Incidence of Burnout Experience Towards Work Among Staff Nurses of Cotabato Regional and Medical Center

A Thesis Presented to the Faculty of

Cotabato Medical Foundation College,Inc.

In Partial Fulfillmentof the Requirements for the

Bachelor of Science in Nursing

Pamela Joy A. CabreraOctober ,2013

Chapter I

INTRODUCTION

Burnout, a term heard with increasing frequency these days, is

becoming a prominent fact of life in the fast-paced and stress-filled

21stcentury. People in all walks of life are experiencing burnout, and many

end up losing their jobs, their health, and sometimes their families because of

it. Some even commit suicide as a way of escape. Since almost everybody

will experience burnout to a certain degree in some stages of life, one may

ask what exactly burnout is, what the warning signs are, how to deal with it

and what can be done in order to prevent it.

Nevertheless, work stress and burnout remain significant concerns in

nursing, affecting both individuals and organizations. For the individual nurse,

regardless of whether stress is perceived positively or negatively, the

neuroendocrine response yields physiologic reactions that may ultimately

contribute to illness. In the health care organization, work stress may

contribute to absenteeism and turnover, both of which detract from the

quality of care. Hospitals in particular are facing a workforce crisis. The

demand for acute care services is increasing concurrently with changing

career expectations among potential health care workers and growing

dissatisfaction among existing hospital staff. By turning toxic work

environments into healthy workplaces, researchers and nurse leaders

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believe that improvements can be realized in recruitment and retention of

nurses, job satisfaction for all health care staff, and patient outcomes

particularly those related patient safety.

The aim of this study is to determine the incidence of burnout among

staff nurses of Cotabato Regional and Medical Center. Since the said

hospital, is one of the busiest hospitals in the city, therefore, nurses are

prone to burnout. This could benefit the nursing staff of the said institution

and this could also be a great help in handling burnout incidence.

Statement of the Problem

This research aimed to determine the incidence of burnout towards work

among staff nurses of Cotabato Regional and Medical Center.

Specifically, it sought to answer the following questions:

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

1.1 sex

1.2 age

1.3 marital status

1.4 length of service in years

1.5 area of assignment

1.6 number of hours worked in a week ( including overtime )

1.7number of patients handled in a week

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2. What is the Incidence of Burn-out experience towards work among the

Respondents in terms of:

2.1 psychological stress

2.2 physical stress

2.3 emotional stress

Theoretical Framework

This study is anchored on the Theory of Hans Selye, a pioneer in the

study of stress and disease, described stages of adaption to a stressful

event: alarm, resistance, and exhaustion. In the alarm stage, the body

senses stress and the CNS is aroused. The body releases chemicals to

mobilize the fight-or-flight response. Epinephrine and nor epinephrine, along

with other hormones causes an increase in heart rate, increased force of

heart contractions, increased oxygen intake, and increased mental activity.

The release of these substances is the adrenalin rush associated with panic

or aggression. In the resistance stage, the body either adopts and achieves

homoestasis (which lead to recovery) or fails to adopt and enters the

exhaustion stage, resulting in disease.

Supported by Betty Neuman’s adaptation theory (Neuman and

Fawcett, 2002), a community health nurse and clinical psychologist,

developed a model based on the individual’s relationship to stress, the

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reaction to it, the reconstitution factors that are dynamic in nature.

Reconstitution is the state of adaption to stressors. Neuman categorizes

stressor as intra-personal stressors those that occur within the individual;

interpersonal stressors, those that occur between individuals; and extra

personal stressors, those that occur outside the person. The individual’s

reaction to stressors depends on the strength of the lines of defense. When

the lines of defense fail, the resulting reaction depends on the strength of the

lines of resistance. As part of the reaction, a person’s system can adopt to a

stressor, an effect known as reconstitution.

Lazarus Transactional Stress Theory encompasses a set of cognitive,

affective, and adaptive coping responses that arise out of person-

environment transactions. The person and the environment are inseparable;

each affects and is affected by the other. Lazarus “referred stress to any

event in which environmental demands, internal demands, or both tax or

exceed the adaptive resources of an individual, social system, or tissue

system.” The individual responds to perceived environmental changes by

coping responses.

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Conceptual Framework

Independent Variable Dependent Variable

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Figure 1: Shows the variables considered in the study of Incidence of Burnout Experience Towards Work among Staff Nurses of Cotabato Regional and Medical Center.

In many situations in our daily lives, often find ourselves experiencing

burnout, suppressing feelings and displaying a more socially accepted

emotion. Indeed burnout literature, substantial research in this field

addresses unfavorable outcomes. This study anchored on the Theory of

Hans Selye, Betty Neuman and the Theory of Lazarus. This study

conceptualizes that the incidence of burnout experienced towards work of

staff nurses of Cotabato Regional and Medical Center is the independent

variable and the dependent variable in terms of their burnout experienced,

are psychological stress, the physical stress and the emotional stress.

General Adaptation Syndrome Theory

Transactional Stress Theory

Adaptation Theory

Incidence Burnout experience in terms of:Psychological stressPhysical stressEmotional stress

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Assumption

This study assumed that staff nurses have a different burnout

experiences towards work regarding stress that may affect them.

Scope and DeLimitation of the Sudy

This study is focused on the incidence of burnout experiences towards

work among staff nurses of Cotabato Regional and Medical Center. The

main respondents of the study are the staff nurses in this hospital.

Significance of the Study

This study is significant to the following population:

To the staff nurses, that they should be aware of their strengths and

weaknesses; be open and willing to learn and change for health care.

improvement of self, the quality of nursing care, and of the profession. To

have better understanding and appreciation of their legitimate and social

roles and functions for them to maximize their effort in providing quality

nursing care.

To the patients, that they may receive quality services and achieve

satisfaction;

To the hospital administrators, to have a better insight into the

stress management of nursing personnel in relation to the hospital’s

standards of health care.

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To the researcher the finding of this study serves as their reference

on formulating this study.

To the future researchers, that they may utilize this study as basis

and references if they are planning to conduct similar study.

Definition of Terms

For the clarity of terms used in this study, the following are defined

operationally.

Burnout Experience. It refers to prolonged stress at work resulting from a

variety of stressors that either individually or together lead the nurse to

experience burnout.

Cotabato Regional and Medical Center. It refers to the tertiary hospital

where the research will be conducted.

Emotional stress. It refers to a condition which occurs when a person is

under stress affecting their emotions.

Incidence. It refers to the rate or range of occurrence of influence or

something.

Physical stress. It refers to relating to the body as distinguished from the

mind or spirit.

Psychological stress. It refers to what people feel when they are under

mental, physical or emotional pressure.

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Staff Nurse. It refers to a Registered Nurse who was currently employed in

this hospital.

Work. It refers to what staff nurses do their job.

Chapter II

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents pertinent reading and studies taken from books,

electronics, journals, published and unpublished articles, these dissertations.

This theories, concept and resources are significantly.

