Coping with Stress during the COVID-19 Crisis: The Case of the BS Nursing Students of

Manuel V. Gallego Foundation Colleges, Inc.

Rosalyn B. Bilog, MAN1, Iluminada B. Santos, MM2, Ferwin P. Precenillo2, Paul Adrian C.
Batas2, Jobelle J. Salac2 and Mario S. Suba, PhD3
Dean, Institute of Nursing and Allied Health Sciences, Manuel V. Gallego Foundation Colleges, Inc.
1
2
Faculty, Institute of Nursing and Allied Health Sciences, Manuel V. Gallego Foundation Colleges, Inc.
3
Director of Research, Manuel V. Gallego Foundation Colleges, Inc.

Abstract
This action research aimed to find out; (1) the stress experienced by the BS Nursing
students of MVGFCI during the COVID-19 pandemic crisis; (2) the effects of stress caused by
COVID-19 on students' attitude to school life and responsibilities; (3) the stress coping strategies
used by BS Nursing students of MVGFCI and its influence on their attitude towards school life
and responsibilities and; (4) to recommend an action plan to improve the stress coping strategies
of students in a healthy way during and immediately after the COVID-19 pandemic crisis. Mixed
methods research design was used and 22 BS Nursing students participated in this study. The
result showed that BS Nursing students expected the inability to comply with requirements due
to limited access to WiFi, learning resources, and connection to their classmates. Meanwhile,
stress affected their class standings, attitudes towards their life, perception of their surroundings,
and inability to focus on their priorities. Their best coping strategy is to set goals that would help
their studies especially in finishing their academic requirements.
Keywords: stress, coping, COVID-19, action plan

Stress is the first step in developing a
possible psychological disorder when not
properly addressed and taken care of. Today,
most people feel stress because of the
pandemic and everyone has their way of
coping. Whenever there is a perceived threat
or danger, our body automatically activated
the fight or flight response. Fight or flight
response is a set of physical and
psychological responses that help us fight a
threat or flee from it. The physiological
response/changes result from the activation
of two systems controlled by the
hypothalamus; the autonomic nervous
system and adrenal-cortical system while the
psychological responses to threat
characterized by emotional, cognitive, and
behavioral responses occur. Fight or flight
response enables an individual whether to
face the perceived threat (to fight) or escape
from it (to flight).
COVID-19 indeed brought too many
fears to people because COVID-19 is not an
imagined danger, the risk is real. It may
affect everyone if it is taken for granted.
However, a fight or flight response can lead
to decisions that would not keep us safer and
may make things worse. It is because fear
has another unfortunate side (uchealth.org).
COVID-19 caused chaos, especially
in the medical field. Medical workers from
doctors to housekeeping are the front liners
providing medical assistance to the COVID-
19 patients. As the cases continue to rise,
bed spaces in the hospitals have been fully
occupied leading into difficulties in
admitting and curing patients.
However, aside from difficulty in the
admission of the COVID-19 patients, the
continuous increase of mental health
problems needs to be addressed as well.
Some predictions were made that the third
wave of COVID-19 is mental health
problems. Mental health is defined by the
World Health Organization (WHO) as "a
state of well-being in which an individual
realizes his or her abilities to cope with the
normal stresses of life, to work productively

