and Coping Strategies, Vol. 7, No. 10. Retrieved on March 14, 2014 on http://dx.doi.org/10.5539/ass.v7n10p30. Deary, I. J., Watson, R., &Hogston, R. (2003).A longitudinal cohort study of burnout and attrition in nursing students. Journal of advanced nursing, 43(1), 71- 81. Retrieved on March 7, 2014 on http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2648.2000.02251.x/full PulidoMartos, M., AugustoLanda, J. M., & LopezZafra, E. (2012). Sources of stress in nursing students: a systematic review of quantitative studies.International Nursing Review, 59(1), 15-25. Retrieved on March 7, 2104 onhttp://onlinelibrary.wiley.com/doi/10.1111/j.1466- 7657.2011.00939.x/full Salamon, E., Bernstein, S. R., Kim, S. A., Kim, M., & Stefano, G. B. (2003). The effects of auditory perception and musical preference on anxiety in naive human subjects. Retrieved on July 3, 2014 on http://europepmc.org/abstract/MED/12960929 26
APPENDICE A LETTER OF CONSENT TO STUDY January 8, 2013 Dear respondents, Good day! We, the students of Liceo de Cagayan University would like to conduct a survey regarding Stress Management of students on how they manage stress. We will observe confidentiality on the information we have gathered. Hoping for your kind consideration and support regarding this matter. Sincerely yours, Kimberly Ann Dolero Aiza Mae B. Fernando Charmaine Gallano Ma. Elaine Angelica Ghan Aryan F Mabelin Krysslyn Navarro
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APPENDICE B QUESTIONNAIRE Name of Respondent (optional) ________________________________ Age:______________ Gender:_____________ Date:_____________
1. What are the different types of stresses that you experienced as 3 rd Year Nursing student? Why? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________
2. Among the preferred 12 Stress Management Techniques of DOH, rank from 1-5 the preferred stress management; 1 as the top most stress management and 5 as the least stress management technique used and why have you chosen that stress management technique. ____Spirituality Why?___________________________________________ ____Self Awareness Why?___________________________________________ ____Scheduling Why?___________________________________________ ____Siesta Why?___________________________________________ ____Stretching Why?___________________________________________ ____Sensation techniques Why?___________________________________________ ____Sports Why?___________________________________________ 29
____Socials Why?___________________________________________ ____Sounds and songs Why?___________________________________________ ____Speak to me Why?___________________________________________ ____Stress debriefing Why?___________________________________________ ____Smile Why?___________________________________________
APPENDICE C GENDER AGE STRESS EXPERIENCED REASON STRESS MANAGEMENT TECHNIQUE Female 20 Academics Full of requirements and difficult Major Subjects Siesta Sensation technique Sports Sounds and songs and Speak to me Female 20 Academics, Intrapersonal Lots of requirements and sleepless nights because of complying requirements Socials Self- awareness Sounds and songs Smile Spirituality Female 21 intrapersonal Sleepless nights and failing grades Sounds and Songs Spirituality Scheduling Socials Smile Female 23 Interpersonal, Intrapersonal Family problems, personal issues with self and class and duty requirements Siesta Stretching Socials Sounds and Songs Smile Female 22 Academics, Intrapersonal Conflict of schedule because of loaded subjects, full of requirements and no time management Scheduling Sounds and Songs Socials Smile Other: Playing Piano Female 23 Academic, Interpersonal Failed Major Subjects, exposure at the hospital with many requirements, failure to prepare on major exams and quizzes, strict clinical instructor Spirituality Scheduling Sports Sounds and Songs Social Female 20 Intrapersonal Emotions and Socials 31
tons of requirements Sounds and Songs Spirituality Sports Siesta Female 21 Intrapersonal Requirements and sleepless nights Sounds and Songs Smile Spirituality Speak to Me Sensation Technique Male 20 Financial, Intrapersonal Financial problems, requirements and hospital duty Siesta Sounds and Songs Socials Smile Spirituality Female 24 Interpersonal, Financial Family problems, financial, requirements on duty and hospital duty Scheduling Sports Siesta Smile Self- Awareness
Female 21 Intrapersonal,Interpersonal, Financial Hospital requirements, no money , family problems Siesta Sounds and Songs Socials Stress Debriefing Spirituality Female 21 Academics Academics especially on major subjects Siesta Socials Sounds and Songs Male 23 Academics, interpersonal Problems in school work, broke, stress on fellow classmates Siesta Smile Stress Debriefing Spirituality Self-Awareness Female 21 Interpersonal Problems in teachers and clinical instructors, hospital and community duty Sensation Technique Sounds and Songs Stretching Sports Smile Male 21 Academics, Intrapersonal Low grades, busy schedule, no time in Sports Smile Socials 32
making school requirements
Female 20 Intrapersonal No time to study Siesta Spirituality Smile Socials Male 24 Many to mention Smile Spirituality Scheduling Sounds and Songs Female 21 Academics, Interpersonal, Financial Major exams, case presentations especially when we are not the ones who made it, strict clinical instructors on duty, requirements and practical exams. Payments also Sounds and Songs Stress Debriefing Speak to ME Spirituality Siesta Female 20 Academics Class reporting especially when I have no time to prepare for it, requirements and case presentations Siesta Socials
Female 21 Academics Hospital duty requirements, conflict of schedule and Major subjects Smile Sports Sounds and Songs Socials
Female 21 Academics, Financial Requirements, case presentation and financial problems Smile Sounds and songs Speak to me Female 21 Academics Low grades, many requirements and case presentation Self-awareness Sounds and songs Speak to me Socials 33
Female 21 Academics Requirements Sounds and Songs Male 22 Financial, Interpersonal Financial problems, bully classmates and many requirements Speak to me Smile Siesta Socials Female 19 Academics Term exams Spirituality Siesta Stretching Socials Female 20 Academics Case presentations and major exams Scheduling Smile Sounds and Songs Siesta Socials Female 20 Intrapersonal No time to study and difficult major subjects Siesta Socials Sensation technique
Male 24 Intrapersonal, Academics Money problems and many requirements Sports Sounds and Songs Smile Socials Speak to me Male 20 Financial No allowance, hospital duty and major examinations Siesta Spirituality Smile Female 20 Academics Difficult major subjects Sounds and songs
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Perceived Stress Scale 0 - never 1 - almost never 2 - sometimes 3 - fairly often 4 - very often In the last month................... ____ 1. Have you been upset because something had happened unexpectedly and how often? _____ 2.How often have you felt that you were unable to control the important matters in your life? _____ 3. Have you felt nervous and stressed? How often? _____ 4. How often have you felt that you can handle personal problems confidently? _____ 5. How often have you felt that things were going the way exactly you want ? _____ 6. H often have you found out that in all the things you do, you couldnt cope well? _____ 7. How often have you been able to control conflicts in your life? _____ 8. How often have you felt that you were things are going the way you want it to be? _____ 9. How often have you been angered because you were things happened outside of your control? _____10. How often have you felt difficulties were piling up so high and you cant anymore contain it? 35
Figuring your PSS score: You can determine your PSS score by following these directions: First, reverse your scores for questions 4, 5, 7, & 8. On these 4 questions, change the scores like this: 0 = 4, 1 = 3, 2 = 2, 3 = 1, 4 = 0. Now add up your scores for each item to get a total. My total score is ______. Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress. Scores ranging from 0-13 would be considered low stress. Scores ranging from 14-26 would be considered moderate stress. Scores ranging from 27-40 would be considered high perceived stress. The Perceived Stress Scale is interesting and important because your perception of what is happening in your life is most important.