LEVEL OF STRESS, BURNOUT, RESILIENCE AND THE

ACADEMIC PERFORMANCE OF LEVEL 1 NURSING

STUDENTS

ESTEBAN, STIFFANY JANE

FLORES, APPLE BLISS
GADGODE, RHONA JEAN
JAVA, GABRIELLA JOYCE
LEGASPI, KISHAMAE

MISAMIS UNIVERSITY
2023
 CHAPTER 1

INTRODUCTION

Background of the Study

In today’s fast-paced and demanding healthcare environment, healthcare facilities need to

cope up with new healthcare settings, thus nursing students face numerous challenges that can

impact their academic performance and overall well-being. One of the significant factors

addressing the problems of learning is the level of stress they experience during their education.

This research aims to explore the relationship between stress, burnout, resilience, and the

academic performance of level 1 nursing students

In most nursing programs, clinical training begins in the first year and extends until

graduation. As clinical training accounts for the majority of the nursing curriculum, stress has

been commonly reported among nursing students, especially in the initial period. However,

depending on how students deal with stressors, stress could have advantageous or

disadvantageous outcomes, while some students become more motivated when faced with

stressors, others become anxious and depressed. Stress can result in several poor academic

performance and elevated burnout levels.

Stress among nursing students has been extensively studied due to its detrimental effects

on their mental and physical health. The demanding nature of nursing education, including

rigorous coursework, clinical placements, and long hours of study, can contribute to high-stress

levels. This stress may negatively impact students' academic performance and overall success in

the program.

Burnout, another important aspect to consider, is a state of emotional, mental, and

physical exhaustion caused by chronic stress. Nursing students are susceptible to burnout due to

the heavy workload, high expectations, and emotional demands of the profession. Burnout has

been linked to decreased academic performance, increased absenteeism, and a higher likelihood

of leaving the nursing program.

On the other hand, resilience plays a vital role in how individuals cope with stress and

adversity. Resilience is the ability to bounce back from challenging situations and maintain a
positive outlook. Research has shown that higher levels of resilience can mitigate the negative

effects of stress and burnout, promoting better academic performance and overall well-being.

Understanding the interplay between stress, burnout, resilience, and academic

performance is crucial for nursing educators and administrators. By identifying the factors that

contribute to stress and burnout among level 1 nursing students, interventions can be developed

to support their mental health and enhance their academic success. Additionally, promoting

resilience in nursing students can equip them with the tools necessary to navigate the challenges

of their profession effectively.

To conduct this research, a mixed-methods approach will be employed, combining

quantitative surveys and qualitative interviews. Level 1 nursing students will be recruited from

multiple nursing programs to ensure a diverse sample. The survey will assess participants'

perceived stress levels, burnout symptoms, resilience levels, and academic performance.

Additionally, semi-structured interviews will be conducted to explore students' experiences and

perceptions regarding stress, burnout, resilience, and their impact on academic performance.

The findings of this research will contribute to the existing body of knowledge on the

relationship between stress, burnout, resilience, and academic performance among nursing

students. The results will inform nursing educators, administrators, and policymakers about the

importance of implementing interventions to support students' mental health and promote

resilience. Ultimately, by addressing these factors, nursing students' academic performance and

overall well-being can be improved, ensuring their success in their nursing careers.

Study Objectives

-general objectives

-specific objectives

Significance of the Study

-agencies or individuals that will benefit the output

 Theoretical Framework

This study is anchored to …

Conceptual Framework

MEDIATING VARIABLE

INDEPENDENT VARIABLE DEPENDENT VARIABLE

BURNOUT

LEVEL OF STRESS ACADEMIC ACHIEVEMENT

RESILIENCE

POTENTIAL CONFOUNDERS

 PERSONAL CHARACTERISTICS (AGE, GENDER, PRIOR EDUCATION)

 SOCIAL SUPPORT (FAMILY, FRIENDS)
 COPING STRATEGIES EMPLOYED BY STUDENTS

Statement of the Problem

This study aims to investigate and understand the intricacies surrounding stress, burnout,

and resilience among level 1 nursing students. Specifically, this study will answer the following

questions:

1. What is the respondents’ level of stress?

2. What is the respondents’ level of burnout?

3. What is the respondents’ level of resilience?

 4. What is the respondents’ academic achievement?

5. Is there a significant relationship between the respondents’ level of stress and their

burnout?

