STRESS LEVEL AMONG NURSES AT MARGOSATUBIG REGIONAL HOSPITAL,

ZAMBOANGA DEL SUR

LLOYD GABRIEL P. POLIGRATES

APRIL JOY C. BANTILAN
JESSEBEL C. MASCARDO
JHONREY T. GOLBIN
ACE HARTZEL JAN S. BERADIO
KARLA S. PARAS
KRISTIAN JACOB P. POLIGRATES

THIS SENIOR HIGH SCHOOL RESEARCH IS PRESENTED IN PARTIAL FULFILLMENT

OF THE REQUIREMENTS FOR THE INQUIRIES, INVESTIGATION, AND IMMERSION
(3IS) RESEARCH

SENIOR HIGH SCHOOL DEPARTMENT

TORIBIO MINOR NATIONAL HIGH SCHOOL
MARGOSATUBIG, ZAMBOANGA DEL SUR

MARCH 2025
 CHAPTER I
INTRODUCTION

Background of the Study

Stress is a complex and pervasive issue that contributes to mental health disorders and
chronic health problems. It also reduces work productivity, decreases our quality of life, and
significantly increases healthcare costs (Manosso, 2022). Stress is a growing global concern
among healthcare professionals, especially nurses, and nurses experience more stress than
doctors (Couarraze, 2021). Despite being crucial to the healthcare system, nurses often face high-
stress levels due to the demands of their roles. The impact of stress among nurses can lead to
decreased job performance, burnout, and compromised patient care, resulting in direct
consequences for both the healthcare providers and the patients they serve. Stress also
contributes to a decline in mental and physical health, higher absenteeism, and increased
turnover rates, further straining healthcare systems (Sharma et al., 2020). These effects are most
pronounced among nurses working in high-pressure environments, where the demands of patient
care and insufficient institutional support exacerbate stress levels (McVicar, 2016).

According to data from the World Health Organization (WHO), stress levels among
healthcare professionals, particularly nurses, have significantly increased over the past few
decades (WHO, 2020). Research indicates that nurses worldwide are experiencing higher levels
of occupational stress than in previous years, which is largely due to increased workload,
emotional demands, and a lack of adequate support systems (McVicar, 2016). During the
COVID-19 pandemic, nurses experienced high levels of stress due to the unprecedented
demands placed on healthcare systems worldwide. A study revealed that during the COVID-19
pandemic, 82.8% of nurses at East Jeddah Hospital in Saudi Arabia experienced high levels of
stress, while 17.2% reported moderate stress. The prevalence of stress among nurses varies by
demographic and occupational characteristics (Albarqi, 2024). In India, the level of stress-related
problems among nurses has increased by 30% (Sharma et al., 2014). The main stressors
identified were fear of infection, overwhelming workloads, and inadequate protective equipment
(Sharma et al., 2014).

In the Philippines, stress has become a persistent issue for Filipino nurses. Aside from
reduced work productivity, stress can result in nurses resigning, switching professions, and
eventually relocating to other countries (Alibudbud, 2022). Physiological stress, mainly
tiredness, is the primary indicator that nurses experience stress. Frontline healthcare workers,
especially nurses, are at risk of physical and mental consequences as a result of providing care to
patients with COVID-19. This shows that nurses experience stress related to their workload
when caring for infected patients and also from receiving more patients (Samonte et.al, 2021).
Despite acknowledging these challenges, there is a lack of localized research examining the
stress experienced by nurses in rural hospitals, where the healthcare environment may
significantly differ from more urban settings.

A national survey conducted by the Philippine Nurses Association (PNA) revealed that a
substantial percentage of Filipino nurses report experiencing high levels of stress, which often
leads to burnout, job dissatisfaction, and even intentions to leave the profession (PNA, 2018). A
study conducted by the University of the Philippines Manila found that a majority of nurses in
public hospitals experience moderate to severe stress due to overwhelming workloads and
limited resources (UP Manila, 2019). Additionally, the Department of Health (DOH) has
acknowledged the growing concern of nurse stress, which has been linked to both the increasing
demand for healthcare services and the systemic challenges within the public health system
(DOH, 2020).

In a local context, specifically in Margosatubig, Zamboanga del Sur, there is a growing

need to examine the stress levels of nurses, particularly at Margosatubig Regional Hospital.
While stress in the nursing profession has been widely studied in various regions, there remains a
geographical gap in research concerning the level of stress faced by nurses in Margosatubig
Regional Hospital. The absence of localized studies limits the understanding of how workplace
conditions, staffing concerns, and patient care demands contribute to stress levels among nurses
in this setting.
 Assessing the stress levels of nurses in Margosatubig Regional Hospital is essential to
addressing this research gap, as it provides valuable insights into their well-being and its
potential impact on healthcare delivery. By identifying the extent of stress experienced by nurses,
this study aims to contribute to the body of knowledge on stress levels in healthcare and serve as
a foundation for future interventions that promote a healthier work environment.

The study is necessary because unaddressed stress among nurses can have serious
consequences. High levels of stress can negatively impact job performance, increase
absenteeism, and raise the risk of errors in patient care (Ribeiro et al., 2020). Additionally,
prolonged stress can lead to mental health issues such as anxiety and depression, which further
complicate the challenges faced by the healthcare workforce (Pham et.al, 2023). Understanding
this problem is crucial for developing targeted interventions to improve their work conditions
and, by extension, the quality of patient care.

This study is motivated by a desire to address the geographical gap regarding the stress
levels faced by nurses in regional hospitals such as Margosatubig. As individuals with a vested
interest in the healthcare system, understanding the challenges faced by nurses in underserved
areas and contributing to solutions that can improve their work environment and patient care
outcomes is the primary driving force behind this research. Through this study, the researchers
aim to determine the level of stress of nurses in healthcare practices at the local level, ensuring
that nurses receive the support they need to perform their vital roles effectively.
Conceptual Framework

The conceptual framework of this research uses the IPO (Input, Process, Output) format.
The first frame presents the input of the study that includes the socio-demographic profile of the
respondent such as their Age, Sex, Workplace Setting, and Marital Status followed by preparing
the survey questionnaire to be used and adopted which is the Expanded Nursing Stress Scale
(ENSS). The second frame presents the process of the study which include permit acquisition
from the research adviser, school principal, and medical chief of Margosatubig Regional
Hospital, Profiling, data gathering process involving the conduct of survey, and data analysis
using software tools such as Microsoft Excel and Paleontological Statistics (PAST). Lastly, the
third frame presents the output of the study which is determining the Level of Stress among
Nurses at Margosatubig Regional Hospital.

