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ENGLAND NEW COLLEGE Quezon City, Philippines THE EFFECTS OF STRESS ON THE ACADEMIC PERFORMANCE OF ASSOCIATE OF SCIENCE IN NURSING STUDENTS IN SELECTED ORANGE COUNTY JUNIOR COLLEGES In Partial Fulfillment of the Requirements For the Degree in Bachelor of Science in Nursing Submitted by: Joan Marie C. Achondo Submitted to: Dean Honey Chille Tolentino, RN, MAN, EDd (Units) All Rights Reserved April 01, 2011 APPROVAL SHEET The research titled, The Effects of Stress on the Academic Performance of Associate of Science in Nursing Students in Selected Orange County Junior Colleges, written and developed by Joan M. Achondo, in partial fulfillment of the requirements for the degree of Bachelor of Nursing has been examined and recommended for acceptance and approval for oral examination. ____________________________ Dean Honey Chille N. Tolentino RN, MAN, Edd (Units) Nursing Research Adviser Approved by the panel of examiner for oral examination. ______________________________________ Prof. Shirley Espina, RN MAN _________________________ Prof. Amor D. Lopez, RN, RM, MAN ____________ Date Passed and approved as partial fulfillment of the requirements for the degree of Bachelors in Nursing. _______________________________ Honey Chille N. Tolentino RN,MAN Dean, College of Nursing DEDICATION This research work is solely to the one and only, Lord God, Almighty, who despite of my shortcomings, has filled me with strength and confidence to continue on in this journey of education. ACKNOWLEDGMENT I would like to dedicate this research to those who Ive for support and encouragement Your genuine trust and understanding will always be appreciated and valued. To the best grandmother in the world, Mamang. To My Future Family, I want to dedicate this book to you. I promise to always be there for you. I cant wait to meet and share my life with my babies Lastly, the Lord God Almighty, for giving me the courage everyday from the day I started the Nursing Program until the very end. JMCA 2011 TABLE OF CONTENTS TITLE PAGE ..................................... APPROVAL SHEET DEDICATION ................................... .................................... ACKNOWLEDGEMENT .................................. TABLE OF CONTENTS .................................. LIST OF TABLES LIST OF FIGURES .................................... .................................... LIST OF APPENDICES .................................... THESIS ABSTRACT ................................... CHAPTER 1 THE PROBLEM AND ITS BACKGROUND INTRODUCTION ................................. BACKGROUND OF THE STUDY ................ THEORETICAL FRAMEWORK ................ STATEMENT OF THE PROBLEM ............... SIGNIFICANCE OF THE STUDY SCOPE AND DELIMINATION DEFINITION OF TERMS .............. .............. ............. CHAPTER 2 REVIEW OF RELATED LITERATURE AND STUDIES RELATED LITERATURE ............................. RELATED STUDIES ............................. CHAPTER 3 METHODOLOGY DESCRIPTION OF THE LOCALE ................. RESEARCH METHOD ..................................... SAMPLE AND SAMPLING TECHNIQUES .. INSTRUMENT AND VALIDATION ................ DATA GATHERING PROCEDURE ............. STATISTICAL TREATMENT ....................... CHAPTER 4 PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA ........... CHAPTER 5 SUMMARY, FINDINGS, CONCLUSION AND RECCOMENDATION SUMMARY OF FINDINGS ........................... CONCLUSIONS .......................................... CODE OF ETHICS FOR NURSES .............. PROFILE OF A NURSES ............................ BIBILIOGRAPHY .......................................... APPENDICES .............................................. CURRICULUM VITAE ................................. LIST OF TABLES LIST OF FIGURES LIST OF APPENDICES APPENDIX A B Letter to the College of Nursing Cover Letter for the Instrument C D E F Instrument Combined Mean Score of Perceptions (mode and the percentage ) Computation of Standard Deviation Computation of t-value THESIS ABSTRACT (should be developed after the study was conducted, in past tense) THESIS TITLE: THE AFFECT OF STRESS ON THE ACADEMIC PERFORMANCE NURSING STUDENTS IN SELECTED ORANGE COUNTY COLLEGES RESEARCHER: DATE OF PUBLICATION: Joan M. Achondo March 2011 Irvine, California USA INSTITUTION: SUBJECT AREA: New England College 5.1 Description: The Affect of Stress on the Academic Performance of Nursing Students in Selected Orange County Colleges. Year, 2011 5.2 Degree Conferred: Bachelors of Science in Nursing RATIONALE/BACKGROUND: The research focuses on the affects of stress on the academic performance among 1st year and 2nd year Nursing students of Saddleback College in Mission Viejo, California and Coastline Community College in Costa Mesa, California. This research