6. Is there a significant relationship between the respondents’ level of stress and their

resilience?

7. Is there a significant relationship between the respondents’ level of stress and their

academic achievement?

8. Is there a significant relationship between the respondents’ level of burnout and

their academic achievement?

9. Is there a significant relationship between the respondents’ level of resilience and

their academic achievement?

Through this research, we aim to understand the challenges faced by level 1 nursing

students and develop strategies and interventions to enhance their well-being and academic

success.

Statement of the Hypothesis

In this study, we have formulated the following hypotheses to be tested in the study:

Ho₁: There is a significant relationship between the respondents’ level of stress and their

burnout.

Ho₂: There is a significant relationship between the respondents’ level of stress and their

resilience.

Ho₃: There is a significant relationship between the respondents’ level of stress and their

academic achievement.

Ho₄: There is a significant relationship between the respondents’ level of burnout and their

academic achievement.

Ho₅: There is a significant relationship between the respondents’ level of resilience and their

academic achievement.

Significance of the Study

 Commission on Higher Education. The study provides valuable data for the

standardization of disaster nursing education from the Commission of Higher Education (CHED)

to assess the adequacy of disaster nursing education in accredited institutions. This serves as a

foundation for CHED to enhance and update curriculum standards, ensuring that nursing

programs incorporate the necessary disaster response skills and knowledge.

School Administrators. The study assumes a pivotal role in influencing the nursing

curriculum within educational institutions. It underscores the importance of incorporating

disaster nursing as a foundational element of the program. By providing nursing students with

the necessary knowledge and skills to respond adeptly to emergencies and disasters, this research

contributes significantly to the modernization of healthcare. Moreover, it ensures that schools are

actively engaged in producing nurses who are well-versed in disaster nursing, thereby enhancing

community safety.

Newly Graduated Nurses. The study plays a pivotal role in enhancing the initial

competence of newly graduated nurses in disaster nursing. This encompasses the latest evidence-

based practices and advancements in disaster nursing, creating a valuable learning opportunity.

By comparing their skills and knowledge to established benchmarks, this research ensures that

these novice professionals are adequately prepared to respond effectively during disaster

situations.

Registered Nurses. RNs bring a wealth of clinical experience and expertise to disaster

nursing, making their contributions invaluable. Their proficiency becomes especially crucial

when managing intricate patient care situations and making critical decisions during

emergencies. This expertise proves essential in disaster scenarios characterized by limited

resources, ensuring that patient care remains of the highest standard.

Healthcare Institutions. Healthcare institutions are pivotal in effectively managing vital

resources during disasters, encompassing medical supplies, equipment, and personnel. Proficient

resource allocation becomes imperative for the organized and efficient delivery of care to a

maximum number of patients. The skill and expertise of healthcare institutions play an

indispensable role in disaster scenarios characterized by resource constraints and the necessity

for swift decision-making.

 Future Researchers. Future researchers' findings on disaster nursing contribute to

community resilience. Their research informs public health initiatives, community education,

and preparedness efforts, ultimately helping communities better withstand and recover from

disasters. Their work can lead to the development of new tools, technologies, and strategies for

disaster response and patient care.

Definition of Terms

For the reader’s clearer understanding of the present study, the following terms were defined

operationally.

Knowledge. Knowledge refers to the understanding of community health, clinical skills, and

disaster response that nurses need to have in order to provide effective care during emergencies.

It focuses on providing care to individuals and communities affected by natural or man-made

disasters.