INPUT PROCESS OUTPUT

Socio-demographic
Profile
1. Age
2. Sex
3. Workplace Setting
4. Marital Status 1. Permit Acquisition Assessed Level
2. Profiling of Stress
3. Survey Questionnaire among Nurses
Level of stress among 4. Data Gathering at
Nurses at Margosatubig 5. Data Analysis Margosatubig
Regional Hospital 6. Interpretation Regional
Hospital
 Figure 1. Input-Process-Output Model of the Study.

Statement of the Problem

Generally, the main objective of this research is to determine the stress levels of nurses at
Margosatubig Regional Hospital. Despite the crucial role that nurses play in patient care, there is
a mounting concern about the stress they endure as a result of the demands of their profession.
Unmanaged stress can lead to burnout and decreased job satisfaction and may even impact the
quality of care provided to patients. Specifically, this study encompasses the following research
question;

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

a. Age
b. Sex
c. Workplace Setting
d. Marital Status?

2. What is the level of stress experienced among nurses at Margosatubig Regional

Hospital?

3. Is there a significant relationship between the level of stress among nurses between
the two age groups?

Hypothesis

Null Hypothesis (H₀): There is no significant difference in the levels of stress among nurses
between the two age groups
Alternative Hypothesis (H₁): There is a significant difference in the levels of stress among
nurses between two age group

Scope and Delimitation of the Study

The study focused on assessing the level of stress experienced by nurses at Margosatubig
Regional Hospital in Margosatubig, Zamboanga Del Sur. The assessment was conducted
exclusively within Margosatubig Regional Hospital by using structured questionnaires to gather
data. The study does not include nurses from other hospitals or healthcare facilities, nor does it
involve other healthcare professionals such as doctors or administrative staff. It also does not
cover long-term outcomes of stress or the effectiveness of specific stress management
interventions. The primary focus is solely on the current stress levels among the nurses at this
particular hospital. For this study, the researcher utilized the descriptive design specifically the
survey design for obtaining quantitative data. The Expanded Nursing Stress Scale (ENSS) will
serve as the primary research instrument to measure the level of stress.

Significance of the Study

This study aims to raise awareness among nurses themselves about their stress and its
extent, encouraging them to seek support and adopt stress management techniques. Through this,
nurses at Margosatubig Regional Hospital can be better equipped to handle the demands of their
profession, ultimately improving the quality of care they provide to patients.

The results of this study could be useful for the Department of Health (DOH) as the
information provided can serve as baseline data for developing strategies to improve the well-
being and mental health support systems for nurses. This study could also assist the
administration of Margosatubig Regional Hospital by providing insights into the stress levels
experienced by their nurses, enabling them to implement targeted interventions that can enhance
the working conditions and overall job satisfaction of their healthcare professionals.
 Moreover, the Local Government Unit (LGU) of Margosatubig could benefit from this
study as it highlights the importance of addressing occupational stress among nurses, which is
crucial for maintaining an efficient and effective healthcare system in the community. By
understanding the factors contributing to stress among nurses, the LGU can take proactive
measures to support the mental and physical health of these essential workers.

Additionally, the findings of this study hold great importance for Margosatubig Regional
Hospital (MRH). By understanding the stress levels affecting their nursing staff, the hospital can
take proactive measures to improve work conditions and mental health support. This will not
only enhance job satisfaction and reduce turnover but also contribute to better patient care and
operational efficiency. The data gathered could help MRH design targeted interventions and
stress management programs that address the unique challenges faced by nurses, ultimately
leading to a more resilient healthcare system.

The findings of this study could also serve as valuable reference material for future
researchers who wish to explore related topics, such as the impact of occupational stress on
healthcare workers' performance or the effectiveness of stress management interventions in
hospital settings. The data gathered can provide a foundation for further studies, contributing to a
broader understanding of the challenges faced by nurses and other healthcare professionals.

Definition of Terms
The researcher conceptually and operationally defined some terms that were commonly used
in the study to arrive at a common understanding of the word described.

1. Nurses - refer to the registered nursing staff employed at Margosatubig Regional Hospital
who are involved in direct patient care.

2. Stress - refers to the level of psychological and emotional strain experienced by nurses at
Margosatubig Regional Hospital, as measured by the Expanded Nursing Stress Scale
(ENSS) scores.
3. Stress Level - The degree of psychological and emotional strain experienced by nurses at
Margosatubig Regional Hospital, as measured by their responses on the Expanded
Nursing Stress Scale (ENSS).
4. Workload - assessed by the number of patients assigned per nurse, the number of working
hours, and the frequency of overtime, as reported by the respondents in the survey.

5. Work Environment - refers to the physical conditions, availability of resources, and

interpersonal relationships within Margosatubig Regional Hospital, as perceived and
reported by the nurses through the survey.

6. Workplace Setting – The specific hospital department or unit where nurses are assigned
to work, such as the Intensive Care Unit (ICU), Emergency Room (ER), Operating Room
(OR), Outpatient Department (OPD), or other specialized hospital ward that presents
unique challenges that contribute to the stress levels experienced by nurses.
 CHAPTER II
REVIEW OF RELATED LITERATURE

This chapter presents the relevant literature that the researcher considered in
strengthening the importance of the present study. It also presents the synthesis of the art to
understand the research for better comprehension of the study fully.