will explore what the underlying causes of stress are and how it affects the academic performance of nursing students in selected orange county junior colleges. STATEMENT OF THE PROBLEM: The research deals with the different stressors that affects academic performance of nursing students. RESEARCH DESIGN: STATISTICAL TREATMENT OF DATA: FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS: Chapter 1 The Problem and Its Background This chapter includes a brief introduction pertaining to the topic selected for discussion. This chapter also consists of the statement of the problem, theoretical framework, the significance of the study, scope and delimitation and the presentation of the terms used as the course of the study progresses. These shall form the background and the foundation on which the study is based. Introduction A degree in Nursing is one of the most popular college degrees students from California pursue. The demand for Registered Nurses in the US health care has never been higher. There are a number of reasons to consider becoming a registered nurse. In addition to the career advantages and personal satisfactions, students choose a career in Nursing because of the different opportunities in the area. Many Filipinos residing in the state of California hold a degree in Nursing. This encourages friends and family members to take up Nursing despite the fact that it is against the students interest. With that thought in mind, several other influences will be addressed which may causes stress to Nursing students and affect their academic performance. Students considering a career in nursing can pursue either a bachelors degree, an associate degree or diploma from an accredited nursing program. In the US, most nurses enter the profession by completing either an associate degree or bachelors degree. Bachelor of Science in Nursing (BSN) is offered by universities and colleges. It takes up to four years to complete. Associate of Science in Nursing (ASN) is offered in the community and junior colleges and takes two years for the degree to complete. Diploma programs are offered by hospitals and can take up to three years to complete. Students must then complete a national licensing exam to obtain a nursing license within their chosen states. BACKGROUND OF THE STUDY: Stress, for many of us , refers to a state of complete overload McEwen (2004). Whether it be a paper or an exam deadline, a family problem, or even a cumulative series of events, life is full of circumstances and events, known as stressors, that produce threats to our well-being. According to the American Association of Colleges of Nursing (2007), there are about 145,845 students enrolled in entry-level ASN program and nursing students from minority backgrounds represent 26% of students in entry-level ASN programs. Research indicates that minority nursing students are at high risk for failure and attrition (Choi, 2005; Gardner, 2005a; Jeffreys, 2007b). Research on stress in nursing students indicates these students experience a variety of stressors, such as fear of failure, financial issues, patient care responsibilities, and balancing school work with personal life (Jones & Johnston, 1997, 1999). In addition, the greater the stress experienced, the greater the negative effects it has on student learning and success (Gwele & Uys, 1998; Jones & Johnston, 1997). Students of Orange County junior colleges pursuing a degree in Nursing deal with stress while trying to maintain their grades and academic workload. With these issues in mund, this research will explore what the underlying causes of stress are and how it affects the academic performance of nursing students in selected orange county junior colleges. STATEMENT OF THE PROBLEM: The study seeks to determine the effects of stress on the academic performance of selected Associate Science in Nursing (ASN) students in selected orange county junior colleges. In this regard, the following problems will be addressed in this study: 1. What is the profile of the ASN students in term of: A. Gender B. Ethnicity C. Age 2. What are the stress factors affecting the academic performance of selected ASN nursing students? 