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“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
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THE EFFECTS OF BURNOUT TO THE ACADEMIC PERFORMANCE
OF 3 RD^ YEAR STUDENT NURSES IN VIRGEN MILAGROSA
UNIVERSITY FOUNDATION
A Thesis Presented to the Faculty of the College of Nursing Virgen Milagrosa University Foundation San Carlos City, Pangasinan In Partial Fulfillment of the Requirements For the Course Nursing Research Leading to the Degree of Bachelor of Science in Nursing OVERCOMERS ARMAS, TRISHA MENDOZA, SHEINA CASTILLANO, ERIKA FRANCES MISLANG, LOVELY JOY DE GUZMAN, ALEESA MAE NIÑO, JOEYLYN MARCENA, SHEKINAH GRACE PAMMIT, CATHERINE ROSE MEDINA, SHEENA MAE UNAY, PAMELA JOY CRISOSTOMO, MARIANNE KARYME May 2023
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
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APPROVAL SHEET
This thesis entitled “ THE EFFECTS OF BURNOUT TO THE ACADEMIC PERFORMANCE OF 3 RD^ YEAR STUDENT NURSES IN VIRGEN MILAGROSA UNIVERSITY FOUNDATION ” which has been prepared and submitted by the researchers in partial fulfillment of the requirements of the course Nursing Research leading to the degree of Bachelor of Science in Nursing is hereby submitted for oral examination. ___________________ MA. CHRISTINA B. ORTEGA, MAN, MPH, PhD Date Research Adviser Approved by the Committee for Oral Examination in partial fulfillment of the requirements of the course Nursing Research. MA. THERESA R. AGUILAN, MAN Chairman MERLY B. CABUANG, MAN ROSALYN G. ROSAL, RPharm, MPH, PhD Member Member Accepted and approved in partial fulfillment of the requirements for the course Nursing Research leading to the Degree of Bachelor of Science in Nursing. Date: MARIA THERESA R. AGUILAN, MAN Dean, College of Nursing
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
iv To our ever-supportive research adviser, Dr. Ma. Christina B. Ortega, for continuously equipping the researchers with enough knowledge, motivation and supervision we needed as researchers. Thank you po! To Ma’am Glorie Ann B. Feliciano, the Head of Guidance Center in University of Luzon, who certified our research instrument and for sharing her support, ideas, encouragement and sincere suggestions to improve our research study; To all of our instructors who took us under their wing during our college experience and supported and directed us not just through our academics but also towards our future jobs. You possess all of the traits that we appreciate and respect, and we will remember you fondly as we read this book; To our dearest classmates, friends, and all the important individuals who contributed to the completion of our research study and who continuously encouraged us to work more, inspired us through the tough days, and supported us at all times. THANK YOU VERY MUCH AND TO GOD BE THE GLORY!
- The Researchers
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
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DEDICATION
We wholeheartedly dedicate this study To our almighty God To our Family, relatives, and friends, Our loving parents, siblings, and benefactors, To our instructors, To our classmates, To our fellow student nurses, this will serve as a basis and information to you. This study is also dedicated To those who helped us and supportive us through this journey. To God be the Glory!
- The Researchers
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
vii clinical duty, students also cannot fulfill their household choirs due to a lot of task that they need to accomplish in their academe. We found out also that the 3 rd^ year Nursing students suffer from stress and anxiety due to burn out with their academe. Many students gaining weight because they do stress eating to overcome the stress and anxiety they feel. We found out also that 2 students encounter of weight loss because they can’t properly because they missed out to eat due to a lot of assignment to accomplish. To surpassed their struggle and challenges, student nurses they must use the different coping mechanism. Faith in God is important, because with God all things are possible. Belief towards oneself is also vital, because being student nurse must believe in themselves in order to produce the best result, and support system is also significant, for the reason that this where the student nurse gets his or her strength.
