Document Code: DCAVRKMI-F-SHSRPF

MANUEL S. ENVERGA UNIVERSITY FOUNDATION

Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 1 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
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QUALITY FORM Approved by: President

RESEARCH PROPOSAL FORM

I. Research Title: “COVID-19 STRESS AND RESILIENCE OF NURSES OF PUBLIC

AND PRIVATE HOSPITALS IN THE PROVINCE OF SULTAN KUDARAT.”

II. Name of Researcher :

:
:
:

Strand :

Name of Research Adviser :

III. Research Proposal

CHAPTER 1
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INTRODUCTION

Background of the Study

The coronavirus disease (COVID-19) outbreak has created a public health

emergency globally. This contagious virus has not only raised health problems, but also
caused stress and lower level of resilience from different layers of populations (Salari et
al., 2020). With more Filipinos infected by COVID-19, the consequences of a medical
brain drain are weighing on the nursing workforce. Private Hospitals Association of the
Philippines, Inc. (PHAPI) has estimated a scarcity of 23,000 nurses nationwide. This
situation is so severe that most Filipinos die without even seeing a medical professional
(Lopez & Jiao, 2020).

Thousands of nurses are working hand in hand against COVID-19 pandemic. As

the largest sector of the healthcare workers in the Philippines, nurses are the backbone
and lifeblood of patients’ care. Many nurses are falling ill or even giving the last breath
of their very lives just to attend to the needs of the patients (Carlson, 2020). As a matter
of fact, nurses have embedded within it an ethos of compassionate care with their
patients and their families, often under COVID-19 stress.

With lack of nurses across the nation, there is an exponentially increasing burden
and pressure on the existing nursing workforce. Acknowledging the need to support the
well-being of nurses to boost their resilience in all healthcare settings has never been
more important at this time of health crisis (Rappler.com, 2020). Anxiety disorders
experienced by the nurses in light of their battle against the unseen enemy cannot be
disparaged. If nurses are not given prior attention by the government, COVID-19 stress
would definitely turn into very serious emotional and social imbalances that can have a
lasting effect on their resilience. If their efforts to fight for the COVID-19 are less
appreciated, their ability to recuperate from the heavy workload as frontliners to win the
battle against this pandemic would be futile.

Caring for patients in the high-risk contexts of the pandemic has caused COVID-
19 stress among nurses. Feelings of danger and contamination, socioeconomic
consequences, xenophobia, traumatic symptoms and compulsive checking among
nurses are likely to occur especially if there is little praise on their ability to do the jobs
(Taylor et al., 2020). World Health Organization (WHO) issued guidance on COVID-19
stress that recognizes the particular needs of nurses. Due to the continuous contagion
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MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
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DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
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of the virus, nurses in Sultan Kudarat are confronted with so much COVID-19 stress
that puts their resilience at risk.

Within the current COVID-19 pandemic and against a backdrop of a pre-existing

shortage of nurses in the country and Sultan Kudarat Province is no exemption, it is
crucial to consider the COVID-19 stress of nurses and how it is related to their
resilience.

Theoretical Framework

This study is anchored on “The Adaptation Model of Nursing” of Sister Callista

Roy. In her theory, she sees the individual as a set of interrelated systems who strives to
maintain a balance between various stimuli. She explained that adaptation occurs when
people respond positively to environmental changes, and it is the process and outcome
of individuals and groups who use conscious awareness, self-reflection, and choice to
create human and environmental integration. The key concepts of her adaptation model
are made up of four components: person, health, environment, and nursing.

Roy’s adaptation model signifies that a person is a bio-psycho-social being in

constant interaction with a changing environment. He or she uses innate and acquired
mechanisms to adapt. The model includes people as individuals, as well as in groups
such as families, organizations, and communities. This also includes society as a whole.
The model states that health is an inevitable dimension of a person’s life, and is
represented by a health-illness continuum. Health is also described as a state and
process of being and becoming integrated and whole.

The environment has three components: focal, which is internal or external and
immediately confronts the person; contextual, which is all stimuli present in the situation
that all contribute to the effect of the focal stimulus; and residual, whose effects in the
current situation are unclear. All conditions, circumstances, and influences surrounding
and affecting the development and behavior of people and groups with particular
consideration of mutuality of person and earth resources, including focal, contextual,
and residual stimuli.

The model includes two subsystems, as well. The cognator subsystem is a major
coping process involving four cognitive-emotive channels: perceptual and information
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MANUEL S. ENVERGA UNIVERSITY FOUNDATION
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processing, learning, judgment, and emotion. The regulator subsystem is a basic type of
adaptive process that responds automatically through neural, chemical, and endocrine
coping channels.