3. What are the effects of the stress factors on the academic performance of selected ASN nursing students? THEORETICAL FRAMEWORK: The theoretical framework of this study is structured on the following theories: The Fight or Flight Reaction According to Cannon, whenever any living creature is faced with what it perceives as an emergency, its body prepares for one of two alternatives. These are (1) a direct confrontation fight - or (2) a hasty retreat - flight. This is a way the body reacts to an existing danger. Our blood circulation increases, and blood glucose are released in the bloodstream. The most obvious sign is the speeding up of breathing. After the stressor goes away, the human body returns to its original state. However, this theory suggests that all stressors go away that easily. There are however events such as poor grades, that might last indefinitely, until the student is able to bring the grades higher. This means to say that the body may not always go back to its original state. General Adaptation Syndrome Based on Cannons study, Physiologist Hans Selye proposed a theory that explains the presence of continuing stress. According to Selye, the General Adaptation Syndrome (GAS) is a three stage reaction to stress. (1) The first stage - alarm- parallels Cannons fight or flight reaction. (2) The second stage is known as Resistance. (3) The third stage is known as exhaustion. The Alarm stage is similar to Cannons fight or flight theory . When our body elicits an immediate danger, it mobilizes itself as a respond to the immediate danger. The same mechanism in our body happens as to what Cannon has proposed to his fight or flight theory. At the beginning of the arousal, blood pressure drops below normal for a few seconds, but then quickly arises to above normal. This arousal is produced by the release of hormones by the endocrine system. The pituitary glands secrete ACTH, which causes a heightened release of adrenaline, noradrenaline, and cortical by the adrenal glands into the bloodstream. The body then return to its normal state. The body cannot stay in this state for long without serious consequences. The Resistance Stage is the second stage. appearing to be adapting to it. An example The body tries to resist an existing stress by when we try to hold ourselves during cold temperatures. Until the cold temperature disappears, then our body does not return to its normal state. If the stressor proceeds, it continues to stage three. The stage of exhaustion is the last stage. The body in this stage has given up and cannot deal with the stress any longer. The end result are diseases, anxiety , illnesses, and even death. The Lazarus Stress Theory: According to Lazarus, stress is a two-way process: (1) the environment produces stressors and (2) the individual find ways on how to deal with the stressors. Cognitive appraisal is a mental process by which people assessed two factors: (1) whether a demand threatens their well-being (2) whether a person considers that they have the resources to meet the demand of the stressors. Two types of appraisals (1) primary (2) secondary. During the primary appraisal stage a person will be seeking answers as to the meaning of the situation with regard to their wellbeing. One of the three types of appraisal could be made (1) It is irrelevant (2) It is good (3) It is stressful. Secondary appraisal appear SIGNIFICANCE OF THE STUDY: This study is conducted in order to trace the causes and effect of stressors on the academic performance of ASN nursing students in selected orange county junior colleges. The proponent of the study sees the need for the study to understand how this trend affects the academic performance of selected ASN nursing students NURSING STUDENTS: This paper will present various facts regarding academic performance and the effects of stress releasing activites to ASN nursing students in selected orange county junior colleges. It is deemed beneficial to nursing students since it will give them an idea of how to release their stress and how this would in turn affect their academic performance. This study also seeks to let the students understand how they further improve their academic perfomance on the basis of beng stress free. THE ACADEME: This paper wish to serve as an avenue to address the academe on the issue of how to make nursing course appealing to students and enrich the quality of the nursing education by understanding the facets that motivates students to pursue the degree. This study hopes to aid professors and school administrators to overcome the boundaries set by exernal stimuli that affect the performance of their students. This paper would like to serve as an additional reference for professors to come up with stress releasing activites which will enhance students academic performance. FUTURE RESEARCHER This paper wishes to serve as added information for future researchers who would pursue the same topic. The information discussed in this paper may be supplemental to future studies that may further be elaborated. Likewise, the proponent see that there are various facets of this topic which may need extensive review for future researcher to explore. Furthermore, this study was conducted on the grounds that it aims to provide an avenue that would explain the current trend, the effects and the factors affecting the academic performance of selected ASN nursing students in relation to stress releasing activites. This paper is not ambitious to declare that it will provide specific annswers but in as much data as possible it may somehow add to the resources that further researcher for this topic may be use in the future. SCOPE AND DELIMINATION OF THE STUDY: To facilitate a better understanding and a more thorough discussion of the subject, the proponents of the study decided to confine the research to registered first year and second year ASN students of junior colleges in orange county. This was done In order to address and discuss extensively the academic perfomance of selected second year nursing students in relation to their participation to stress releasing activities. The proponents seek to involve the participation of selected first and second year nursing students in selected junior colleges in orange county. This is facilitated though the use of the method of random sampling. At least 50% of the total number of registered nurse enrolees will form the pool of respondents. The participants were chosen because of their intense demand of the course during the stage with clinical immersion being part of the curriculum. The study focuses on two major aspects. These two modulating variables include the Cumulative GPA of the participants and their participation to selected stress releasing activites. The proponent will utilize the use of a self-constructed questionnaire with 10 items. This will be validated through a test and retest method. This will assure the validity and reliability of the study. Furthermore, it should be known that the opinions, explanation and concepts embodied in the succeeding pages are based on the researchers course of study and on the availability of data and information needed in the study. Definition of Terms: Conceptual Definitions: Extrinsic motivation refers to motivation to engage in an activity as a means to an end Intrinsic motivation is motivation to be involved in an activity for its own sake Migration Systems Approach sets out to provide a conceptual framework that includes both ends of the flow and studies all dimensions of the relations between emigration and immigration countries. Motivation are sets of processes that arouse, direct, and maintain human behavior toward attaining some goal. Academic Performance how success in educational institution is measured or how well a student meets standards set out local by government and the institution itself. Stress is a normal physiological response of the body to situations or stimulus which are perceived as dangerous to the body. Stressors are events, experiences that causes stress. Stress reducing activities is a management tool in reducing stress. Operational Definition Cumulative GPA refers to the total quality of points the student had achieved in all courses he had taken since his enrolment at the university , divided by the total number of credit hours assigned for these courses. CHAPTER 2 REVIEW OF RELATED LITERATURE AND STUDIES This chapter consists of series of literature and studies conducted under the same topic. This information were gathered and added to this paper due to its importance and relevance to the said topic being discussed. RELATED LITERATURE: A. Local The Effect of Stress on Attention Stress can have cognitive effects on students, particularly their academic performance. Factors that are affected by stress are mental sharpness, memory focus, concentration, and attention span. In general, under stress, attention appears to channel or tunnel, reducing focus on peripheral information and tasks and centralizing focus on main tasks. The tunneling of attention can result in either enhanced performance or reduced performance, depending on the nature of the tasks and the situation. For instance, when peripheral cues are irrelevant to task completion the ability to tune them out likely to improve performance. On the other hand, when these peripheral cues are related to the task and their incorporation would otherwise facilitates success on the task, performance suffers when they are unattended. The Effect of Noise on Stress Several authors have explored the effect of noise on attention and found results consistent with the attention tunneling hypothesis (Broadbent, 1978; Houston, 1969). Broadbent identified three deficits resulting from noise exposure: (1) reduction in signal detection, (2) increase in inefficient performance leading to increase in error rates, and (3) selective attention (focusing on some aspects of an object while neglecting others). Diaz, Hancock, and Sims (2002) reported a speed/ accuracy trade-off, reducing the effectiveness of viusal search under noise conditions. Houston(1969) found an increase in noise resulted in centralized focused that improved performance on the Stroop color-word task while limiting attention to peripheral cues. The Stroop task or one of its variations is perhaps the most widely used test for the assesment of attentional interference (MacLeod, 1991). The Effect of Stress on Memory The research literature concerning the effects of stress on memory consistently demonstrates that elements of working memory are impaired. There are a variety of tasks in which memory has been measured under stress. To be more precise, these investigations have typically addressed working memory, and unless otherwise specified in the text, the reader should consider general references to memory as references to working memory . Typically, long-term memory remains intact under stress; however, various elements of working memory are more vulnerable. Anxiety is perhaps the most common stress condition by which memory researchers have examined memory performance (Eysenck, (1979); Eysenck (1985); Wachtel (1968). Anxiety has been generated in a number of ways but most frequently by way of math performance. The negative effects of this stressor on working memory are well established. Ashcraft and Kirk (2001) reported that individuals high in anxiety tend to be slower and more deliberate in their processing of various aspects of mathematical functions. B. FOREIGN Amigo-Ferrolino (2009) Stress is related to coping difficulties (Chan and Kho, 2007). The coping strategies of students influence their quality of life and adjusment to the environment. (Drybye et al, 2006) Students use of active coping for their stressors is inversely related to depression (Firth- Cozens 2001) while disengagement strategies or problem-avoidance, wishful thinking, social withdrawal and self-criticism are positively related to symptoms of depressions (Motley et al, 1994) and correlated negatively with academic performance (Stewart 1999). Preference for a particular coping response is related to type of stressor and the year level of the student but not to gender (Stern 1993). Related Studies: A. LOCAL Ellis (2008) Researchers at the University of Minnesotas Boynton Health Service surveyed 9,931 students at 14 different schools. They found that students with unhealthy beahviors had significantly lower academic performance. Of the 69.9 percent students who reported they were stressed, 32.9 percent said that stress was hurting their academic performance The study found that the ability to manage stress is equally important. Students who said they are able to handle stress effectively perfromed much better than those who said they couldnt. Wommble (2008) In a study n 2000, Barnes found that students who exercise seven or more hours a week obtained significantly lower grades than students who exercise six or fewer hours weekly or not at all. Nutrition is also a problem with nursing students. Students may have difficulty finding time to cook adequate meals. Most students are just learning to live on their own an learning to cook can prove to be a challenge. The effects of perceived social support are mixed Some studies have shown that the amount of time of social support from the university and outside contributors like family, friends and mentors can make ahuge impact on a nursing students success. Support such as emotional, academic, and financial are tremendous factors in the success of a college student. Whitman (1985) When students appraise their education as a challenge, stress can bring them a sense of competence and an incease capacity to learn. When education is seen as a threat, however, stress can elicit feelings of helplessness and a foreboding sense of loss. According to American Holistic Nurses Association, a study comparing the stress levels of various professional students found that nursing students experience higher level of stress than medical, social work, and pharmacy students (Beck et al 1997). Even more poignant, another study showed that one third of nursing students experience stress severe enough to induce mental health problems such as anxiety and depressions. In addition to contending with exams, grades, long hours of studying, work, family and other personal commitments you are also faced with the challenges of clinical practice. Clinical practice has been identified as one of the most anxiety producing components in nursing programs. Lack of experience, fear of making mistakes, difficult patients, discomfort at being evaluated by faculty members, worrying about giving the patients wrong information or medication, and concern about possibly harming a patient are just a few stressors for the beginning student nurse. (Masoumi & Sharif, 2005) Mckeen, Misra (1998) The most common reaction to stress among students appeared to be emotional - fear, anxiety, worry, anger, guilt, grief, or depression and cognitive Reactions. Other reactions that occurs