EXPLORING THE PSYCHOLOGICAL EXPERIENCES OF MUNICIPAL HEALTH

OFFICE NURSES IN MONITORING SUSPECT COVID19 PATIENTS IN LAGAWE

Submitted by: Alvincent D. Binwag

Submitted to: Ma’am Ana Marie G. Pagaddut
Section: 12 STEM C
Date: December 1, 2020
 CHAPTER I

THE PROBLEM AND ITS BACKGOUND

Rationale

An unidentified acute severe virus has been discovered from patients with unexpected

pneumonia in Wuhan, China. They added that it was named by the International Committee of

Viral Classification on February 12, 2020 into 2019-nCoV (Song et. Al., 2020). This unexpected

illness mainly causes respiratory and digestive tract symptoms in their paper they described it to

be “ranging from mild self-limited disease to severe pneumonia, acute respiratory distress

syndrome, septic shock, and even systemic multiple organ failure syndrome”. The source of the

infection is mainly those who have the SARs infection before and those who suffers from

diseases. Elderly people with underlying disease are more likely to be infected with the virus and

develop severe disease and children and infants are also at risk. At present, cure is still not found.

The treatment includes isolation, antiviral, symptomatic support, and close monitoring of disease

progression. (Wei L. et al., 2020)

Globally, as of 3:37pm CET, 30 November 2020, there have been 62,363,527 confirmed

cases of COVID-19, including 1,456,687 deaths according to the World Health Organization

(2020). Meanwhile, in the Philippines the total number of cases according to World Health

Organization from January 3 to 3:37pm CET, 30 November 2020, there have been 429,864

confirmed cases of COVID-19 with 8,373 deaths. Locally, according to the Department of

Health (2020), the total number of COVID19 cases in the Cordillera Administrative Region is

5,533, 108 from the province of Abra, 65 from Apayao, 1,961 from Benguet, 101 from Ifugao,

294 from Kalinga, 42 from Mt. Province and 2,962 from Baguio City.
 From the first positive case of the said virus fifty-eight countries have also recorded their

own Covid-19 case (Sun et al. 2020). Meanwhile, by August 25, 2020 there are about 6,735

health workers (mostly nurses) have contracted the Corona Virus Disease (COVID-19)

according to the Department of Health (DOH) in August 2020. Due to the 80 additional

infections the DOH reported infections towards healthcare workers have increased (Ramos,

2020). Medical workers, as the main force in the battle against the epidemic, bears a great task

and responsibility in combating the virus. Unfortunately, these health care workers sacrificed so

much that even their lives were not spared and thus makes a great risk to the mental health of

other health practitioners in the country (Sun N. et al., 2020).

Studies have shown that it is the selfless contributions out of their moral and professional

responsibility that makes health practitioners be the face of such disaster. At the same time,

physical, emotional and mental stress is a big threat to medical practitioners when facing

emergencies. Wang (2020) have shown that “when nurses are in close contact with patients with

emerging infectious disease such as SARS, MERS-CoV, Ebola, H1N1, they will suffer from

loneliness, anxiety, fear, fatigue, sleep disorders, and other physical and mental health

problems.” They also added that “the incidence of depression, insomnia, and post-traumatic

stress among nurses involved in the treatment of SARS patients was 38.5%, 37% and 33%,

respectively. In a study of Psychological status of Ebola patients’ caregivers, 29% of respondents

felt lonely and 45% received psychological counselling. On the contrary, some studies also

demonstrate the positive experience and growth brought by the collective anti-epidemic efforts.”

Due to the out-break of Covid-19 nurses and all other practitioners are expected to assist

these people who have acquired the disease only with a brief training and consultation. Song

(2020) stated that:

 Nurses from other departments were required to go through 3 training stages before

starting nursing duties for patients with COVID-19: pre-job training, adaptive training

by nursing other patients in the infection department, and negative pressure ward

training. This process occupied by 1 week. Nurses who entered the negative pressure

ward would work for 0.5-3 months before being transferred to other non-anti-epidemic

positions. Because COVID-19 is a new disease and the medical system and culture of

different countries varies, further research is needed on the psychological experience of

frontline nurses fighting against COVID-19. Currently, published studies have

highlighted the disease prevalence, clinical characteristics, diagnosis and treatment.

Some reports have paid attention to the severity of psychological problems in medical

personnel and the urgency of providing care. However, no qualitative studies have been

published on the psychological experiences of nurses combating COVID-19.

This study aims to understand the subjective experience of nurses participating in nursing

COVID-19 patients through semi structured interviews and to analyze the data using the

phenomenological methods, providing fundamental data for the psychological experience of

nurses. (Wei L. et al., 2020)

Objective of the Study

This study aims to explore the psychological experiences of Municipal Health Office

(MHO) nurses in monitoring suspected COVID19 patients in Lagawe.

Specifically, this study seeks to answer the following questions:

1. Do nurses experience psychological problems?

2. How do nurses feel when they work beyond their time in monitoring suspected COVID19

patients?