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
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CONTENTS
TITLE PAGE i APPROVAL SHEET ii ACKNOWLEDGEMENT iii DEDICATION v ABSTRACT vi TABLE OF CONTENTS viii LIST OF APPENDICES x LIST OF TABLES xi LIST OF FIGURES xii CHAPTER 1: INTRODUCTION 1 Background of the Study 1 Significance of the Study 6 Researchers Background 7 Statement of the Problem 8 Assumptions 9 CHAPTER II: METHODOLOGY 11 Research Design 11 Sources of Data 12 Locale of the Study 14 Informants of the Study 19 Research Instruments 20
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
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LIST OF APPENDICES
Appendix Title Pages A Letter to the Dean 67 B Letter to the Informants 68 C Data Gathering Procedure 69 D Sample Interview Guide 70 E Informed Consent 72
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
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LIST OF TABLES
Table Title Pages 1 First Theme and Sub-themes 40 2 Second Theme and Sub-themes 52 3 Third Theme and Sub-themes 56 4 Themes, Sub-themes and Categories 57
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
CHAPTER I
INTRODUCTION
Background of the Study Burnout is a syndrome of emotional exhaustion, cynicism, and low professional efficacy that occurs frequently among individuals who do 'people work’ of some kind (C Maslach, SE Jackson; Jeung et al., 2018 ). As students entering college, they must be happy and excited as they get closer to their desired profession. However, when they reach third year, burnout syndrome happens. Burnout is defined as a response, which may be inappropriate, to chronic emotional and interpersonal stressors in the workplace (Costa, et al.). Students are experiencing it due to overload activities, schedules and deprived sleep. The excessive workload and educational content, combined with the high level of educational demands, a lack of time for leisure, family and friends, studying for residency exams, the choice of a specialty and the delayed income also contribute to stress among medical students (M Tarnowski, MS Carlotto, Aguiar et al., Carlotto et al.). Burnout Syndrome affects work performance, self-esteem, and psychological health, and it may progress to other mental disorders (Costa et al.). Burnout syndrome was described as a progressive process of emotional exhaustion and professional apathy caused by enduring, high-level stress from work situations, particularly among those who take care of others. The Maslach Burnout Inventory identifies three multidimensional components as burnout, namely emotional exhaustion (it can measure feeling of being emotionally overextended and exhausted by one’s work), depersonalization (measures
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
2 an unfeeling and impersonal response toward recipients of one’s service, care treatment, or instruction), and diminished personal accomplishment (measures feelings of competence and successful achievement in one’s work). The incidence of burnout is exponentially higher on healthcare-related professions which includes nursing. Nurses may not be able to render quality care because of insomnia and depression. This will worse lead to turnover or workforce deficiency. Since nursing profession is a platform that aims to attend effectively to patients or clients, it is important that as early as possible, burnout syndrome would be address even when still as nursing school. Recent research has examined burnout in college students, expanding upon the definition and verifying the presence of the three variables on the Maslach Burnout Inventory, in this population. When a student suffers from burnout, he or she will experience: emotional exhaustion, which is the sensation of being drained as a result of studying; disbelief, the development of a doubtful and aloof mindset toward studying; and low professional effectiveness, the perception that he or she is ineffective as a student, respectively. Burnout remains a chief working problem, in nursing and the sector of health in general, with many consequences that affect the nurses’ quality of life and quality of care they render. It much timely happens that there were numerous cases of reported negative patient rating on nurses. As to a study conducted, burnout affects the nurses’ health specifically the brain structures and cognitive function that results to work performance and patient’s safety issues while at the nurses’ care. Work environment and work load routine was seen as the main contributors with the aforementioned case (Aoyjai P. Montgomery, PhD, BSN)
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
4 burnout. Abundant studies have documented the negative impact of burnout. Burnout lowers nurses’ quality of life, performance level, and organizational commitment and increases their intention to leave the job. As well, burnout increases turnover rates and negatively affects the quality of nursing care. Thus, it is important to assess burnout levels among Jordanian nurses specially with the situation of lack of studies in this field in Jordan. (Mudallal, Othman, & Al Hassan, 2018) In Brazil, the students surveyed in burnout studies were found to be free of the disorder. However, these studies were carried out in private institutions, and it is important to examine burnout in students from public institutions as well, in order to establish whether there are any differences between these contexts. Nevertheless, despite the fact that a burnout study was conducted in a public institution, it was identified that nurses working there were exposed to a number of situations that might lead to emotional exhaustion, disbelief, and diminished professional efficacy. The high incidence of burnout among nurses, particularly staff nurses working in the hospital setting, has been reported in several previous studies around the world on different continents, comprising Europe, America, Asia, and Africa (Elbarazi et al.; Putra, 2019; Hu et al., 2020 ; Nimako et al., 2022 ). In a previous study conducted by Woo et al. (2020), the overall pooled-prevalence of burnout symptoms among global nurses was 11.23% against the United States previous 34-45% (Dyrbye et al., 2018 ; Nimako et al., 2022 ). Matsuo et al. (2020) also found a 46.8% prevalence rate of burnout among nurses in Japan, whereas Hu et al. (2020) reported a similar finding in a large-scale cross-sectional where
