Stress and RLE Performance… 1

Stress and Related Learning Experience (RLE) Performance of Third Year Nursing
Students in Cancer Rotation amidst the Covid-19 Pandemic
Sombilon NE, Magluyan RC, Magno KM, Nantin S, Omboy EL, Quiogue JJE, Roca AP
BSN 3B-Group 5
Nursing Department, San Pedro College

Introduction
Stress has been defined as the perception of emotional and physical tension and it can be
external forces like environment, psychological or social situations, and internal factors like
illness or because of a medical procedure to which it could initiate a fight or flight response.
Stress could lead to negative behaviors that a person could manifest, but sometimes can be
positive to someone’s body, however, prolonged stress can lead to severe health conditions
which can affect our daily activities such as work, hobbies, and most especially, education. High
levels of stress can interfere with a student’s ability in learning and achieving good grades and
could even lead to poor physical, emotional, and mental health. [1] This can be seen as an
example in South Korea which the country is widely known for its competitive educational
system and its stressful environment in academics that harms adolescent students and it
accounted for 46% of depression among high school students in Seoul. [2]

A university in France has reported that causes of stress were because of low self-esteem
of about 57.6 % and little optimism of about 56.7 % by students, while there is only about 25%
of them that were slightly satisfied with their well-being.[3] On the other hand, the study of
Aghajari and Loghmani [4] also found out that as the 223 undergraduate nursing students who
participated in the research, there was no significant correlation between the quality of learning
experiences as the score was 35.16 and academic burnout of the students was 44.20. In Brazil,
research was conducted about stress in nursing students and it was found out that female nursing
students have a higher proportion of stress cases of about 65.4% compared to male student
nurses with a result of 40.7%. [5] About this, a study in India conducted by Reddy et. al [6]
discovered that several students fall to the category of having average to high-stress levels and
those female students have a higher score with a mean= 12.29 and SD= 7.39 while the males
have a mean score of 10.53 and SD= 6.70 and this was due to the fear of failure.
 Stress and RLE Performance… 2

Another study is by Nandamuri and Gowthami [7] in which they have conducted among
students in professional studies, have found out that curriculum and instruction parameters were
the most responsible with the stress of about 86% on students and is followed by 63% placement
related issues and teamwork issues of 24%.
Literature Review
Stress
Stress Level measures the amount of stress that the person is dealing with and stress is an
uncomfortable situation that disturbs our sense of well-being and quality of life. College students
experience various educational, social, environmental, and psychological adjustment difficulties
when faced with a new atmosphere which affects their psychosocial well-being and learning
outcomes [8]. As supported by Yikealo, Tareke, and Karvinen [9], stating the environmental and
school-related components of stress were discovered to be higher in students. Regarding
academic stress, the students were having problems with academic overload, difficulty dealing
with one’s academic problem, and poor subject matter, and that led to high stress. While
environmental stressors were mainly lack of electricity supply, computer, and internet access. On
the other study, life is more stressful for students in a nursing program, and that the numerous
demands of academic expectations created stress [10]. Moreover, this study is congruent with
another research stating that studying medical courses brings stressful activities to students, and
prolonged stress can cause detrimental effects and lead to further professional burnout. Also,
Long periods of exposure to high-stress levels have different negative impacts on the physical
and psychological well-being of nursing students [11]. Mostly known negative impacts are
restlessness, headaches, sleep disorders, irritability, memory impairment, forgetfulness, abnormal
fatigue, and a decrease in learning and academic performance [12].

Related Learning Experience Performance

RLE performance is the measurement of student achievement across any subject.
According to Narad and Abdullah (2016), it refers to the knowledge gained and educational
goals set by instructors to be attained in a specific time with the relation to apply it in a certain
field. Instructors and educational officials measure achievement using classroom performance,
 Stress and RLE Performance… 3

continuous assessment, and examination results. The academic performance is defined by a

student’s reporting of a past semester Cumulative Grade Point Average (CGPA) or Grade point
Average (GPA) and the final GPA for the current semester. Learner’s academic performance and
graduation rates have long been the area of interest for educational institutions. Tertiary
institutions have utilized GPA as a convenient measurement for academic performance among
students. School-related performances represent performance outcomes that stipulated the extent
to which an individual has accomplished specific goals which were the focus of the activities in
an instructional environment specifically in educational institutions. Educational systems mostly
define cognitive goals that apply across multiple subject areas such as critical thinking including
the acquisition of knowledge and understanding in a specific intellectual domain. Therefore,
academic achievement must be considered to be a multifaceted construct that comprises different
domains of learning.

According to Narad and Abdullah, the performance of students determines the success or
failure of an academic institution [13]. Academic achievement affects the self-esteem,
motivation and, perseverance of learners in higher education Several studies suggest that
academic performance is affected by respective factors such as the teaching process, socio-
economic factors, social interactions, psychological and environmental factors. This finding is
supported by Mushtaq and Khan, such that communication, learning facilities, and proper
guidance garners a positive impact on student performance, and stress shows a negative impact
on academic performance. Moreover, this finding is congruent with the findings of Haider and
Mehfooz, which indicates that there is a relationship between stress and academics; which is
inversely proportional. Medical education is perceived as stressful and a high level of stress
obtain a negative effect on the cognitive functioning and learning of medical students [15].
Correspondingly, Khaliq et al reported that the teaching method has a positive relationship with
academic performance, wherein the interaction between lecturers and students through
questioning able to enhance student retention which leads to outstanding academic performance
[16]. Moreover, this finding is congruent with the findings of Sohail, such that diversity of stress
sources and a high level of stress among medical students and results suggests that a higher level
of stress is associated with poor academic performance [17]. On the contrary, Abdullah, Idris,
and Shah reported that stress has a negative relationship with academic performance and it
 Stress and RLE Performance… 4

heavily depends upon the parental involvement in academic activities to attain a higher level of
academic success [18].