3. What are the coping mechanisms do the nurses do to avoid psychological imbalance?

Significance of the Study

This study will benefit the following;

Healthcare workers specially nurse, the main beneficiaries of this study. Most of the

health workers who are working beyond the given time are forced to work still in their post

despite the risks of getting infected with COVID-19. Through this research it will be a great

help for health workers to know and to be psychologically aware on the impact of COVID-19

specially on the mental aspect.

Community. Through this research people will know and understand how complex

the work of a frontline health worker in combating SARS-Cov2. Also to be psychologically

aware on the negative impact of COVID-19 on the mental aspect.

Researchers, this research will be of great help specially to the future researchers.

Scope and Delimitation

This research focuses on the experiences of Municipal Health Office nurses

psychologically at MHO Lagawe, Ifugao while monitoring suspected COVID19 patients in terms

of mental, emotional and behavioral aspect.

This study will be conducted during the school year 2020-2021 at Don Bosco High

School.
 Theoretical Framework

The possible findings on the psychological experiences of nurses in monitoring patients

with suspected COVID19 disease according to the American Journal of Infection Control (2020)

are the following; high risk of pressure, homesickness, emotional breakdown, discomfort,

distress, insomnia, impression of exhaustion and fear, mild risk of anxiety, high levels of

depression, feeling the unfairness, perceiving incompetence in rescue task, and unexpected

professional benefits.

This presented study used an in-depth online interview and phone call to gather data. This

aims to find ways on how to cope up with the struggles caused by the COVID19 to the health

care nurses in order to avoid psychological imbalance. The possible ways are the following;

implementation strategies to reduce the chances of infections, shorter shift lengths, mechanisms

for mental health support could reduce the morbidity and mortality amongst the nurses and self-

management strategies like doing meditations, taking a break, having a strong faith to the

almighty and make time to socialize or bond with colleagues. In addition, possible nursing

programs should be managed in a way to prevent nurses to be exhausted so they can afford

continuing work. (Shaukat N. et al., 2020)

Figure 1. Research Paradigm

INPUT
INPUT PROCESS
PROCESS OUTPUT
OUTPUT

To explore the possible An in-depth online interview Contribution to all the

findings on the psychological and phone call will be used. healthcare workers (nurses)
experiences of nurses in for them to be
monitoring suspected psychologically aware and to
COVID19 patients and help them cope-up with the
coping mechanisms in negative effects of COVID19
order to avoid specifically to their mental
aspect.
psychological imbalance.
Definition of Terms

 SARS-CoV 2 or COVID-19- (Severe Acute Respiratory Syndrome) a newly discovered

ribonucleic acid coronavirus.

 MERS-CoV- (Middle East Respiratory Syndrome) according to WHO, it emerged in

2012 in Saudi Arabia, a type of corona virus through the contact with camels.

 SARS-CoV - (Severe Acute Respiratory Syndrome) according to WHO, a type corona

virus appeared in Southern China in November 2002.

 Ebola – A deadly virus disease with occasional outbreaks that occur primarily on the

African continent.

 H1N1- (Hemagglutinin 1 Neuraminidases 1) a new virus detected in humans in 2009. It

is considered a regular flu virus. It is one of the three viruses included in the regular

(Seasonal) flu vaccine.

CHAPTER II

REVIEW OF RELATED LITERATURE AND STUDIES

Related Literature

This chapter reviews the work of the researcher on the studies closely related to the

present day, as follows:

A newly discovered novel corona virus was now renamed as severe acute respiratory

syndrome coronavirus 2 (SARS-CoV-2) (Hou 2020). According to the World Health

Organization, they announced that corona virus or COVID-19 was officially named by the NCP.
It had been listed as on January 30, 2020 it was first declared as a public health emergency of

international concern. However, on month of March 11, 2020, it was confirmed as pandemic.

Symptoms of fever, dry cough, and fatigue, are all characterized by the newly discovered

infectious disease. In addition, some patients who acquired the virus disease may experience

runny nose, nasal congestion, diarrhea and sore throat. However, in worst cases, patients can

develop hypoxemia and or dyspnea, which often leads to metabolic acidosis, acute respiratory

distress syndrome, septic shock, multiple, organ failure, coagulopathy, and possibly loss of lives.

It is hard to accept that this deadly virus disease is transmitted quickly and worst, unknowingly.

At present, the accepted transmission routes of the corona virus are contact transmission and

droplets.

An Australian Research Council Laureate Fellow was conducted by Holmes (2020), a

Fellow of the Australian Academy of Science and a Fellow of the Royal Society in London, said

that “There is no evidence that SARS-CoV-2, the virus that causes COVID-19 in humans,

originated in a laboratory in Wuhan, China”. He also added that “Coronaviruses like SARS-

CoV-2 are commonly found in wildlife species and frequently jump to new hosts. This is also the

most likely explanation for the origin of SARS-CoV-2. In addition, we know that viruses related

to SARS-CoV-2 are also found in pangolins. This suggests that other wildlife species are likely

to carry relatives of SARS-CoV-2. In summary, the abundance, diversity and evolution of

coronaviruses in wildlife strongly suggests that this virus is of natural origin. However, a greater

sampling of animal species in nature, including bats from Hubei province, is needed to resolve

the exact origins of SARS-CoV-2.”