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
5 most frontline nurses reported moderate to high job burnout levels during the COVID- 19 outbreak in China. However, there are limited data regarding the overall prevalence of burnout in the Philippines, even though Lu (2017) revealed that of 246 nurses, nearly half missed work due to illnesses. Many researchers believe that the incidence of nursing burnout is exceptionally high because of the high emotional and physical demands of nursing practice (Riedl & Thomas, 2019; Fasbender et al., 2019 ; Nimako et al., 2022 ). High levels of burnout are associated with heavy workloads, nursing shortages, long working hours (Nimako, 2021 ; Nimako et al., 2022 ), conflicts with physicians and patients, repeated exposure to disease and death, insufficient staffing, conflicting views, unpredictability, inadequate pay, low work atmosphere (e.g., lack of power, lack of administrative support) and job dissatisfaction (Muriithi et al., 2016; Hoff et al., 2019 ; Nimako et al., 2022 ). Currently, there are only few studies made with a concern for burnout in the Philippines. Further, there is a scarcity of information for its prevalence and influencing factors especially among nurses. However, in recent international studies, occupational satisfaction, working environment, and temperament have been associated or linked with burnout. Therefore, in this study, the same variables will be considered as the determinants of burnout among Filipino nurses. (Baylon, 2019) According to the researchers, the journey in college must be a joyful ride for the students to experience the positive side without experiencing burnout. However, because of some unfortunate circumstances causing the students to feel unhappy and exhausted. This study aimed
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
7 To the Future Researchers. This study may also support the future researchers to have an available resource concerning the burnout syndrome that the student nurses are experiencing. Researchers Background At the prestigious Virgen Milagrosa University Foundation's college of nursing, the researchers are currently in their third year of study. Student nurses report moderate levels of personal accomplishments, low levels of emotional exhaustion and depersonalization, and low levels of depersonalization. Therefore, the researchers decided to investigate the impact of burnout on their clinical and academic performance. Moreover, he primary reason why the researchers had chosen to conduct this study about the effects of burnout on the academic and clinical performance of the student nurses under the third-year level in Virgen Milagrosa University Foundation is based on their experience and observation of how the student nurses cope with their daily challenges and struggles they encounter. The researchers have seen the passion, love, and how dedicated they are in their chosen field of endeavor. The researchers have decided to conduct this study because they wanted to know the struggles and difficulties of third-year nursing students in their academic and clinical performances. Because as future nurses, they face many problems and burnout along the way and need to know how to deal with them while we are still student nurses. Academic burnout in student nurses appears to be caused by clinical duty and academic overload and may have a negative impact on learning and care quality during the clinical performance. That is why the researchers need to deliberate on how to deal with this. Throughout
“The Home of God-Loving and Globally Competent Individuals” Martin P. Posadas Avenue, San Carlos City, Pangasinan, 2420, Philippines
COLLEGE OF NURSING
8 the journey of being a student nurse allows them to grow their knowledge, skills, and critical thinking in order to become a effective and efficient nurse in the future. The researcher’s job is just as vital as the professionals', but we suffer from burnout, which can impair our performance as student nurses. Our desire to serve others and our enthusiasm for health care push us to do well. We wanted to be great nurses someday by showing love and respect to our patients. To address the difficulties and obstacles faced by nursing students and provide a better knowledge of the breakdowns experienced by third-year nursing students, we, the researchers are motivated to perform this study for our fellow student nurses under the college of nursing in Virgen Milagrosa University Foundation. Furthermore, to investigate the burnouts faced by third-year student nurses in Virgen Milagrosa University Foundation of San Carlos City, Pangasinan in order to have a lot of knowledge that could be useful to improve the mental and physical well-being of third-year level nursing students. It could also help other levels in the college of nursing to be aware of the problems and obstacles that are needed to address and be an effective efficient healthcare provider. Statement of the Problem This research study aims to determine into the effects of academic burnout among the third-year student nurses in VMUF. Specifically, it seeks to answer the following questions:
