“FRONTLINERS: NURSES LIVED EXPERIENCES WORKING IN COVID-19 ISOLATION

FACILITIES AT COTABATO REGIONAL MEDICAL CENTER"

A Thesis Proposal Presented to the Faculty of the Graduate

Program of Davao Doctors College Davao City 

In Partial Fulfilment of the Requirements for the Degree of

Master of Arts in Nursing  

Major in Clinical Management 

AKIKA L. GURO, RN

December 2021
 Davao Doctor’s College
General Malvar St., Davao City
Masters of Arts in Nursing

TABLE OF CONTENTS

Chapter 1

Introduction

Background of the study 3

Purpose of the Study 5

Research Question 5

Review of Related Literature 5

Theoretical Lens 14

Importance of the Study 14

Delimitation and Limitation of the Study 15

Definition of Terms 16

CHAPTER 2 

Methodology

Research Design 17

Setting 17

Research Participants and Sampling 18

Data Sources 18

Data Collection 18

Trustworthiness of the Study 19

Role of the Researcher 21

Research Reflexibility 21

Ethical Consideration 21

Researcher’s Reflexivity 22

Data Analysis 22

REFERENCES 24

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Masters of Arts in Nursing

CHAPTER 1

INTRODUCTION

Background of the Study

Year 2020 has been a challenging time for the humanity, for all of us. A time we fear,

grieve and became desperate and this hit us hard. We all have been affected by the current

COVID-19 pandemic. So many things happened, unfortunate circumstances we never imagined.

Months of being assigned at COVID ward I have witnessed death, sadness, grief and pain. It’s

hard to see people suffer due to this virus. It’s hard for us health workers attending and seeing

pain and grief. It was honestly a heartbreaking scene; you want to do something for them but all

you can help is to give them a sincere prayer.

COVID-19 is killing people on a large scale. According to World Health Organization

(WHO), globally, as of 6:21pm CET, 26 November 2021, there have been 259,502,031 confirmed

cases of COVID-19, including 5,183,003 deaths, reported to World Health Organization (WHO).

Coronavirus disease 2019 (COVID-19) has altered the usual activities of daily living of people

since its global rapid pandemic spread since December of 2019 to date; it has created significant

weight and stressful environments for healthcare providers, especially nurses and doctors in both

hospital and community settings, where the majority of the workforce has been set out to assist in

managing and preventing the spread of this infection (Nurses’ perspectives of taking care of

patients with Coronavirus disease 2019: A phenomenological study).

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Masters of Arts in Nursing

During this global phenomena, COVID-19 pandemic has positioned front liners under

enormous and unprecedented pressure, putting mental, physical, and social well-being at

jeopardy. Exposure to excessive stress, for prolonged periods can have many harmful

consequences on the emotional and mental well-being of frontline workers (World Health

Organization). Psychological matters are not unique in the healthcare ground especially among

nurses and those who are not immune to such demanding working situations. The COVID-19

illness has caused anxiety, uncertainty, and panic as situations quickly change and particularly

when the disease is still not under control. Studies has revealed nurses and other healthcare

professionals working as front liners in times of disasters and pandemic crisis can experience

various psychological problems, especially when working in high–pressure and high–risk situations

(Sadang, 2021).

Health workers, especially nurses, plays a significant role in fighting this health problem on

both preventive and curative sides. Studies being conducted with results reported a higher level of

physical and psychological distress among nurses (Nurses’ perspectives of taking care of patients

with Coronavirus disease 2019: A phenomenological study). As Nurses being the largest and

foremost workforce front liners battling in global crisis serving 24 hours, seven days a week (24/7)

both in patient’s at bedside and in communities. From screening to hospitalization, observing and

after discharge nurses are the most in contact with suspected or confirmed COVID-19 patients.

Nurses have testified experiencing different intrinsic and extrinsic struggles and encounters in and

out of their workplaces. Some studies and literature published has revealed that nurses have

encountered anxiety, depression, burnout, stress and even work related bullying in their day-to-day

combat against COVID-19 (Sadang 2021).