less frequently were behavioral - crying, abuse of self and others, smoking and irritability- and physiological - sweating, trembling, stuttering, headaches, weight loss or gains or body aches. Although females has lower stress levels than males in three of the five stress categories, they experienced more reactions than males. This diffeence, however, was not statistically significant except in physiological reactions. B. FOREIGN According to Garcia, students entering college encounter new stressors that can possibly affect them personally or academically. The most common variables that affect academic performance are sleep habits, social networking, alcohol and drug consumption and emotional issues. Studies suggest that quality and quantity of sleep are related to learning ability and grades. Social networking accounts for students wasting countless hours on face book and disregarding class work or home work that needs to be accomplished. Other students have the idea of multitasking trying to do their work while chatting on Facebook. In all reality, humans beings do not possess the ability to multitask; our brains need time to switch from one task to another. The brain needs time to adjust. Chapter 3: METHODOLOGY This chapter presents the method of research that was used by the proponents of the study, which includes research design, population and sampling, research instrumentation, data gathering procedure and the statistical treatment of the data. Research Design The descriptive method of research is used in this study. Descriptive method of research is a fact-finding study with adequate and accurate interpretation of the findings (Glass & Hopkins, 1984). It describes with emphasis what actually exist situations or any phenomena. The aim of descriptive research is to verify technoformulated hypotheses that refer to the present situation in order to elucidate it. Since the present study was concerned with the such as current conditions, practices, correlation of the academic performance to participation in stress releasing acivities, the descriptive method of research was the most appropriate method to use. Population Sampling The proponents of the study will employ the use of random sampling. Random sampling is a sampling technique where we select a group of subjects (a sample) for study from a larger group (a population). Each individual is chosen entirely by chance and each member of the population has a known, but possibly non-equal, chance of being included in the sample. From the entire nursing population from first year to second year, the proponents unanimously agreed to choose the nursing students in the second year level. From the group of freshman and sophomores, the proponents willl randomly select among the regular students 50% of its total population. They will represent the entire population of first and second year students.and the entire students of AS Nursing. Participants of the Study The proponents decided to confine their study to all first year and second year students within selected junior community colleges in orange county currently enrolled as regular students under the School of Nursing. These populations where chosen because as first and second year, they are mostly loaded with strenuous activites. Data Gathering Procedure To work with this theory the proponents of the study would request the final grades of the participants as a gauge of their academic performance. In turn, this will have to use the theories of motivation. A triangulate will be done to see the relation between the students participation in stress releasing activities, motivation theory and the measure of academic performance (participants final grade). In this case, the proponents seek to expound on that idea. The idea on how participating in stress releasing activites can actually improve the students academic performance will be further studied. The influence however will be concentrated on the academic performance of the AS Nursing student. This is facilitated in order to come up with an extensive analysis of the current situation. Statistical Analysis of Data The proponents of the study computed for the percentage, weighted mean and standard deviation. All computations are pertinent in proving the validity and reliability of the study. Since the research is dealing with nominal scores, Chi-Square test of Independence was used to find out if patients treatment preference is related to their adherence of the treatment. Another factor to be taken into account is whether their preference of the treatment yields consistent results. A chi-square test (also chi-squared or x2 test) is any statistical hypothesis test in which the sampling distribution of the test statistic is a chi-square distribution when the null hypothesis is true, or