Burnout

Burnout is a psychological term for the experience of long-term

exhaustion and diminished interest. Research indicates general

practitioners have the highest proportion of burnout cases; according to a

recent Dutch study in Psychological Reports, no less than 40% of these

experienced high levels of burnout. Burnout is specified as a “State of vital

exhaustion” under "Problems related to life-management difficulty"

The term can be used to refer to different parts of lives, but usually is

in reference to one’s work life. Burnout may be seen by coworkers as the

effects of personal conflict or the lack of enjoyment of one’s job (Maxfield,

2005). Sadovich, 2005 has found that work excitement effects burnout. This

assessment may be correct; yet, true burnout goes much deeper. Stress in

the workplace does affect one’s personal stress levels just as stress in one’s

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personal life can affect workplace stress (Hurley, 2007). However, it takes

feeling unrelenting stress over a long period of time to finally lead to the

result of burnout (Altun, 2002)

Burnout is frequently related to emotional feeling. For example, main

Components of the burnout syndrome include exhaustion and

depersonalization. Another major component of burnout is feelings related to

personal achievements (Taormina, 2000). Pines, (2004) describes burnout

as being related to attachment styles. She finds that the more secure, rather

than anxious or avoidant, the adult’s attachment style, the more likely the

participant would notice causes of burnout and be less likely to experience

burnout. Maslach, (2001) further defines burnout as a type of mental illness.

Other researchers agree that burnout is related to mental health in

addition to its other life effects. There are physical, social, and organizational

or environmental as well as mental effects from and on burnout (Wu, 2007).

Burnout causes feelings of depression, fatigue, loss of sense of humor,

dissatisfaction, and ability to be alert and learn (Billeter-Koponen & Fredén,

2005).

The burned out employee feels as though there is too much work to

do and feels Unappreciated. Burnout results in poor work performance and

severe mental and physical symptoms such as mental and physical

exhaustion, feelings of hopelessness, poor health in general, boredom, and

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low self-esteem (Altun,2002). Schneider, (2007) goes on to suggest possible

severe consequences of burnout including coronary disease, heart attack,

asthma, hostility, suicidal feelings, and uncontrollable crying.

All of these symptoms affect each part of one’s life, work and

personal. They have the potential to change life such that it may not return to

the way it was before the burnout experience. As humans who experience

stress we are all subject to these consequences. (Schneider,2007).

Nursing Is Stressful

Nursing is a profession that is particularly vulnerable to stress

Augusto, (2008) explains that nurses’ stress results from the hospital

environment itself. The nature of nursing and patient care are identified as

stressful by Milliken, (2007). Specifically, the emotional work required while

working with patients is stressful to the nurse who must be emotionally

available and participatory while maintaining control over emotions.

In reflecting on her own experience, Beech, (2007) explains that the

stress of nursing can be felt at home as well. She reflects on often being

asked health-related questions and to provide nursing care even while off

duty and trying to rejuvenate. Nursing is a stressful career and that stress

definitely spills over from work life into home life.

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Stress is Related to Burnout

This frequent stress along with the lack of effectively dealing with

stress can lead to burnout (Altun, 2002) Specifically, Garrosa, (2008) found

that an increase in nursing job stressors can increase the tendency toward

burnout. Increasing burnout led to greater job stress, less satisfaction, and

poorer performance.

Nursing is stressful and this stress can lead to burnout. Burnout starts

with one nurse feeling stressed, and without proper interventions the stress

builds and can lead to burnout. The burnout of one nurse, and thus the loss

of one nurse from the team, leads to more work for the remaining nurses.

This extra workload can cause stress on the remaining nurses which may

build and lead to another nurse’s burnout (Sadovich, 2005).

Nursing is Related to Burnout

The nursing profession has been identified to be at a great risk for

burnout Demerouti, (2000) has identified that a great cause of stress and

emotional taxing is experienced when caring for people and dealing with

patient’s concerns and feelings.

This describes a specific stress in nursing that leads to the general

link to increased risk for burnout. Aiken, (2002) found that over 40% of the

nurses studied were experiencing burnout. Burnout is obviously a well

identified problem considering all of the research that is available.

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Significance of Nursing Burnout

Burnout is related to several different factors and varies depending on

the nurse and environmental factors. As the age of the nurse increases, the

amount of experience of emotional exhaustion and depersonalization

decreases and environmental factors (Patrick & Lavery, 2007). The risk for

burnout decreases with increasing age and experience. Overtime work has

been found to lead to burnout with mandatory overtime and unpaid overtime

causing more severe burnout results.

The risk of experiencing burnout increases quickly as the number of

patients per nurse increases. When a nurse is responsible for zero to four

patients the chance of burnout is greater than 50%. If the number of patients

increases to five to eight, the risk for burnout increases to about a two-thirds

chance. If the number of patients increases to nine to twelve and to greater

than thirteen, the risk for burnout increases to 80% and 100%, respectively

(Sheward, 2005). Billeter-Koponen, (2005) found that nurses with the most

patients were twice as likely to be burned out as those with the least patients,

confirming the significance of staffing levels on nurse satisfaction.

There are conflicting findings on the overall satisfaction of nurses. On

the one hand, Patrick and Lavery, (2007) found about 89% of nurses were

happy with nursing as their career choice. Buerhaus, (2005) found similar

results with 87% of nurses were satisfied being a nurse.

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Patient care is becoming more difficult as the length of stay shortens.

Since patients are not in the hospital as long, the time they do spend in acute

care is while they are quite ill (Lacey & Shaver, 2002). With the nursing

shortage, patient safety is threatened and the quality of care is decreased

(JCAHO, 2002).

Causes of Burnout

There are many different things that contribute to the onset of burnout.

Some are related to individual characteristics or values. Emotional

intelligence can lower stress and burnout (Augusto , 2008). Moral distress or

the pains that come from not being able to do what the nurse thinks is right

can lead to burnout (Pendry, 2007).

Other causes of burnout can include dealing with emotions of patients

and families and a lack of effective coping strategies (Wong, 2001). Nurses

have different preferences as to what they need to feel fulfilled professionally

(Takase, 2005). Some of the differences in needs are related to generational

differences in nurses (Rivers, 2005). Having a lot of responsibilities in the

nurse’s social and private life can create added stressors that can lead to

burnout in this professional nurse (Glasberg, 2007).

Many other causes of burnout are related to the work environment

(Oddie &Ousley, 2007). Working long hours and unfairness in working

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conditions can lead to burnout in staff (American Institute of Stress, 2008).

Similarly, being shown a lack of respect from staff and management

(Khowaja, 2005); and a poor relationship between nursing staff and doctors

can lead to burnout.

Nursing staff also can be affected by burnout when they do not feel

they are a part of the decision-making process (American institute of Stress)

or feel they lack power to have an effect (Manojlovich, 2007). Signs of a lack

of respect from patients and families such as expressions of violence can

also cause for burnout (Andrews, 2005).

A major cause of stress among nurses is staffing that does not allow

for enough staff to adequately care for the number of patients (AACN, 2005;

Glasberg, 2007) Aiken, (2002) found that an increase of one patient per

nurse in a hospital increased burnout in nurses by 23%.

Burnout can be caused by heavy workload (Khowaja, 2005) high

patient acuity, lack of autonomy, and feeling insufficiently trained for the job.

Some nurses feel as though there is not enough time to provide the nursing

care that meets the standard the nurse desires (McGrath, 2003). This lack of

time can lead to going through the day task by task rather than by holistically

caring for the patient (Wong, 2001).

