ST.

VINCENT COLLEGE OF CABUYAO

Brgy. Mamatid, City of Cabuyao, Laguna 4025

DEPARTMENT OF PSYCHOLOGY

STRESS LEVEL AND PSYCHOLOGICAL WELL-BEING OF HEALTH

CARE WORKERS IN BARANGAY MAMATID
AMIDST THE COVID-19 PANDEMIC

AN UNDERGRADUATE THESIS PROPOSAL

Presented to:
The Faculty of the Department of Psychology
ST. VINCENT COLLEGE OF CABUYAO

In Partial Fulfillment
of the Requirements for the Degree
BACHELOR OF SCIENCE IN PSYCHOLOGY

By:
Noñala, Zarah Elaine D.

Pagkalinawan, Nap Charlie C.

Se, Nica Lorraine R.

DECEMBER 2021
 TABLE OF CONTENTS

PAGE
Table of Contents

CHAPTER

I. THE PROBLEM AND ITS BACKGROUND

Introduction
Background of the Study
Theoretical Framework
Conceptual Framework
Research Paradigm
Statement of the Problem
Hypotheses
Significance of the Study
Scope and Limitation
Definition of Terms

CHAPTER
II. REVIEW OF RELATED LITERATURE

CHAPTER
III. RESEARCH METHODOLOGY
Research Design
Research Locale
Population and Sampling
Instruments
Data Gathering Procedure
Validation of Instrument
 CHAPTER I

THE PROBLEM AND ITS BACKGROUND

The introduction, background of the study, theoretical framework, conceptual

framework, research paradigm, statement of the problem, hypotheses, significance of

the study, scope and limitation, definition of terms are all included in this chapter.

INTRODUCTION

The latest Coronavirus Disease (COVID-19) first appeared in Wuhan, China,

in 2019, sparking a global public health crisis. On January 30, 2020, the World Health

Organization (WHO) announced the discovery of a new coronavirus and designated it

a Public Health Emergency of International Concern under the International Health

Regulation. Not only has the pandemic resulted in a high number of viral infection-

related deaths, but it has also had psychological and emotional impacts on the rest of

the world. In the Philippines, there were over 2.4 million confirmed infected

individuals in 2021, with 37,000 deaths, and over 219 million people globally, with a

mortality rate of 4.55 million and still ongoing (WHO 2021).

The demands placed on healthcare personnel during a pandemic are

significant and long-lasting. When health-care professionals are in close touch with

patients,  since caring for them, or when they are exposed to patient biological fluids

or the environment, they are at the greatest risk. During a pandemic outbreak of an

infectious illness, stress and job burnout among health-care professionals are in all

level. Working with patients who are quarantined and bearing the virus can cause

severe issues such as interpersonal isolation, fear of contagions, and concerns for

family well-being, which can cause stress in health care professionals. Extended work

hours, the fear of becoming sick as the virus load increases, and, most significantly,
all types of discourses and strategies that disregard the labor of healthcare workers

who risk their own health are the most common reasons of their stress during

pandemics. (Jiang et al., 2020) employed 310 volunteers in a research to assess the

psychological symptoms of healthcare professionals in Wuhan during the COVID-19

pandemic. They discovered that they were under moderate to severe stress, with some

expressing significant anxiety and depression. Healthcare professionals are already at

danger in situations like the COVID-19 pandemic, since they encounter a range of

challenges and difficulties even while performing routine services. This scenario may

affect their lifestyle and job, while also produce significant health issues. Stress and

burnout have a strong positive link, as per a research of healthcare workers

(Morgantini et al., 2020). During the COVID-19 pandemic, another research

examined the correlation between burnout, anxiety, and stress problems, and found

that other professional healthcare workers like doctors and nurses had significant

levels of psychological problems, including stress (Sung et al., 2020).

Anxiety, fear, post-traumatic stress symptoms, psychological distress,

problem-solving ability, avoidance of contact, sleep disturbances, helplessness, and

isolation from family and social support have all been reported among healthcare

workers as a result of the COVID-19 pandemic, as well as concerns about their

friends and family being infected. Despite the fact that mental health and psychosocial

disorders are widespread among healthcare workers, most do not seek or get regular

treatment and care. Furthermore, healthcare workers' psychological problems would

have a negative impact on their attention, cognitive capacity, and clinical decision-

making, affecting their quality of life and well-being. Stress in crises is also proven to

have a long-term impact on general well-being. As a result, the psychological issues

that healthcare workers are experiencing as a result of the COVID-19 pandemic have
become a serious public health problem. The current study aims to assess stress levels

and psychological well-being among healthcare workers who interact with COVID-19

patients by quantifying the magnitude of their stress, anxiety, and well-being and

analyzing the potential factors associated with these symptoms during the COVID-19

pandemic.