The study is also based from “The Society-to-Cells Resilience Theory” based on
6 fundamental tenets (Szanton & Gill, 2016). This theory states that each person is born
with resilient potential. That potential changes over time depending on interactions
between society, community, and family, and individual psychological, physiologic, and
cellular factors and how each factor reacts to a challenge. Resilience includes 3
aspects: (a) resistance to a challenge, resulting in the continual maintenance of health,
(b) recovery from a challenge, resulting in a return to previous levels of functioning after
a period of compromised functioning, or (c) rebounding from a challenge, resulting in
the attainment of a higher level of functioning than before the challenge. Nurses can
foster resilience through action affecting one or more factors, and this action has
increased possibility of affecting comprehensive change if it addresses multiple factors.
Each factor may interact with all the other factors. Just as there may be particularly
vulnerable periods of risk, there are times during which an individual, community, or
society may be particularly resilient in meeting a challenge. Resilience is both a process
and a capacity. Resilience can be measured in studies as an outcome but is also a
measure of theoretical resilient capacity. This perspective is essential, as all individuals
are in constant adaptation, and the process of adaptation must also be considered a
facet of resilience, not only the final outcome.

Timely, the two theories above appreciate the ability of the health care system
particularly the nurses to remain emotionally and socially solvent in the middle of
changes in COVID-19 patients’ care delivery. The major purpose of this study is to
investigate the effect of COVID-19 stress to the resilience of nurses in the province of
Sultan Kudarat.

Conceptual Framework

Independent Variable Dependent Variable

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Intervening Variable

Figure 1. Research Paradigm

This figure presents the conceptual framework of the study. It depicts how the
resilience of the nurses will be affected by COVID-19 stress. The arrow connecting the
two boxes illustrates how the dependent variable will respond or react to the stimulus
given by the independent variable. The five indicators of COVID-19 stress such as
danger and contamination, socioeconomic consequences, xenophobia, traumatic
symptoms and compulsive checking will serve as the independent variable of the study.
On the other hand, the resilience of nurses such as such as self-belief, optimism,
purposeful direction, adaptability, ingenuity, challenge orientation, emotion regulation
and support seeking will as the dependent variable of the study. The research paradigm
also shows the demographic profile of nurses relative to gender, civil status, tribe,
religion and length of service which will serve as the intervening variable that might
influence the independent and dependent variables of the study.
Statement of the Problem
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MANUEL S. ENVERGA UNIVERSITY FOUNDATION
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DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
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The general purpose of this study is to determine the effect of COVID-19 stress
on the resilience of nurses of the private and public hospitals in the Province of Sultan
Kudarat, Region XII.

Specifically, this study will be carried out find answers to the following questions:
1. What is the demographic profile of nurses in terms of:
1.1 Gender;
1.2 Civil Status;
1.3 Tribe;
1.4 Religion; and
1.5 Length of Service?
2. What is the level of the COVID-19 stress of nurses relative to:
2.1 Danger;
2.2 Contamination;
2.3 Socioeconomic Consequences;
2.4 Xenophobia;
2.5 Traumatic Symptoms; and
2.6 Compulsive Checking?
3. What is the level of the resilience of nurses in relation to:
3.1 Self-Belief;
3.2 Optimism;
3.3 Purposeful Direction;
3.4 Adaptability;
3.5 Ingenuity;
3.6 Challenge Orientation;
3.7 Emotion Regulation; and
3.8 Support Seeking?
4. Is there a significance relationship between COVID-19 stress and resilience
of nurses?

Hypotheses

This study is guided by the following hypothesis:

H01: There is no significant difference on the COVID-19 stress and resilience of
nurses when they are grouped according their demographic profile.
H02: There is no significant relationship between COVID-19 stress and resilience
of nurses.
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Review of Related Literature

This section presents the literature reviews from a variety of studies both local
and foreign settings on COVID-19 stress, resilience and effect of COVID-19 stress on
the resilience of nurses.

COVID-19 Stress of Nurses

Concurrent with the prevalence of coronavirus disease 2019 (COVID-19) is the
presence of stress among nurses. This pandemic has caused so many emotional and
socioeconomic problems. It has had a significant impact on public stress level. Salari et
al. (2020) emphasized that monitoring and oversight of the population’s emotional and
social imbalances during this hardest time is an immediate priority. Nervousness and
anxiety in a society affect everyone to a large extent. People who are kept in isolation
and quarantine experience significant levels of anxiety, anger, confusion, and stress.
Simione and Gnagnarella (2020) comprehensively explained how COVID-19 originated.