In summary, school performance is a multi-contextual word in the educational setting. It

involves various factors that affect a student’s academic performance. Among the widely known
factors are stress, financial status, teaching process, psychological and environmental factors
which are considered as barriers to the academic performance of an individual as what several
researchers have investigated. These factors are recognized in the educational institutions which
affect the learning outcomes and perception of the students. Similar studies have shown that
there is a high correlation between stress and academic performance. It is a vital element in the
learning process of a student specifically in tertiary education since it serves as a basis on the
educational degree one attains and influences one’s career path after education.

In the current situation where the COVID-19 pandemic exists, it hinders institutions such
as schools to be fully functional. As safety is the main concern of everyone, many facilities resort
to online platforms as alternative ways of learning. Nursing students are trained through clinical
exposure but due to protective measures by the family and school, even the related learning
experience (RLE) resorted via online. It is conducive to have this measure to prevent the further
rise of Covid-19 cases as schools weigh the overall safety more than learning. However, nursing
students expressed their sentiments about how this change can affect their future where they
perhaps are filled with theoretical knowledge but with unpolished skills and inadequate clinical
experiences in providing nursing care. In regulating an intravenous (IV) fluid, there is no online
simulation for that matter and if clinical instructors push students to require a return
demonstration video of nursing procedures, there is no guarantee that the student learned or
memorized the procedure where he/she can have notes not seen in the camera. An Internet
connection and technological defects are also big factors that can affect the students’ learning
which can add stress. Imagine a virtual RLE, endorsement is the first thing of the hospital duty.
Via online, there may be power interruption or connection problems, whereas, in face-to-face
clinical interaction, nursing students just need to be concerned about their listening skills. The
online endorsement does not only trigger stress, but it discourages a nursing student to cope with
a certain procedure. Overall, the connection of the main problem of this study to the researchers
 Stress and RLE Performance… 5

is the factors that would hinder learning via online instead of face-to-face clinical interaction
despite protective measures. Thus, there is a need to conduct research specifically on the
relationship between stress and RLE performance of third-year nursing students amidst the
Covid-19 Pandemic. The researchers wanted to find out any significant results between the
variables.

The findings of this study will find utilization to the nursing education, practice,
administration, and research, which will rebound to the benefit of the third-year nursing students
in cancer rotation, considering that the stressors and RLE performance on cancer concepts play
an important role in nursing education and practice. Data garner will provide information and
would heighten awareness to the possible threats given by the problem to both students and
administration in the formality of learning and training in the science of nursing as it discusses
the possible stressors encountered by the nursing students which affects the student’s RLE
performance in the midst of pandemic-COVID 19 with the new-normal education system
program of the school year 2020-2021. Along with the nursing practice and application, the main
aim of this study addresses the lack of interventions and coping mechanism towards stress
impacted by this pandemic, it may be able to foster an adapted technique of enhancing
knowledge, skill, and attitude, thus sculpting and preparing globally competitive future nurses.
To the administrators, data given will help initiate collaboration among the faculty to help
alleviate the gravity of the problem and regard a plan to the enhancement of nursing education
amidst the pandemic. For researchers, this study may also serve as baseline information on the
recent data, provided it renders an inquiry designed to promote and amplify verified pieces of
evidence in addressing issues overlooked in the nursing profession, practice, and education that
many researchers were not able to explore and maybe a significant opportunity for more
researchers to refine and expand such novel findings.

Theoretical Framework
The Roy Adaptation Model that was created by Sister Callista Roy contains the following
key concepts, in which the person is adapting in a stable interaction with the environment either
internal and external. Roy explained that adaptation occurs when people respond positively to
environmental changes, and it is the process and outcome of individuals and groups who use
 Stress and RLE Performance… 6

conscious awareness, self-reflection, and choice to create human and environmental integration.
The environment here serves as the source of a range of stimuli that will either threaten or
promote the person's unique wholeness, and the person's major task is to maintain integrity in
face of these environmental stimuli [19]. Here Roy categorized stimuli as focal, contextual, or
residual. In this study, the focal stimulus is the online class, this is the new way of learning due
to COVID19 Pandemic which students are forced to stay at home for health safety purposes. The
contextual stimulus contributing to the focal stimuli are a low internet connection, unavailable
gadgets, and lack of financial support, all of could cause stress and affect the RLE performances
of the Third year Nursing students in learning Cancer Nursing Rotation.

In these adaptation model of nursing, there are two major coping mechanisms and control
processes. Namely the regulator subsystem and cognate subsystem. The regulator is by which an
individual adapts to or copes with internal and external environmental stimuli through neutral
processes like an increase in vital signs, a sympathetic stress response. The cognate subsystem on
the other hand occurs through the cognitive-emotive process, encompasses perceptual and
information processing learning, judgment, and emotion such as unwinding coping mechanisms
or meditations [20]. These coping mechanisms responses can be observed and related primarily
to the four adaptive modes of the adaptation model: physiologic needs, self-concept, role
function, and interdependence. For the possible physiologic adaptive mode, there will be changes
in sleeping pattern, increase and decrease of weight due to lack of physical actions compare to
face to face learning set up. Next self-concept, here students' feelings and beliefs have formed
about themselves thinking that they are not learning anymore but rather just compiling to the
requirements. Some label themselves as lazy and procrastinators taking advantage of the online
setup. Meanwhile in Role function, according to Roy that the role of a person consists of
primary, secondary, and tertiary roles in the society to achieve wholeness. For the primary role,
we put family a role such as a son/daughter and a brother/sister. The secondary is the role of a
student and for the tertiary the role of classmates. These three roles coincide as one factor
affecting students' level of stress on how to divide and balance their time. Lastly, the
Interdependence where students seek for social support of their family to guide them as they
adapt to the new learning curriculum.
 Stress and RLE Performance… 7

In addition to the researchers to evaluate coping mechanisms more effectively consider

the positive, as well as negative, emotions that arise during the stress process. The transactional
theory of stress and coping, developed by Lazarus and Folkman has been particularly
instrumental in shaping stress and coping research over the past five decades [21]. According to
this theory, stress is perceived as the imbalance between the demands placed on the individual
and the individual’s resources to cope [22]. An individual’s level of stress at a given time
depends on the dynamic transaction between the individual and his/her environment. These
theoretical explanations can be categorized according to their primary conceptualization of the
stress experience: stress as an external stimulus; stress as a response; stress as an
individual/environmental transaction. In health psychology, the overall physical and
environmental effects of stress are often studied along with mediating and moderating factors,
such as coping and social support. Three types of these theories are distinguished as harm, threat,
and challenge. Harm refers to the psychological damage or loss that has already happened, in this
study the COVID19 Pandemic is considered to be the harm. The threat is the anticipation of
harm that may be imminent, the effects of online class during the Pandemic. Challenge results
from demands that a person feels confident about mastering, the RLE performance of the Third
year student in Cancer Nursing Rotation RLE.
These two theories will help researchers evaluate the level of stress of the third year nursing
students and the resulting RLE performance. To cope up with the stressful life events, there is a
need to reflect defense mechanisms' ability to adapt to the constantly changing environment to
have a good RLE Performance amidst the COVID19 pandemic.