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Some nurses may have a difficult time prioritizing due to a high workload

and patient acuity (Glasberg, 2007). Adding to stresses that can cause

burnout are low morale, reduced resources and being required to

perform administrative duties (Wong, 2001) Nurses find completing paper

work stressful too, because it takes time away from the patients and patient

care (Rivers, 2005).

Along with all of these stresses is the stress of society’s demands,

which, not unlike the nurses’ desires, seem to be different from what is

possible (Glasberg, 2007). Nurses have anxiety about possibly making a

mistake and do not feel they have the social support needed to prevent or

recover from a mistake (Wong, 2001).

Burnout Prevention Measures for the Nurse

Since there are so many causes of burnout, there are also many ways

the nurse can help prevent and treat burnout for his or her self. A lack of

clinical knowledge can cause stress that leads to burnout, so being up to

date with clinical knowledge is important to prevent burnout. The nurse can

be certain to learn and practice how to use all equipment needed for the job

(Augusto, 2008). Staff nurses should have social support, whether it is from

coworkers or from individuals outside the profession, nurses need someone

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who will listen and be supportive (Espelan, 2006).The nurse may benefit by

addressing any issues with coworkers to maintain a low stress environment

(Augusto, 2008). Nurses need their coworkers to share their frustrations and

receive the support and encouragement needed to help combat burnout.

Negative relationships with coworkers make nurses feel lonely and

lead to burnout (Đlhan, 2008). Lateral violence in nursing is a negative

response of the nurse to the stressful environment although it is directed

toward an innocent coworker. This leads to the spread of the feeling of

powerlessness (Sheridan-Leos, 2008).

Nurses can help by working on being assertive. Assertive

communication includes positive and constructive communication between

staff, rather than threatening, or abusive (Garrosa, 2008), conflictive

interaction is a major predictor of burnout. Each nurse can work on self-

improvements to help protect him or herself from burnout. The nurse can

work on maintaining a steady emotional level by learning to control his or her

emotions (Augusto, 2008). Also, furthering education has been shown to help

prevent burnout. Found that nurses with tertiary level education have better

coping skills. Increasing the knowledge of coping skills will itself help

maintain a healthy mental status (Wong, 2001).

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Every nurse should be aware of signs and symptoms of burnout and

be able to identify it and get help early in the process (Espeland,

2006).Personality traits can also be a risk for burnout. A hardy personality

can diminish one’s risk. The nurse needs to work on being open to change

and being resilient to help prevent burnout (Garrosa, 2008). Hodges, (2008)

found that nurses who were able to continue learning and growing into a

professional nurse despite the discrepancies and discouragements they face

showed self-efficacy, wisdom, and professionalism.

New nurses find differences between what they learned in school and

what they had believed nursing to be, and with real nursing. They find

discouragements as they continue through the learning process and as they

learn which co-workers can and cannot be turned to for support and

questions.

Those nurses who focus on the positive experiences through which

they have come and continue in the field will develop better coping strategies

along with self-efficacy, wisdom, and professionalism. These nurses will

become resilient and will likely stay in the profession as they have developed

their fit within nursing (Hodges, 2008).The nurse can prevent burnout by

noticing and changing how he or she treats him or herself. Nurses should

consider setting realistic goals and prioritizing work.

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The nurse may work to develop a positive attitude and work to

maintain it; controlling one’s own thoughts can help decrease stress. The

nurse may consider learning to not be too hard on him or herself (Espelan,

2006) and helping to keep the spirit light by adding humor into life (Beech,

2007).

The nurse can reduce burnout by learning how to be assertive and

practicing this skill. The nurse may choose to practice communication while

being aware of values and biases to ensure effective communication (Altun,

2002). A nurse may be often asked to help family and friends. Each nurse

can set boundaries and know when to stop and put oneself first (Beech,

2007).

The nurse may choose to be sure to get enough rest and to eat well

and exercise since a healthy body and mind can best deal with stress

(Beech, 2007) The nurse can help prevent burnout in oneself by helping to

create an overall healthy work environment (AACN, 2005). If possible, the

nurse may try to always work the same shift to reduce stress (Winwood,

2006). If nothing seems to reduce the stress and progression toward burnout,

the nurse may need to change jobs in order to maintain his or her health

(Espeland, 2006).

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Burnout Treatment Measures for the Nurse

In addition to the preventative measures discussed, there are also

some treatment measures the nurse can apply if burnout is already in

process. Improving coping skills may help reverse burnout (Browning, 2007);

Changing one’s thoughts to be more positive can help maintain health

(Wong, 2001). The nurse can also change his or her self-expectations to help

relieve burnout. Other ways to reduce stress are to practice delegation skills

and use them, and to say “No” when the nurse feels overloaded (American

Institute of Stress.).

Ways of Coping with Burnout

Research in the field of burnout started as an attempt to make sense

of what front line health workers were experiencing at work. Along with it

grew a body of research and literature on how to ameliorate the stress

placed on health care providers (Leiter, 2005). This led to proliferation of

strategies such as stress management programs and research on their

efficacy. coping as “constantly changing cognitive and behavioral efforts to

manage specific external and internal demands that are appraised as taxing

or exceeding the resources of the person”.

They emphasize a process-based approach to coping and propose a

transactional model that views the person and the environment in a dynamic,

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mutually reciprocal, bidirectional relationship. Leiter, (2005) have outlined

strategies for improving one’s relationship with work and align them with six

areas of work life (workload, control, reward, community, fairness and

values).

Emotional Exhaustion

Emotional exhaustion is a chronic state of physical

and emotional depletion that results from excessive job and/or personal

demands and continuous stress. It describes a feeling of being emotionally

overextended and exhausted by one's work. It is manifested by both

physical fatigue and a sense of feeling psychologically and emotionally

"drained". (Ghalandari, 2012), job burnout construct was formulated to reflect

the psychological response to repeated emotional and interpersonal stress

on the job. There have been three principal characterizations of burnout.

The original measure, the Maslach Burnout Inventory (MBI),

conceptualized burnout in service work as having three dimensions:

emotional exhaustion, depersonalization and reduced personal

accomplishment. Emotional exhaustion reflects a chronic feeling that one is

overtaxed and exhausted by the emotional demands of a job.

Depersonalization captures the degree to which one distances and

disconnects themselves from others. Eventually, diminish personal

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accomplishment is characterized by negative self-assessment on the job.

Emotional exhaustion is a main component of burnout, which refers to

individual’s “feelings of being emotionally overextended and drained by one’s

contact with other people”.

Job Satisfaction

Describes how happy an individual is with his or her job. The happier

people are within their job, the more satisfied they are said to be. Logic would

dictate that the most satisfied (“happy”) workers should be the best

performers and vice versa. Employee satisfaction, more frequently known as

job satisfaction, is described as both a global construct and a multi-

dimensional concept used most frequently in industrial-organizational

psychology when researching employee behavior and organizational

effectiveness.

Roelen , (2008) point out that there is no ‘gold standard’ of overall job

satisfaction therefore it is necessary to look at all facets of satisfaction when

considering measuring job satisfaction. Price describes satisfaction as a

degree of emotion that individuals have toward the organization or the

system.