Stress Levels of Nurses

The stress levels among nurses globally are significantly high, as indicated by research
conducted in various countries. These studies consistently highlight the demanding nature of
nursing, exacerbated by long working hours, emotional fatigue, and a lack of adequate support.
For instance, in the United States, nurses reported stress levels nearly twice as high as other
medical staff, primarily due to the immense pressure they face from high patient loads and
understaffing (White et al., 2019). This trend is also observed in developing nations such as
Southern Ethiopia, where 55.9% of nurses experienced moderate stress and 24.8% faced high
stress due to overwhelming workloads and resource limitations (Bolado et al., 2023). It is evident
that the high-stress environment within nursing is not confined to specific regions but is a global
phenomenon. In both developed countries like the United States and developing nations such as
Southern Ethiopia, nurses are subjected to extreme workloads and inadequate resources, which
exacerbate their stress levels. This points to the need for systemic changes in healthcare to better
support nurses, ensuring that their well-being is prioritized and that they have the necessary
resources to manage their demanding roles effectively.

Moreover, these high stress levels in both developed and developing countries indicate
that nursing stress is not a localized issue but a systemic problem in healthcare. In India, for
instance, 74% of nurses reported moderate to severe stress driven mainly by increased workloads
and insufficient administrative support (Azad et al., 2020). Likewise, similar findings from Saudi
Arabia and Pakistan show that stress levels among nurses are around 87.8% and 72.34%
respectively, highlighting that nursing challenges transcend borders (Alharbi & Alshehry, 2019;
Jamir et al., 2023). These findings are also similar to the previous findings but vary in stress level
percentage. Based on the statistics, the highest stress levels among them occur in Saudi Arabia.

High levels of stress were also experienced during the time of the COVID-19 Pandemic.
In Asia, 82.8% of the first-line nurses in East Jeddah Hospital, Saudi Arabia experienced high
levels of stress and only 17.2% had moderate stress. These levels were affected by various work-
related factors such as the department of work, hours of work, years of experience, access to
PPEs, nature of the relationship with the other coworkers, and nature of work relationship
(Albarqi, et.al, 2024). Beyond that, the overall occupational stress level of nurses in a
Vietnamese Tertiary hospital was at a mild level, nearly one-third of nurses experienced
moderate and severe stress levels (Vu et.al, 2024). The global nature of this issue emphasizes the
need for comprehensive strategies to reduce nursing stress, whether through better staffing,
emotional support systems, or resource allocation.

In the Philippines, the stress levels of nurses have been rising particularly during the
pandemic. The COVID-19 pandemic has significantly impacted the stress levels of nurses in the
Philippines, revealing a complex interplay of psychological and occupational factors. Nurses in
Davao City, Philippines, experienced high COVID-19 stress levels during the pandemic,
impacting their organizational commitment (Aballe & Nieve, 2024). Similarly, during the
COVID-19 pandemic, nurses in the Philippines experienced moderate stress levels, with 83.9%
showing moderate stress and 3.6% reporting high stress levels and other Philippine nurses
working during COVID-19 experienced moderate to high levels of occupational fatigue,
impacting their stress levels (Sampayan et.al, 2022; Stevens et.al, 2023).

While numerous studies have been conducted on the stress levels of nurses globally and
nationally, local research has yet to be carried out in Margosatubig, Zamboanga del Sur, to
specifically examine the stress levels of nurses working in the region. This highlights a
population gap in determining the stress level of healthcare professionals, specifically, the
nurses; underlining the need for this study to provide valuable local insights. Addressing this gap
will help in developing strategies tailored to this kind of challenge for nurses in Margosatubig.

Workplace Stressors

Stressors are external stimuli, chemicals, or biological agents that are believed to cause
stress in an organism (Sato et al., 2006). These stressors contribute to varying levels of stress
experienced by nurses worldwide. Workplace stressors significantly impact nurses' well-being
and performance, with several factors contributing to this issue globally. Research consistently
highlights that stress in nursing arises from excessive work demands, role conflicts, and
inadequate support systems, leading to high burnout rates and job dissatisfaction. For instance, a
study in Nigeria found that 63% of nurses experienced moderate to severe stress due to
workplace stressors such as work overload, role conflicts, role ambiguity, and workplace
relationships, affecting performance in public hospitals in Nigeria's Federal Capital Territory
(Dominic et al., 2024). Similarly, in a study conducted in Ethiopia, nurses reported that shift
work and rotating shifts disrupted their sleep patterns and work-life balance, contributing to
higher stress and burnout rates (Zekiwos et al., 2024). Research in India highlighted the negative
impact of workplace relationships, where poor interpersonal dynamics and lack of social support
were linked to 78% of nurses experiencing increased mental health risks and burnout (Khade et
al., 2024).

Moreover, a study in Australia showed that role conflict and ambiguity, with unclear job
expectations, caused confusion and stress, negatively affecting job performance and satisfaction
among 68% of surveyed nurses (Norful et al., 2024). These international findings emphasize the
widespread nature of workplace stressors and their detrimental effects on nurses' overall health
and professional performance.

The work environment for nurses in the Philippines presents a variety of stress factors
originating from both internal and external sources that significantly affect their well-being.
Research identifies key stress contributors, such as heavy workloads, lack of support, and
workplace conflicts, all of which can lead to burnout and mental health issues. One of the
primary stressors is workload and job demands, with high patient loads and long working hours
leading to overwhelming stress levels (Dantis et al., 2024; Imani-Goghary et al., 2023). For
instance, workload and conflicts with colleagues were significant stressors in a private hospital in
Metro Manila, impacting job satisfaction, perceived quality of care, and turnover intention
(Bautista et al., 2020). Similarly, work-related stressors like workload were prevalent among
staff nurses in Metro Manila, with moderate stress levels reported across various factors such as
age, civil status, and patient load (Jabonete, 2017). Interpersonal conflicts with colleagues and
challenging interactions with patients and their families further compound stress (Dantis et al.,
2024; Norful et al., 2024).

Furthermore, the lack of support, whether in terms of social backing or clear workplace
goals, increases the risk of burnout and mental health problems (Norful et al., 2024; Alibudbud,
2023). Additionally, the emotional strain of caring for critically ill patients and facing ethical
dilemmas contributes to significant emotional stress among nurses (Imani-Goghary et al., 2023).
While nurses in the Philippines often use problem-focused coping strategies to manage these
stressors (Dantis et al., 2024), structural issues such as low salaries and understaffing further
complicate their working conditions, emphasizing the need for systemic changes to improve
nurses' well-being and retention (Alibudbud, 2023).