The professor of Infectious Disease Epidemiology at the London School of Hygiene and

Tropical Medicine and head of the Centre on Global Health Security at Chatham House, London,
Dr. David Heymann said that “COVID-19 is similar to most of the infectious diseases in the

world today, which originated in the animal kingdom and breached the barrier between animals

and humans to become endemic in humans.” In addition, “These diseases include tuberculosis

and a host of diseases that we have learned to live with; we are witnessing first-hand emergence

of a new infectious disease’, he said. ‘Though we don’t yet understand COVID-19’s complete

destiny, we believe it’s on its way to becoming endemic, as did the human immunodeficiency

virus (HIV) after it emerged at the beginning of the twentieth century before it spread throughout

the world”. He also said that the SARS-Cov-2 virus is similar to four endemic coronaviruses that

have emerged and gone on to become endemic in human populations and is likely to become the

fifth endemic coronavirus. ‘Infectious viruses such as these are likely to remain in human

populations for the foreseeable future. The way to learn to live with COVID-19 includes ‘making

sure that the disease does not overwhelm our communities by responding to outbreaks when they

occur”.

World Health Organization (2020) stressed that, as of September 24, 2020, the number of

cases is 31,664,104 confirmed cases of corona virus disease, including 972,221 deaths. As days

go by, the world continues to face the effect of the pandemic. Many people have suffered

physically and mentally specially the practitioners who have sacrificed themselves to stop the

fast spread of COVID-19. Despite the lack of preparedness, lack on the facilities, equipment and

pre job training, another reason why many healthcare workers are suffering from over

discomfort, fatigue, loneliness, anxiety and depression.

ICM’s Director of research Dr. Lincoln Lau stated that, “Healthcare workers are working

tirelessly to care for COVID-19 patients. So training to improve adherence to infection

prevention practices is important to limit transmission within health care settings.”

 Pe Mesias of Lopez District Farmers Hospital Dr. Eden C. stressed that “Front-liners face

many challenges during the COVID-19 pandemic that not only assault our physical well-being

but also our mental health.” He also added that “As the Medical Director, I have to protect the

safety of our health workers. We already have shortages of manpower in the hospital and most

are exhausted from extended hours of duty.”

Due to the fast spread of the deadly disease globally, ensuring the preparedness of public

health care systems and response operations is one of the best option of defense. According to

the United Nations International Strategy for Disaster Reduction (2020), they said that

“preparedness is defined as the knowledge and capacities developed by governments,

professional response and recovery organizations, communities and individuals to effectively

anticipate, respond to, and recover from the impacts of likely, imminent or current hazard events

or conditions.” Effective preparedness of organizations, proactivity and individuals in public

health systems are therefore required to reduce or control the spread of COVID-19.

Related Studies

The Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of

Wuhan University, Wuhan China (2020) stated that in February, 2020 four physicians and nine

practitioners recruited from five hospitals with COVID-19 cases in the province of Hubei.

However, one nurse and three physicians have declined to participate in the said study due to

over fatigue. All selected participants took care of COVID patients in the selected hospitals in

which they were employed. Using an empirical phenomenological approach, the researchers did

a qualitative approach. Physicians and nurses were recruited from five hospitals COVID cases in

Hubei province using snowball and purposive sampling. From Feb 10 to Feb 15, 2020 with no
face to face interview the researchers participated in semi-structured, in-depth interviews by the

use of telephone. They added that:

“Interviews were transcribed verbatim and analyzed using Haase's adaptation of

Colaizzi's phenomenological method. In the findings, the researchers recruited nine

nurses and four physicians. Three theme categories emerged from data analysis. The first

was (being fully responsible for patients' wellbeing ‘this is my duty’). Health-care

providers volunteered and tried their best to provide care for patients. Nurses had a

crucial role in providing intensive care and assisting with activities of daily living. The

second category was (challenges of working on COVID-19 wards). Health-care

providers were challenged by working in a totally new context, exhaustion due to heavy

workloads and protective gear, the fear of becoming infected and infecting others, feeling

powerless to handle patients' conditions, and managing relationships in this stressful

situation. The third category was (resilience amid challenges). Health-care providers

identified many sources of social support and used self-management strategies to cope

with the situation. They also achieved transcendence from this unique experience.”

The study of Portuguez, R. and Bacaoco, J. (2020) concluded that toxic cultural

environment, stress, weak job design that leads to overwork, lack of hazard pay, limited number

of workforce, extended work hours, exposure to massive deaths of patients with corona virus,

and fear of acquiring the disease are causing psychological problems to practitioners. “Aside

from exposure to stressful situation, HCWs are also experiencing an increase in the number of

deaths of their patients due to the severe effects of the virus. Being exposed to massive deaths

can be traumatic to some individuals.” Bacaoco added.