The restriction in social mobility to control the pandemic is stressful as it prevents

face-to-face connections and traditional social interactions (Zhang et al., 2020). Those
who can go out like the workers who provide essential services exhibited less
symptoms of anxiety and depression compared to those who stay 20 to 24 hours at
home. Those who exhibited COVID-related symptoms or potential contacts of COVID
were isolated and separated from loved ones. Those who were isolated from loved ones
gradually developed COVID-19 stress (Health et al., 2020). The very strict imposed
quarantine outbreaks have associated COVID-19 stress that may be linked to fears of
having the infection and spreading it to family members; frustration and boredom from
being isolated; duration of uncertainty and scarcity of basic supplies (Brooks et al.,
2020).

Cereda et al. (2020) stated that COVID-19 outbreak greatly affects the emotional
status of the nurses. They referred COVID-19 stress as a state of mental or emotional
strain or tension resulting from adverse or very demanding health circumstances. Taylor
et al. (2020) identified the indicators of COVID-19 stress such as danger and
contamination, socioeconomic consequences, xenophobia, traumatic symptoms and
compulsive checking. Maben and Bridges (2020) added that experiencing barriers to
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work as frontliners in the COVID-19 outbreak adds to the complexities of their

responsibilities.

Health et al. (2020) emphasized that COVID-19 stress occurs when nurses feel
threatened, their nervous system responds by releasing a flood of stress hormones,
including adrenaline and cortisol, which rouse the body for emergency action. If nurses
experience COVID-19 stress, their hearth pounds faster, muscles tighten, blood
pressure rises, breath quickens and their sense become sharper. Fletcher and Sarkar
(2020) added that COVID-19 pandemic has caused adversity, trauma, tragedy, threat or
significant source of stress to the general populations particularly to the nurses.

Based on the research findings so far by Simione and Gnagnarella (2020),

healthcare workers particularly the nurses have shown higher levels of stress, anxiety,
depression, and death apprehension particularly to the places where the contagion was
higher. In fact, their findings revealed that direct exposition to virus outbreak affected the
emotional and social competence of nurses. Lai et al. (2020) reported that those living
in the region of Wuhan, China had higher CPVID-19 stress than colleagues living
elsewhere. They found out that nurses perceived higher levels of risk for themselves
and for their relatives and that this effect was true even when controlling for such
traumatic stress. As a matter of fact, it was revealed that higher risk perception was not
linked only to a worse emotional state, but also to a greater knowledge of the COVID-19
disease and of its possible consequences. It was found out that nurses have already
higher levels of knowledge of the new coronavirus and they keep them updated with the
news circulating online and other sources of data that caused them more stressful. Due
to the containment and prevention measures, nurses reported a higher engagement in
preventing measures with respect to other people and request for more stringent
containment measures. Relative to this, their responsibilities to take care of the
suspected and confirmed cases of COVID-19 have caused them stressful situations.

Resilience of Nurses amid COVID-19 Pandemic

On the frontlines of healthcare, resilience has been described as the ability to
improvise with materials at hand to develop solutions to unexpected problems, thereby
enabling patient care to be delivered safely despite obstacles (Schumacher et al. 2020).
Resilience is known to have three interconnected levels: (i) the individual level, for
example, individual healthcare workers who use workarounds to temporarily resolve
recurring safety problems on the frontlines, and then communicate their safety concerns
to managers, in an effort to prevent problem recurrence; (ii) the team level, for example,
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managers who encourage frontline healthcare workers to freely communicate their

safety concerns, with a view to addressing underlying issues and preventing problem
recurrence; and (iii) the organizational level, for example, senior leadership commitment
to patient safety and lasting improvement or change (Hollnagel et al., 2015; Wreathall,
2018). In other words, resilience can be described as a property of individuals, teams,
and the whole organization.

Effect of COVID-19 Stress on the Resilience of Nurses

Li et al. (2020) found out that negative affective state in healthcare workers
significantly lowers their resilience. They added that doctors were found to have
considerably lower resilience levels compared to other healthcare workers due to the
COVID-19 stress they experience. Individuals tend to develop negative emotions to
protect themselves if they start to feel COVID-19 stress (Polizzi & Lynn, 2020). People
have reported heightened negative emotions during the COVID-19 virus outbreak.
Prolonged negative affective state, however, may lead to various problems that caused
low levels of resilience.