While many studies have focused on workplace stress among nurses at the national and
international levels, there has been no local research conducted in Margosatubig, Zamboanga del
Sur, to specifically assess the stressors that impact nurses in this region. This lack of local data
creates a gap in understanding the unique challenges faced by nurses at Margosatubig Regional
Hospital. Without localized research, the specific workplace stressors, such as workload,
interpersonal conflicts, and lack of support, remain undocumented in this area. Conducting local
studies is crucial to gain insights into the stressors that may be affecting nurses in Margosatubig,
potentially leading to more effective stress management strategies tailored to the region's
healthcare environment.

The workplace setting significantly affects the stress levels experienced by nurses, as
different hospital environments present unique challenges and demands. Studies have shown that
nurses working in high-intensity units, such as the Intensive Care Unit (ICU), Emergency Room
(ER), and Operating Room (OR), experience significantly higher stress levels compared to those
in general wards or outpatient clinics (Alharbi & Alshehry, 2019). These specialized units require
quick decision-making, expose nurses to frequent patient deaths, and involve a heavy workload,
contributing to emotional and physical strain.

Globally, research has consistently highlighted the impact of workplace settings on nurse
stress. A study in the United States found that ICU nurses experience higher stress due to rapid
patient deterioration, complex medical interventions, and ethical dilemmas regarding end-of-life
care (White et al., 2019). Similarly, in Ethiopia, nurses working in emergency departments
reported significantly higher stress levels than those in general wards, primarily due to high
patient influx, lack of medical resources, and exposure to traumatic injuries (Bolado et al., 2023).
In Australia, unclear job expectations and frequent role-switching in different hospital units led
to job dissatisfaction among nurses, further increasing workplace stress (Norful et al., 2024).

Nationally, studies in the Philippines also support the link between workplace setting and
nurse stress. Research conducted in Metro Manila found that nurses in ICUs and ERs experience
higher stress levels due to understaffing, high patient turnover, and administrative workload
(Bautista et al., 2020). Another study revealed that nurses assigned to private hospitals
experienced significant stress due to strict work policies, long shifts, and pressure from hospital
management (Dantis et al., 2024). Conversely, nurses in outpatient departments and
administrative roles reported lower stress levels but faced different challenges, such as
paperwork overload, bureaucratic inefficiencies, and workplace conflicts (Khade et al., 2024).

Locally, there is currently no research specifically examining how workplace settings

affect nurse stress in Margosatubig Regional Hospital. Given that rural hospitals often operate
with limited resources, fewer specialized staff, and higher patient-to-nurse ratios, it is crucial to
investigate how these factors contribute to workplace stress among nurses in Margosatubig.
Localized studies would help identify the unique challenges faced by nurses in different hospital
units, enabling hospital administrators to implement targeted interventions such as workload
redistribution, mental health support programs, and better staffing policies.
 This review of related literature delves into stress levels, workplace stressors, and coping
strategies among nurses at different levels - global, national, and regional. Despite the wealth of
existing studies, there are noticeable gaps, especially in the context of Margosatubig Regional
Hospital. Globally, research shows that nurses face high levels of stress due to long working
hours, emotional fatigue, and understaffing, which are consistent across various countries. The
stressors include excessive workloads, lack of administrative support, and resource shortages,
further exacerbated by events like the COVID-19 pandemic. However, there is limited
generalizability to the local context in Margosatubig due to geographical and institutional
differences. At the national level, studies in the Philippines reflect similar trends, demonstrating
that Filipino nurses, particularly during the COVID-19 pandemic, encounter moderate to high-
stress levels. Nevertheless, most of these studies are conducted in major urban areas and fail to
capture the unique challenges faced by nurses in rural areas such as Margosatubig. This
geographical gap presents an opportunity for localized research to address the distinct stressors
specific to rural healthcare settings, including limited resources and differing patient-to-nurse
ratios compared to urban hospitals.

In addition, while the literature extensively discusses stressors and coping strategies,
there's little emphasis on cultural factors that may impact how stress is perceived and managed in
rural areas. Understanding these local practices, along with the stressors of Margosatubig nurses,
could offer valuable insights into developing effective stress management strategies tailored to
this specific group. Despite comprehensive global and national research on stress among nurses,
there remains a significant gap in localized research for Margosatubig Regional Hospital.
Conducting localized research can help fill this gap, providing essential insights into stressors
and coping strategies, potentially improving nurse well-being and healthcare quality in
Margosatubig.
 CHAPTER III
METHODOLOGY

This chapter presents the procedures of the study and data gathering that are needed to
answer the problem. The following subject matter are the following; Research Design, Research
Environment, Research Participants, Sampling Technique, Research Instruments, Data Gathering
Procedure, Data Analysis, and Ethical Consideration.

Research Design

This study employed a quantitative descriptive research design, specifically survey

design to quantify the stress levels among nurses at Margosatubig Regional Hospital. A survey
design was used to systematically collect numerical data, allowing for the identification of trends
and patterns in stress levels. This approach ensures an objective measurement of stress, providing
statistical insights into the extent and distribution of the phenomenon (Creswell & Plano Clark,
2017).

This approach aligns with the study's objectives by ensuring the quantitative findings
accurately measure the extent of stress among nurses. A descriptive survey design allows for the
systematic collection of numerical data, capturing the prevalence and distribution of stress levels
(Guetterman et al., 2013). By relying on statistical analysis, this method enhances the reliability
and validity of the findings, making it particularly suitable for studying measurable constructs
like stress.
Research Environment

This study was conducted at Margosatubig Regional Hospital located in the municipality
of Margosatubig, Zamboanga Del Sur. The hospital employs approximately 859 healthcare
workers including doctors, nurses, midwives, and other support staff, who work regularly. Based
on our observations, the hospital serves a varying number of patients from various
municipalities, which results in a varying number of patient loads. This context highlights the
quality of patients and care for further investigation into how these staffing issues impact the
stress level in hospital operations.

Research Participants
 A total of 60 nurses were chosen as participants in this study. The availability and
willingness of nurses were taken into consideration when choosing the participants. The
participants were nurses from different workplace areas in Margosatubig Regional Hospital.

Sampling Technique

The survey was conducted at Margosatubig Regional Hospital, Zamboanga del Sur, using
a non-random sampling method, specifically convenience sampling. This technique was chosen
due to the demanding and unpredictable work schedules of nurses, which limited their
availability for participation. Convenience sampling allowed the researchers to select nurses who
were readily available and willing to participate, ensuring that data collection was feasible
despite time constraints. This method was appropriate as it enabled the study to gather responses
from nurses without disrupting their essential duties while still capturing relevant data on
workplace stress.

Research Instrument

Primary data from the nursing staff of Margosatubig Regional Hospital were used to
assess the stress level. The data were gathered quantitatively through a structured questionnaire.
The approach used by the researchers in developing the questionnaire, is, one adapted from the
Expanded Nursing Stress Scale (ENSS) which evaluates the nurses' stress levels. The researchers
adopted the levels of stress, which included never stressful, occasionally stressful, frequently
stressful often stressful, and always stressful. In addition, the researchers used a self-
administered questionnaire.

Data Gathering Procedure

The researchers followed a structured approach to ensure the accuracy and reliability of
data collection. The data-gathering process began with a review of the survey questionnaire by
the research adviser to ensure clarity and validity. Once approved, the questionnaire was
submitted for further review and approval by the school principal and subsequently by the
medical chief of Margosatubig Regional Hospital to secure permission to conduct the study.

Upon obtaining the necessary approvals, the survey was self-administered to the selected
nurse respondents. The participants were provided with clear instructions to facilitate accurate
responses while ensuring they fully understood the nature of the study. The researchers remained
available to address any clarifications needed during the process.

After the completion of the questionnaires, the researchers collected the responses and
reviewed them for completeness and accuracy. To ensure confidentiality, no personal identifiers
were included, and all data were securely stored and used exclusively for research purposes. By
adhering to this systematic approach, the study maintained ethical integrity while obtaining
reliable data on the stress levels experienced by nurses at Margosatubig Regional Hospital.

Data Analysis

Concise descriptive statistics were generated for the selected respondents’ demographic
data using Microsoft Excel. The data from the demographic profiles of the respondents were
calculated in terms of frequency and percentage. Microsoft Excel was utilized to calculate the
quantitative data in terms of mean and standard deviation about the level of stress among nurses
at Margosatubig Regional Hospital using Microsoft Excel. Inferential statistics is also applied to
determine if there is a significant difference between the two age groups. The researchers utilized
paleontological statistics software, specifically used T-test to assess whether there is a significant
difference of level of stress of two age group.

Ethical Consideration

This study adhered to all necessary ethical considerations to ensure the protection and
rights of the participants. Initially, the researchers sought approval from the administration of
Margosatubig Regional Hospital and the school authorities before conducting the study. Upon
receiving consent, participants were provided with a clear explanation of the study's purpose,
procedures, and objectives to ensure informed participation. They were given the choice to
voluntarily participate, with the option to withdraw at any point without facing any negative
consequences.

Each respondent was approached individually and given ample time to ask questions or
raise concerns about the research. The researchers ensured that participants understood that their
responses would be kept confidential and that their identities would not be disclosed. No
personally identifiable information was collected to maintain anonymity. Additionally, data was
stored securely and used solely for academic purposes.

Principle of Informed Consent. Participants were fully informed about the study and
voluntarily agreed to participate without coercion.

Principle of Confidentiality and Anonymity. The researchers ensured that all responses
remained confidential, with no identifying information included in the data analysis.

Principle of Respect and Protection. The dignity and well-being of the participants were
prioritized throughout the study, and no harm, discomfort, or pressure was imposed upon them.

Principle of Objectivity and Integrity. The study upheld honesty and accuracy in data
collection, analysis, and reporting, avoiding any form of bias or misrepresentation.

By adhering to these ethical standards, the study maintains the credibility and reliability of its
findings while ensuring the well-being and rights of all participants.
 CHAPTER IV
RESULTS

The study focuses on determining the level of stress among nurses at Margosatubig
Regional Hospital. Thus, this chapter provides a detailed account of the data collected, analysis,
and interpretation of data regarding the profile of the respondents, as well as their level of stress.

A quantitative descriptive survey method was utilized to gather precise and reliable data
to address the specific research questions. To commence, the researchers present the outcomes of
the demographic profile of the respondents (as shown in Table 1), which were obtained through a
questionnaire that is self - administered by the respondents.

Among the age groups, respondents aged 31-35 comprise the largest portion, accounting
for 35% of the total sample. This is closely followed by individuals aged 36-40, who constitute
33.33%. Meanwhile, the smallest groups are those aged 41 and above, comprising only 11.67%
of the respondents. These findings suggest that the workforce at the hospital consists primarily of
individuals in their early to mid-thirties.

Regarding gender distribution, female respondents form the majority, representing 70%
of the total sample, whereas male respondents account for only 30%. This indicates a significant
female presence in the hospital workforce, which aligns with the general trend observed in
healthcare professions where women dominate the industry.

In terms of workplace setting, the highest percentage of respondents are from the
Intensive Care Unit (ICU), making up 15% of the sample. This is followed by the Emergency
Room at 11.67% and the Operating Room and Outpatient Department (OPD), both at 10%.
Conversely, the lowest representation is observed in the Neonatal Intensive Care Unit (NICU),
Station A/B/E, and the Delivery Room, each comprising 6.67% of the respondents. These figures
suggest that more personnel are assigned to critical and emergency care units, reflecting the
hospital's priority in staffing these high-demand areas.

Examining marital status, the majority of respondents are married, making up 73.33% of
the total sample. Single individuals constitute 21.67%, while widowed respondents represent the
smallest group at only 5%. Notably, no respondents identified as separated. This distribution
implies that most hospital employees have established families, which may influence their work-
life balance and professional responsibilities.