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Masters of Arts in Nursing

Purpose of the Study

The purpose of this study is to create an understanding on the lived experiences of the

nurses who are working directly in Covid-19 faicilities at Cotabato Regional Medical Center, with

confirmed

cases and suspects. It aims to explore the perceived meaning and challenges of these

experiences. Further, this literature aims to promote an intervention that may help nurses in any

crisis which is

crucial in giving quality care. This study may also serve them as an avenue for them to voice their

concerns and make them feel that support is there.

Research Questions

1. What are the lived experiences of nurses who are taking care of Covid-19 positive

and suspected patients in covid facilities at Cotabato Regional Medical Center?

2. How these experiences mean to them?

3. Can these experiences may be a help to future crisis?

Review of Related Literature

Nurses serves a vital role and responsibilities during the COVID-19 pandemic. Nurses will

carry on to be at the front line of patient care in hospitals and actively engaged with assessment

and monitoring in the community. They are also involve in planning for projected COVID-19–

related outbreaks, which increase the demand for nursing and healthcare services to cope with

potential surges in patients. Moreover, nurses must maintain effective supply and usage of

sanitation materials and personal protective equipment and offer screening information,
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Masters of Arts in Nursing
confinement guidelines, and triage protocols based on the latest guidance. The American Nurses

Association’s Code of Ethics for Nurses (2015) is the definitive professional conduct norm for the

nursing field.

The code specifies that “the sole responsibility of the nurse is toward the patient.” The code also

notes that the nurse has the same obligation to themselves and to others (Fawaz et al.,2020).

As Nurses are now dynamically engaged in COVID-19 interventions, with adequate

assistance, nurses will continue to be the main players to bring an end to this global issue.

Therefore, a healthy work environment must be provided to empower their efforts to control and

manage the outbreak. An open minded environment for staff, where they will feel free to comment

on accidents such as exposure to body fluids, other infection control risks, or reports of abuse, and

to take prompt follow-up action such as providing counseling for staff members is a must. Having

appropriate infection control procedures and personal protective equipment (masks, gloves,

goggles, gowns,

hand antiseptics, soap and water, and cleaning materials) in ample amounts for personnel who

care for suspect or verified COVID-19 patients is essential that hospitals must ensure to allocate.

Staff members should also be guided on how to carry out regular self-assessments, and directed

on how to follow quarantine or isolation measures, when indicated, to protect them, their families,

and their community, as well as to safeguard their mental health and well-being (Fawaz et

al.,2020).

According to the World Health Organization (WHO, 2020), COVID-19 is a highly infectious

disease caused by a SARS-CoV 2 strain. Literature has revealed that nurses need to sacrifice

their own needs to prioritize the crisis management strategies and a need to make unselfish and

important contributions out of moral and professional responsibility. According to Sadang (2020),

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Masters of Arts in Nursing
the COVID-19 health crisis triggered an unpredicted paradigm shift in nurses’ life in healthcare

systems, resulting in stressful and overwhelming challenges in their daily battle against this illness.

One study, whose key informants are OFW nurses assigned in the COVID-19 intensive care units,

outlined a major theme one of which is, challenges during the pandemic. This comprises the

struggle of donning and doffing personal protective equipment (PPE) the feeling of anxiety on the

probability of getting infected, not meeting the standards of care and thinking about their families’

way back home

worrying about their protection. Front-line nurses experience a vast amount of work, long-term

exhaustion, infection risk, and frustration with the death of patients they care for.

Pogoy and Cutamora (2021) also stated in their study that the current COVID-19 pandemic

presents an considerable occupational susceptibility for the health care team, causing fear or

anxiety. These can be brought about by knowing or having more information and fear of the

unknown related to the virus. Fear of the unknown appears to be a fundamental fear and is a core

component of anxiety. To protect themselves with the appropriate PPE should be the number

priority of nurses. Nursing care should focus on limiting the exposure and spread of the virus

(Pogoy and Cutamora, 2021).