In addition, resilience showed significant correlation with COVID-19 stress. Taylor

et al. (2020) noted that during the times of COVID-19 pandemic, many people exhibit
stress or anxiety-related responses that include fear of becoming infected, fear of
coming with possibly contaminated objects or surfaces, fear of foreigners who might be
carrying infection, fear of socioeconomic consequences of the pandemic and
compulsive checking. Tomyn and Weinberg (2016) found a moderate, positive
correlation between resilience and stress. Abolghasemi and Varaniyab (2010) found that
resilience and perceived COVID-19 stress explained 31 and 49%, respectively, of the
variance of life satisfaction based on multiple regression analysis. Smith (2019) showed
that resilience and positive emotions might have a reciprocal influence on each other.

Significance of the Study

The fundamental advantage of this study is to improve the level of resilience of

nurses for them to be emotionally, mentally and socially healthy in light of COVID-19
pandemic. It is believed that with the findings of this research, stress and anxiety of
nurses amid this global health crisis will be given prior attention by the local government
of units in the province of Sultan Kudarat.
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Further, this study will be a useful tool in helping the nurses as frontliners to fight
for this COVID-19 pandemic and it is deemed significant to the following:

Nurses. Exploring the issues and concerns that nurses face during their battle
against COVID-19 pandemic will support their emotional, mental and social well-being
and develop protocols and plans to improve their preparedness. This study will explore
the challenges faced by nurses during their response to the COVID-19 crisis. It will help
to provide support and identify the needs of nurses in all affected municipalities of
Sultan Kudarat to ensure that they can work and respond to this crisis with more
confidence. Moreover, this will help enhance preparedness for pandemics and consider
issues when drawing up crisis plans.

Local Government Units (LGUs of Sultan Kudarat). The major goal of this
research is to determine the current emotional, mental and social health status and
resilience of nurses in the face of COVID-19 outbreak. This study also aims to stimulate
investigations and perspectives on how they are psychologically affected by COVID-19
pandemic and how they can cope with this kind of health emergency. It will serve as a
discussion platform on how to help nurses cope with and adjust to the critical situation.
Through the findings of this research, the LGUs from the province of Sultan Kudarat can
give their full attention and support to the needs and priorities of the health workers
particularly the nurses. Specific aims of this research include reducing the risk of
developing distress, improving well-being, as well as promoting preventive behaviors
among nurses. This study can offer LGUs research-based recommendations to improve
the resilience of nurses. finally, it will elucidate strategies 10ffecttively manage physical,
emotional and social state of nurses in the COVID-19 pandemic.

Community. Concern for the community where the nurses live, is more, not less,
important during this COVID-19 pandemic. This study will enlighten the community to
understand the nature of work of nurses in light of COVID-19 pandemic that they should
give their full support and love to the nurses. Their unconditional love of the family and
community will really help a lot to improve the emotional, mental and social well-being of
nurses and develop their effective resilience strategies to cope with the heavy tasks to
win the battle against this global health crisis.

Scope and Limitation of the Study

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This study focused on determining the relationship of COVID-19 stress and

resilience of nurses of public and private hospitals in the Province of Sultan Kudarat.
The study will employ a descriptive correlational research design. The respondents will
include one hundred ninety-five (195) nurses who will be proportionally chosen from the
two (2) biggest municipalities of Isulan and Esperanza and only one (1) city of Tacurong
in the Province of Sultan Kudarat.

Raosoft will be employed to compute for the total number of samples.

Proportional allocation formula will be applied to determine the sub-sample per hospital.
Simple random sampling using lottery method will be used to select individual
respondents of the study. The statistical tools to be used will be frequency and
percentage, mean, ANOVA and Pearson Product Moment Correlation. The study will be
conducted in the two (2) municipalities and one (1) city in the Province of Sultan
Kudarat from December 2020 to March 2021.

Definition of Terms

There are a few important terms discussed throughout this study and these terms
need to be operationally defined for clarity of meanings.

Adaptability. This refers to the extent to which nurses are willing to adapt their
behavior and approach in response to changing circumstances.

Challenge Orientation. This refers to the extent to which nurses enjoy

experiences which challenge them, and perceive stretching situations as opportunities
to learn and develop.

Compulsive Checking. This refers to the extent to which nurses have an

attitude of always checking the news media or social media, seeking reassurance from
friends or medical professionals and afterwards they have a fear of the possible
consequences of COVID-19.

Contamination. This refers to the extent to which nurses have a fear of the
objects they are handling are contaminated with the virus.
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COVID-19 Stress. This refers to the physical, mental or emotional state of

nurses that causes bodily or mental tension. This is classified as danger, contamination;
socioeconomic consequences; xenophobia; traumatic symptoms; and compulsive
seeking.

Danger. This refers to the extent to which nurses have a fear of becoming
infected, a fear that their family will get infected with the virus and a fear that healthcare
system is unable to protect them from the virus.