Conceptual Framework
The independent variable of the study is the level of stress on third-year nursing students
amidst Covid-19 Pandemic. Indicators are Very Low Life Stress, Low Life Stress, Moderate Life
Stress, Significant Life Stress, and Highly Significant Life Stress. These indicators are chosen by
the researchers to quantify stress in 5 levels and to assess the stress of students amid life change
events inspired by the 5-point Likert Scale. The dependent variable is the RLE performance in
cancer rotation in third-year nursing students. The indicators are Excellent, Good, Average, Poor,
and Very Poor which are decided by the researchers to label and divide it into five to be in line
with the criteria of the independent variable. The dependent variable measures the student’s RLE
 Stress and RLE Performance… 8

performance on a certain concept, Cancer nursing rotation, amid the pandemic. Furthermore, the
conceptual framework shows how the level of stress can have a significant relationship with the
RLE performance on cancer rotation in third-year nursing students amid the pandemic. The
results of this study will be a head start in implementing intervention programs. In the figure, the
intervention programs will be health teaching via pamphlet and counseling faculty from school
once this study is approved.
   
 Stress and RLE Performance… 9

Independent Variable Dependent Variable

Intervention Program

Health Teachings

School Counseling
Performance
Level of Stress
in RLE

Figure 1. The Conceptual Model of the Study

Statement of the Problem

The study aims to determine the relationship between level of stress and RLE performance
of third year nursing students in cancer rotation amidst Covid-19 Pandemic.

Specifically, it seeks to answer the following:

1. What is the level of stress of third year nursing students amidst the pandemic?
2. What is the RLE performance of third year nursing students in cancer rotation amidst the
pandemic?
3. Is there a significant relationship between level of stress and RLE performance of third
year nursing students in cancer rotation amidst the pandemic?
4. What intervention program can be developed based on the findings of the study?

Null Hypothesis

Ho: There is no significant relationship between level of stress and RLE performance of third
year nursing students in cancer rotation amidst the pandemic.
 Stress and RLE Performance… 10

Significance of the Study

Through this research, the students will be able to identify various stressors that affect
their RLE performance. This research will give awareness that stress must not be ignored and
should be given appropriate action. With that, the students will be prepared to find a solution and
improve RLE performance amidst the pandemic.

This research will benefit future researchers regarding the topic on the relationship
between stress and RLE performance in cancer rotation during the Covid-19 pandemic. This
study will lead subsequent researchers to have further understanding and knowledge that stress
may decline RLE performance. This research will help widen the references on this topic making
the search for information faster and easier.

Method

Design

The study will utilize a non-experimental quantitative correlational method of research. A

correlational research design is a non-experimental design that focuses on answering the
relationship between the research variables. In this research design, the researchers will measure
the two variables and evaluate their relationship without manipulating the independent variable.
McCombes stated that there are 3 possible relationships between the variables namely, the
positive, negative, and zero correlation. These relationships will determine how will the
dependent variable react with the independent variable based on the data gathered. Furthermore,
the researchers will utilize a mixed method approach which involves a quantitative structured
interview and secondary data analysis. McLeod stated that a structured interview is a quantitative
research method in which the interviewer has prepared a set of closed-ended questions in the
form of an interview schedule, which the interviewer reads exactly as worded. Secondary data
are data which have already been retrieved and are readily available to the community. With the
help of secondary data, the researchers will be able to identify the gaps and deficiencies and what
additional details needs to be collected.

Participants
 Stress and RLE Performance… 11

The study will utilize the third-year nursing students of the educational institution. The
participants will include students who have finished Cancer Nursing in the first and second
rotations of the first and second semester. The total population of third-year nursing students
who accomplished RLE cancer concept online classes in the said educational institution in the
school year 2020-2021, is 247. Furthermore, a total of 151 third year nursing students of San
Pedro College attending Related Learning Experience - Cancer concept online classes year 2020-
2021 will be chosen as participants of the study based on Raosoft sample calculator application.

To be able to get the sample respondents, the researchers employed stratified random
sampling for this study. It is a method of sampling which involves dividing a population into
smaller groups–called strata. The groups or strata are organized based on the shared
characteristics or attributes of the members in the group. The process of classifying the
population into groups is called stratification. With the use of the Fishbowl Technique, the
researchers will be gathering 151 third year nursing students through writing the names of the
members in all six sections in a small-rolled piece of papers, placed in a container. The
proponent will draw the names of the respondents of each section until the desired number of
participants are obtained.

Moreover, 151 respondents for the whole third year nursing students of San Pedro
College which will be divided among six sections taking up the cancer concept of the said higher
institution: 26 respondents from BSN 3B, 25 respondents from BSN 3C, 25 respondents from
BSN 3E, 25 respondents from 3H, 25 respondents from 3I and 25 respondents from BSN 3J. The
researchers selected the number of respondents for each section in order to obtain a fair
distribution of data and further achieve the required demands of the research.