Overall, the data highlights significant trends in the demographic characteristics of the
hospital workforce, with a predominance of female employees, a concentration of personnel in
critical care units, and a majority of respondents in their early thirties. These findings provide
valuable insights into the composition and distribution of healthcare professionals in
Margosatubig Regional Hospital, which may inform future staffing and policy decisions.
Table 1. – Demographic profile of the respondents in Margosatubig Regional Hospital (n = 60)
Category Subcategory Number of Percentage (%)
respondents
Age
21 – 25 5 8.33%
26 – 30 7 11.67%
31 – 35 21 35.00%
36 – 40 20 33.33%
41 Above 7 11.67%
Sex Male 18 30.00%
Female 42 70.00%
Workplace setting NICU 4 6.67%
Station A/B/E 4 6.67%
Surgical Ward 5 8.33%
Laboratory 5 8.33%
Radtech 5 8.33%
Operating room 6 10.00%
Delivery room 4 6.67%
Emergency room 7 11.67%
Isolation room 5 8.33%
ICU 9 15.00%
OPD 6 10.00%
Marital status Single 13 21.67%
Married 44 73.33%
Separated 0%
Widowed 3 5.00%

The results, as shown in Table 2, indicate that the overall mean stress level among nurses
has a verbal interpretation of "Frequently Stressful," suggesting that most nurses frequently
experience stress in their work environment. The highest mean score was recorded for "The
death of a patient with whom you developed a close relationship", followed by "Having to deal
with violent patients", highlighting the emotional toll and potential physical risks nurses face.
Conversely, the lowest mean score was observed for "Experiencing discrimination based on sex",
indicating that while discrimination is a concern, it is not as frequently encountered compared to
other stressors.
 Other notable stressors included "Not enough staff to adequately cover the unit, "Being
exposed to health and safety hazards, and "The death of a patient" all categorized as "Frequently
Stressful," suggesting that understaffing, exposure to hazards, and patient deaths significantly
contribute to stress levels. Interestingly, stress related to "Criticism by a physician" and
"Disagreement concerning the treatment of a patient" were both interpreted as "Occasionally
Stressful," indicating that while professional conflicts occur, they are not among the most
pressing stressors faced by nurses. Overall, the data reflects that nurses at Margosatubig Regional
Hospital frequently experience stress, particularly in emotionally and physically demanding
situations, underscoring the need for improved support systems, sufficient staffing, and stress
management strategies to enhance the well-being of healthcare professionals.
Table 2. The mean level of stress among nurses at Margosatubig Regional Hospital, Zamboanga
Del Sur (n = 60)
Mean ± SD Verbal
Statement
Interpretation
1. Performing procedures that patients experience 2.92 ±1.14 Occasionally
as painful. Stressful
2.88 ±1.13 Occasionally
2. Criticism by a physician
Stressful
3. Feeling inadequately prepared to help with the 2.97 ±1.12 Occasionally
emotional needs of a patient's family Stressful
4. Lack of opportunity to talk openly with other 2.98 ±1.23 Occasionally
personnel about problems in the work setting. Stressful
3.07 ±1.39 Frequently
5. Conflict with a supervisor Stressful

3.05 ±1.13 Frequently

6. Breakdown of computer Stressful

7. Inadequate information from a physician 2.93 ±1.29 Occasionally

regarding the medical condition of a patient Stressful
3.18 ±1.30 Frequently
8. Patients making unreasonable demands Stressful

2.68 ±1.45 Occasionally

9. Being sexually harassed
Stressful
3.03 ±1.12 Frequently
10. Feeling helpless in the case of a patient who
Stressful
fails to improve
2.72 ±1.18 Occasionally
11. Conflict with a physician
Stressful
12. Being asked a question by a patient for which I 2.77 ±1.09 Occasionally
do not have a satisfactory answer Stressful
13. Lack of opportunity to share experiences and 2.92 ±1.26 Occasionally
feelings with other personnel in the work setting Stressful
3.12 ±1.31 Frequently
14. Floating to other units/services that are short- Stressful
staffed

3.37 ±1.30 Frequently

15. Unpredictable staffing and scheduling Stressful

3.1 ±1.25 Frequently

16. Physician ordering what appears to be an
Stressful
inappropriate treatment for a patient
17. Patients' families making unreasonable 3.3 ±1.30 Frequently
 Stressful
demands
18. Experiencing discrimination because of race or 2.63 ±1.26 Occasionally
ethnicity Stressful
19. Listening or talking to a patient about his/her 2.82 ±1.18 Occasionally
approaching death Stressful
3.18 ±1.31 Frequently
20. Fear of making a mistake in treating a patient Stressful

21. Feeling inadequately prepared to help with the 2.82 ±1.16 Occasionally
emotional needs of a patient Stressful
22. Lack of an opportunity to express to other 2.97 ±1.06 Occasionally
personnel on the unit my negative feelings toward Stressful
patients
2.7 ±1.17 Occasionally
23. Difficulty in working with a particular nurse
Stressful
(or nurses) in my immediate work setting
2.47 ±1.04 Occasionally
24. Difficulty in working with a particular nurse
Stressful
(or nurses) outside my immediate work setting
25. Not enough time to provide emotional support 2.93 ±1.15 Occasionally
to the patient Stressful
3.25 ±1.31 Frequently
26. A physician not being present in a medical
Stressful
emergency
3.25 ±1.36 Frequently
27. Being blamed for anything that goes wrong
Stressful
2.3 ±1.22 Occasionally
28. Experiencing discrimination based on sex
Stressful
3.35 ±1.31 Frequently
29. The death of a patient Stressful