Taking care of COVID-19 patients was a challenge seldom faced before due to its

characteristics of rapid deterioration, pathogenicity, and high transmission rate. It was specified

that the condition of critically ill patients with the disease was very unpredictable, and that they

often had more than one complication leading to multiple organ failure demonstrated that nursing

in this emerging situation was considered with high-intensity work and fatigue which became

extremely physically and emotionally demanding when combined with excessive working hours. In

addition to difficult responsibilities of nursing, what impacted nurses and their efforts were

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Masters of Arts in Nursing
uncertainty and fear of the disease which had similarities to the reports of the previous pandemics.

It is well-known that fear can negatively impact effectiveness, or even, lead to the avoidance of

patients. Studies also showed that PPE shortage on the one hand and low usability of personal

equipment on the other hand put nurses in an uncomfortable situation, impacting their health and

performance (M.K. Danesh et al., 2020).

A study conducted by Gunawan et al,. (2021) developed seven themes. One of the theme is

being rejected and reflects the current situation that the nurses received after what they did to save

the lives of the people. Nurses are frequently well-thought of a source of viral transmission and

they are rejected by their community, peers, family members, other nurses, and health

practitioners. This creates a terrible environment for front-line nurses, and it is often the worst

situation that the nurses have experienced in their lives. Rejection happens because of the

misinformation the society may not be able to confirm. Under the theme we miss home, nurses

miss their homes after being isolated for such a long time during the pandemic. This quarantine is

a must to prevent the local transmission to the family members (Gunawan et al. 2021).

As the number of people becoming ill due to this virus increases, the scarcity of nurses and

other medical health workers is likewise increasing. In The Philippines, there is an estimated

23,000 shortfall of nurses nationwide; the situation is getting worse and most Filipinos die without

consulting a medical professional. The shortages of human resources as well as insufficiency of

medical supplies and facilities have greatly affected the delivery of effective nursing care

throughout these trying times. In response, in most hospitals working in longer shifts to

compensate for the lack of human resources, nurses are left without choice. The inadequate

number of human resources and support coming from their respective local government units were

some of the factors recognized by participants contributing to their burden in the performance of

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Masters of Arts in Nursing
their work as nurses. They were usually left with the responsibility to continue working beyond their

normal hours to compensate for the lack of human resources. Most had experienced working

continuously for 48 hours or more in their respective facilities (Sadang, 2020).

Moreover, there are insufficient monetary and logistical supports coming from the

government, especially the lack of personal protective equipment (PPE), putting them at risk of

exposure to infection; this has generated uncertainty, fear, and panic among health workers

serving as front liners throughout this crisis. According to Sadang (2020), participants revealed that

there

was a vast deficiency of basic PPE in their respective quarantine facilities which is essential for

putting a stop to the spread of this infection and protecting them from getting the virus.

Theseprotective supplies comprised but were not limited to facemasks, gowns face shields, shoe

covers and other medical needs. Nurses considered these shortcomings of their respective

facilities as essential indicator of a barrier in the provision of quality nursing care in the midst of the

pandemic. Nurses often experience heightened anxiety and work-related stress as a result of their

concern about their susceptibility to infection. Studies have revealed nurses who are assigned to

the care of COVID-19 patients were exposed to inappropriate psychological and professional

circumstances however they still managed and continued to render nursing care for their patients.

Some medical workers in The Philippines were expelled from their rented dormitories and

apartments due to tenants’ fear of being infected and were forced to look for new areas to live in

the midst of the pandemic (Sadang, 2020).

A study has reported self-fulfillment and job satisfaction as important predictors affecting

nurses’ quality of life and the services they provide in their respective workplace. Permanent and

stressful situations such as the presence of constant physical and mental exhaustion contributes to

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lack of motivation, poor engagement, and illness among nurses in their workplace. A crucial

element of individuals’ psychological well-being is a feeling of self-fulfillment and it adds to one’s

happiness when standards of success are achieved and recognized. On the other hand, job

dissatisfaction has always been the main cause and reason for significant rates of absence and

turnover among nurses in the nursing workforce, creating a major risk to the capacity of healthcare

systems to provide efficient and effective quality health services. Overall, regardless of any

circumstances, nurses often consider it a professional privilege to work during the pandemic crisis.

They believe that this is part of their pledge and a calling to their chosen profession. This result to

a similar qualitative study in

China were nurses believed that in times like the COVID-19 crisis, this is where people and their

patients needed their help and services most, they were bound by duty and their professional oath

as healthcare providers on the front line to save lives and protect the health of the community. The

COVID-19 pandemic has also created opportunities for nurses around the globe to be more

valued, and has increased the morale of the nursing profession (Sadang, 2020).

In a study conducted N. Sun et al (2020), the physical exhaustion, psychological

helplessness, health threat, lack of knowledge, and interpersonal unfamiliarity under the threat of

epidemic disease led to a large number of negative emotions such as fear, anxiety, and

helplessness, which have been reported by several studies. Therefore, early psychological

intervention is especially crucial to nurses in an epidemic. It is best to conduct stress assessment

and screening of nurses immediately after receiving the epidemic prevention tasks and to provide

professional, flexible, and continuous psychological intervention to promote emotional release and

improve nurses’ mental health. At the same time, it is important to establish early support systems,

such as adequate supplies of protective materials, reasonable allocation of human resources,

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Masters of Arts in Nursing
elderly and infant care services for nurses' families, pre-job training, and interpersonal interaction

among nurses to facilitate nurses' adaptation to the anti-epidemic tasks (N. Sun et al, 2020).

A study conducted in Hong Kong aimed to explore the experiences of registered nurses

caring for people with suspected or diagnosed COVID-19 during the first 6months of the ongoing

global pandemic, revealed that although their experiences on SARS and swine influenza

epidemics had significantly influenced hospital planning, including workflows and procedural

guidelines, during the COVID-19 pandemic, Nurses during this pandemic still needs to learn

numerous new specific protocols and guidelines, including triage criteria, transport of patients to

intensive care, nasopharyngeal swab (NPS) and nasopharyngeal aspirate (NPA) procedures, safe

handling of test

specimens, and transfer and admission of suspected or confirmed cases under quarantine. They

also reiterated the importance of nurses’ awareness of environmental contamination risks and

abiding by infection control practices more strictly, for instance the proper use of PPE and hand

hygiene. Adapting with rapidly changing guidelines and protocols posed a major challenge.

Ensuring being updated on modifications to infection control policies in response to PPE

shortages, requirements of FTOCC (fever, travel history, occupational exposure, contact history,

clustering) risk assessment, and new knowledge on disease pathology and symptoms to inform

screening, treatment and infection control. The rapid dissemination of evidence-based information

from reliable and easily available sources was also important during the outbreak , particularly text

messaging groups with hospital and ward staff, change-of shift meetings, and communication kits

prepared by the hospital authority (Chau JPC, et al. BMJ Open 2021).

According to American psychologist Richard Lazarus' stress and coping model, whether the

stressors are effective or not depends mainly on the process of cognitive evaluation and coping.

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Masters of Arts in Nursing
Cooperation and teamwork strategies was stressed by Nurses in Hong Kong as means to ensure

safety and reassurance among colleagues especially when being confronted with their own

feelings of despair and unease due to the uncertainty and unpredictability associated with COVID-

19. Regardless of such negative feelings and loneliness resulting from working at the front line of

the pandemic, the sense of professional duty, pride and responsibility, strengthened by support of

colleagues, friends and family. (Chau JPC, et al. BMJ Open 2021). Nurses who partook in self-

reflection of their own values and found positive forces such as expressing more appreciation for

health and family and gratitude for social support. It is acknowledged that coping style, cognitive

evaluation, and social support are all mediators of stress. Studies have shown that psychological

adaptation and social support play an intermediary role in psychological rehabilitation under

outbreak stress (N. Sun et al, 2020).