any in which this is asymptotically true, meaning that the sampling distibution (if the null hypothesis is true) can be made to approximate a chi-distribution as closely as desired by making the sample size large enough. The following formulas were employed during the course of the study. PERCENTAGE (%) %= APPENDIX NEW ENGLAND COLLEGE College of Nursing 40 Quezon Avenue, Quezon City The Effects of Stress on the Academic Performance of Nursing Students on Selected Orange County Colleges I. Profile A. Gender B. Ethnicity C. Age II. What are the stress factors affecting the academic performance of selected ASN nursing students? Perceived Stress Scale 0 = never 1= almost never 2= sometimes 3= fairly often 4=very often 1. Physical/Psychological Stressors: A. Do you have fear of failure with your academic goals? 01 2 3 4 B. Do you worry about your health? 01234 C. Do you have fear of criticisms? 0123 4 D. Does lack of confidence affect you? 0 1 23 4 E. Do you have anger problem? 0 II. Economic Stressors A. Do you think of your financial situation for matriculation? 01234 B. Do you think of your financial situation for every day expenses 01234 C. Do you deal with traffic everyday? 12 34 012 3 4 E. Do you need childcare everyday? 01234 III. Professional Stressors A. Does lack of experience affect you? 01234 B. Do you have fear of making mistakes? 01234 C. Do difficult patients affect you? 01234 D. Does lack of control affect you? 01234 E. Do you worry about harming a patient? 01234 IV. Social Stressors A. Is there a family pressure and does it affect you? 01234 B. Is there peer pressure and does it affect you? 01 2 3 4 C. Does culture affect you? D. V. Environmental Stressors: A. Does the size of classroom affect you? 01234 B. Does loud noise affect you? 0 1 2 34 C. Does overcrowding affect you? 01 D. VI. Academic Stressors 1. Does the Length of Program affect you? 2. Does the amount of homework affect you? 3.Does the Nursing Curriculum affect you? 4. Does being evaluated by faculty members affect you? 234 III. What are the effects of the stressors on the academic performance of selected ASN nursing students? Perceived Stress Scale 0 = never 1= almost never 2= sometimes 3= fairly often 4=very often I. Psychological Stressors: Do you experience any of the following when you are stressed out? a. Decrease in concentration 01234 b. Easily Burned out 01234 c. Negative emotional states 0123 d. Racing thoughts 01234 e. Anxiety/Depression 01234 II. Economic Stressors: Do you experience any of the following when you are stressed out? a. emotional distress 4 01 2 3 4 b. poor teacher-student relationship 01234 c. sleeping difficulty 01234 d. fear/anger 012 34 e. low self-esteem 01234 III. Professional Stressors: a. constant tiredness 0 1 2 34 B decrease concentration 012 34 c. Reduced work productivity 012 34 d. Difficulty making decision 012 34 e. Little interest in punctuality 01 2 3 4 IV. Social Stressors: a. Insomnia 012 b. Nervous habits 012 c. Low self-esteem 01234 d. Social Withdrawal 012 e. Isolation 34 34 34 012 V. Environmental: a. Headaches 01 34 23 4 b. Disorganization 0 12 34 c. Rapid/ Mumble speech 0 1234 d. Excess worry 012 e. Excess guilt 0 1 234 VI. Domestic Stressor a. Impulse buying 0 12 b. Weight gain 0 12 34 34 34 c. decreased appettite 0 12 34 d. increased appettite 0 1 2 34 e. Feeling of worthliness 01234 VII. Academic Stressor a. decrease in memory 0 1 23 4 b. decrease in concentration 012 34 c. lies or excuses to cover up poor work 0 1 2 3 4 d. increased frustations 0 1 2 34 e. decreased 012 34 BIBLIOGRAPHY BOOKS p.324-329 Psychology: Its Principles and Applications. 9th ed. Engle, T.I. & Snellgrove, Louis. 1989 Orlando florida Capter 15 Coping with stress Thesis: p. 12 Stress, Ways of Coping and Perceived Social Support among Medical Students By Joseline A Amigo-Ferrolino M.D. 2008 -2009 University of the Philippines MnL INTERNET PUBLICATIONS Physical/Psychological Stressors: a. fear of failure, b. health status c. fear of criticisms d. hate towards self e. II. Economic Stressors: a. Finances for matriculation b. .Finances for everyday expenses. c. Traffic d. e. Childcare III. Professional Stressors: a. lack of experience b. fear of making mistakes c. difficult patients d. discomfort at being evaluated by faculty members e. concer bout possibly harming a patient IV. Social Stressors: a. Family pressure b. Peer pressure c. Classmate conflict d. Unjust treatment e. verbal aggression V. Environmental: a. small classroom size b. limited academic supplies c. limited instructors d. weather changes e. limited parking VI. Domestic Stressor VII. Academic Stressor a. Busy schedule b. Heavy schoolload c. Examinations d. Not enough time to study e. Length of Program ... View Full Document

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