Therefore, if an employee has positive sentiments towards the

organization, then the job satisfaction levels will be higher. If the individual

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does not feel an emotional attachment to the organization job dissatisfaction

can occur. Locke developed his own definition of job satisfaction around the

same time as Price. Locke in his studies of industrial and organizational

psychology.

Stress

According to Spielberger, Vagg & Wasala (2003), stress is recognised

as a complex process that consist of three major mechanisms: sources of

stress that are encountered in the work environment, the perception and

appraisal of a particular stressor by an employee, and the emotional

reactions that are a response to perceiving a stressor as threatening.

Spielberger’s State-Trait (ST) model of occupational stress focuses on the

perceived severity and frequency of occurrence of two major categories of

stressors, i.e. job pressures and lack of support (Spielberger, 2003).

Stress resulting from work is described as the mind-body arousal

resulting from physical and psychological job demands. If a stressor is

perceived as threatening then the person may react with anger and anxiety

and this leads to the activation of autonomic nervous system. If the reaction

continues to be severe, the resulting physical and psychological strain may

cause adverse behavioural consequences (Spielberger, 2003).

24Emotional intelligence

Emotional intelligence is concisely defined as “an ability to recognize

the meanings of emotions and to reason and problem solve on the basis of

them,” and it involves “the capacity to perceive emotions, assimilate emotion-

related feelings, understand the information of those emotions and manage

them”. Mayer and Salovey’s Theory essentially connects the main

components of emotions with intelligence at the same time preserving the

two distinct terms. As such they proposed that emotional intelligence involves

the ability to carry out accurate reasoning about emotions and the ability to

use emotions and emotional knowledge to boost thought (Ghalandari, 2012).

A Professional Nurse

Nursing is gaining recognition as a profession. Profession has been

defined as an occupation that requires extensive education or a calling that

requires special knowledge, skill, and preparation. Professionalism refers to

professional character, spirit or methods. It is a set attributes, a way of life

that implies responsibility and commitment. And, professionalization is the

process of becoming professional, that is, of acquiring characteristics

considered to be professional. (Kozier, 2004).

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Synthesis:

Burnout is a familiar term for today‟s health care professionals with

emotional, psychological, physical, and social consequences for those who

experience it. It leads to job dissatisfaction, low organizational commitment,

absenteeism, as well as inter personal conflict in teams and patient care.

Burnout happens when there is lack of intervention with a Stress. Stress

happens to anyone.

Most stressors affect family, work pressures, heavy workload and their

work environment. Some facts about stress said it can be relieved by

breathing exercises, plan a vacation, be honest about how you feel and

should learn how to balance life. And for the Staff Nurses to beat up stress,

time management, better sleeping habits, general health improvement and

most of all therapeutic effective technique or regimen to manage stressful

event in life.

The prevalence of perceived stress seems to be high among staff

nurses in this said institution, which tend to affect not only their performance

but all aspects how to deal to their work. Based on the above premise, this

research aims to study the Incidence of burnout experienced towards work

among staff nurses of Cotabato Regional and Medical Center.

Chapter III

Methodology

This chapter includes the research design, respondents of the study,

research locale, sampling technique, the data gathering instrument, research

procedures and the statistical treatment of the data.

Research Design

This study aimed to know the incidence of burnout experience among

staff nurses of Cotabato Regional and Medical Center. Thus, this study

employed a non-experimental descriptive research design. It described the

Incidence of burnout experience to the respondents psychologically,

physically, and emotionally.

Respondents of the Study

The respondents of this study were 91 staff nurses of Cotabato

Regional and Medical Center using total enumeration. Specifically, the

participants were conveniently selected from the entire population of hospital

nurses of CRMC. And to come up with a more reliable and comparative

result, the participants came from different assigned areas or wards.

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Research Locale

The research was conducted in a hospital institution at Cotabato City,

the Cotabato Regional and Medical Center (CRMC). It stands as the only

tertiary hospital in Central Mindanao with 400-bed capacity and its services

are categorized as Tertiary and classified as a General Hospital. CRMC

workforce is composed of 65 doctors, 91 nurses, 80 administrative

personnel, and accommodates student affiliates such as student nurses and

midwifery students. It is composed of different wards and special units. It also

covers the whole region and accepts referrals from different provincial

hospitals. It has the most number of hospital nurses here in Mindanao thus,

the hospital caters a large number of patients all over region XII and is one of

the busiest hospital in the city where nurses are prone to burnout.

Sampling Technique

This study utilized the non probability sampling technique in selecting

the respondents. The respondents were chosen purposively sampling

method based on the Incidence burnout experience in terms of

psychological, physical and emotional. A total of 91 staff nurses were

considered in the study as the population.

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Research Instrument

The research instrument used in gathering the data was a survey

questionnaire. The set of questionnaire was composed of two parts. Part I,

contains the demographic profile of the respondents which includes; sex,

age, marital status, length of years in service, area of assignment, number of

hours work in a week and number of patients handled in a week, the Part II,

contains the incidence of burnout experience among staff nurses of Cotabato

Regional and Medical Center in terms of psychological stress, physical stress

and emotional stress.

Research Procedure

The study was conducted, with a formal request letter sent to ask

permission from the chief administrator of Cotabato Regional and Medical

Center. When it was granted, a convenient date/time was scheduled for the

survey. The researcher gave the participants specific instruction to answer

the questionnaires individually, and as honest as possible, informing them

that their answers would be confidential. This is to ensure accuracy and

validity in the data gathered by establishing trust. Then the data was

organized for analysis.

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Statistical Treatment

To answer the questions proposed in this study, the data were

subjected to statistical treatment. The data gathered was consolidated and

tabulated. For the first Research Problem, the data on the demographic

profile of the respondents was analyzed by using descriptive measure likes

frequency and percentage distribution. For Problem number 2 the incidence

of burnout experience in terms of psychological stress, physical stress and

emotional stress were determined by using the frequency, percentage and

measures of central tendency were used with the weighted mean.

To determine the incidence of burnout experience for Problem 2, the 4-point

scale below will be used:

Number Description Range of Mean1 – Never (not done at all) .50-1.49

2 – Sometimes (done once in a while)

1.50-2.49

3 – Always (consistently done) 2.50-3.49

The Level of Significance on the tests will be 0.05. All computations will be

done through the aid of a Scientific Calculator.

Chapter IV

PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter includes the presentation, tabulation, analysis,

interpretation of the data collected from the 91 staff nurses of Cotabato

Regional and Medical Center from the different areas of assignment.

Table 1

Frequency and Percentage Distribution of the Staff Nurses According to Gender

Gender Frequency PercentageFemale 59 65

Male 32 35Total 91 100

Table 1 shows the frequency and percentage distribution of the staff

nurses according to gender. Apparently, it reveals that majority (65%) of the

respondents are female and (35%) are males.