According to a study conducted by Sun et al, (2020), to psychologically adapt to the

situation, nurses adopted avoidance, isolation, speculation, humor, self-consciousness, and other

psychological defenses. It has been established that all coping measures under the epidemic

disaster can lessen stress and promote mental health. Generally, nurses can adjust their

reasoning to adapt to the epidemic, which may also be related to health care professionals' rich

medical knowledge and more rational and positive attitude. Nurses constantly adjust cognitive

assessment through professional knowledge to promote self-psychological balance, take the lead

to be cosiderate, seek out team support, take the initiative to reduce stress, regulate sleep, diet

and exercise to adapt to internal and external environment changes, and prevent injuries caused

by stress, which has positive implication for mental health (N. Sun et al, 2020).

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One important supporting factors is Physical and mental rewards to nurses from work units.

Nurses generally, believed that positive emotions were related to the multi-dimensional support of

patients, family members, team members, government, social groups etc. Therefore, social

support is vital for nurses in the fight against epidemics. Positive emotions also play an important

role in the recovery and adjustment of psychological trauma. Strengthening multidimensional

social support, adjusting cognitive evaluation, guiding positive coping styles, and stimulating

positive emotions are all crucial to promote the psychological health of nurses. (N. Sun et al,

2020). Nurses who have assigned to confirmed cases or witnessed patients dying from this illness

are usually experiencing more psychological pressure. These experiences from their respective

work assignment directly affects their mental health as care providers, and therefore indicates as

integral component that must be understood and be aware of during pandemic or any crisis.

Having mental health support

readily available during any crisis to meet the needs of nurses is crucial in helping alleviate their

psychological challenges and to make them feel supported by their respective organizations

(Sadang 2021).

Some concerns arise due to isolation, fears of developing symptoms and fears of having

brought the illness home to loved ones. Taking into consideration in finding an alternative

accommodation should be given to assisting staff in away from home to reduce the fear of

exposing their families. It is worth remembering what we can do for ourselves in this time of

uncertainty. Many of the habits and routine we had that helped us get through in this crisis will still

be going throughout this pandemic. It will be useful to be able to acknowledge the gravity of the

situation, noticing what is in your control and what is not. Psychological reactions to the acute and

prolonged stress of the pandemic will be common and you are likely to experience these – it does

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not mean they will last long term or that you are ‘weak’. Remember that it is the virus that kills

people, not the staff. This pandemic is a marathon and not a sprint – take your breaks, try to keep

leave and take time to ‘reset’ yourself. Although not always easy but it is important, to permit

yourself rest and reset, but here are some practical things you can try.

Starting small can be easier, eat, drink, sleep and exercise first, and try to focus on

positives and be thankful for the good things in your life, for example family and friends (Walton et

al, 2020). “Our society should now regard these individuals as ‘gold dust’ and it is our duty to

provide the support they deserve”, Walton et al, 2020.

Theoretical Lens

To create and develop an understanding on the lived experiences on nurses taking care of

Covid 19 positive and suspected patients in covid facilities at Cotabato Regional Medical Center,

the study will utilize the theory of Dorothea Orem’s which is Self-Care Deficit Theory. The self-care

deficit theory defines, this theory is helpful especially in nursing is needed because a person is

limited or incapable of providing self-care and needs help. It focuses on the performance or

practice of activities that individuals perform on their own behalf. Those might be actions to

maintain one’s life and life functioning, develop oneself or correct a health deviation or condition

(Smith et al,. 2015).

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Masters of Arts in Nursing
Another theory utilized in this study is Hildegard Peplau’s Interpersonal relations theory, this

theory studies the "personal growth" shared by both the patient and the nurse, based on the

organized interpersonal relationship in the healthcare process (de Dios-Aguado et al., 2021).