Skills. Skills refer to the abilities and knowledge that nurses need to provide effective care

during disasters. These skills include competencies such as disaster preparedness,

communication, triage, wound care, infection control, and psychosocial support.

Disaster Nursing. Disaster nursing is a subject in the nursing curriculum of some universities.

For example, Centro Escolar University in Manila, Makati, and Malolos offers a course on

disaster nursing (NCM 120) that covers topics such as disaster preparedness, response, and

recovery. The course is worth 2 units of lecture and 1 unit of laboratory work per week and is

taken during the 4th year of study 1.

Newly Graduated Student Nurse. A newly graduated student nurse is someone who is pursuing

their certification as a registered nurse and has graduated from nursing school or completed the

regular course of study, practical hospital training, and disaster training. They are student nurses

who just graduated from school in 2022 and have disaster nursing as part of their curriculum.
Registered Nurse. A registered nurse (RN) refers to a healthcare professional who has graduated

from nursing school or completed the regular course of study, practical hospital training, and

disaster training, passed a state board examination, and been registered and licensed to practice

nursing. They graduated from the school year 2018–2019 and have 1-2 years of experience in

disaster nursing.

The field of nursing has long been regarded as one of the most demanding and stressful

professions. As such, it is essential to explore the factors that influence the well-being and

academic performance of nursing students, particularly in the early stages of their education.

Stress and Burnout in Nursing Education:

Nursing education encompasses rigorous academic coursework, challenging clinical

rotations, and the responsibility of caring for patients' well-being. Consequently, nursing students

frequently experience high levels of stress and burnout. The demanding nature of the profession,

combined with the emotional and physical demands of patient care, can result in a negative

impact on students' mental health and academic performance.

Several studies have highlighted the prevalence of stress and burnout among nursing

students. For instance, a study conducted by Pulido-Martos et al. (2012) found that 56.5% of

nursing students experienced high levels of burnout. Additionally, a systematic review by

Labrague et al. (2017) revealed that nursing students worldwide encounter various stressors,

including heavy workload, time pressure, lack of support, and challenging clinical experiences.

Resilience in Nursing Education:

While stress and burnout pose significant challenges to nursing students, resilience has

emerged as a protective factor that can mitigate their negative effects. Resilience refers to an

individual's ability to adapt positively and recover from adversity. In the context of nursing

education, resilience can help students cope with the demands and pressures they encounter

throughout their training.

Research investigating resilience in nursing students has shown promising results. For

example, a study by Sinclair et al. (2017) found that higher levels of resilience were associated

with reduced psychological distress and burnout among nursing students. Additionally, resilience
has been linked to improved academic performance, as indicated in a study conducted by Karimi

et al. (2015). These findings underscore the importance of resilience as a potential buffer against

stress and burnout in nursing education.

Academic Performance and its Relationship with Stress, Burnout, and Resilience:

Academic performance is a crucial outcome variable in nursing education. Students'

ability to excel academically not only determines their future professional success but also

reflects the quality of their education. Research has shown that stress and burnout can have

detrimental effects on academic performance, compromising students' ability to grasp and apply

complex nursing concepts.

A study by Azhar et al. (2019) demonstrated a negative correlation between stress and

academic performance among nursing students. Similarly, a meta-analysis conducted by Dewa et

al. (2017) revealed a significant association between burnout and decreased academic

achievement. Conversely, resilience has been linked to improved academic performance, as

indicated by a study conducted by Windle et al. (2011).

The research focusing on the level of stress, burnout, resilience, and academic

performance of level 1 nursing students emphasizes the significant impact these factors have on

students' well-being and educational outcomes. Extensive research demonstrates the prevalence

of stress and burnout in nursing education, highlighting the need for interventions and support

systems to promote students' mental health. Furthermore, the protective role of resilience against

the negative effects of stress and burnout underscores the importance of fostering resilience

among nursing students. By understanding these dynamics, educational institutions can

implement strategies to enhance student well-being and academic performance, ultimately

producing competent and resilient nursing professionals.