 According to the American Journal of Infection Control (2020), employing a

phenomenological approach, the analysts enlisted 20 medical caretakers who provided care for

patients with COVID in the first Affiliated Associated Healing Center of Henan College of

Science and Innovation from January 20, to February 10, 2020. The interviews were conducted

face-to-face or by phone and were analyzed by Colaizzi's 7-step strategy. The result, the mental

involvement of medical attendants caring for COVID-19 patients can be summarized into 4

topics. To begin with, negative feelings display in early-stage comprising of weakness,

inconvenience, and defenselessness was caused by high-intensity work, fear and uneasiness, and

concern for patients and family individuals. Moment, self-coping styles included mental and life

alteration, charitable acts, group back, and judicious cognition. Third, the analysts found

development beneath weight, which included expanded fondness and gratefulness, improvement

of proficient duty, and self-reflection. At long last, the study showed that positive feelings

happened at the same time with negative feelings. Amid an plague flare-up, positive and negative

feelings of the front-line medical attendants interweaved and coexisted. Within the early

organize, negative feelings were prevailing and positive feelings showed up slowly. Self-coping

styles and mental development played an critical part in keeping up mental wellbeing of medical

attendants

Sheng Q. Et al. (2020) said that proficient character of medical caretakers isn't inactive

and effectively influenced by numerous components. The COVID‐19 scourge brings the huge

physical and mental challenges for protect medical attendants. At display, there are constrained

information on the impact of protect encounters on the nurses’ proficient character. This think

about utilized a face‐to‐face meet with semi‐structured questions to memorize approximately the

impact of protect encounters on the proficient identity of medical caretakers. Intentional testing
was utilized to gather members (n = 14), and meet information were analyzed taking after the

Colaizzi's phenomenological examination. The comes about, the ‘impression of weariness and

fear’, ‘feeling the unfairness’, ‘perceiving ineptitude in protect task’ and ‘unexpected proficient

benefits’ were the most components influencing the proficient personality of protect medical

caretakers. The think about appeared that extraordinary consideration and focused on back

measures ought to be given to move forward the proficient personality of protect medical

caretakers.

Wei Et al. (2020) stated that this research provided a comprehensive and in-depth

understanding of the mental involvement of caregivers of patients with COVID-19 through a

phenomenological approach. They also found that amid the scourge, positive and negative

feelings of cutting edge medical caretakers against the plague interweave and coexist. Within the

early days, negative feelings were prevailing and positive feelings showed up at the same time or

steadily. Self-coping fashion and mental development are important for medical caretakers to

preserve mental wellbeing. This study provided principal information for encourage mental

intercession.

Kackin O. Et al. (2020) stated that the study utilized the graphic phenomenological

approach. The interviews were conducted face-to-face by means of the web and were analyzed

with Colaizzi’s seven-step strategy. The encounters and psychosocial issues among medical

attendants caring for patients analyzed with COVID-19 were categorized beneath three subjects,

which were encourage isolated into subcategories. The topic of the impacts of the flare-up was

isolated into working conditions, mental impacts and social impacts; the subject of short-term

adapting methodologies was isolated into normalization, refusal to stay on encounters, evasion,

expression of feelings and diversion; and the topic of necessities was separated into psychosocial
back and asset administration. In conclusion, the medical attendants caring for patients analyzed

with COVID-19 in Turkey were antagonistically influenced, both mentally and socially, by the

widespread; they utilized short-term adapting methodologies, and they required psychosocial

back and asset administration. They also too confronted stigmatizing states of mind and

encountering burnout and were at hazard for auxiliary injuries due to seeing infection and

passing.

According to Wiley Online Library (2020), 13 medical attendants who were taking care

of patients with COVID‐19 were chosen utilizing deliberate examining within the Lorestan

College of Restorative Sciences. The information was collected through phone interviews and

analyzed based on the Lundman and Graneheim's approach. The think about appeared that

medical attendants experienced numerous challenges such as terrible feeling of wastefulness,

push, intemperate physical weakness, situation between care conveyance and contamination and

encased in defensive hardware amid taking care of patients with COVID‐19 that all this could

lead to diminish of the quality of understanding care. One of the sources of nurses' fear and

uneasiness is the agonizing passing of a patient with COVID‐19. Therefore, it is advisable to

consider psychological counselling for nurses so that they can take care of patients in complete

calm. Other causes of anxiety in nurses are falling apart from their families and the fear of

infecting them in returning home. So, authorities need to consider appropriate precautions to

ensure that nurses have the least risk of being contaminated when they go to their homes.