Emotion Regulation. This refers to the extent to which nurses are able to
remain calm and in control of their emotions in stressful situations.

Ingenuity. This refers to the extent to which nurses perceive that they are
capable of finding solutions to problems they encounter.

Optimism. This refers to the extent to which nurses believe that they will
experience good outcomes in life, and the way in which they explain setbacks that they
experience.

Purposeful Direction. This refers to the extent to which nurses have clear goals
that they are committed to achieve their goals in life.

Resilience. This refers to the nurses’ process of adapting well in the face of
adversity, trauma, tragedy, threat or significant source of stress caused by COVID-19
pandemic. This is classified into self-belief, optimism and purposeful direction,
adaptability, ingenuity, challenge orientation, emotion regulation, support seeking.

Self-Belief. This refers to the extent to which nurses have confidence in their
ability to address problems and obstacles that they encounter.

Socioeconomic consequence. This refers to the extent to which nurses have a

fear of job losses, fear of having economic instability due to closure of many business
establishments, fear of disruption in the supply chain and fear of looting or rioting.

Chapter II
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METHODOLOGY

This chapter presents the methodology that will be used in this study. It begins
with a description of the research design, setting, participants, measures, ethical
considerations, procedures, data analysis and scope and limitations of the study.

Research Design

This study will employ a descriptive correlational research design that will
determine the relationship between COVID-19 stress and resilience of nurses. It will
also investigate the influence of demographic profile of nurses to the COVID-19 stress
they experience and their resilience. This research design will underlie three premises
in gathering necessary data. First, information for the COVID-19 stress and resilience of
nurses will be collected, averaged and synthesized. Second, after determining the
weighted mean for each main variable and its indicators, the level to which the variables
and indicators’ scores using the set criteria for each variable will be determined. Third,
inferential statistics will be utilized to determine if there is a significant difference of
COVID-19 stress and resilience of nurses when grouped according to their
demographic profile and finally to examine the relationship of the COVID-19 stress on
the resilience of nurses.

Setting

This study will be conducted in the private and public hospitals of the two (2)
municipalities and one (1) city such as Isulan, Esperanza and Tacurong City in Sultan
Kudarat, Region XII. There are five (5) hospitals such as Hospital A, Hospital B, Hospital
C, Hospital D and Hospital E in Isulan, Sultan Kudarat. There are nine (9) hospitals
such as Hospital F, Hospital G, Hospital H, Hospital I, Hospital J, Hospital K, Hospital L,
Hospital M and Hospital N. There are four (4) hospitals such as Hospital O, Hospital P,
Hospital Q and Hospital R in Esperanza Sultan Kudarat.Map of Sultan Kudarat Province
where the setting of the study will be conducted is presented in Figure 2.
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Figure 2. Site Map

Respondents

The respondents of this study are the nurses of private and public hospitals of
the two (2) municipalities and one (1) city in Sultan Kudarat, Region XII. They are
chosen as the respondents of the study since their resilience has been challenged by
COVID-19 stress.

Their profession focuses on health care sector on the care of individuals,

families, and communities so they may attain, maintain or recover optimal health and
quality of life. A stratified random sampling technique will be used for selecting the
participants of the study. This procedure will be employed to ensure a fairly equal
representation of nurses per municipality and per hospital to really get the general
responses of the nurses as to their COVID-19 stress and resilience. To determine the
number of sample size of nurses, Raosoft will be utilized.

For specific identification of sub-sample per municipality or per hospital,

proportional allocation formula will be used. Then, simple random sampling will be used
to determine the actual participants of the study. There are three hundred ninety-five
(395) nurses in the private and public hospitals in the two (2) municipalities and one (1)
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city in Sultan Kudarat. Using Raosoft sample size calculator, a sample of 195 is
expected.

Table 1. Number of Nurses and Sample per Respondents-Municipality or City

Municipality of City Numbers of Sample Percentage
Nurses (%)
1. Esperanza 85 42 21.54
2. Isulan 105 52 26.67
3. Tacurong 205 101 51.79
Total 395 195 100

Table 1 presents the total number of nurses per municipality or city as well as the
expected number of samples of the study.

Measures

Adopted research tool will be used in this study. It is divided into two parts: Part I
will determine the level of the COVID-19 stress of nurses of private and public hospitals.
Part II will describe the level of the resilience of nurses of private and public hospitals.

The first part consists of six (6) indicators such as danger, contamination;
socioeconomic consequences, xenophobia, traumatic symptoms and compulsive
checking. Each indicator consists of (6) items; a total of 30 items for COVID-19 stress.
This survey questionnaire is adopted from the COVID-stress scales of Taylor et al.
(2020).