Table 2

Frequency and Percentage Distribution of the Staff Nurses According to AgeAge Frequency Percentage

24-28 22 2429-33 22 2434-38 25 2739-43 12 1344-48 8 849-53 2 2Total 91 100

Table 2 indicates the frequency and percentage distribution of the staff

nurses according to age. It reveals that most of the staff nurses are within

31

the age bracket of 29-33 years old and 34-38 years old both with the same

total frequency of 25 and with a percentage of 27 percent, It is followed by

the respondents who belong to the age bracket of 24-28 in age with the

frequency of 22 and with the equivalent percentage of 24. As for the age

bracket of 39-43, the total frequency is 12 and its percentage is 13. For the

staff nurses under the range of 44-48, the frequency is 8 and its percentage

is 8. Then, for the staff nurses within the age bracket of 49-53, the frequency

is 2 and the percentage is 2.

Table 3

Frequency and Percentage Distribution of the Staff Nurses According to Marital Status

Marital Status Frequency PercentageMarried 60 66Single 31 34Total 91 100

Table 3 reflects the frequency and percentage distribution of the staff

nurses according to marital status. It reveals that majority of the staff nurses

66 percent are married and 34 percent of the staff nurses are single.

Table 4

Frequency and Percentage Distribution of the Staff Nurses According to Length of Years in Service

Length of years in Service Frequency Percentage1-5 18 20

6-10 26 2911-15 24 2616-20 18 2021-25 4 426-30 1 1Total 91 100

32

Table 4 presents the frequency and percentage distribution of the staff

nurses according to length of years in service. It reveals that 26 staff nurses are

within the length of 6-10 years in service with a percentage of 29, It is followed by

those who are 11-15 years in service with a frequency of 24 and with a percentage

of 26. There were 18 0r 20% of nurses who have been in service for 1-5years, so

with those who have been in service 16-20 years in service for which got a

frequency of 18 and or a percentage of 20. The staff nurses who have served for

21-25 years obtained a frequency of 4 and or a percentage of 4. Nevertheless one

staff nurses have been in service for 26-30 years.

Table 5

Frequency and Percentage Distribution of the Staff Nurses According to Areas of Assignment

Area Of Assignment Frequency Percentage

Oncology 4 4.4Surgery Ward 7 7.7NICU 5 5.5Pedia Ward 9 9.9Intensive Care Unit 2 2.2Out Patient Department 4 4.4OB Ward 9 9.9Operating Room 8 8.8Medicine Ward 8 8.8Delivery Room 9 9.9Ortho 5 5.5Hemodialysis 3 3.3PIAD 1 1.1Heart Station 1 1.1P-Ward 6 6.6Emergency Room 10 10.9Total 91 100

Table 5 shows the frequency distribution of the staff nurses according

to areas of assignment. It indicates that 10 staff nurses work in emergency

33

room with a percentage of 10.9. It is followed by those who worked at pedia,

ob, and delivery room with the same frequency of 9 and with a percentage of

9.9; followed by the staff nurses assigned in the operating room and

medicine ward with the frequency of 8 and with a percentage of 8,8; for the

surgery ward with a frequency of 7 and with a percentage of 7.7; followed by

P-ward with a frequency of 6 and with a percentage of 6.6; And for staff

nurses assign in NICU and ortho areas with the frequency of 5 and and with

a percentage of 5.5; for oncology areas and in opd department with a

frequency of 4 and with a percentage of 4.4; In the area of hemodialysis with

a frequency of 3 and with a percentage of 3.3; Then, for the area of icu with a

frequency of 2 and with a percentage of 2.2. Nevertheless in area of heart

station and piad with the frequency of 1 and a percentage of 1.1.

Table 6

Frequency and Percentage Distribution of the Staff Nurses According to Number of hours worked in a week (including overtime)

Number of hours worked in a week (including overtime)

Frequency Percentage

36-45 29 3246-55 10 1156-65 44 4866-75 8 9Total 91 100

Table 6 indicates the frequency and percentage distribution of the staff

nurses according to number of hours worked in a week (including overtime).

It reveals that most of the staff nurses worked 56-65 hours in a week with the

total frequency of 44 and with a percentage of 48. It is followed by the staff

34

nurses worked in 36-45 hours in a week with a frequency of 29 and a

percentage of 32. Then, for the staff nurses worked in 46-55 hours in a week

with a frequency of 10 and with a percentage of 32. Nevertheless, the staff

nurses worked 66-75 hours in a week with a frequency of 8 and a percentage

of 9.

Table 7

Frequency and Percentage Distribution of Staff Nurses AccordingTo Number of patients handled in a week

Number of Patients Handled in a week

Frequency Percentage

1-30 23 25.331-60 10 10.961-90 15 16.5

91-120 13 14.3120150 17 18.7151-180 9 9.9181-210 4 4.4

Total 91 100

Table 7 reflects the frequency and percentage distribution of staff

nurses according to number of patients handled in a week. It reveals that 23

staff nurses handling 1-30 patients in a week with a percentage of 25.3. It is

followed by 17 staff nurses handling 120-150 patients with a percentage of

18.7.Then, followed by 15 staff nurses handling 61-90 patients in a week

with a percentage of 16.5. For 13 staff nurses handling 91-120 patients in a

week with a percentage of 14.3. Then 10 staff nurses handling 31-60 patients

in a week with a percentage of 10.9. For 9 staff nurses handling 151-180

patients in a week with a percentage of 9.9. Nevertheless, For the 4 staff

35

nurses handling 181-210 patients in a week with a percentage of 4.4. Nurses

with the most patients were twice as likely to be burned out as those with the

least patients, confirming the significance of staffing levels on nurse

satisfaction. (Billeter-Koponen, (2005)

Table 8

Frequency and Mean Distribution of the Incidence of Burnout Experienced of Staff Nurses in terms of Psychological Stress

Psychological Stress N S A Mean Interpretation1.Felt anxious when stressed 13 78 0 1,85 Sometimes2. Anger arise when stressed 33 44 14 1.79 Sometimes3. Feel depress when stressed 78 5 8 1.23 Never4. Feel easily embarrassed when stressed 73 14 4 1.24 Never5. Forgetfulness occur when experiencing stress 28 49 14 1.84 Sometimes6. Able to concentrate with what is doing; when feel stress 14 63 14 2.0 Sometimes7. Feel hopeless when in stress 3 88 0 1.96 Sometimes8. Turn to work or other substitute activities to occupy mind on things

76 14 1 1.17 Never

9. Stress causes a low self-esteem 90 1 0 1.0 Never10. Feel psychologically drained 74 16 1 1.19 Never11. Feel weak when stressed 17 61 13 1.95 Sometimes12. Feel easily tired when stressed 7 71 13 2.06 Sometimes13. Feel stress when noisy environment trigger 30 58 3 1.70 Sometimes14. Feel stress when seeing schedule of duty 0 80 11 2.12 Sometimes15. Maintain balance between professional and personal

0 9 82 2.90 Always

Grand Mean 1.73 Sometimes

Table 8 states frequency and mean distribution of the incidence of

burnout experienced towards work among staff nurses of Cotabato Regional

and Medical Center in terms of psychological stress. It reveals that staff

nurses maintaining balance between professional and personal got the

highest mean which is 2.90 described as always; With regard to the staff

nurses experiencing stressed seeing scheduled of duties It then got the

mean of 2.12 and described as sometimes; Next to it is the mean of 2.06

36

which indicates that the staff nurses do sometimes experienced feeling tired

and stressed; Furthermore it also shows that sometimes the staff nurses able

to concentrate with what is doing when feel stressed with the mean of 2.0;

However it reveals that the staff nurses sometimes experienced hopeless

when in stress as it gets 1.96 mean; Then 1.95 mean which indicates that

they sometimes experienced weak when stressed; Also, they Feeling

anxious when stressed described as sometimes and it then got the mean of

1.85; They sometimes experienced forgetfulness when stressed and it has

1.84 mean; Apparently, the staff nurses sometimes experienced anger when

stressed as it gets the mean which is 1.79; Next to it is the mean 1.70 which

shows that staff nurses sometimes experienced stress when noisy

environment trigger; Then 1.24 mean which indicates that they never easily

embarrassed when stressed; Furthermore it also shows they never

experienced depression when stressed as it has the mean of 1.23; Also the

staff nurses turn to worked or other activities to occupy mind on things which

is supported by the mean of 1.17 and described as never; On the other hand

the staff nurses never experienced psychologically drained and it has the

mean of 1.16; Lastly they never experienced stressed that causes a low self-

esteem with the mean of 1.01.