Furthermore, patients with COVID‐19 and their families should be provided with psychological

comfort by forming palliative care teams consisting of psychologists and religious experts. As

the Achilles' heel of any healing center, any issue for medical caretakers can deliver the entire

care framework and compromise quiet care. So, it is vital for specialists to move forward the
working put for medical caretakers and increase the security framework so that medical

caretakers have no concerns other than quiet care. These necessities are satisfied as it were

through an effective administration approach. As the COVID‐19 malady may remain for months,

and given that the number of patients is expanding each day, nursing programs ought to be

overseen in a way to avoid medical attendants to be depleted so they can bear proceeding work

for up and coming weeks or months. The results of this study can clear the way for encouraging

inquires about how to progress the physical and mental exhibitions of medical caretakers amid

care of COVID‐19 patients, which can straightforwardly or by implication make strides in the

quality of care of these patients.

On January 20 to February 10, 2020 the researchers from the First Affiliated Hospital of

Henan University of Science and Technology enrolled 20 nurses who provided care for the

patient who acquire the disease, using a phenomenological approach. The interviews were

conducted either via telephone or face-to-face and were analyzed by Colaizzi's 7-step method.

Nurses who are enrolled to care the patients with COVID19 based on their psychological

experiences can be summarized into four themes. To begin with, negative feelings show in early

organize comprising of weariness, inconvenience, and powerlessness was caused by high-

intensity work, fear and uneasiness, and concern for patients and family individuals. Second,

self-coping styles included psychological and life adjustment, altruistic acts, team support, and

rational cognition. Third, the researchers found development beneath the weight, which included

expanded love and gratefulness, the advancement of proficient duty, and self-reflection. At last,

the researchers showed that positive feelings happened at the same time as negative feelings.

During an epidemic outbreak, positive and negative emotions of the front-line nurses

interweaved and coexisted. In the early stage, negative emotions were dominant and positive
emotions appeared gradually. Self-coping styles and psychological growth played an important

role in maintaining mental health of nurses. (Sun N. et al., 2020)

Cui S. Et al (2020) stated that methods in midmonth of February, 2020, comfort

examining was utilized to enroll EFO medical caretakers from clinics in Jiangsu Territory.

Information were gotten by self-administered online surveys, which comprised of a common

survey, the Self-Rating Uneasiness Scale, Seen Stretch Scale-14 and Disentangled Adapting

Fashion Survey. An add up to of 481 surveys were returned and 453 substantial surveys were

recuperated. Different direct relapse was utilized to investigate the impact of socio-psychological

and working condition variables on uneasiness, push and stretch adapting inclination. Pearson

relationship coefficients were calculated to evaluate the affiliations among uneasiness, stretch

and adapting propensity. Comes about Among the members, 281(62.03%) had no uneasiness

indications, 154(34.00%) had gentle uneasiness, 16(3.53%) had direct uneasiness, and 2(0.44%)

had serious uneasiness. There were 146(32.23%) participants with scores more prominent than

25 within the PSS, showing intemperate push. They also found that 229(50.55%) participants

were more likely to reply emphatically to push, whereas 224(49.45%) were more likely to reply

adversely. The models we utilized included sex, fear of contaminating family individuals,

lamenting being a nurture, having children, certainty in battling episode, rest time, proficient

states of mind, having gone to contamination anticipation preparing, and number of night shifts;

and they were all indicators of the mental wellbeing of EFO medical caretakers. Pearson

relationship appeared a positive relationship of the uneasiness with stretch score (r=0.443,

P<0.001), whereas the adapting inclination score was found adversely connected with uneasiness

(r=-0.268, P< 0.001) and stretch (r=-0.503, P< 0.001). Conclusion, COVID-19 contains a certain

psychosocial affect upon EFO medical caretakers. Viable measures, such as reinforcing security
preparing, satisfactory medical attendants for crisis and fever clinics, decreasing night shifts, and

convenient overhauls of most recent scourge circumstance, ought to be taken. In addition, more

noteworthy consideration ought to be paid to female EFO medical attendants and medical

caretakers with children.

Synthesis

Amidst the effects of COVID19 to the society. Many people around the globe have

suffered not just financially and physically but also mentally, specially the health care workers

working in the hospital to fight the spread of this contagious coronavirus disease. Many nurses

have already sacrificed themselves, their will to combat this disease. Many have already lost

their lives and still most nurses are working in the ward despite their conditions of being unwell.

Because of these COVID19, many health workers have suffered from mental distress, factors

that may affect them mentally specially on their relationship to their family as well as taking care

of the COVID19 patient.

Prior researches studied the psychological effects of COVID19 to the nurses, the findings

and coping mechanisms for the frontline workers to be psychologically aware. Primarily, these

studies utilized phenomenological method, determining the effects of COVID19 to the mental

state of nurses, findings on its effects and coping mechanisms to avoid psychological imbalance.

Moreover, previous researchers have conducted their studies in different context, time and place.