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and to make contribution to his or her family
and community."
Mental Health amidst COVID-19
In a survey conducted by Social
Weather Stations (SWS) last July 3 to 6,
2020, 86% of the Filipinos said that
COVID-19 brought them too much stress
(newsinfo.inquirer.net). Based on the same
survey, junior high school graduates
experienced great stress than the other
participants.
Premier Value Provided Inc. or PVP
conducted a similar survey by SWS, in
which it measured the effect of pandemic
and community quarantine on the workers in
the Philippines. 450 employees served as
participants and the survey was conducted
from May 5 to 16, 2020. Results showed
that the level of stress, anxiety, and
depression of people were quite alarming. It
also showed that millennials and generation
Z employees were the most affected.
Employees who are in a work from home
setup reported a higher level of anxiety and
depression compared to those who work on-
site (onenews.ph).
Depression, on the other hand also
affects Filipinos amidst COVID-19. WHO
reported that the Philippines have one of the
highest rates of depression in Southeast
Asia, affecting more than three million
Filipinos.
Suicide is one of the possible results
of stress especially now that we have a
pandemic crisis. Suicide reports due to
depression are sad manifestations of the
negative mental health effects caused by
COVID-19 (Gorecho, 2020;
businessmirror.com.ph).
Emotional and financial stressors are
the common risk factors of suicide;
emotional stressors such as worrying too
much, overthinking, anxiety, panic attacks,
etc… and financial stressors like having no
work, getting fired at work, deduction due to
2
skeletal workforce are common problems we
experienced now according to the news.
These stressors can be linked to COVID-19.
Similarly, the Center for Disease Control
and Prevention (2015), identified several
factors that may increase a person's risk of
attempt and even complete suicide. These
factors are previous suicide attempts, history
of depression or other mental illness, alcohol
and drug abuse, family history of suicide or
violence, physical illness, and feeling alone.
The same observation was noted by Nadine
J. Kaslow (2014), in her study which shows
the different risk factors of suicide on a
young person. These are serious loss of
loved ones, mental disorder (particularly
mood disorders), hopelessness, guilt,
worthlessness, previous suicide attempts,
disciplinary problems, high-risk behaviors
and even sexual orientation confusion.
Another contribution to the above
study was done by the World Health
Organization in 2014. According to the
study, the lowest suicide cases were noted
among the school-age population with 15
years of age while the highest are those in 70
years of age or above for both sexes. The
report also shows that all those suicide rates
are at their peak among young adults but
will subside during middle age. The
Philippine Psychiatric Association also
added that suicide incidence is high in young
adults with age ranges from 15-24 years old.
Stress and Coping Mechanisms
Stress may be interpreted as
negative, however, stress can also be
positive; it is called eustress. According to
the renowned guru in Clinical Psychology,
Selye in 1974, eustress is pleasurable
satisfying experiences; it is positive stress.
Stress and coping are intertwined. Stress can
be psychologically positive or negative, and
the means of coping can be effective or
ineffective in meeting the challenge
presented by the stressful situation.
 Another expert in coping
mechanism, Folkman & Lazarus (1980),
defined coping mechanisms as cognitive and
behavioral efforts to master, reduce, or
tolerate demands. Likewise, Matheny,
Aycok, Pugh, Curlette, & Silva-Cannella
(1986) defined coping as "any effort,
healthy or unhealthy, conscious or
unconscious, to prevent, eliminate, or
weaken stressors, or to tolerate their effects
in the least hurtful manner".
Further, if an individual feels stress,
coping mechanisms will immediately follow
regardless of how useful it is or not. Some
people feel stress and choose an unhealthy
coping mechanism and some people
healthily use coping mechanisms.
Recently, the World Health
Organization listed some coping
mechanisms amidst COVID-19. These are;
talking to trusted people, contact family and
friends, stay at home and maintain a healthy
lifestyle, do not use smoking, alcohol, or
other drugs to deal with emotion, limit
worry and agitation, and seek professional
help.
In recent news, the government asks
the help of religious leaders to help aid the
overwhelming mental health issues.
Stress and its effects on Academic
Attitude of the Students
Students also had difficulties
adjusting and coping with the stress brought
by the COVID-19. It may decrease their
motivation to go back to school or when
they return to school, it might affect their
academic performance. It is important for
them to address the stress they have
experienced during community quarantine
and how they deal with it so that the
institution will come up with an intervention
program to improve the stress coping
strategies of students during and
immediately after the COVID-19 pandemic
crisis.
3
Stress can greatly affect the
academic attitude and performance of the
student. They might get anxious coming
back to school and lose their drive to learn.
Gunnar (1998) called this academic stress.
Academic stress is already present before
the COVID-19 pandemic. He defined it as
the anxiety and stress that comes from
schooling and education. Some academic
stressors are studying homework, tests, labs,
reading, and quizzes. There is the stress of
doing all of the work, balancing the time,
and finding time for extra-curricular
activities. In our current situation, those
academic stressors may cause them a lot of
burden because of the strict guidelines of
IATF. Due to limited face-to-face classes,
the educational institutions shifted to
flexible-learning system (FLS). This new
setup of teaching-learning process
minimizes the possibility of acquiring a
virus. However, this is challenging not only
to the teachers but also to the students.
Regardless of what is happening in
the world, the resiliency of the Filipinos is
still evident today. Even though we are
wearing masks, we still manage to smile and
the joy can be seen through the eyes.
Stressors are everywhere thus coping
mechanisms are. Amidst what is happening
to the world, it is better to figure out the best
and healthy coping mechanisms to prevent a
bigger problem.
Based on the findings from the
related studies, the researchers find it
important to determine the stress-related
experienced among BS Nursing students of
MVGFCI and determine the stress coping
strategies used by them to come up with an
action plan to improve their stress coping
strategies.
The study also addressed one of the
major health research thrusts as articulated
in the 2020 MVGFCI Health Research
Agenda which is “Clinical characterization
and management of disease caused by the
virus”.
The same study can also be
replicated in other institutes of MVGFCI to
address its mission to provide opportunities
and avenues for students to experience
quality life while in school.
Objects of the Study
This study aims:
1. To find out if the BS Nursing
students of MVGFCI experience stress
during this COVID-19 pandemic crisis.
2. To find out the effects of stress
caused by COVID-19 on students’ attitude
to school life and responsibilities.
3. To find out the stress coping
strategies used by BS Nursing students of
MVGFCI and their influencing effect on
their attitude towards school life and
responsibilities.
4. To recommend an action plan to
improve the stress coping strategies of
students in a healthy way during and
immediately after the COVID-19 pandemic
crisis.
Significance of the Study
Identifying the various forms of
stress experienced by the college nursing
students at MVGFCI during the early part of
the pandemic brought by COVID 19 and the
effects of these stresses to the respondents
provided the researchers the basic
information in instituting appropriate
strategies/measures to improve the coping
strategies of the students to alleviate the
effects of the COVID-19 crisis. The school
can use the results of this action research in
formulating policies that can cushion the
impact of the pandemic on the lives of the
students, side by side with concerned units,
i.e., student services office and the medical
services unit. Likewise, the faculty can be
coached in developing teaching strategies in
alleviating the effects of the pandemic to
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facilitate effective learning conditions for
their students amidst the crisis.
Conceptual Framework
The conceptual framework (Figure
1) indicated the focus of this research. This
study determined stress experienced by the
nursing students and its effects on their
attitude to school life. People during this
stressful time tend to use their coping
strategies to overcome their stressors.
Moreover, the students coping strategies and
the effects of stress on their academic
responsibility and attitude are also
determined in this research. Furthermore, the
data gathered from the study (stress
experienced by BSN students, effects of
stress, and coping strategies) was used to
make an action plan to improve the stress
coping strategies of students during and
immediately after the COVID 19 pandemic
crisis.
Figure 1. Conceptual Framework
Methodology
All students across year levels
enrolled in the BS Nursing program of
MVGFCI during the first semester of the SY
2021-2022 were the respondents of this
action research. A survey questionnaire
developed by the team of researchers were
utilized to answer the statement of the
problem of this study. The same were sent
via Google form to all student respondents
and they were given ample time to answer
and send back the accomplished survey
questionnaire to the researchers.
 The questionnaire was composed of I. During the early part of the quarantine
three major parts. The first part is made up period (ECQ) in the province of Nueva
of five statements to enumerate and describe Ecija, I expected the following.
the numerous types of stress experienced by Verbal
the students during the early part of the Statement Item Mean Interpretati
# 
on
quarantine period. Each statement was rated
Having
by the respondents using the 4-point Likert
difficulty
Scale where: moderately
1 communicating 1.80
1.0 to 1.75 – disagree agree
with my
1.76-2.50 – moderately agree mentors;
2.51-325 – agree Inability to
3.26 – 4.0 – strongly agree comply with
The second part with 6 items requirements in
identified the effects of stress in the 2 school due to 3.07 agree
respondents’ lives. The last part consists of limited access
15 statements that enumerate the coping to WIFI
strategies employed by the students to connections;
alleviate their stress during the lockdown Connection with
moderately
3 my classmates 1.85
period. agree
is challenging
All the data collected were analyzed Resources
using descriptive statistics (mean and (journals,
standard deviation) using SPSS. books, and e-
materials) to
Results and Discussion complete my
4 3.00 agree
Table 1 shows the respondent’s requirements for
experiences during the quarantine period. all the courses I
With regards to the respondent's am currently
enrolled in are
expectations during the quarantine period,
limited; and
they agreed that they expected not to comply
Conflict with
with the requirements in the school due to oneself due to
limited access to WIFI connections 5 inability to 1.50 disagree
(x=3.07). Aside from limited access to address personal
internet connection, respondents agreed that issues
they have limited resources to complete their  
moderately
requirements (x=3.00). They also find it General Weighted 2.24
agree
difficult connecting with their classmates Mean:
and mentors with a mean of 1.85 and 1.80 Legend:
respectively. Although in general, they 1.0 to 1.75 – strongly disagree
experienced difficulties in their academics, it 1.76 to 2.5 moderately agree
2.51 to 3.25 – agree
is noteworthy that they conflict with
3.26 to 4.0 – strongly agree
themselves due to their inability to address
personal issues having the lowest mean of
The effects of stress were seen in
1.50.
their class standing due to limited resources
got the highest mean with (x=3.20) followed
Table 1. Stress experienced during by their ability to focus on priority, attitude
Quarantine Period towards life, and perception of everything

5
around me having a similar mean of 3.13. students tried to stay calm and developed a
While the relationship with their significant healthy coping strategy amidst the COVID-
people and spiritual connection was least 19 pandemic.
affected by stress with a mean of 1.50 (Table
2). Table 3. Coping Strategies of BS Nursing
Students
Table 2. Effects of Stress in the III. To cope up with the stress I am
Respondent’s Life experiencing, I do the following:
II. The stress that I experience affects my..: Verbal
Mea
Verbal #  Statement Item Interpreta
Me n
# Statement Item Interpretatio tion
an Talk about my
n
Ability to focus on 3.1 problems with a
1 agree strongly
my priorities; 3 1 support person 3.40
agree
Class standing due (parents, friends,
to the limited 3.2 and loved ones);
2 agree I engage in
resources that I 0
have; different relaxing
Relationship with activities
my parents, (meditation, strongly
1.5 2 3.30
3 friends, disagree calming agree
0 techniques,
classmates, and
significant other; listening to soft
Spiritual music);
1.5 Try to identify my
4 connection with disagree
0 problems and then
God; strongly
Attitude towards 3.1 3 put into action 3.27
5 agree agree
life 3 some potential
solutions;
Perception of
3.1 I choose a natural
6 everything around agree
3 and healthy form of
me
stress relief
General Weight 2.6 strongly
agree 4 (running, yoga, 3.30
Mean 0 agree
swimming,
walking, dance,
Despite the stress they had and others);
experienced, students were able to cope with I make light of a
it (Table 3). They set goals to help them to stressful situation
strongly
study amidst the pandemic having the 5 by having fun and 3.33
agree
highest mean of 3.67. They were also able to find humor in
develop personal strategies to get back on everything
track and focus on their study (x=3.60). I practice
Apart from developing positive coping relaxation
techniques strongly
strategies, they also worry about the 6 3.40
whenever I hear agree
negative effects of COVID-19 in the news about COVID
Philippines (x=3.53). Meanwhile, they find 19
themselves overwhelmed with COVID 19 7 I seek out 3.40 strongly
updates that they shut down completely got emotional support agree
the lowest mean of 2.25. This means that from others every

6
 time there is news communicating to their teachers and
about new cases of classmates all because of the limited access
COVID 19 to WIFI connections.
I try to find the In a recent study by Elmer et. al.,
health information
strongly (2020), the social relationships of
8 that I need to 3.47
agree individuals are likely to be affected by the
understand COVID
19 more crisis in different ways. Social relationships
I find myself so are conduits of social support. In times of
overwhelmed with crisis, social support may be more important
moderately than ever. But at the same time, physical
9 COVID 19 updates 2.25
agree
that I shut down proximity and opportunities for interaction
completely are important in developing and fostering
I find it difficult to social ties. As face-to-face interactions and
find someone to random encounters are minimized due to the
1 moderately
confide in about 2.30 social distancing measures, individuals
0 agree
my anxiety relating likely focus on those relationships that are
to COVID 19
spatially close, most meaningful, or most
I worry about the
established.
negative
1 consequence of strongly The respondents experienced stress
3.53 because of this crisis, especially in their
1 these stressful agree
events in the academics. The respondents experienced
Philippines stress because of their class standing due to
I develop personal limited resources. They think they will get a
1 strategies to get me strongly low grade because they did not comply with
3.60
2 back on track and agree the requirements of their teachers. This crisis
focus on my study affects the focus of the respondents from
I take time to relax their academics and because of unexpected
1 and be free from strongly circumstances, the focus will turn to anxiety
3.37
3 new about COVID agree
then the mental health of the respondents
19
I keep thinking that
will be varied and they absorb more stress.
there's not much I Most of the respondents experienced stress
1 especially on their academics and focus
can do to help 3.10 agree
4 priorities, but the relationship with their
myself and my
family friends, family, and classmates, spiritual life
I set goals to help is not affected by the stress.
1 strongly
my studies during 3.67 Even the respondents experienced
5 agree
the pandemic stress during this crisis, they developed
  coping strategies to handle their stress
strongly
General weighted 3.45 specifically in their academics by setting up
agree
mean:
goals for them to continue pursuing their
dreams in life. The respondents make
The BS Nursing Students of strategies to cope with the other stress
MVGFCI experienced the impact of the experienced by developing their personality,
COVID-19 crisis. They encountered being physically fit by doing exercise, and
difficulties during their studies to comply taking time to relax, practicing the health
with all the requirements had difficulties in protocols to avoid this disease, giving

7
emotional support for everyone that is 4. Post the daily class schedule so that
suffering from the disease, and also they know what the teachers can expect
suffering emotional and mental health from them.
because of this pandemic. 5. Encourage involvement in
Conclusion extracurricular to help alleviate some
The following has been concluded based anxiousness to promote a sense of social
on the results of this study: belonging.
1. Students experienced stress due to 6. Continue monitoring students’
the inability to comply with the progress in a way that is not stressful to
requirements due to limited internet them.
connection, limited resource and difficulty 7. Regularly check with parents to
communicating with their classmates and share their observation and better understand
teachers. the cycle of mood fluctuation more
2. Stress also affected their class effectively.
standings, their focus on their school, 8. Provide slow activities for slow
attitudes towards life, and their perception of students to catch-up
themselves. 9. Come up with programs to
3. Students developed coping strategies encourage social interaction such as small-
by setting goals that can help them study group work.
amidst the pandemic and developed personal 10. Engage the involvement of parents to
strategies to get back on track. work closely with the school in managing
4. In general, students experienced students experiencing academic pressure.
academic stress that resulted in poor 11. Come up with information drive
academic performance. Meanwhile, they about mental health
developed healthy coping strategies to catch
up on their academics. References
Center for Disease Control and Prevention
Proposed Strategic Measure to Improve Coping Strategies amidst
(2015). Understanding Suicide. Fact
Pandemic
Sheet. {Online}
To the School: www.cdc.gov/violenceprevention
Gunnar, M. (1998). Stress and emotion in
1. Improvement of instructional
early childhood
practices and strategies through flexible
https://onlinelibrary.wiley.com/doi/abs/
teaching Tool and Materials.
10.1002/0471264385.wei0605\
2. Follow through by activating the
Hiremath, P., Kowshik, C.S.S., Manjunath,
Students Affairs Office function in a way
M., & Shettar, M. (2020). COVID 19:
that is not stressful
Impact of lock-down on mental health
3. Create or activate the Parents
and tips to overcome. Asian Journal of
Teacher Association.
Psychiatry 51 102088. 2
To the Teachers:
pages. https://doi.org/10.1016/j.ajp.20
1. For teachers, model calmness and 20.102088
self-control. Kaslow, Nadine J. (2014). Suicidal Behavior
2. Flexible deadline on the students’ in Children and Adolescents.
activities and assignments. American Psychological Association.
3. Provide choices for the assignments www.apa.org/topics/suicide/
that can help them have some control over
the environment.

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Mesnikoff, Nathan. (2020) Why the
coronavirus pandemic triggers such
deep fears and how we can calm
ourselves down. UC Health Today.
https://www.uchealth.org/today/how-
to-tame-fight-or-flight-responses-to-
the-coronavirus-pandemic/
Matheny, K. B., Aycock, D. W., Pugh, J. L.,
Curlette, W. L., & Silva Cannella, K.
A., (1986). Stress coping: A
qualitative and quantitative synthesis
with implications for treatment. The
Counseling Psychologist, 14, 499-549.
One News. (2020, June 1). Stress, anxiety,
depression on the rise among gen z,
millennial employees and those
working from home – survey.
https://www.onenews.ph/stress-
anxiety-depression-on-the-rise-among-
gen-z-millennial-employees-and-
those-working-from-home-survey
Philippine Daily Inquirer. (2020, July 26).
84% of Pinoys stressed by the covid-
19 pandemic.
https://newsinfo.inquirer.net/1312001/
84-of-pinoys-stressed-by-health-crisis