Generally, the grand mean in this table is 1.73. It only shows that the

staff nurses do sometimes experienced in terms of psychological stress.

37

Burnout causes feelings of depression, fatigue, loss of sense of humor,

dissatisfaction, and ability to be alert and learn (Billeter-Koponen & Fredén,

2005).

Table 9

Frequency and Mean Distribution of the Incidence of Burnout Experienced of Staff Nurses in terms of Physical StressPhysical Stress N S A Mean Interpretation1 .Engage in physical activities 16 68 7 1.90 Sometimes2. Maintain therapeutic relationship with clients 0 0 91 3.0 Always3. Set realistic goals for self 0 2 89 2.97 Always4. Take direct action to get around the problem 0 5 86 2.94 Always5. Restrain myself from doing anything too quickly 0 70 21 2.23 Sometimes6. Provide care round the clock 0 1 90 2.98 Always7. Work the same shift versus Different shifts 0 75 16 2.17 Sometimes8. Create a healthy work environment 0 1 90 2.98 Always9. Ensure adequate staffing 1 1 89 2.96 Always10. Lack of recognition of good work 73 18 0 1..19 Never11. Maintain Sense of humor when stressed 3 71 17 2.15 Sometimes12. Maintain sense of control over work responsibilities

1 66 24 2.25 Sometimes

13. Feel stress when you lack of sleep 13 74 4 1.90 Sometimes14. Feel stress when physical pain occurs 19 69 3 1.82 Sometimes15. Feel headache when stressed 30 60 1 1.68 SometimesGrand Mean 2.34 Sometimes

Table 9 shows frequency and mean distribution of the incidence of

burnout experience towards work among staff nurses of Cotabato Regional

and Medical Center in terms of physical stress. It reveals that maintained

Therapeutic relationship with clients got the highest mean which is 3.0

described as always; with regard to Providing care round the clock the staff

nurses do always with the mean of 2.98; Also they always create a healthy

38

worked environment got the mean of 2.98; Howevever, Setting realistic goals

for self got the mean of 2.97 and described as always; They always ensure

adequate staffing and it has a mean of 2.96; Apparently the staff nurses do

always take direct action around the problem as it gets the mean which is

2.94; Next to it is the mean of 2.25 which indicates that the staff nurses do

sometimes maintained sense of control over work responsibilities; Then 2.23

mean which indicates that they sometimes restrained myself from doing

anything too quickly; Furthermore it also shows that the staff nurses

experienced work the same shift versus different shifts with the mean of 2.17;

Also, they sometimes maintained sense of humor when stressed and it then

get the mean of 2.15; With regard to the staff nurses they engaged in

physical activities it then got the mean of 1.90 and described as sometimes;

They sometimes experienced stress when you lack of sleep and it has 1.90

mean; Also, they sometimes experienced stress when physical pain occurs

and it then get the mean of 1.82; On the other hand the staff nurses

sometimes experienced headache when stressed and it has the mean of

1.68; Nevertheless, they sometimes experienced lack for recognition for

good work as it gets the mean of 1.14.

Overall, the grand mean in this table is 2.34; it only shows that staff

nurses do sometimes experienced burnout in terms of physical stress.

Burnout results in poor work performance and severe mental and physical

39

symptoms such as mental and physical exhaustion, feelings of

hopelessness, poor health in general, boredom, and low self-esteem

(Altun,2002).

Table 10

Frequency and Mean Distribution of the Incidence of Burnout Experienced of Staff Nurses in terms of Emotional StressEmotional Stress N S A Mean Interpretation1.Have a less ability to Handle emotions 11 80 0 1.87 Sometimes2. Feel emotionally drained 90 1 0 1.01 Never3. Force myself to stay calm even though feel angry deep inside

4 86 1 1.96 Sometimes

4. Try to get emotional support from friends and relatives

1 88 2 2.01 Sometimes

5. Have so much to do on my job that in takes me away from my personal interest

2 88 1 1.98 Sometimes

6. Pretend to be happy even though feel sad deep inside

57 34 0 1.37 Never

7. Have enough time to do what is important on my job

0 80 11 2.12 Sometimes

8. Feel exhausted at work 0 12 79 2.86 Always9. Covered up true feelings when dealing with patients feelings

0 91 0 2.0 Sometimes

10. Get upset and let my emotion out 72 19 0 1.20 Never11. Feel stress when their are problems at home arises

1 90 0 1.98 Sometimes

12. Feel stress when emotional pain occurs 7 84 0 1.92 Sometimes13. Experience palpitation when stressed 82 9 0 1.09 Never14. Maintain professional Identity and values 0 20 71 2.78 Always15. Maintain self-awareness and self monitoring 0 19 72 2.79 AlwaysGrand Mean 1.92 Sometimes

The Table 10 indicates frequency and mean distribution of the

incidence of burnout experience towards work among staff nurses of

Cotabato Regional and Medical Center in terms of psychological stress. It

reveals that experienced exhausted at work got the highest rank which mean

40

is 2.86 described as always; With regard to the staff nurses maintained self-

awareness and self-monitoring it then got the mean of 2.79 and described as

always; Next to it is the mean of 2.78 which indicates that the staff nurses do

always Maintained professional identity and values; Furthermore it also

shows that the staff nurses have enough time to do with what is important on

my job with the mean of 2.12 described as sometimes; However, it reveals

that the staff nurses sometimes tried to get emotional support from friends

and relatives as it gets 2.01 mean; Then 2.0 mean which indicates that they

sometimes covered up true feelings when dealing with patients; Also, they

have so much to do on the job that it takes away from my personal interest

described as sometimes and it then get the mean of 1.98; They sometimes

experienced stress when there are problem at home arises and it has 1.98

mean; Apparently, the staff nurses sometimes forced myself to stay calm

even though feel angry deep inside as it gets the mean which is 1.96; Next to

it is the mean 1.92 which shows that staff nurses sometimes experienced

stress when emotional pain occurs; Then 1.87 mean which indicates that

they sometimes have less ability to handle emotions; Furthermore it also

shows that the staff nurses pretending to be happy even though feel sad

deep inside with the mean of 1.37; Also, they experienced upset and let my

emotion out described as never and it then get the mean of 1.20; In addition

to that, staff nurses experienced palpitation when stressed got the mean of

41

1.09 which mean that they only experienced sometimes; Lastly, they never

experienced emotionally drained got the lowest mean of 1.01.