The coronavirus 2019 (COVID-19) pandemic has affected societal beliefs through exposure to the

mental toll of massive infection rates, loss of life, social isolation, and other downstream

consequences (Kverno et al., 2021). Social isolation, forced to contain coronavirus infection,

increases the risk of individuals to develop stress due to the change in daily routine, adaptation to

the new scenario, community, family and work distancing. Thus, Peplau’s theoretical principles

admit to rise above to the physical spaces of hospital institutions and can be applied in all contexts

of health care. Therapeutic communication, guided by Hildegard Peplau’s Theory of Interpersonal

Relations, can help in coping (Dal’Bosco et al,. 2020).

Importance of the Study

This literature is being develop to the advantages of the following person 1) Nurses and

health care workers in general, 2) the management/ hospital, 3) the general public. This literature

is of an

advantage to health care workers like physicians, nurses, nursing attendants, medical

technologist, dieticians and institutional workers who are also working in covid-19 facilities hence

that this study will help to enhance health care system responses to future pandemic or any crisis

by improving the preparedness through appropriate education and training. This will also provide

proper intervention and protection to their well-being so they can continue their honorable service

in fighting and eliminating this worldwide infection through in depth interview by the lived

experiences of nurses who are working at the covid facilities.

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Masters of Arts in Nursing
This literature also aims to benefit the hospital management since nures are the foundation

of any healthcare system in managing COVID-19 as such leaders may provide better importance

on the contribution of nurses by supporting and providing their needs amidst any pandemic so as

to be able to function healthy and can provide quality health care for all.

And through this literature, the general public, by being educated and being aware to the

surrounding and protocols, they are helping to prevent the infection thus generating a nurse-

patient rapport and trust. Improving the quality of care and life of one another.

Delimitation and Limitation of the Study

This study will be conducted to develop an awareness to the lived experiences of nurses

are nursing covid-19 positive and suspected patients especially in covid facilities at Cotabato

Regional Medical Center starting the surge of pandemic.

The possible limitation of this study, first, this study will be conducted during pandemic so

safety of the participants and the research will be put at risk. Proper observation of the safety

protocols will lessen probability of infection such as social distancing, faceshield and mask.

Second, the study will be conducted only at one hospital in Cotabato City which is the

Cotabato Regional Medical Center although it is referral hospital in the region there are still

different

hospital in the Philippines which makes the generalibility of the findings limited. Thismight not

represent all nurses in the Philippines so there will be a need for further studies from other regions.

Definition of Terms

Covid -19

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-Coronavirus disease (Covid-19) in an infectious disease caused by the Sars-cov-2 virus.

Most people who fall sick to covid 19 will experiences mild to moderate symptoms and

recover without special treatment. However, some will become seriously ill and will require

medical attention.

Pandemic

-A pandemic is an epidemic of an infectious disease that has spread across a large region,

for instance multiple continents or worldwide, affecting a substantial number of individuals.

Personal Protective Equipment (PPE)

-The official PPE definition from the Occupational Safety and Health Administration (OSHA)

states that personal protective equipment is any equipment worn to minimize exposure to

hazards that cause serious workplace injuries and illnesses.

Mental Health

-Mental health includes our emotional, psychological, and social well-being. It affects how

we think, feel, and act. It also helps determine how we handle stress, relate to others, and

make choices. Mental health is important at every stage of life, from childhood and

adolescence through adulthood.

CHAPTER 2 

METHODOLOGY

Research Design

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This study will utilize a descriptive phenomenological research design which will be

done through in depth, unstructured interviews performed separately by participating nurses who

are taking care of covid-19 positive and suspected patients in covid facilities at Cotabato Regional

Medical Center. This design is being use to understand, describe and explore the lived

experiences of nurses and because this is unstructured it will promote and build a bond with the

participants due to which there are high chances that the respondents will be 100% truthful with

their answers. Participants are interviewed separately to promote confidentiality and any biases.

Setting

The research will be conducted on Covid-19 facilities at Cotabato Regional Medical Center,

a tertiary level hospital with a 400 bed capacity located in RH 10 Sinsuat Avenue, Cotabato City,

Cotabato, which caters the following services: Medical, OB-Gyne, Pediatrics, Ortho-Surgery,

Oncology, Hemodialysis, and OPD services.

Figure 1. Cotabato Regional Medical Center Site Map

Research Participants and Sampling Method

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Purposive sampling will be used in this study for the selection of the participants, which will

include 10 participants who are under quarantine or post quarantine and had directly handling

covid-

19 positive and suspected patients assigned in covid facilities at Cotabato Regional Medical

Center since the start of pandemic, march of 2020.

Data Sources

Through in- depth interview shared by the 10 participants, information will be gathered. The

participants who agreed to participate in the study will be considered a primary data sources and a

structured literature review will be the secondary data source which was carried out to investigate

nurses’ challenges during the early stages of the pandemic and which will serve a supplementary

data to back up the study gathered to the primary data. Participants are interviewed separately to

adhere to safety protocols, to avoid risking researcher’s and participant’s health. Adhering also to

privacy act thus remaining animosity and confidentiality and may avoid biases of answers.

Data Collection

This study will follow through the following procedures for the data collection:

1. Secure the approval from the Master of Arts in Nursing Program Chair of Davao Doctors

College (including the authorizing body of the participating institution/s) to conduct the

study;

2. the informed consent of the participating Nurses will be secured prior to data gathering;

3. prior to data gathering, participants will be oriented about the nature of the study, its

purpose, and the data collection procedure and duration. To be included in the orientation,

as well, are the rights of the participants in the study, which will include, but not limited to,

the right to self-determination, which will speak about their voluntary decision, right to ask

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questions, right to refuse to give information, and right to withdraw from the study. The

participants’ right to privacy and confidentiality will be observed.

4. Actual data gathering will be performed.

5. The participants will be informed that the interview will be audio-recorded. The recordings

will then be transcribed word for word after the interview to ensure data accuracy. Interview

will be used in gathering data for the study.

6.The interview will be conducted separately to avoid putting risk to both the researcher and

the participants by adhering to safety protocols guided by AITF.

7. If the necessary data are gathered, the interview will end and the participant will be given

appreciation for her participation in the research study.

8. Inductive Analysis especially the Thematic Content analysis will be used to analyze the

compiled results obtained from all the participants of this study. 9) The generated themes

will be re-evaluated by the participants as a final validating step of the researcher so as to

confirm the accuracy of their intended message for the study.

Trustworthiness of the Study

A trustworthy study to be reliable, researchers must demonstrate data analysis has been

conducted in a precise and consistent manner and disclosing of the methods of analysis with

enough detail to enable the reader to determine whether the process is credible.

Qualitative research, intended to produce knowledge grounded in human experience and it

has established a distinctive place in research literature. It is also all important to conduct it in a

meticulous and methodical manner to come up with a meaningful and useful results. When

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conducting data analysis, the researcher becomes the instrument for analysis, making judgments

about coding, theming, decontextualizing the data. Each qualitative research method has specific

techniques for conducting, documenting, and evaluating data analysis processes, but it is the

individual researcher’s responsibility to assure rigor and trustworthiness (Nowell et al., 2017).

This study will utilize an unstructured interview and data gathered are analyzed through an

inductive thematic analysis. It has been long argued that thematic analysis thematic analysis

should

be a foundational method for qualitative analysis, as it provides core skills for conducting many

other forms of qualitative analysis. It is a method for identifying, analyzing, organizing, describing,

and

reporting themes found within a data set. Thematic analysis is also useful for summarizing key

features of a large data set, as it forces the researcher to take a well-structured approach to

handling data, helping to produce a clear and organized final report. To be precise, unstructured

interview resembles a conversation more than an which is focused towards the interests of the

interviewer (Nowell et al., 2017).

Since this study will utilize an unstructured interview, it will aim to gather in-depth

information and usually do not have pre-planned set of questions. The researcher and participants

will focus on interview in which the interviewer is well aware of the respondent and in times of

deviating away from the main issue the interviewer generally refocuses the respondent towards

key subject. In order to have the interview data captured more effectively, recording of the

interviews is considered an appropriate choice but sometimes it is a matter of controversy among

the researcher and the respondent but researcher will fully orient and explain all about the study

(Nowell et al., 2017). The participants have the right to refuse and back out to the if he/she will feel

violated during the data gathering.

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Masters of Arts in Nursing

Role of the Researcher

The researcher will conduct an in depth, one on one interview with the participants who are

nurses directly assigned in covid facilities at Cotabato Regional Medical Center. The researcher

will

do an unstructured interview, do observations to participants and facilitate the whole data

gathering process. The researcher will be the one responsible in the conceptualization of the data

gathering procedures. While gathering data through one on one interview researcher must ensure

and adhere to safety protocols.

Research Flexibility

Conducting a research requires an openness and a sensitivity with regard to the practical

material one finds while collecting data. These “unexpected turns of events” can become important

aspects in the process of gathering data and they can ultimately improve findings as they help

empirical sensitivity. A research can carry us in directions that we don't always foresee, and part of

being a good researcher is maintaining the flexibility necessary to explore those directions when they

present themselves (Pultz, S. 2018).

Ethical Consideration

Making certain that ethical considerations shall be observed by the researcher by securing

permission from the ethics committee and the MAN Program Chair of Davao Doctors College prior

to conducting the study. A letter of permission shall also be secured from the ethics committee and

the Cotabato Regional Medical Center.

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General Malvar St., Davao City
Masters of Arts in Nursing
Participation in the study will be observe and written consent will be secured after cautious

explanation to participants of the purpose, how it is done, their rights, benefits as well as the risk in

participating in this study, and also their right to withdraw at any time during the research process.

Discretion and right to privacy will be assured using number (e.g. N1) instead of their real identity

during the record of their responses. Health safety measures (e.g. wearing of PPE and social

distancing) as set by the Inter-Agency Task Force for Emerging Infectious Diseases (IATF-EID)

will be strictly observed throughout the conduct of this study for the safety of both researcher and

the participants.

Researcher’s Reflexivity

This study involves health care workers especially nurses. As a researcher of this study and

being a nurse who have handled and taking care of covid-19 positive and suspected patients in

covid facilities, I have witnessed and experience first-hand how this pandemic affects us in our

daily lives and in work. As a researcher I am fully aware about possible biases. Through

identifying own beliefs, judgments, and practices may help avoid any biases. By focusing solely

on the problem, creation an unintentional cerebral gridlock may be avoided. In turn, this will

improve the credibility of the study. To ensure the accuracy, it is helpful to work with coded data,

meaning that the information should be organized and labeled to identify various relationships

and themes.

Data Analysis

This study utilized the qualitative phenomenological approach to describe and explore the

meaning of nurses’ lived experiences caring for COVID-19 positive and suspected patients in covid

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Masters of Arts in Nursing
facilities at Cotabato Regional Medical Center. To analyze the conversation of the participants and

the researcher.

An in-depth, one on one interview will be conducted alongside with audio recording. The

researcher will transcribe the digital audio files. Participants will then receive transcripts to check

the accuracy with their experiences this is to avoid any biases and through this reliability will be

meet.

In this study, thematic analysis is the method to be used for analyzing data gathered. Thematic

analysis is a qualitative data that involves searching across a data set to identify, analyze, and

report repeated patterns. It is a method for describing data, but it also involves interpretation in the

processes of selecting codes and constructing themes. It also involves reading through a data set

such as transcripts from in depth interviews or focus groups, and identifying patterns in meaning

across the data (Braun and Clarke, 2006).

The process in analysis starts when the researcher begins to notice, and look for, patterns

of meaning and issues of potential interest in the data – this may be during data collection. The

endpoint is the reporting of the content and meaning of patterns (themes) in the data, where

themes are abstract constructs the investigators identify before, during, and after analysis. Writing

begins in phase one, with the jotting down of ideas and potential coding schemes, and continue

right through the entire coding or analysis process (Braun and Clarke, 2006).

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Masters of Arts in Nursing

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