Professor Edward Holmes (2020) said that the findings on the history on the origin of

COVID19 was not in an speculated animal named bats nor pangolins and even in the laboratory

of virology in Wuhan. In any case, the plenitude, differences and advancement of coronaviruses

in natural life unequivocally proposes that this infection is of normal origin. However, a greater
sampling of animal species in nature, including bats from Hubei province, is needed to resolve

the exact origins of SARS-CoV-2. Consistent with the thought on the discoveries and comes

about of these Infection, COVID19 contains a negative impact on the individuals around the

globe, youthful children, youthful grown-ups and uncommonly the elderly (Hou Y. et al., 2020).

According to the World Health Organization (2020), as of September 24, 2020, the number of

cases is 31,664,104 confirmed cases of COVID-19, including 972,221 deaths. Haase's

adjustment of Colaizzi's phenomenological strategy were utilized on the qualitative studies of

most analysts to decide the impacts of COVID19 to the mental viewpoint of medical caretakers

combating the infection.

Because COVID-19 is rapidly spreading globally, many of the healthcare nurses have

sacrificed themselves to fight these diseases putting their lives and their mental state at risk. The

study of Portuguez, R. and Bacaoco, J. (2020), toxic cultural environment, poor job design that

leads to overwork, limited number of workforce, lack of hazard pay, concluded that stress,

extended work hours, exposure to massive deaths, and fear of acquiring the deadly corona virus

are causing psychological problems to medical practitioners. Study showed that positive

emotions occurred simultaneously with negative emotions. During an epidemic outbreak,

positive and negative emotions of the front-line nurses interweaved and coexisted. In the early

stage, negative emotions were dominant and positive emotions appeared gradually (Sun N. et al.,

2020). The impression of fatigue and fear, feeling the shamefulness, seeing ineptitude in protect

errand and startling proficient benefits were the most variables influencing the proficient

personality of protect medical attendants whereas combating the COVID19 (Sheng Q. et al.,

2020). The medical attendants caring for patients analyzed with COVID-19 were unfavorably

influenced both mentally and socially by the widespread (Kackin O. et al., 2020). According to
Wiley Online Library (2020), the study appeared that medical caretakers experienced numerous

challenges such as the terrible feeling of wastefulness, stretch, intemperate physical weariness,

the problem between care conveyance and contamination, and encased in defensive gear amid

taking care of patients with COVID‐19 that all this may lead to the diminishing of the quality of

understanding care. One of the sources of nurses' fear and uneasiness is the agonizing death of a

patient who acquires the deadly coronavirus and also other causes of uneasiness or anxiety in

medical attendants are falling separated from their families and the fear of tainting them in

returning domestic. In the primary stage, negative emotions were dominant and positive

emotions appeared gradually. (Sun N. et al., 2020). Results Among the participants (nurses),

281(62.03%) had no anxiety symptoms, 154(34.00%) had mild anxiety, 16(3.53%) had moderate

anxiety, and 2(0.44%) had severe anxiety. There were 146(32.23%) participants with scores

greater than 25 in the PSS, indicating excessive stress. We found that 229(50.55%) participants

were more likely to respond positively to stress, while 224(49.45%) were more likely to respond

negatively. (Cui S. et al., 2020).

By that, ensuring their preparedness is of great significance for them to avoid

psychological imbalance. (Zhou Q. et al., 2020). Flexibility in the midst of challenges, health-

care suppliers recognized numerous sources of social back and utilized self-management

techniques to manage with the circumstance. They also achieved transcendence from this unique

experience. (Liu Q. et al., 2020) According to Wiley Online Library (2020), it is prudent to

consider mental counseling for medical caretakers so that they can take care of patients with

COVID19 in complete calm conjointly specialists got to consider suitable safety measures to

guarantee that medical attendants have the slightest hazard of being sullied when they go to their

homes. Moreover, medical attendants enduring from mental trouble, patients with COVID‐19,
and their families ought to be given mental consolation by shaping palliative care groups

comprising of clinicians and devout specialists. Despite its negative effects on the people

especially the nurses working in the hospital, the only way to learn is to live with the deadly

corona virus or COVID19, includes making sure that the disease does not overwhelm our

communities by responding to outbreaks when they occur. (Heymann D., 2020)

CHAPTER III

RESEARCH METHODOLOGY

Research Design

The study utilizes qualitative approach to gather information, specifically the researcher

used online interview and phone call. In addition, empirical phenomenological approach was

also used to obtain detailed descriptions of the experiences of nurses in monitoring suspected

patients with COVID-19 in MHO Lagawe, Ifugao. The focus of phenomenological research is to

explore the psychological experiences across this deadly corona virus. This phenomenological

research approach helps researcher to acquire an in-depth understanding on the psychological

experiences of nurses in monitoring suspected patients with COVID19 at MHO Lagawe.

Research Locale
 The research will be conducted at the Municipality of Lagawe specifically in the

Municipal Health Office (MHO Lagawe).

Respondents of The Study

The study sample used 10 registered nurses who are currently working at MHO-Lagawe

as front-liners 1 male and 9 females respectively at the age ranging from 26 to 34 years old.