30. Disagreement concerning the treatment of a 2.88 ±1.18 Occasionally

patient Stressful
31. Feeling inadequately trained for what I have 2.97 ±1.22 Occasionally
to do Stressful
32. Lack of support from my immediate 2.78 ±1.28 Occasionally
supervisor Stressful
2.65 ±1.31 Occasionally
33. Criticism by a supervisor
Stressful
3.13 ±1.20 Frequently
34. Not enough time to complete all of my nursing
Stressful
tasks
35. Not knowing what a patient or a patient's 2.85 ±1.03 Occasionally
family ought to be told about the patient's Stressful
condition and its treatment
36. Being the one that has to deal with patients' 2.97 ±1.17 Occasionally
families Stressful
3.52 ±1.35 Frequently
37. Having to deal with violent patients Stressful

3.35 ±1.29 Frequently

38. Being exposed to health and safety hazards Stressful

3.55 ±1.26 Frequently

39. The death of a patient with whom you
Stressful
developed a close relationship
3.05 ±1.24 Frequently
40. Deciding for a patient when the physician is
Stressful
unavailable
2.98 ±1.18 Occasionally
41. Being in charge with inadequate experience
Stressful
2.85±1.28 Occasionally
42. Lack of support by nursing administrators
Stressful
43. Too many non-nursing tasks required, such as 2.78 ±1.21 Occasionally
clerical work Stressful
3.33 ±1.30 Frequently
44. Not enough staff to adequately cover the unit Stressful

45. Uncertainty regarding the operation and 3.28 ±1.05 Frequently

functioning of specialized equipment Stressful
3.53 ±1.16 Frequently
46. Having to deal with abusive patients Stressful

3.33 ±1.11 Frequently

47. Not enough time to respond to the needs of
Stressful
patients' families
3.27 ±1.21 Frequently
48. Being held accountable for things over which I
Stressful
have no control
3.18 ±1.18 Frequently
49. Physician(s) not being present when a patient
Stressful
dies
3.12 ±1.08 Frequently
50. Having to organize doctors' work Stressful

3.1 ±1.19 Frequently

51. Lack of support from other healthcare
Stressful
administrators
52. Difficulty in working with nurses of the 2.72 ±1.42 Occasionally
opposite sex Stressful
53. Demands for a patient classification system 2.58 ±1.17 Frequently
 Stressful

3.1 ±1.31 Frequently

54. Having to deal with abuse from patients'
Stressful
families
3.05 ±1.24 Frequently
55. Watching a patient suffer Stressful

2.87 ±1.26 Occasionally

56. Criticism by nursing administration
Stressful
3.03 ±1.21 Frequently
57. Not knowing whether patients' families will
Stressful
report you for inadequate care
2.9 ±1.21 Occasionally
58. Having to make decisions under pressure
Stressful
3.00 ±1.22 Frequently
OVERALL Stressful

Verbal Interpretation:
1.0-1.99- Never Stressful
2.0-2.99- Occasionally Stressful
3.0-3.99- Frequently Stressful
4.0-4.99- Moderately Stressful
5.0 Above- Extremely Stressful

Stress level data were further subjected into inferential statistics to determine if there is a
significant difference of stress level between two age group. The selected age group were age 31-
35 and 36-40. Researchers decided to select these age groups because they were almost equal. To
put the independent samples t-test was conducted to determine whether there was a statistically
significant difference in stress levels between Group 1 (nurses aged 31–35) and Group 2 (nurses
aged 36–40) as shown in Table 3. The results indicate that Group 1 had a mean stress level of
2.79, while Group 2 had a mean stress level of 3.06.

The computed t-value of 4.8514 exceeds the critical t-value of 1.981 at a significance
level of α = 0.05. Furthermore, the p-value (3.9191E-06) is much lower than 0.05, indicating that
the difference in stress levels between the two groups is statistically significant. These findings
suggest that nurses aged 36–40 experience significantly higher stress levels than those aged 31–
35.
Table 3. Result of Independent sample t-test on the significant difference between group 1
(age 31 – 35) and (age 36 – 40).
Variables Mean t – value p – value Interpretation
Group 1 2.79 4.8514 3.9191E – 06 Significant Difference
Group 2 3.06
Significant level at α = 0.05.
 CHAPTER V
DISCUSSION

Stress among nurses is a critical issue that significantly affects their well-being, job
performance, and patient care outcomes (McVicar, 2016). The results of this study indicate that
the overall level of stress among nurses at Margosatubig Regional Hospital is a "Frequently
Stressful" interpretation. This suggests that nurses regularly experience stress in their work
environment, aligning with previous research indicating high stress levels among healthcare
professionals worldwide (Couarraze et al., 2021). The primary stressors identified include patient
deaths, violent patients, understaffing, and exposure to health hazards, which are similarly
reported in studies on nursing stress (Bolado et al., 2024).

In Margosatubig, the death of a patient with whom nurses developed a close relationship
recorded the highest mean score, indicating that emotional distress is a significant stressor.
Research indicates that nurses' emotional responses to patient deaths are significantly influenced
by the depth of their relationships with patients (Cybulska et.al, 2022). A study analyzing nurses'
attitudes toward patient death found that the death of a patient with whom nurses had developed
a close relationship elicited the highest mean scores of sadness, helplessness, and regret. These
emotions were notably influenced by factors such as the patient's age, the nature of the death, and
the quality of the relationship between the nurse and the patient and their family (Cybulska et.al,
2022). Similarly, having to deal with violent patients and being exposed to health and safety
hazards were among the most frequently reported stressors, suggesting that physical safety
concerns contribute to nurses’ stress levels. This supports findings from Alharbi & Alshehry
(2019), who reported that nurses working in high-risk environments, such as ICUs and
emergency rooms, experience heightened stress due to potential physical harm.

Staffing-related stressors also emerged as a major concern. The study found that "Not
enough staff to adequately cover the unit" was frequently stressful for nurses. This reflects
findings from similar research indicating that understaffing increases workload and job
dissatisfaction, contributing to burnout (Bolado et al., 2024). Furthermore, "Unpredictable
staffing and scheduling" was another major stressor, underscoring the impact of erratic work
schedules on nurses' mental health (Azad et al., 2021).