Third-Year Nursing Students

Sections Population Percentage (total Number of Percentage ( total

population) Participants # of participants)

3B 39 15.8% 26 17.22%
3C 40 16.2% 25 16.56%
3E 41 16.6% 25 16.56%
3H 43 17.4% 25 16.56%
 Stress and RLE Performance… 12

3I 44 17.8% 25 16.56%
3J 40 16.2% 25 16.56%
TOTAL 247 100% 151 100%

Study Site

The researchers will conduct the study at a school in Davao City which falls under the
Davao Region in the province of Davao Del Sur. Years after its foundation, it began opening
various programs, including graduate programs.

Data Measures

To be able to collect the required data, a survey questionnaire was considered as a basis
to limit the questions in students amidst pandemic. The researchers are inspired to make the
questionnaire from the Student Stress Scale (SSS) which is a research instrument to quantify the
amount of stressful life events of a student. The respondents are assessed through possible stress
events in the midst of class and pandemic such as increased workload in school, disturbing
learning environment, etc. The scale assesses the student whether he or she was able to adapt
these life stress events within the 12-month period. To be in line with the level of stress which is
the independent variable of the study, the researchers make use of 5-point Likert Type to the
independent variable with a description of 1 as not stressful at all, 2 as slightly stressful, 3 as
moderately stressful, 4 as highly stressful and 5 as extremely stressful. The scoring is revised to
be able to collect and analyze the data with precision to determine the correlation of level of
stress to the RLE performance in cancer nursing rotation.

Independent Variable Interpretation

Scale Range Interpretation Description

5 4.20-5.00 Extreme Highly Significant Life

 Stress and RLE Performance… 13

Stress

4 3.40-4.20 High Significant Life Stress

3 2.61-3.40 Moderate Moderate life stress

2 1.81-2.60 Low Low life stress

1 1.00-1.80 Almost no stress Very Low life stress

For the dependent variable, the researchers may direct to the clinical instructors to collect the
RLE performance of the participants assuring that the respondents are fully aware and are
cooperative to the study. To be in line with the independent variable scale, the researchers made
use of 5-point rubric grading scale where 1 is very poor, 2 is poor, 3 is average, 4 is good, and 5
is excellent. The process of distribution of range per scale is based on the researchers’
prerogative of considering 78 below scores as poor because according to the Nursing Department
protocol, the student is considered passed if he or she attained a grade of 78 or higher, thus
scores ranging 78-100 with congruent distribution will be divided from poor, average, good and
excellent. The table shows the scale of RLE performance.

RLE Performance Scale

Scale Range Interpretation Description

Excellent RLE
5 95-100% Excellent
Performance

Very Good RLE

4 89-94% Very good
Performance

Good RLE
3 84-88% Good
Performance

2 78-83% Fair Fair RLE Performance

 Stress and RLE Performance… 14

Poor RLE
1 78 below Needs Improvement
Performance

Data Collection Procedure

Data collection is a vital part when developing a successful research paper wherein all the
evidence should be reliable. The initial steps that the researchers would do includes
conceptualization of the chosen research topic, gathering all the suggested ideas, making of the
manuscript, the formulation of questionnaire for both dependent and independent variables and
the conversion of the questionnaire to online or google docs.

The researchers will present the proposed manuscript to the technical expert to identify
errors and improve the paper. The revision of the paper is based on the comments and
suggestions from the expert, then the researchers will submit the questionnaire for content
validation, pilot testing, and reliability test using the Cronbach’s Alpha, then the submission of
the manuscript to the SPC Research Ethics Committee. They ensure that the research that the
researchers would do will not violate any human rights and the participant’s confidentiality will
be protected. Once accept the researchers would choose valid and key participants. The
researchers will send invitations via online to the chosen participants and the participants would
be asked to sign the informed consent. At this time, the participants will be receiving a link
connecting to the online google docs questionnaire. After the survey has been completed and
sent, the researchers will be able to retrieve the raw data via the same platform. Then the
collation, tabulation, analysis, and interpretation of data will follow with the help of the data
analyst. The interpreted data will be disseminated in a research forum and lastly the publication
of the study in a reputable refereed journal.

Ethical Considerations
 Stress and RLE Performance… 15

As the researchers of this study, we will critically discern and conform to the ethical

considerations in the gathering of data, the researchers will guarantee that
the research participants who accomplished Cancer Rotation amidst the pandemic will not be
subjected to any harm. When the participants are to be selected through fishbowl method, they
have the right to be informed. Thus, the researchers will obtain full consent from the
participants before the study is to be conducted for appropriate measures in documentation.
According to Saunders and Thornhill the principle of informed consent is to provide researchers
with sufficient information and assurances about participation, to make individuals fully aware
of the implications of involvement and whether or not to do so without the use of coercion [23].
With this voluntariness, participants will be given priority, still, they have the right to withdraw
from the study at any phase if they are willing to do so. The researchers are also responsible for
securing the privacy and anonymity of the participant’s essential profile and will be treated as
autonomous agents able to exercise their autonomy to the fullest extent possible. Adrianna
Surmiak asserted that the identity of the participant is significantly important with members of
vulnerable groups because it prevents them from further disempowerment or stigmatization [24].
Researchers will responsibly abide by the republic act 10173-Data Privacy Act of 2012
of the Republic of the Philippines protecting the participant’s information [25]. Works of the
authors used in any part of the dissertation will be acknowledged by
utilizing the Vancouver referencing style without practicing any kind of infringement and will
only assess components relevant to the study to be conducted. Any data to be utilized and
presented will be provided with pure honesty and transparency, if this will be
formally done without any breaches the researchers and the study's validity credibility and
eligibility will be protected.

Data Analysis

The study will use mean and the Pearson correlation coefficient statistic method to
analyze the data and initiate a relationship between the independent and dependent variables.

The mean is the statistical refence for average and the overall sum of the values of each
category divided by the number of categories. This is represented by the formula [30]:

s u m o f al l e l e m e n t s in s e t
m e a n=
nu m b e r o f e l e m e n t s in s e t
 Stress and RLE Performance… 16

The Pearson correlation coefficient statistic is also known as the Pearson product-
moment correlation and Pearson’s r method and this technique has been considered as the most
widely used test for measuring the degree of relationship or association between two variables
for it is based on the method of covariance (Statistic Solutions, 2020). It gives information about
the magnitude of the correlation and the direction of the relationship and The Pearson correlation
coefficient technique is represented by the formula:

Σxy
r=
√ Σ x2 Σ y2
In order to determine the relationship of independent variable and dependent variable, the
level of stress and the RLE performance in cancer rotation, the researchers made use of the
Pearson-r Correlation, a statistical measure to assess the strength of correlation via r-coefficient,
which will be based in the following corresponding scores and interpretation [31].