The second part is composed of eight (8) indicators with five (5) items for each
indicator, to wit: self-belief, optimism, purposeful direction, adaptability, ingenuity,
challenge orientation, emotion regulation and support seeking. This survey
questionnaire is adopted from the resilience questionnaire developed by Assessment
and Development Consultants (A&DC) (2017).

The two parts of the research instrument use a Five-Point Likert Scale with the
following descriptors: 5 – Strongly Agree; 4 – Agree; 3 – Moderately Agree; 2 – Disagree
and 1 – Strongly Disagree.
Since that the research tool is adopted from foreign settings, validation and
reliability tests of the research tool will be ensured. The research tool will be validated in
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 16 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

terms of content, grammar and style. Pilot testing will be conducted in one of the private
hospitals in South Cotabato to determine the internal consistency of the indicators and
items per indicator of the survey questionnaire. The researcher will present the initial
drafts of the research tool to her adviser for necessary corrections of the style,
indicators and items of the main variables involved in the study. From time to time, her
adviser, together with other members of the panelists will be consulted for potential
suggestions, comments, revisions, and refinement as to the organization, structure,
appropriateness and format of the research instruments. Five (5) research experts and
language specialists will be consulted for the improvement of the items of each variable
and indicator involved in the study.

Ethical Consideration
Ethical Considerations In the conduct of the study, the researcher will comply all
requirements particularly ethical considerations. Before the conduct of this study, this
will undergo ethical review and approval by the concerned authorities and individuals.

After incorporating all the necessary comments and suggestions of the panelists
during the outline defense, permission from the Master of Arts in Nursing (MAN)
Program will be secured.

Informed Consent. The respondents will be informed about the purpose,

expected duration, and the benefit of the research. Systematic random sampling will be
employed to get accurate representatives of the population. If there will be respondents
who will decline or withdraw their participation in the research process, another simple
random sampling will be considered in order to not affect the number of respondents
needed in this study. Reasonably foreseeable factors that may influence the
participants’ willingness to participate such as potential risks, discomfort or adverse
effects will be explained during the orientation of the respondents. It will be stated in
consent form that the respondents’ contribution will be completely voluntary. With this,
the respondents will opt to refuse answering the items they will not feel comfortable to
answer or if they will not be willing to take part in this study,

Recruitment of the Respondents. Recruitment of the respondents will be

carefully planned and handled in an ethical manner. Except in unusual circumstances,
the researcher should not directly ask the nurses to be one of the respondents, as it
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 17 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

may be hard to refuse such request. Instead, nurses will be recruited indirectly through
letter.

Respondents’ Rights. In this study, protection of respondents’ human rights will

be the top consideration. The researcher will ensure that all research activities
particularly in gathering data such as face to face distribution of the survey
questionnaire will conform to the highest degree of protecting human rights and safety.
Protecting the rights and welfare of those who will willingly participate in this research
will be a fundamental tenet of this ethical consideration. The researcher will guarantee
that respondents will be protected from unintended harm, especially in the areas of
confidentiality and informed consent. She will assist the respondents in avoiding errors
or oversights that can result in justifiable actions. Human dignity, inherent to all
respondents, irrespective of place of residence, gender, ethnic origin, religion, language,
or any status, will be carefully safeguarded.

Privacy and Confidentiality. In some cases, simply being invited into a study
may involve time consumption and privacy concerns. For instance, sending a formal
letter inviting the nurses to take part in the study will be done. Recruitment methods
must take into account of private concerns. No nurse will be surprised that he or she will
be one of the respondents of the study. Prior notice will be sent through approved letter
by the MAN Program Chair. The respondents will be approached by the researcher in
their most convenient time. The researcher will look into the situation in which nurses
will not so busy in doing their responsibilities as frontline health workers. That will be the
time that their consent to participate in the study will be asked from them.

Data Handling and Storage. The researcher herself is the custodian of the
research data and is responsible for data handling and storage. It is ensured that
physical access to the data are strictly confined only to the researcher. No one will be
given granted to have an access to the data. Strict protocols for the unauthorized
access of all physical locations where the data are stored will be ensured. The
researcher will ensure that data will be handled with utmost confidentiality and will never
be exposed to anyone else. A month after the researcher’s graduation, the data will be
destroyed and discarded. The survey answered questionnaire will be destroyed in such
a way that no more data will be exposed from the answered research too to ensure that
the data will no longer be accessed. The researcher will do everything to protect their
privacy.
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 18 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

Accuracy of Results. Before the limited face to face distribution of the survey
questionnaire following the minimum health standards and protocols set by Department
of Health (DOH) and COVID-19 Inter-Agency Task Force (IATF), content validity,
acceptability and reliability tests will be conducted to ensure the accuracy of the results
that will be taken from the respondents’ responses. Mimited face to face orientation
before distributing the survey questionnaire will be conducted to explain the all the
variables, indicators and items of the survey questionnaire.