Research Instrument

The researcher determined the interview outline by consulting relevant literature, seeking

health care experts’ opinions, and selecting 10 samples specifically nurses 1 male and 9 females

for an online interview. The interview was in a form of online communication method or via

phone call. The researchers focused on the economic status, income, preparedness and their

awareness to their mental health. The main interview questions posed to the participants are the

following: (1) Being one of the frontliner (nurse) working beyond the given time, with this

pandemic are you psychologically affected? (1.1) If YES, please expound your reason. (1.2) If

NO, please expound also your reason. (2) As one of the medical practitioner working in

Municipal Health Office Lagawe, please describe a day in monitoring the suspected patients with

COVID19. (3) As a nurse working over-time in the quarantine facilities, how do you cope up

despite the struggles psychologically in monitoring suspected COVID19 patients?”

Samples and Sampling

In this study, the researcher will make use of purposive sampling where in the

respondents are chosen according to the needs of the study. These are sample of participants or

respondents that were thoughtfully, purposefully recruited in order to fully answer the research

question. (Trinidad R., 2014). The respondents will be nurses, selected nurses from the
Municipal Health Office Lagawe who have already psychological experiences battling

COVID19 since the study focuses on the psychological experiences of nurses in monitoring

suspected COVID19 patients.

Data Gathering Procedure

TIME/DAY LOCATION TASKS/WORKS/ACTIVITIES PERSON

INVOLVED
09-06-20 At Home Preparation and brainstorming Researcher
for a research title.
Determining the aim and purpose
of the research.
Specifying the Topic
09-07-20 At Home Finalization of the research title. Researcher

09-09-20 At Home Approval of Research Title and Researcher and

starting to make Chapter I Ma’am Ana Marie
(Background of the Study). G. Pagaddut
09-10-20 At Home Finished the background of the Researcher
study and start creating or
composing the questions for the
Statement of the problem.
09-14-20 At Home Almost done with Chapter I, Researcher
finalizing the Definition of
Terms.
09-16-20 At Home Writing the Review of Related Researcher
Literature.
09-18-20 At Home Writing the Review of Related Researcher
Studies.
09-20-20 At Home Writing synthesis and finalizing Researcher
Chapter II.
09-24-20 At Home Starting to make Chapter III Researcher
specifically Research Design and
Research Environment.
09-26-20 At Home Determining and finalizing the Researcher
Respondents of the Study.
09-28-20 At Timmac Cafe Writing the Instrument of Researcher
Instrument of the Study.
09-30-20 At Timmac Cafe Writing the Samples and Researcher
Sampling.
10-01-20 At Home Writing the Data Gathering Researcher
Procedure.
10-03-20 At Home Finalizing the Treatment of Data. Researcher
 10-05-20 At Home Finalizing and passing the Researcher
Chapter I, II and III both
softcopy and hardcopy.

Treatment of Data

The results of the interview were transcribed, translated and grouped. Thematic analysis

was utilized to classify the topics that are common and making patterns with their

commonalities. (Braun & Clark, 2013). Thematic analysis is generally used in data coding, data

familiarization and theme development. (Auckland, 2006). This will be then produce the result of

the psychological experiences on nurses combating COVID19 at Municipal Health Office

Lagawe.

Bibliography

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healthcare-workers-mental-health/

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QUALITATIVE QUESTIONAIRES:
Greetings! I am Mr. ALVINCENT D. BINWAG, conducting an online interview in line with my research
study entitled “Exploring the PSYCHOLOGICAL EXPERIENCES of Municipal Health
Office Nurses in Monitoring Suspected COVID19 Patients at Lagawe”.
Answer the 3 questions below, thank you.
(1) Being one of the frontliner (nurse) working beyond the given time, with this pandemic are

you psychologically affected?

(1.1) If YES, please expand.

(1.2) If NO, please explain.

(2) As one of the practitioners working in Municipal Health Office Lagawe, please describe a

day in monitoring the suspected patients with COVID19.

(3) As a nurse working over-time in the quarantine facilities, how do you cope up despite the

struggles psychologically in monitoring suspected COVID19 patients?”

Mr. Collin Blu Dangayo (Male)

(1.) (1.2) “No. As a nurse, part of my job, in whatever situation I am in especially during

emergency and health crisis, is to maintain critical thinking. Personally, I have already

conditioned my mind, that amid this crisis and as a frontliner, I have to maintain mental fortitude

to be able to live up to the challenges.”

(2.) “A day of monitoring can be described as exhausting, physically exhausting and a bit

mentally tiring. A frontliner has to deal with clients who are demanding and difficult to deal

with. Difficult in the sense that you have to deal with their rebellious behavior; especially with

regard to observing SOPs, guidelines and protocols in relation to quarantine and precautions to
not spreading and contacting the virus. Nevertheless, though, again, you must have to apply the

principle "mind over matter" to retain the mind in a mentally and psychologically healthy state.”