Scores Interpretation
   ±1 Perfect Correlation
±0.80 to < ±0.99 Very Strong Correlation
±0.60 to < ±0.79 Strong Correlation
±0.40 to < ±0.59 Moderate
±0.20 to < ±.39 Weak
> 0 to < ±0.19 Very Weak
0 No Correlation

As the correlation coefficient approaches r is greater than or equal to +0.60 it can be

translated that there is a strong positive correlation between level of stress and RLE performance
in cancer rotation. Since it is a positive correlation, the increased rate of the independent variable
will result on increased rate of dependent variable. When the correlation yields a negative score,
it can be translated that there is an inverse proportion or relationship. If the independent variable
scores are low, then the dependent variable scores are high and vice versa. The Pearson
coefficient r is obtained from the respondents drawn from the population. The formula for r in
Microsoft Excel 2016 is as follows:
 Stress and RLE Performance… 17

Where:
· Are the sample means

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 Stress and RLE Performance… 18

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Students-Academic.pdf
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Per-formance of Undergraduate Nursing Students. 2020;
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18. Abdullah S, Shah N, Idaris R. Stress and Its Relationship with the Academic
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28th of October 2020].
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model-and-its-impact-.php. [Accessed on 28th of October 2020].
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December 2020].
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 Stress and RLE Performance… 19

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2. Wyzant. (2020). Averages. Available at
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 Stress and RLE Performance… 20

APPENDIX A

LETTER OF PERMISSION

November 2020

Dr. Sarah Bernadette L. Baleña, RN

Dean of Nursing-RT Department

San Pedro College

Dear Dr. Baleña

We are the Group 5 of section 3B, Bachelor of Science in Nursing students of San Pedro
College. We are currently undertaking these research for the said course. With this, I would like
to ask for permission to conduct the study entitled,

“Stress and RLE performance of Third year Nursing students in Cancer Rotation amidst the
Covid-19 Pandemic", in your humble institution. This study will be conducted as partial
fulfillment of the requirements for Bachelor of Science in Nursing (BSN) and at the same time
the result of this study will be used to determine the stress levels of the 3rd year Nursing student
and their RLE performance in Cancer Rotation.

This study will only be limited to the third year nursing student who take cancer rotation of this
institution. A survey questionnaire will be distributed for you to answer and please answer the
said questionnaire for 30 minutes.

    Also, attached is the survey questionnaire and the informed consent for each respondent for
the said research study for your kind perusal. Rest assured that all of the answers given for the
study will be confidential. The documents will be placed in a locked cabinet reserved for the
researcher and will only serve for the purpose of this study.

Thank you and God bless.

Respectfully Yours,

Sgd. Reizel Ceyhan C. Magluyan, St. N

 Stress and RLE Performance… 21

Sgd. Keziah Marrie A. Magno, St. N

Sgd. Shaine C. Nantin, St. N

Ella Lorraine S. Omboy, St. N

Jacob Joshua Elias Q. Quiogue, St. N

Andre Paulo T. Roca, St. N

Noah Emmanuel G. Sombilon, St.N

Researchers of BSN-3B Group 5

Sgd. Samuel F. Migallos, PhD, RN

Mentor
 Stress and RLE Performance… 22

APPENDIX B

LETTER TO THE PARTICIPANTS

Stress and RLE Performance of Third Year Nursing Students in Cancer Rotation amidst the
Covid-19 Pandemic
BSN3B Group 5
Nursing Department, San Pedro College
Dear Maam/Sir,

Your participation to this research entitled “Stress and RLE performance of third
year nursing students in cancer rotation amidst the Covid-19 pandemic” has been greatly
acknowledge by the researcher and is the key to the success of this research. This study is
conducted as a partial fulfillment of the requirements for 3rd year research subject and the
result of the said study will be used to determine if there is a significant relationship
between the stress and the RLE performance of third year nursing students amidst the
covid-19 pandemic.

The scope of this study is narrowed only to the student nurses who undergone
cancer rotation. A link to the survey questionnaire will be hand outed to you to be
answered and please answer with honesty.

You have the right to cancel your participation anytime you like as this research is
also voluntarily and does not force you to participate in the study. Guaranteed that all the
responses will be held in confidentiality and will only serves for the purpose of this study

Thank you and God Bless.

Respectfully Yours,

Reizel Ceyhan C. Magluyan, St. N

Keziah Marrie A. Magno, St. N

Shaine C. Nantin, St. N

Ella Lorraine S. Omboy, St. N

Jacob Joshua Elias Q. Quiogue, St. N

Andre Paulo T. Roca, St. N

 Stress and RLE Performance… 23

Noah Emmanuel G. Sombilon, St.N

Researchers of BSN-3B Group 5

 Stress and RLE Performance… 24

APPENDIX C

INFORMED CONSENT FORM FOR THE PARTICIPANTS

San Pedro College

Department of Nursing

This is an informed consent for the Bachelor Science in Nursing third year students
enrolled in San Pedro College of Davao. We would like to invite these participants to join in this
research entitled “Stress and RLE Performance of the Third Year Nursing Students in Cancer
Rotation amidst the Covid-19 Pandemic”

Stress and RLE Performance of the Third Year Nursing Students in Cancer Rotation
amidst the Covid-19 Pandemic

Reizel Ceyhan C. Magluyan, St. N

Keziah Marrie A. Magno, St. N

Shaine C. Nantin, St. N

Ella Lorraine S. Omboy, St. N

Jacob Joshua Elias Q. Quiogue, St. N

Andre Paulo T. Roca, St. N

Noah Emmanuel G. Sombilon, St.N

This informed consent has two parts:

- Information Sheet (to share information about the research with you)
- Certificate of Consent (for signatures if you wish to take part of the study)

Part I

A. PURPOSE AND BACKGROUND

 Stress and RLE Performance… 25

You are invited to take part with the Group 5 of BSN-3B who is conducting a research
with supervision of their research instructor, Dr. Samuel F. Migallos, on how stress affects the
RLE performance among third year nursing students in cancer concept through the pandemic.
The role of your participation in this research is to help the researchers in determining the
relationship between level of stress and RLE performance of third year nursing students in
cancer rotation amidst Covid-19 Pandemic.