Research Misconduct. The researcher will ensure that research misconduct

which includes fabrication, falsification, or plagiarism will never be committed. She will
really avoid the data-fraudulent practices like falsification, alteration, misrepresentation,
concealing of findings, biased or subjective language, labeling people or singling out a
group.

Procedures

The following steps will be followed by the researcher in conducting this

descriptive correlational study:
1. The researcher will secure permission to conduct the study from the Program
Chair of the Master of Arts in Nursing (MAN) of Davao Doctors College and from
the Medical Center and Chief Nurse of Davao Regional Medical Center.
2. After the permission will be granted, survey questionnaire will be formulated.
Consequently, it will undergo validation process by the validation committee of
Davao Doctors’ College.

3. Afterwards, permission letter will be sent to one of the private hospitals in South
Cotabato for testing the reliability of the research tool. Informed consent for the
initial respondents of the study will be secured in voluntary basis. Nurses who will
be included in the validation and reliability tests of the research tool will not be
part of the final respondents of the study.

4. After ensuring that the research tool is valid and reliable already, letter of
permission from the Office of the Medical Director from each hospital will be
secured.
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 19 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

5. The researcher will give a letter to the Human Resource Department (HRD) of
each respondent-hospital and will ask for a complete list of names of their nurses
for sampling purposes.

6. Upon getting the total number of nurses per respondent-hospital, the researcher
will use Raosoft to compute for the sample size and proportional allocation
formula to compute for sub-sample per hospital.

7. After identifying the individual respondents of the study, informed consent will be
secured for each respondent before the limited face to face distribution of the
research tool.

8. The researcher will conduct a face to face orientation to each randomly chosen
respondent of the study following the safety protocols and minimum health
standards by the COVID-19 IATF and DOH. She will explain the objectives of the
study.

9. Respondents will be given ample time to answer the survey questionnaire in their
most convenient times. Researcher will be back to retrieve the survey
questionnaire based from the date scheduled by each respondent.

10. Upon the retrieval of the survey questionnaires from the respondents, tabulation
of data will be the next step.

11. All the gathered data will be encoded in a Microsoft excel and will be subjected
to statistical computation with the help of the statistician.

12. Then, presentation, analysis and interpretation of the data will be the last step in
data gathering procedures.

Statistical Tools
The following statistical tools will be employed in this study:

Frequency and Percentage. These will be used to describe the demographic

profile of the respondents.
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 20 of 26
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DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

Mean. This will be employed to determine the level of the COVID-19 stress and
resilience of the respondents.

Analysis of Variance (ANOVA). This tool will be used to analyze the differences
of the COVID-19 stress and resilience of the respondents relative to their demographic
profile.

Pearson Product Moment Correlation. This tool will be employed to determine

the relationship of the COVID-19 stress and resilience of the respondents.
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 21 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

REFERENCES

Abolghasemi, A. & Varaniyab, S. (2020). Resilience and perceived stress: predictors of

life satisfaction in the students of success and failure. Procd. Soc. Behv. 5, 748–
752. 10.1016/j.sbspro.2010.07.178

Adaptation Model of Nursing of Sister Callista Roy (2019). Nursing Theories Guide.
Retrieved from https://nurseslabs.com/sister-callista-roys-adaptation-model/ on
December 1, 2020

Anderson, M. (2012). Factors of resiliency and depression in adolescents.

dissertation/master’s thesis. La Crosse (IL): University of Wisconsin-La Crosse.

Anyan, F. & Hjemdal, O. (2020). Adolescent stress and symptoms of anxiety and
depression: resilience explains and differentiates the relationships. J. Affect.
Discord. 203, 213–220. 10.1016/j.jad.2016.05.031

Artuch-Grade, R., Gonzales-Torres, M., De La Fuente, J., Vera, M., Fernandez-

Cabezas, M. & Lopez-Garcia, M. (2017). Relationship between Resilience and
Self-regulation: A Study of Spanish Youth at Risk of Social Exclusion

Assessment & Development Consultants (A&DC) (2017). The resilience questionnaire.