(3.) “Personal experience wise, I usually go chill with friends and colleagues, observing

precautions and protocols. Also, involving myself to any / or initiating productive activities,

especially health related activities in my area of assignment for work. Moreover, enough rest and

sleep is also a must which helps in gaining physical and mental strength for the next day’s

endeavor. A cycle. And most of all, asking for Divine providence.”

Ms. Sheena Belle Bayninan (Female)

(1.) (1.2) “Hindi pa naman kase psychologically stable naman tayo kaya di basta basta

niwawagot, more on physically exhaustion.”

(2.) “Challenging lalo na sa feeling magaling na LSI (Locally Stranded Individuals) talo pa ang

protocols & guidelines, exhausting sa mga matitigas and ulo na lsi na on quarantine plus dun sa

mga pumupuslit kc daw apor sila, fulfilling naman sa mga nakakaintindi at compliant na LSI

(Locally Stranded Individuals).”

(3.) “Chismisan with colleagues, continue implementing regular health programs in the

community with innovations para di nila mafeel masyado na marami ng nag iba, involve the

community sa mga health programs meaning continue pa din yung mga pacontest (health

related) & seminars, a weekend breather with family if may time, a lot of rest (seriously) with

good food & coffee, morning or evening walks are good also but most importantly pray.”

Ms. Kimberly Kristine Fragata (Female)

(1.) (1.2) “Hindi, kase nakaka function at nakakapag isip naman tayo ng maayos. Nagagawa pa

din naman naten yung mga usual things na ginagawa naten before pandemic although pag

exhausted na kung minsan eh gusto din na makalabas at makapamasyal din sa ibang lugar para

ma refresh ang pakiramdam.”

(2.) “Challenging, depende kase sa makakausap mo na kelangan imonitor, kung may attitude

syempre maiistress ka din kahit paano, kung madamihan naman ang dumarating nakakapagod

physically and pag gabi ang time of arrival syempre nakakapuyat swerte nalang kung off mo the

next day.”

(3.) “After work, bonding with friends and colleagues then pag off bonding with family, kung

my pwede pasyalan within the community mamasyal din or kakain sa labas, mag order online

and tamang rest.”

Ms. Melody Puhi (Female)

(1.) (1.2) “No, kasi nakakapagfunction pa rin namn tayo tulad ng dati, we are psychologically stable.”

(2.) “Challenging”

(3.) “Pray, have enough rest and eat more”

Mrs. Loisam Dumawol (Female)

(1.) (1. 1) “Yes, if working beyond working tym i am affected psychologically because ideally a person

should be working 8hours a day. Yung sa 8hrs nga lng na toxic nakakapagod na, how much more pa kaya

pro sa medical field kc we are used to work or give more. Hindi kase pwede sa atin ung saktong 5 o’clock

gora na mas madalas naco-consume ang oras ntn sa endorsmnt.lalo pg late c nxt shift tpos wlng OT pay.

nkka inis pro gnun. life in the field.”

(2.) “A day of monitoring is like COUNSELING. You put yourrself in their shoes. U need to smile say

goodmorning and ask how are u, how are u feeling and the hardest part is dapat ready ka sa isasagot sa

kanila. Others hindi magsasabi ng saloobin but others bongga mag reklamo and after hearing them

iaassure mo nman sila na you'll look into their concerns if kaya.”

(3.) “As stress reliever, dapat mayroong malinaw na separate line between work and personal.when u go

to work leave ur personal.when u go home leave ur work. as CT mas mahirap kc most of the tym off days

nmen ang ndadali pro isipin nlng saglit lng nman.mttpos dn tong COVID na to.”

Ms. Cherry Takinan (Female)

(1.) (1.2) “No, because I can still think properly and do my daily normal routines, though I get angry

sometimes pag pagod sa work at pag uwi ay nkakastress nnman environment, still we're able to handle

things well pa rin after.”

(2.) “Challenging, exhausting at times “

(3.) “Have enough rest, involve myself more in community works, pray.”

Mrs. Sharlene Fontanilla (Female)

(1.) (1.1) “Yes, there were sleepless nights thinking about the possibilities of getting infected or worst

bringing home the virus to my family.”

(2.) “A day of monitoring patients is a roller coaster ride. I can be calm, nice and respectful but there are

times I need to be sarcastic and a little fierce, it all depends on the attitude of the patient.”

(3.) “Quality time with family and friends is the best stress reliever. Spending a whole day playing with

the kids, cooking and laughing with friends is good enough to energize me for another week of work. Not

to forget, the several add-to-cart & check-out items to reward thy self.”

Ms. Jackie Lou Catti (Female)

(1.) (1.2) “Hinid naman kasi despite of this pandemic atleast hindi pa nman bumigay, we still manage

those stressful situations and nakakapagfunction parin nman tayo.”

(2.) “Challenging kasi you are dealing lot of people with different behaviors.”

(3.) “When away from work, I spend time outdoors activities..do physical activities like walking,etc.,

Prayers of course and eat healthy foods.”