Demographic analysis revealed that the majority of respondents were female, married,
and aged between 31-35 years old. Research suggests that nurses in the age range of 31-35, their
careers often face increasing responsibilities, both professionally and personally, which can
contribute to heightened stress levels (Kundrata et al., 2022). Studies have shown that female
nurses experience higher stress levels than their male counterparts due to factors such as
increased workload, emotional labor, and family responsibilities (Kundrata et al., 2022).
Additionally, married nurses often report higher stress levels due to the dual burden of
professional and household responsibilities (Nopa et al., 2023).

Regarding workplace settings, the highest percentage of respondents came from the
Intensive Care Unit (ICU) and Emergency Room, both of which are known to be high-stress
environments due to the critical nature of patient care (Imani-Goghary et al., 2023). Nurses
assigned to these departments often face greater emotional and physical strain compared to those
in outpatient or general care units (Mangilep et al., 2024).

Interestingly, "Experiencing discrimination based on sex" received the lowest mean

score, interpreted as "Occasionally Stressful." This suggests that while gender discrimination
exists, it is not a predominant stressor for nurses in this setting. However, previous studies have
shown that gender bias remains an issue in some healthcare institutions (Filomeno et al., 2024).

The study also found that stress related to "Criticism by a physician" and "Disagreement
concerning the treatment of a patient were both interpreted as "Occasionally Stressful." This
aligns with research indicating that while professional conflicts occur, they are not the primary
cause of stress for most nurses (Rowalt, 2023). However, persistent interpersonal conflicts can
contribute to job dissatisfaction and burnout (Hart et al., 2009).

Despite recognizing these stressors, many nurses do not engage in proactive stress
management strategies. While some rely on problem-focused coping mechanisms, such as
planning and seeking social support (Mangilep et al., 2024), others resort to avoidance strategies,
which have been linked to higher burnout rates (Filomeno et al., 2024). Religious coping also
emerged as a prevalent strategy among Filipino nurses, consistent with findings that faith-based
practices help mitigate occupational stress (Nopa et al., 2023).

The independent samples t-test results further highlight significant differences in stress
levels between nurses aged 31–35 and those aged 36–40. The analysis revealed that nurses in the
older age group reported significantly higher stress levels compared to their younger
counterparts. This suggests that nurses may experience increased stress as they age due to greater
professional responsibilities, higher patient care demands, and the cumulative impact of
workplace stressors.

This finding aligns with previous studies suggesting that mid-career nurses often face
higher stress levels due to leadership roles, administrative duties, and expectations to mentor
junior staff (Nopa et al., 2023). Additionally, nurses in this age group may experience work-
family conflicts, contributing to elevated stress levels (Kundrata et al., 2022). Research has
shown that older nurses are more likely to suffer from burnout and job dissatisfaction, often due
to prolonged exposure to stressors such as understaffing, emotional distress from patient care,
and physical exhaustion (Mangilep et al., 2024).
 A possible explanation for the observed difference in stress levels is the varying ability of
nurses in different age groups to cope with workplace challenges. Younger nurses may have
greater physical resilience and adaptability to high-pressure situations, whereas older nurses may
feel the cumulative burden of workplace stress, particularly if they have been in the same high-
stress environment for years (Alharbi & Alshehry, 2019). Furthermore, older nurses may
experience increased stress due to concerns about career advancement, job security, and
retirement planning, factors that are less pressing for their younger colleagues (Filomeno et al.,
2024).
 CHAPTER VI

CONCLUSION AND RECOMMENDATIONS

The main objective of this research is to determine the stress levels of nurses at
Margosatubig Regional Hospital. This study was able to determine the levels of stress
experienced by nurses at Margosatubig Regional Hospital. The findings revealed that nurses
frequently experience high levels of stress, primarily due to patient deaths, violent patients,
understaffing, and exposure to health hazards. The results also indicate that demographic factors
contribute significantly to stress levels among nurses. The demographic data unveiled that the
majority of nurses surveyed in Margosatubig Regional Hospital, were female, married, aged 31 -
35, working in ICU station.

The study determined that the overall level of stress experienced by nurses at
Margosatubig Regional Hospital is "Frequently Stressful" (Mean = 3.00 ± 1.22). This indicates
that nurses regularly encounter significant stress in their work environment, primarily due to
factors such as dealing with violent and abusive patients, exposure to health hazards, patient
deaths, and understaffing.

Moreover, the findings of this study also indicate that there is a significant difference in
stress levels between nurses aged 31–35 (Group 1) and those aged 36–40 (Group 2). The
independent samples t-test revealed that nurses in the older age group experienced significantly
higher stress levels (M = 3.06) compared to their younger counterparts (M = 2.79), with a t-value
of 4.8514 and a p-value of 3.9191E-06, which is well below the significance threshold of 0.05.

These results confirm that age is a significant factor influencing stress levels among
nurses at Margosatubig Regional Hospital. The increased stress in the older age group may be
attributed to factors such as greater professional responsibilities, cumulative exposure to
workplace stressors, and work-life balance challenges. This suggests that stress management
interventions should be tailored to the specific needs of nurses at different career stages to
promote well-being and job satisfaction.
Recommendations
Based on the insights gathered from this study, several recommendations have been
formulated to advance future research endeavors and tackle the challenge of stress in a more
holistic manner.

Primarily, the quantitative approach of the study suggests that future research should
employ qualitative methods to explore the specific stressors they encounter and the coping
strategies used toward stress.

Moreover, future studies should expand their scope beyond the 60 respondents from
Margosatubig Regional Hospital to include municipalities aside from Margosatubig such as
Pagadian, Aurora, Dumalinao, and Molave. By doing so, researchers can compare variations in
stress levels.

To gain further valuable insights into the level of stress experienced by nurses and the
factors contributing to it, it is recommended that future questionnaires include the year of
working in their hospital to understand how long nurses have worked in the hospital.

Additionally, future research should consider including other healthcare workers, such as
doctors, midwives, and medical technologists, to assess and compare stress levels across
different healthcare professions. This would provide a more holistic understanding of workplace
stress in the healthcare sector and help tailor interventions specific to different roles.

Instead of convenience sampling, future research should use random sampling,

specifically, stratified sampling to ensure a more diverse and representative group of participants.
A more rigorous sampling method can help reduce bias and improve the reliability of the results.
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