B. PROCEDURE

If you agree to participate in this research study, the following will occur: (1) We would
like your permission on taking an ample amount of your free time to fill out the survey
questionnaires which will be provided and collected by the researchers. (2) We would also like to
inform you that the questionnaire may request for personal information, however it is guaranteed
by the researchers that it will be kept confidential. (3) Questionnaires to be filled out must not
have any unanswered items as this will alter the results of the study and will be considered as
inviable.

C. PARTICIPATION SELECTION

You were selected as a possible participant in this study due to the fact that you are
currently enrolled as a third year nursing student in San Pedro College of Davao and had already
or currently taking a cancer concept that can provide the essential information needed for this
study.

D. VOLUNTARY PARTICIPATION

Your decision whether or not to participate in this study is voluntary and will not affect
your relationship with the Nursing Department of San Pedro College. If you choose to participate
willingly in this study the researchers would greatly appreciate of you investing your time in this,
however, you can still withdraw your consent and discontinue participation at any time without
prejudice.

E. DURATION

The research study will only take 30 minutes at most of your time as you fill up the items
on the questionnaires and will take only a day at most for the data gathering to be done in the
whole group.

F. RISKS

There may be some questions that are too personal for the participant to answer, which
may result to an uncomfortable state that may cause inconvenience during filling out of the
survey.
 Stress and RLE Performance… 26

G. BENEFITS AND REIMBURSEMENTS

There will be no direct benefit to you from participating in this research study, but we
will offer a simple token for your participation. However, the anticipated benefit of your
participation in this study is the results which are essential as it presents the clear evidence of the
problem. Furthermore, through this study the department of nursing of San Pedro College will be
aware with this problem and would be able to provide recommendations and strategies in helping
students cope on stress and at the same time enhancing their RLE performance amidst the
pandemic.

H. CONFIDENTIALITY

The records from this study will be kept as confidential as possible. No individual
identities will be used in any reports or publications resulting from the study such as answered
questionnaires, transcripts or summaries will be given codes and stored separately from any
names or other direct identification of participants. Research information will be kept in locked
files at all times. Only authorized research personnel will have access to the files and material
surveys and only those with an essential need to see names or other identifying information will
have access to that particular file. After the study is completed that will be the time for the
researchers to decide with the retained collected data will be destroyed by shredding and
burning. In line with this, the researchers will formally comply to the Republic Act 10173-Data
Privacy Act of 2012 in protecting the participant’s information.

G. QUESTIONS

If you have any questions about the study or having difficult in understanding some of
the words in the questionnaire, please contact Mr. Noah Sombilon by calling [insert phone
number with area code/social acc.] to guide you. You can also contact Ms. Keziah Magno [insert
phone number with area code/social acc.] with any questions about the rights of research
participants or research related concerns.

CONSENT:

You are making a decision whether or not to participate in the research study. Your
signature below indicates that you have decided to participate in the study after reading all of the
information above and you understand the information in this form, have had any questions
answered and have received a copy of this form for you to keep.

Signature: __________________________ Date: ____________________

Research Participant

Signature:__________________________ Date: _____________________

Interviewer
Stress and RLE Performance… 27
 Stress and RLE Performance… 28

CERTIFICATE OF CONSENT

Your kind gesture in actively participating in this study is of great significance to the
researchers. In engaged your presence with our research entitled “Stress and RLE Performance
of the Third Year Nursing Students in Cancer Rotation amidst the Covid-19 Pandemic” is greatly
acknowledged. This study will be conducted as a partial fulfillment of the requirements of NCM
211-Nursing Research 1 for Bachelor of Science in Nursing, third year level and along with this
the results of this study will be utilized in determining the relationship between level of stress
and RLE performance of third year nursing students in cancer rotation amidst Covid-19
Pandemic.

I have read the foregoing information, or it has been read to me. I have had the opportunity to
ask questions about it and any questions that I have asked have been answered to my satisfaction.
I consent voluntarily for my child to participate as a participant in this study.

Print Name of Participant: __________________

Signature of Participant: ___________________

Date: ___________________________

Day/month/year

Statement by the researcher/person taking consent:

I have accurately read out the consent form to the potential participant, and to the best of
my ability made sure that the partaker understands that the following will be done:

1. The participant will be oriented satisfactorily on the contents of the questionnaire.

2. The participant will completely answer the questionnaire provided.

3. The questionnaire will then be collected by the researcher with guarantee of information
confidentiality.

I confirm that the participant was given an opportunity to ask questions about the
study, and all the questions asked by him/her have been answered correctly to the level of his
 Stress and RLE Performance… 29

understanding and to the best of my ability. I confirmed that the individual involved in this study
has not been coerced into giving consent, and the consent has been given freely and voluntarily.

A copy of this Informed Consent Form (ICF) has been provided to the participant.

Name of researcher taking the consent: ____________________________

Signature of researcher taking the consent: _________________________

Date: ___________________________

Day/month/year

Submitted by

Name Signature

Endorsed by/Recommended by: Samuel F. Migallos, PhD, RN

Research Adviser/Mentor

APPENDIX D

LETTER TO THE VALIDATORS

November 2020

Prof. Melinda L. Tantoy, RN, MAN

Faculty, Graduate School

San Pedro College

Dear Prof. Tantoy,

Good Day!
 Stress and RLE Performance… 30

We, the Group 1 of BSN 3B, San Pedro College is currently conducting a study on the “In the
Midst of Pandemic: Level of Stress and RLE Performance on Cancer Rotation among Third Year
Nursing Students”.

The researchers formulate a series of questions that will serve as the group’s survey guide during
the conduct of the class surveys through a series of validated questionnaires.