Retrieved from www.psionline.com on November 22, 2020

Balzarotti, S., John, O., & Gross, J. (2010). An Italian adaptation of the emotion
regulation questionnaire. Eur. J. Psychol. Assess. 26, 61–67. doi: 10.1027/1015-
5759/a000009

Bandag, F. & Ergun, N. (2020). Psychological resilience of healthcare professionals

during COVID-19 pandemic. SAGE Public Health Emergency Collection.
Retrieved from https://doi: 10.1177/0033294120965477 on December 2, 2020

Beiter, R., Nash, R., Mccrady, M., Rhoades, D., Linscomb, M. & Clarahan M. (2015).
The prevalence and correlates of depression, anxiety, and stress in a sample of
college students. J. Affect. Disord. 173, 90–96. 10.1016/j.jad.2014.10.054
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 22 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

Black Dog Institute. (2020). Mental health ramifications of COVID-19: The Australian
context. https://blackdoginstitute.org.au/docs/default-source/default-document-
library/20200319_covid19-evidence-and-reccomendations.pdf

Szanton, S. & Gill, J. (2016). Facilitating resilience using a society-to-cells framework: A

theory of nursing essentials applied to research and practice. Advances in
Nursing Science, 33(4(: 329-343

Taylor, S., Landry, C., Paluzzek, M., Fergus, T. McKay, G. & Asmundson, G. (2020).
Journal of Anxiety Disorders. ELSEVIER. Retrieved from
https://doi.org/10.1016/j.janxdis.2020.102232

Tugade, M., Fredrickson, B. & Barrett, L. (2020). Psychological resilience and positive
emotional granularity: examining the benefits of positive emotions on coping and
health. J. Pers.

Vitale R. A. (2015). Spirituality, resilience, and social support as predictors of life

satisfaction in young adults with a history of childhood trauma.
dissertation/master’s thesis. Kent (IL): Kent State University. Available at:
https://core.ac.uk/download/pdf/47055528.pdf (Accessed October 11, 2018).

Waugh, C. & Koster, E. (2020). A resilience framework for promoting stable remission
from depression. Clin. Psychol. Rev. 41, 49–60. 10.1016/j.cpr.2014.05.004, PMID

Watson, P. J., Friedman, M. J., Ruzek, J. I., and Norris, F. (2002). Managing acute
stress response to major trauma. Curr. Psychiatry Rep. 4, 247–253. doi:
10.1007/s11920-996-0043-x

CURRICULUM VITAE
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 23 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

Name: Juan Patrick L. Dela Cruz (Picture)

Birthday: March 27, 2000
Birthplace: Lucena City
Permanent Address: Brgy. Ibabang Iyam,
Lucena City
Contact Number: 09458111111
E-mail Address: [email protected]

Educational Background:

School/University Inclusive Years Honors/Awards

Academic affiliations:

RESEARCH INSTRUMENTS
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 24 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

Dear Nurse:
I am pleased to inform you that I am a graduating student of Davao Doctors
College, General Malvar St., Davao City, taking up Master of Arts in Nursing. Because
of your full commitment to serve the general populace of Sultan Kudarat against the
spread of COVID-19, you have been chosen as one of the respondents of my master’s
thesis entitled “COVID-19 STRESS AND RESILIENCE OF NURSES OF PUBLIC AND
PRIVATE HOSPITALS IN THE PROVINCE OF SULTAN KUDARAT.”

Kindly answer the survey questionnaire to the highest level of your honesty
based from your experiences amid COVID-19 pandemic particularly during the strict
implementation of quarantine protocols. The honest responses you give to this online
survey questionnaire will be vital information that can be used to initiate programs in
enhancing the resilience of frontline health workers in Sultan Kudarat. Rest assured that
your responses will be held with utmost confidentiality.

Juan Patrick L Dela Cruz

Researcher

PART I: DEMOGRAPHIC PROFILE

Direction: Please fill in the blanks the appropriate spaces for what is being asked.
1. Name of the Respondent (Optional): ___________________________
2. Gender: ___________________________
3. Civil Status: ___________________________
4. Tribe: ___________________________
5. Religion: ___________________________
6. Length of Service (in years): ___________________________

PART II: QUESTIONAIRE ON COVID-STRESS

Direction: This questionnaire will assess the COVID-19 stress you experience for the
past months. Please indicate your responses by checking the appropriate
columns/boxes that correspond to your answers.
 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 25 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

PART III: QUESTIONNAIRE ON RESILEINCE

 Document Code: DCAVRKMI-F-SHSRPF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Senior High School Research Proposal Form
An Autonomous University Page No.: Page 26 of 26
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: June 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

Direction: This questionnaire measures your resilience or how equipped you are to
bounce back after stressful events, tragedy or trauma. Please indicate your responses
by checking the appropriate columns/boxes that correspond to your answers.