In this table, the grand mean is 1.92, reveals that Incidence of burnout

experienced by staff nurses of CRMC they sometimes encountered in terms

of emotional stress. Burnout is frequently related to emotional feeling. For

example, main components of the burnout syndrome include exhaustion and

depersonalization. Another major component of burnout is feelings related to

personal achievements (Taormina, 2000)

Table 11Incidence of Burnout Experienced towards Work among staff nurses of

CRMC in terms of:Mean Interpretation

Psychological Stress 1.73 Sometimes

Physical Stress 2.34 Sometimes

Emotional Stress 1.92 Sometimes

Grand Mean 1.99 Sometimes

Table 11 reveals the summary on the incidence of burnout

experienced towards work among staff nurses of Cotabato Regional and

Medical Center. It shows that the Incidence of burnout experienced by staff

nurses in terms of physical stress is sometimes as indicated by a mean of

2.34. Next is emotional stress gives a mean of 1.92 and described as

42

sometimes. Then, Psychological stress a mean of 1.73 and describe as

sometimes.

Overall, the grand mean is 1.99. It only shows that staff nurses

sometimes experienced burnout of worked in Cotabato Regional and Medical

Center.

Chapter V

Summary, Conclusion and Recommendation

This chapter presents the summary of the study, findings of the study,

conclusions derived from the study and recommendation based on the

findings and conclusions.

Summary of the Study

This study aimed to find out the Incidence of Burnout experience

towards work among staff nurses of Cotabato Regional and Medical Center.

Specifically, this study sought to answer the following questions.

1. What is the demographic profile of the staff nurses in terms of:

a. sex

b. age

c. marital status

d. length of years in service

e. area of assignment

f. number of hours worked in a week (including overtime)

g. number of patients handled in a week

2. What is the Incidence of Burnout Experienced towards work among staff

nurses in terms of:

a. psychological stress

b. physical stress

c. emotional stress

44

Findings of the study

The following where the findings of the study conducted:

1. The demographic profile of the staff nurses is presented in the study. It

reveals that majority of the staff nurses are females (65%); majority of the

staff nurses are 29-33 years of age and 34-38 years of age (27%); majority of

them are married (60%); majority of them are 6-10byears in service (26%);

majority of them are in emergency room department; majority of them worked

at 56-65 hours in a week including overtime (48%); majority of them have 23

number of patients handled in a week (25.2%) and they are selected as total

enumeration.

2. Moreover, the incidence of burnout experienced towards work among staff

nurses in terms of psychological stress reveals a mean of 1.73 which is

described as sometimes, with regard to physical stress it indicates a mean of

2.33 which is describe as sometimes. As for emotional stress it signifies a

mean of 1.92 which is describe as sometimes.

Conclusions:

Based on the findings presented and discussed in this study the

researcher concluded that the incidence of burnout experience towards work

among staff nurses of CRMC indicates a grand mean of 1.99 which

corresponds of its experienced as sometimes.

45

Recommendations:

After drawing the conclusion based on the findings of the result of the

study, the researcher highly recommends the following:

To the Staff Nurses. This study recommends to the staff nurses that they

should have self-evaluation of their strengths and weaknesses to evaluate

their strong and weak points for individual efficiency. This will be beneficial

for their own self improvement and for the betterment of quality nursing care

that standard to their profession

To the Patients. This study recommends to the patients that in return they

may be considerate also of the nurse’s feelings most especially during busy

times at work; or they should not overact or over seek nurses attention and

they will understand that there are also other patients needing the nurse’s

care in the hospital.

To the Hospital administrator. This study recommends to the hospital

administrator that they should have a better insights into the stress

management of nursing personnel of the hospital should conduct a regular

performance evaluation with the staff nurses for individual improvement.

To the Future Researcher.This study recommends to the future researcher

that they may be able to study the Incidence of burnout experienced of staff

46

nurses in other hospitals aside from Cotabato Regional and Medical Center

hospital in Cotabato City. And they should include in the research instrument

the coping management that they may be able to come up with a widely

acceptable theory about burnout of a staff nurses to possess. And this study

may serve as their source in their research.

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CURRICULUM VITAE

Name: Pamela Joy A. Cabrera

Nick Name: “Pam” or “Joy-Joy”

Age: 23 years old

Date of Birth : August 09, 1989

Place of Birth : Cotabato City

Address : Zone4, PC Hill Cotabato City

Religion : Roman Catholic

Civil Status: Single

EDUCATIONAL ATTAIMENT:

Elementary : PC Hill Elementary School

High School : Notre Dame RVM College of Cotabato

College : Cotabato Medical Foundation College,Inc.

Course : Bachelor of Science in Nursing

SEMINARS AND TRAINING

Basic Life Support Training

A Seminar in Best Practices on Managing Eye Emergencies

A Seminar on Caring with Disability

A Seminar in Cancer Care Management

A Seminar in Nutrition Facts For a Balanced Personality: A must for Young Adults

A Seminar in Management for Children with Special Needs

A Seminar in ECG Reading and Common Emergency Drugs.

TABLE OF CONTENTS

TITLE PAGE ....…………………………………………………………..…….. i

TABLE OF CONTENTS…………………………………………………............ii

LIST OF TABLES……..…………………………………………………………. iiii

Chapter I INTRODUCTION

Background of the Study.……………………...….……………..1

Statement of the Problem ……………..………...……............. 2

Theoretical Framework ……………………………...…….…... 3

Conceptual Framework .…………………………...………...…. 5

Assumption of the Study ………………………………………...6

Scope and Delimitation of the Study....……………...…...…... 6

Significance of the Study .…………………………...………..... 6

Definition of Terms ...…………………………………….…....... 7

Chapter II REVIEW OF RELATED LITERATURE AND STUDIES

Burnout.................................................................................... 9

Nursing is Stressful.....................…. ..…….............……..........11

Stress is Related to Burnout.……..…...................................... 12

Nursing is Related to Burnout….……………….……..........…..12

Significance of Nursing Burnout..................…….…................ 13

Causes of Burnout................................................................... 14

Burnout Prevention Measures for Nurses............................... 16

Burnout Treatment Measures for the Nurse............................ 20

Ways of Coping with Burnout.................................................. 20

Emotional Exhaustion............................................................ 21

Job Satisfaction....................................................................... 22

Stress...................................................................................... 23

Emotional Inteligence.............................................................. 24

A Professional Nurse............................................................... 24

Synthesis ....…………………………………………….…….......25

Chapter III METHODOLOGY

Research Design .............………………………………………. 26

Respondents of the Study .....………………………………….. 26

Research Locale.........................………………………….........27

Sampling Technique…………………………………………...... 27

Research Instruments ..……………………………………….... 28

Research Procedure................................................................28