Scope and Delimitation

Scope:
 1. Assessment of stress levels: The study can focus on determining the stress levels

experienced by nursing students. This includes identifying common stressors, such as academic

workload, clinical rotations, exams, and personal factors.

2. Examination of burnout: The study can explore the occurrence of burnout among

nursing students. This involves assessing emotional exhaustion, depersonalization, and reduced

personal accomplishment.

3. Investigation of resilience: The study can analyze the resilience levels of nursing

students. This includes examining their ability to cope with stress, adapt to challenges, and

maintain mental well-being.

4. Factors influencing stress, burnout, and resilience: The study can explore various

factors that contribute to stress, burnout, and resilience among nursing students. These factors

may include academic demands, clinical experiences, social support, coping strategies, and

personal characteristics.

Delimitation:

This study limits its coverage on the first year Nursing students of the Misamis

University that had experienced return demonstration. The researchers limited the study to 80

randomly selected freshmen student nurses in 2023. Its main purpose is to identify the level of

stress and burnout and considers every aspect of students' personal information that has an

impact on their academic performances and how they cope up with. Each of the respondents are

given online surveys and questionnaires through Google Forms for the researchers to get their

response.
References
 Chapter 2

REVIEW RELATED LITERATURE

This chapter presents related literature and studies that helped support the determination and

relationship between the level of stress, burnout, and resilience among Level 1 nursing students,

ultimately examining their impact on academic performance.

 Chapter 3

RESEARCH METHODOLOGY

Research Design- Joyce

This study will employ quantitative research method utilizing a correlational research

design. The correlational study design can compare two or more relevant variables and reports

the association between them without controlling the variables. The aim of correlational study

design is to uncover any types of systematic relationships between the studied variables

(Rezigalla, 2020). Findings from correlational research can be used to determine prevalence and

relationships among variables (Curtis, Comiskey, Dempsey, 2016). Correlational research design

will find the correlational between the variables in the study. In this type of research, the goal is

to examine the relationships or associations between variables: stress, burnout, resilience, and

academic performance at a specific point in time.

Research Setting – (kisha)

This study will be conducted on Misamis University located in Ozamiz City in the

province of Misamis Occidental during school year 2023-2024. Misamis University is a private

non-sectarian institution of higher learning founded in 1929 and granted its University status in

1997. The University is an ISO 9001:2000 certified and several programs are accredited withy

PACUCOA. This study will be conducted to first year students of Misamis University enrolled

in the College of Nursing, Midwifery, and Radiologic Technology taking Bachelor of Science in

Nursing.

Respondents of the Study – (Kisha)

The respondents of this study are the fist year students of Misamis University enrolled in the

College of Nursing, Midwifery, and Radiologic Technology taking Bachelor of Science in

Nursing.

Research Instrument -

Data Gathering Procedure – (kisha)

In collecting the data, a systematic approach will be utilized by the researchers following

these steps: 1) we will send a letter to the Dean of College of Nursing, Midwifery, and

Radiologic Technology to secure permission to conduct our study; 2) upon approval of the

request, we will then secure permission from BSN 1 advisors; 3) after the consents were given,

the researchers will then distribute the questioners to nursing students based on their year level.

The researchers will explain the instructions to the students and will entertain some questions for

clarifications; 3) and lastly, the data collected will be analyzed and will be interpreted by the

researchers.

Data Analysis Technique

Ethical Consideration – (Gadgode)

Before we will conduct the study, consent from the necessary authorities will be sought.

Before nursing students provide their full agreement to participate as responders, the goal of the

research will be fully explained to them. It must be made clear to them that this research will

cause no harm and that they may withdraw at any time if they feel threatened. People's privacy

and confidentiality will be preserved, such as keeping the names of persons engaged private and

not disclosing them in public. The dignity of respondents in research will be prioritized. In

general, this study guarantees that its purposes and objectives are neither misrepresented or

exaggerated.

Researcher Reflexivity- Stiffany