Recognizing your expertise in this field, we are humbly asking for your assistance in validating
the interview questions and also our research paper.

Thank you very much for your kind consideration and valuable contribution and God Bless!

Respectfully Yours,

Reizel Ceyhan C. Magluyan, St. N

Keziah Marrie A. Magno, St. N

Shaine C. Nantin, St. N

Ella Lorraine S. Omboy, St. N

Jacob Joshua Elias Q. Quiogue, St. N

Andre Paulo T. Roca, St. N

Noah Emmanuel G. Sombilon, St.N

Researchers of BSN3B Group 5

 Stress and RLE Performance… 31

November 2020

Prof. Elvie D. Abesia, RN, LPT, MAED

Faculty, Graduate School

San Pedro College

Dear Prof. Abesia,

Good Day!

We, the Group 1 of BSN 3B, San Pedro College is currently conducting a study on the “In the
Midst of Pandemic: Level of Stress and RLE Performance on Cancer Rotation among Third Year
Nursing Students”.

The researchers formulate a series of questions that will serve as the group’s survey guide during
the conduct of the class surveys through a series of validated questionnaires.

Recognizing your expertise in this field, we are humbly asking for your assistance in validating
the interview questions and also our research paper.

Thank you very much for your kind consideration and valuable contribution and God Bless!

Respectfully Yours,

Reizel Ceyhan C. Magluyan, St. N

Keziah Marrie A. Magno, St. N

Shaine C. Nantin, St. N

Ella Lorraine S. Omboy, St. N

Jacob Joshua Elias Q. Quiogue, St. N

Andre Paulo T. Roca, St. N

Noah Emmanuel G. Sombilon, St.N

Researchers of BSN3B Group 5

Stress and RLE Performance… 32
 Stress and RLE Performance… 33

APPENDIX E

LETTER OF INTENT
Stress and RLE Performance… 34
 Stress and RLE Performance… 35

APPENDIX F

POPULATION DATA
Stress and RLE Performance… 36
 Stress and RLE Performance… 37

APPENDIX G

VALIDATION CRITERIA

Name of Evaluator:

Highest Educational Attainment:

Level/Position:

Instruction: To the evaluator, please indicate your degree of evaluation on the statements
provided below by encircling the number which corresponds to the best of your judgment.

(Copy from forms)

1 – Very Poor 2 – Poor 3 – Fair 4 – Very Good 5 – Excellent

Criteria Scale

The items in the instrument are relevant to answer the

5 4 3 2 1
objectives of the study.

The items in the instrument can obtain depth to constructs

5 4 3 2 1
being measured.

The instrument has an appropriate sample of items for the

5 4 3 2 1
construct being measured.

The items and their alternatives are neither too narrow nor
5 4 3 2 1
limited in its content.

The items in the instrument are stated clearly. 5 4 3 2 1

The items on the instrument can elicit responses which are

5 4 3 2 1
stable, definite, consistent and not conflicting.

The terms adapted in the scale in the scale are culturally

5 4 3 2 1
appropriate.

The layout or format of the instrument is technically

5 4 3 2 1
sound.
 Stress and RLE Performance… 38

The responses on the scale show a reasonable range of

5 4 3 2 1
variation.

The instrument is not too short or long enough that the

5 4 3 2 1
participants will be able to answer it within a given time.

The instrument is interesting such that participants will be

5 4 3 2 1
induced to respond to it and accomplish it fully.

The instrument as a whole could answer the basic purpose

5 4 3 2 1
for which it is designed.

Final Rating:

Comments/Suggestions/Recommendations:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________

Signature of Evaluator: ___________________

Date: ___________________________

Day/Month/Year

APPENDIX I

SURVEY QUESTIONNAIRE

The questions below are intended to collect the data on the independent variable which is the
level of stress amidst the pandemic. There are no erroneous answers but we highly recommend to
provide the most accurate response from the situations given below. Your identity and answers
will be kept confidential and the data collected will be only used solely for the study.

The following statements can be answered via 5-point likert scale

 Stress and RLE Performance… 39

Scoring Interpretation
5 Extremely Stressful
4 Highly Stressful
3 Moderately Stressful
2 Slightly Stressful
1 Not Stressful at All

Questions Extremely Highly Moderate Slightly Not

Stressful Stressful ly Stressful stressful
(5) (4) Stressful (2) at all
(3) (1)
Struggling to cope with Cancer
RLE due to pandemic
Increased workload in school that
may hinder the performance in
Cancer RLE
Class Interruptions due to home
errands, Wi-Fi and Power
Interruption, etc.
Lower Grades in RLE than
Expected
Change in Personal Time due to
online classes
Online Learning Environment as a
way to cope with the Covid-19
situation.
Terror and inconsiderate teachers
amidst pandemic
Device problems for school-related
works
 Stress and RLE Performance… 40

Questions Extremely Highly Moderate Slightly Not

Stressful Stressful ly Stressful stressful
(5) (4) Stressful (2) at all
(3) (1)
Expensive School Fees despite the
mode of learning is resorted via
online
Work with classmates you barely
know
Mental Breakdown related to
online class.
Uncooperative Group mates in
making school requirements

APPENDIX J
 Stress and RLE Performance… 41

PLAGIARISM SCAN
 Stress and RLE Performance… 42

APPENDIX K
GRAMMARLY SCAN
 Stress and RLE Performance… 43

BIOGRAPHICAL SKETCH

REIZEL CEYHAN C. MAGLUYAN

Third Year Student, Bachelor of Science in Nursing

San Pedro College, Davao City, Philippines

Mobile No. +639567993558

FB Messenger: @ Reizel Magluyan | E-mail: [email protected]

Reizel Ceyhan C. Magluyan completed her junior high at Assumption College of Nabunturan,
Davao de Oro, as with honor and graduated her senior high at the same school. She is currently
studying at San Pedro College, Davao City.

During her junior high days, she was the elected president of the Book Lovers Club, secretary of
the Marian club and P.I.O of Makabayan club. Throughout the senior high years she was an
active member of the Sci-Math club, STEM organization, Sports Club, RCY club and was the
vice president of the artist’s guild.
 Stress and RLE Performance… 44

KEZIAH MARRIE A. MAGNO

Third Year Student, Bachelor of Science in Nursing
San Pedro College, Davao City, Philippines
Mobile No. 09471935066
FB Messenger @ Keziah Magno; Email: [email protected]

Keziah Marrie A. Magno, born on January 2, 2000, completed her junior high school in
Ateneo de Davao University and received a loyalty award. She graduated her senior high school
with honors at Ateneo de Davao University. She is currently studying at Bachelor of Science in
Nursing at San Pedro College, Davao City.

During her junior high school years, she was an active member of the Badminton Club
and was elected as the secretary. In her Grade 12 years, she was a member of the Rizal Book
Club and has attended various out of school activities and seminars. In her senior high school
days, she was elected as the secretary of the class. Apart from attaining with honors, she has also
been a member of the Elysian Club.
 Stress and RLE Performance… 45

SHAINE C. NANTIN
Third Year Student, Bachelor of Science in Nursing
San Pedro College, Davao City, Philippines
Mobile No. 09954140156
FB Messenger @ Shaine Nantin; Email: [email protected]

Shaine C. Nantin, born on September 05, 1999, completed her junior high school in
Lupon National Comprehensive High School and received a journalism award for winning 2nd
place in Division Schools Press Conference (DSPC) and participating in Regional Schools Press
Conference 2016 (RSPC) in Editorial Writing category. She graduated her senior high school
with honors at Assumption College of Davao. She is currently studying Bachelor of Science in
Nursing at San Pedro College, Davao City.

During her junior high school years, she was an active member of the Journalism Club
"The Vestige" as an Editorial Writer both in Filipino and English, she was also part of the Drum
and Bugle corps. In her senior high school years, she was a member of the Journalism Club
"Touchstone" and part of the Student Government Council as a representative of General
Academic Strand (GAS) and has attended various out of school activities and seminars.
 Stress and RLE Performance… 46

ELLA LORRAINE S. OMBOY

Third Year Student, Bachelor of Science in Nursing

San Pedro College, Davao City, Philippines

Mobile No. 09092086563

Facebook: Ella Lorraine

Email: [email protected]

Ella Lorraine S. Omboy completed her junior high school in Holy Cross of Mintal Inc.
in Davao City and she graduated her senior high school at San Pedro College Basic Education.
She is currently studying at San Pedro College, Davao City in the Bachelor of Science in
Nursing.

During her junior high years, she was part of cheer dance crew and has also
participated as a cheer dancer in Davao Association of Catholic Schools, also known as DACS
between 2015 and 2016. She has also been a member of the book lovers club in Holy Cross of
Mintal. Other than that, she was also able to participate in volleyball tournament during the Holy
Cross of Mintal Intramurals S.Y. 2015-2016 and won a medal.
 Stress and RLE Performance… 47

JACOB JOSHUA ELIAS Q. QUIOGUE

Third Year Student, Bachelor of Science in Nursing

San Pedro College, Davao City, Philippines

Landline (082) 225-6336; Mobile No. 09194198822

FB Messenger @ Joshua Quiogue; Email: [email protected]

Jacob Joshua Elias Q. Quiogue completed his junior high school in Our Lady of Fatima
Academy Inc. in Davao City and he graduated his senior high school at San Pedro College of
Davao. He is currently studying at San Pedro College, Davao City in the Bachelor of Science in
Nursing.

During his Junior high years , he was part of communication arts club in Our Lady of
Fatima Academy and has also participated as a table tennis athlete in the Davao Association of
Catholic Schools sportsfest between 2012 and 2015 in the single player and double player
division. In his Senior high, He has also been a member of the Red Cross Youth in San Pedro
College. Other than that, he was also able to participate in a Taekwondo tournament during the
San Pedro College Intramurals S.Y. 2016-2017 and had won a bronze medal even with without
experience of the sport.

Andre Paulo T. Roca

Third Year Student, Bachelor of Science in Nursing
San Pedro College, Davao City, Philippines
Landline (082) 296-9988; Mobile No. 09955508211
 Stress and RLE Performance… 48

FB Messenger @ Andre Roca; Email: [email protected]

Andre Paulo T. Roca completed his junior high school in Ateneo de Davao University.
He also graduated senior high school in the same university under science, technology, and
mathematics (STEM) strand, Pre-science. He is currently a third-year college student at San
Pedro College with the course of Bachelor of Science in Nursing.

During his junior high days, when he was in first and second year, he was a member of
the basketball club. He was a member of the robotics club and youth for Christ when he was in
third year until fourth year high school. He also participated in the Davao Association of
Catholic Schools in the year 2015 as a member of the taekwondo varsity team. In Senior high
school he was a member of a club named Liga ng Atenistang Mananayaw (LIAM) and won a
Gold medal at the ego supreme crew wars held at Gaisano mall of Davao and in grade 12 he
participated in the intramurals as a member of the basketball team
 Stress and RLE Performance… 49

NOAH EMMANUEL G. SOMBILON

Third Year Student, Bachelor of Science in Nursing
San Pedro College, Davao City, Philippines
Landline (082) 226-2314; Mobile No. 09303830984
FB Messenger @ Noah Emmanuel G. Sombilon; Email: [email protected]

Noah Emmanuel G. Sombilon completed his junior high as Holy Cross of Davao
College, Davao City, as with honors. He graduated his senior high with honors at Ateneo
de Davao University. He is currently studying at San Pedro College, Davao City and he
has been a consistent dean’s lister for 2 years.

During his junior high days, he was the secretary of Math Club and the President
of the Non-Catholic Organization. In his senior high, he was elected as the class president
and an active member of the Math Club and Scrabble Club. Aside from attaining With
Honors, he was also the champion of Power Duet in the Intramurals S. Y. 2016-2017.
Before the graduation, His group received a Clavius Research Award representing the
STEM Pre-Science Strand as selected by the Research Department with the research title
“Stressors and the Level of Social Anxiety in AdDU-SHS Grade 12 STEM Learners”.