Statistical Treatment .………………………………………........29

Chapter IV PRESENTATION, ANALYSIS, AND NTERPRETATION

OF DATA ………………………………………………….….......30

Chapter V SUMMARY, CONCLUSIONS, RECOMMENDATIONS

Summary of the Study ...………………………………………... 42

Findings of the Study ..………………………………………......43

Conclusions ...……………………………………………………. 44

Recommendations ....………………………………………….... 45

BIBLIOGRAPHY

APPENDICES

A. Letter to the Chief of Hospital

B. Letter to the Respondents

C. Research Instrument

CURRICULUM VITAE

LIST OF TABLES

Table Pages

1 Frequency and Percentage Distribution of the Staff Nurses

According to Gender…………………………………………………..........30

2 Frequency and Percentage Distribution of the Staff Nurses

According to Age………….……………………........................................ 30

3 Frequency and Percentage Distribution of the Staff Nurses

According to Marital Status……….………………………………….....…. 31

4 Frequency and Percentage Distribution of the Staff Nurses

According to Length of Years in Service................................................. 31

5 Frequency and Percentage Distribution of the Staff Nurses

According to Area of Assignment............................................................32

6 Frequency and Percentage Distribution of the Staff Nurses

According to Number of Hours Worked in a week (including overtime).. 33

7 Frequency and Percentage Distribution of the Staff Nurses

According to Number of patients Handled in a week............................. 34

8 Frequency and Mean Distribution of the Incidence of Burnout

Experienced of Staff Nurses in terms of Psychological Stress............. 35

9 Frequency and Mean Distribution of the Incidence of Burnout

Experienced of Staff Nurses in terms of Physical Stress...................... 37

10 Frequency and Mean Distribution of the Incidence of Burnout

Experienced of Staff Nurses in terms of Emotional Stress.................... 39

11 Incidence of Burnout Experienced towards Work among Staff

Among Staff Nurses of Cotabato Regional and Medical Center.......... 41

APPENDIX A

LETTER TO THE CHIEF OF HOSPITAL

Cotabato Medical Foundation College Inc.Midsayap ,Cotabato

Dr. Helen P. Yambao, MD, FPOG, FSGOPChief of Hospital IIICotabato Regional and Medical CenterCotabato City

Thru: Jorge L. Padilla, MD Research Committee Chairman Cotabato Regional and Medical Center

Dear Doctor/ Ma’am:

Greetings of Peace.

I, the undersigned fourth year nursing student of the College of Nursing, Cotabato Medical Foundation College, Inc, and currently undertaking the study entitled “Incidence of Burnout Experience Towards Work Among Staff Nurses of Cotabato Regional and Medical Center”, would like to ask permission to conduct a survey from your institution. The staff nurses of different wards will be our respondents in the said study.

Rest assured that all data will be dealt with utmost care and confidentiality.

Thank you and God bless!

Respectfully yours,

Pamela Joy A. CabreraThe Researcher

Noted by:

Dr. Romulo M. Garcesa Mrs. Edelweiss P. Jaum, RM, RN,MAN Adviser Dean of College of Nursing

APPENDIX B

LETTER TO THE RESPONDENT

Dear Sir/ Maam:

Good day!

I, a student of College of Nursing, Cotabato Medical Foundation College, Inc, and currently conducting a research study entitled” Incidence of Burnout Experience Towards Work Among Staff Nurses of Cotabato Regional and Medical Center” would like to have a survey in your institution as part of the fulfillment of the requirements for the degree of Bachelor of Science in Nursing.

Rest assured, all information will be kept confidential.

Thank you very much for your cooperation and support.

Respectfully yours,

Pamela Joy A. Cabrera The Researcher

Noted by:

Dr. Romulo M. Garcesa Mrs. Edelweiss P. Jaum, RM, RN,MAN Adviser Dean of College of Nursing

------------------------------------------------------------------------------------------------------CONSENT FORM

I would like to signify my intentions to (please check the appropriate line below)

______ Participate in the said study

______ Not participate in the said study (Please state your reason for not participating)

_________________________ Name and Signature (optional)

APPENDIX C

Research Instrument

“Incidence of Burnout Experience Towards Work Among Staff Nurses of

Cotabato Regional and Medical Center”.

I. Demographic Profile of the Respondents. Your honest answers are

highly appreciated. Rest assured that all responses will be treated

confidentially.

Name: ____________________________ (Optional)

Sex: M [ ] F [ ] Age: ____

Marital Status:_____________

Length of Years in Service: ______ Area of assignment: __________

Number of hours worked in a week (including overtime ): _________

Number of patients handled in a week:______________________

II. Instruction. Please complete the following by encircling one

number that corresponds to your incidence of burnout in terms of

psychological stress, physical stress and emotional stress. The

rating scale ranges from;

3 – Always 2 – Sometimes 1 – Never

Psychological Stress 1 2 3

1. Felt anxious when stressed. 1 2 3

2. Anger arise when stressed 1 2 3

3. Feel depress when stressed. 1 2 3

4. Feel easily embarrassed when stressed. 1 2 3

5. Forgetfulness occurs when experiencing stress. 1 2 3

6. Able to concentrate with what is doing, when feel stress. 1 2 3

7. Feel hopeless when in stress 1 2 3

8. Turn to work or other substitute activities to occupy

mind on things. 1 2 3

9. Stress causes a low self-esteem. 1 2 3

10. Feel psychologically drained. 1 2 3

11. Feel weak when stressed. 1 2 3

12. Feel easily tired when stressed. 1 2 3

13. Feel stress when noisy environment trigger. 1 2 3

14. Feel stress when seeing schedule of duty. 1 2 3

15. Maintain balance between professional and personal lives. 1 2 3

Physical Stress

1. Engage in physical activities. 1 2 3

2. Maintain therapeutic relationship with clients. 1 2 3

3. Set realistic goals for self. 1 2 3

4. Take direct action to get around the problem. 1 2 3

1 2 3

5. Restrain myself from doing anything too quickly. 1 2 3

6. Provide care around the clock. 1 2 3

7. Work the same shift versus different shifts. 1 2 3

8. Create a healthy work environment. 1 2 3

9. Ensure adequate staffing. 1 2 3

10. Lack of recognition for good work. 1 2 3

11. Maintain sense of humor when stressed 1 2 3

12. Maintain sense of control over work responsibilities 1 2 3

13. Feel stress when you lack of sleep. 1 2 3

14. Feel stress when physical pain occurs. 1 2 3

15. Felt headache when stressed. 1 2 3

Emotional Stress

1. Have less ability to handle emotions. 1 2 3

2. Feel emotionally drained. 1 2 3

3. Force myself to stay calm even though

feel angry deep inside. 1 2 3

4. Try to get emotional support from friends and relatives 1 2 3

5. Have so much to do on my job that it takes me away

from my personal interest. 1 2 3

31 2

6. Pretend to be happy even though feel sad deep inside. 1 2 3

7. Have enough time to do what is important on my job. 1 2 3

8. Feel exhausted at work. 1 2 3

9. Covered up true feelings when dealing with

patient’s feelings. 1 2 3

10. Get upset and let my emotion out. 1 2 3

11. Feel stress when their are problem at home arises. 1 2 3

12. Feel stress when emotional pain occurs. 1 2 3

13. Experience palpitation when stressed. 1 2 3 14. Maintain professional identity and values. 1 2 3

15. Maintain self-awareness and self-monitoring. 1 2 3

-Thank you and God bless.-