According to Reuters article by Adrian Portugal (2021), MANILA, Sept 1- It

stated that ‘As hospitals are battling one of Asia's longest-running coronavirus

epidemics, dozens of healthcare workers protested in Manila on Wednesday

to protest what they described as government neglect and unpaid benefits. At the

Department of Health (DOH), demonstrators wearing protective medical gear held

placards demanding their hazard pay and risk allowances, as well as the resignation of

Health Secretary Francisco Duque. There have been 2

million Coronavirus cases in the Philippines since Wednesday, a fifth of the cases in

the past month alone. Medical personnel are overwhelmed and 103 people have died,

among some 33,500 Coronavirus deaths in the Philippines. “It is sad that many of us

have died, that many of us became ill, and many of us resigned or opted to retire

early, yet we are still kneeling before the DOH asking for our benefits," Robert

Mendoza, president of the Alliance of Health Workers, said from the back of a pickup

truck.   In response to nurses' threats to resign and unions' warnings of strikes,

Rodrigo Duterte gave health and budget ministries 10 days to pay health workers

from Aug. 21. "The government promised it will give the benefits today but up to

now, it has not. I pity us because we are the ones begging," said nurse Nico Oba.  

Duterte has stood by Duque during repeated calls for his resignation, most recently

following a state audit that flagged "deficiencies" in more than $1 billion in COVID-

19 spending. According to Reuters, Duque said the government was working on the

release of benefits, but requested more time. In a virtual protest, the Philippine Nurses

Association demanded better working conditions and more staff in hospitals, nearly a

third of which have reached critical levels of occupancy of over 85%, according to

government data. There have been more deaths and cases of the highly transmissible

Delta variant in the Philippines than anywhere else in Southeast Asia where

vaccination rates are low’.

Another article also states about HCW’s got affected by the Covid-19

pandemic. According to The Organization for World Peace by Jack Treston (2021,

September 5). ‘Accusations that the government mismanaged COVID-19 emergency

money have driven Filipino healthcare workers to breaking point. Protesters

assembled in front of the Department of Health on September 1st, wearing safety

gear, to demand the release of unpaid financial compensation and an increase in state

money to hire additional palliative care professionals. Health-care professionals in the

Philippines are poorly funded, underpaid, and overworked. If these difficulties aren't

addressed, the profession may face a mass departure in the near future. Filipino

hospitals are at capacity, and COVID infections are fast increasing on a daily basis.

The highly contagious delta type of coronavirus is the most common in the

Philippines, posing significant challenges for the country's healthcare system. Only

13.1 percent of the population has been fully vaccinated, despite the fact that 34.1

million vaccine doses have been administered. Infection rates are at all-time highs,

with daily infections reaching 16,000, up 20% from the previous week. After the first

COVID-related fatality outside of China, the Philippines' cumulative case numbers

have surpassed two million, and the archipelago has recorded over 33,000 deaths out

of a population of 108 million. Workers on the front lines are particularly vulnerable.

"You are exposed to the virus when you work in a hospital during a pandemic like
COVID-19," said Jao Clumia, union president at St. Luke's Medical Center. "It's as

though you've already put one foot in the grave." Many people thought that the

epidemic would result in major changes in the health-care system. Instead, it has

worsened existing problems. Filipino healthcare salaries are much lower than those of

other professions in Southeast Asia, according to a survey undertaken by information

aggregator iPrice Group. According to the data, nurses in the Philippines earn 57

percent less than those in Vietnam, the next lowest-paying country. Singaporean

nurses are said to make 480 percent more than Filipino nurses, with monthly salaries

of $1,000 and $6,500, respectively. Despite the fact that the Philippines is a prominent

producer of healthcare personnel, local supply is struggling to keep up with demand

due to the epidemic. According to the Philippine Private Hospitals Association,

roughly 40% of palliative care professionals in private hospitals quit last year, and the

delta variant is expected to exacerbate this trend. Dr. Takeshi Kasai, the World Health

Organization's regional director for the western Pacific, warned the Philippine

government in a report with the Australian Broadcasting Corporation to guarantee that

its healthcare personnel are receiving enough assistance. "Surges are pushing health

systems uncomfortably close to what we term the 'red line,'" According to Dr. Kasai.

He warns that if ICU capacity is exceeded, hospitals would be unable to provide

essential care. Protests in front of the Department of Health are seen by many

frontline employees as important to force a change in circumstances. "Does the

government believe we really need to be marching in the streets?" "We'd rather be

caring for our patients in our hospitals," a frontline worker told Deutsche Welle.

Protests appear to be having an effect. President Rodrigo Duterte has responded to the

public's outrage by directing the health and finance ministries to pay medical

professionals what they are due. Duterte instructed Department of Health Minister
Francisco Duque III to pay healthcare employees "whatever money there is" in a

public speech. "Give the privileges that nurses in both the government and the private

sector are requesting," Duterte remarked. "The volunteers should be acknowledged."

To avoid becoming the virus's new epicenter, the government will have to act quickly.

The first step is to ensure that critical healthcare employees receive enough support

and financial incentives’.

Providing assistance to people during the COVID-19 pandemic might create

stress, anxiety, and other negative feelings among Barangay Mamatid's healthcare

professionals. How successfully someone either handles these emotions may affect

their own well-being, the care they offer everyone else at work, and the well-being of

people they care about outside of work. It's crucial to know how stress presents itself

throughout this pandemic. Everyone is adversely affected when they are exposed to or

witness life-threatening or stressful events.

BACKGROUND OF THE STUDY

No one could have predicted that in the year 2019, a viral report would

become a significant destroyer of all economies and the well-being of individuals

living in their own country. It was about a cluster of pneumonia cases in Wuhan

(Hubei, China) with no specific cause. (Lu et al., 2020). An investigation of deep

sequencing analysis from lower respiratory tract samples identified a novel virus

severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative

agent for the reported pneumonia cluster when January 2020 arrived (Huang et

al.,2020). According to World Health Organization (2020), The World Health

Organization (WHO) Director-General, Dr. Tedros Adhanom Ghebreyesus, termed

the disease caused by the SARS-CoV-2 "COVID-19" in a report on February 11th,

2020, and the WHO acknowledged the pandemic status on March 11th, 2020, with

114 countries involved, over 118,000 cases, and over 4000 deaths.

The COVID-19 pandemic has found its way to the Philippines, with the lot of

instances being found in the National Capital Region (Espiritu et al., 2020). Travel

bans and limitations have been imposed over the world as a result of control

measures. On March 16, 2020, President Rodrigo Duterte of the Philippines declared

the whole Luzon archipelago under enhanced community quarantine (Official

Gazette, 2020). Every place or part of the Philippines had curfews, checkpoints, and

travel restrictions (PCOO, 2020). Business, school activities, and public gatherings

have all been put on hold indefinitely. People were obliged to stay at home, and a new

normal was formed, such as virtual online classes and the requirement that any mass
gathering utilize a virtual application to discuss agendas and crucial meetings. With

the novel coronavirus spreading across worldwide, there are also plenty of unknowns

surrounding the sickness, which has the potential to be devastating. Distress, anxiety,

sadness, and insomnia have all been documented in general populations (Wang et al.,

2020).

According to the most recent statistics, there are 2,470,175 total cases in the

Philippines as of September 2021, 2,267,678 cases of recoveries, 165,092 of which

are active, and 37,405 have died (DOH, 2020). The Philippine government has

switched its propaganda from 'stay at home' and tight quarantine rules to rigorous

handwashing, physical separation, and wearing a mask, especially while going out in

public, in order to help the economy. To avoid the collapse of health institutes and to

aid the health care workers dealing to COVID-19 outbreaks in the Philippines, the

Philippines' Department of Health has actively encouraged cooperation with at least

the minimal health standards and protocols. To enhance frontline health workers'

morale, the Duterte administration introduced monetary compensation for doctors and

nurses who contract the virus while on the job. As of the 22nd of June 2020, the virus

has infected 3,122 health-care workers across the country, with nurses accounting for

the majority of those afflicted (Esguerra, 2020). 

Despite the fact that the repercussions of a disease epidemic are costly, the

psychological health impact of a pandemic is often overlooked during pandemic

management. Individuals' psychological well-being has a significant impact on their

performance. COVID-19 has been shown to have a negative influence on

psychological health in a variety of demographics, including health care professionals,

in a number of nations (Naser et al., 2020).

 According to WHO (CORONAVIRUS DISEASE (COVID-19) OUTBREAK:

RIGHTS, ROLES AND RESPONSIBILITIES OF HEALTH WORKERS,

INCLUDING KEY CONSIDERATIONS FOR OCCUPATIONAL SAFETY AND

HEALTH, n.d.). Healthcare workers are on the front lines of any epidemic response,

and as a result, they are exposed to risks that put them at risk of contracting an

outbreak virus (in this case COVID-19). Pathogen exposure, long work hours,

psychological anguish, exhaustion, occupational burnout, stigma, and physical and

psychological aggression are all potential hazards. This paper emphasizes health

professionals' rights and obligations, as well as the precise steps required to ensure

workplace safety and health. Employers and management in health institutions

have the following rights: (1) accept overall responsibility for ensuring that all

essential preventative and protective actions are implemented in order to reduce

occupational safety and health hazards; (2) supply health and safety at work

information, teaching, and training, including: Infection prevention and control (IPC)

refresher training; and Personal protection equipment (PPE) use, application, removal,

and disposal (PPE); (3) make sure you have enough IPC and PPE (masks, gloves,

goggles, gowns, hand sanitizer, soap, water, and cleaning products) in adequate

quantities to healthcare or other employees caring for suspected or confirmed

COVID-19 patients, so that workers don't have to pay for workplace safety and health

requirements; cleaning materials) to healthcare or other personnel caring for suspected

or confirmed cases in sufficient quantities; (4) educate workers with COVID-19

technological changes and give necessary tools to screen, evaluate, and treat patients.

Patients should be tested and treated, and information on infection prevention and

control should be shared with patients and the public; (5) offer suitable security

measures for personal protection as needed; (6) provide a blame-free atmosphere for
workers to report occurrences, such as exposure to blood or body fluids from the

respiratory system or situations of violence, and to implement quick follow-up

actions, such as victim assistance; (7) provide a blame-free environment for workers

to report incidents, such as exposures to blood or bodily fluids from the respiratory

system or cases of violence, and to take immediate action, including victim support;

(8) advise healthcare workers on self-assessment, symptom reporting, and staying at

home when sick; (9) establish appropriate working hours with recovery periods; (10)

Consult with healthcare workers about workplace safety and health issues, and alert

the labor department inspectorate for occupational illness cases; (11) not be forced to

return to a job that poses an ongoing or substantial risk to one's life or health, unless

the employer has taken whatever corrective action that is required; (12) allow

healthcare workers to utilize their freedom to leave a job if they had a strong

justification to believe that their life or health is in grave risk.  HealthCare  Worker

whom exercises this freedom, they are protected from any unjustified consequences;

(13) respect the right to be paid, recovery, and treatment if infected with COVID-19.

If a healthcare worker exposed in their workplace.   This would be considered

occupational exposure, and any disease that resulted would be treated as such  be

termed a work-related illness; (14) offer services for mental health and counseling;

and (15) enable management and employees and/or their representatives to work

together. While, Workers in the health field should: (1) observe established

workplace safety and health procedures, avoid exposing people to health and safety

concerns, and attend employer-provided workplace safety and health training; (2)

evaluate, assess, and treat patients according to established guidelines; (3) treat

patients with professionalism, respect, and sympathy; (4) keep patient information

private; (5) follow established public health reporting procedures for suspected and
confirmed illnesses as quickly as possible; (6) offer or reinforce correct infection

prevention, control, and public health information, even to those who are worried but

do not have symptoms or are at risk; (7) correctly put on, use, remove, and dispose of

personal protective equipment; (8) self-monitor for indicators of sickness and, if

necessary, self-isolate or notify supervisors; (9) notify management if they are

showing indications of excessive stress or mental health issues that

require interventional support; and (10) any circumstance in which they have

sufficient basis to think should be reported to their immediate supervisor. Provides a

life or health threat that is urgent and significant.

Health care workers require a support structure at work to improve their

psychological well-being, and their behavior must be regularly checked - this is

especially important during public health programs (Greenberg et al., 2020).

During this pandemic, many employees feel stressed and burned out.

According to a study conducted by MindNation, a mental health and well-being

organization, 35 percent of the 6,000 employees polled were unproductive at work for

an average of two hours every day. According to the study, 23% of employees were

considering quitting their employment owing to stress, anxiety, or despair, while 47%

claimed they were overworked. (Rappler Talk: Filipino employees' mental health

during pandemic, n.d.)

HealthCare Workers that assist in the treatment of sick people as well as an

individual's health needs and belongingness, such as administering vaccines and

assisting pregnant women, are known as front-line healthcare workers (HCWs).

Working in such an unusual environment, often beyond their capabilities, and with the

threat of infection puts HCWs at risk for psychological issues. Because health care
workers are the only ones who can determine what is the best course of action for a

patient with a health problem.

There were early media complaints of insufficient testing kits and a shortage

of PPEs during the immediate reaction to COVID-19 (Sapkota, n.d.). The growing

number of confirmed cases and deaths, work stress, insufficient personal protective

equipment (PPE), media coverage, lack of specific treatment, vulnerability to

infection and having to stay in quarantine, as well as feelings of being under

supported at work, can all contribute to health workers' psychological stress  (Bastola

et al., 2020).

The psychological stress that healthcare providers, frontline workers, and

members of the public experience is based on each person's individual situation,

experiences, and stresses (LAbate, 2012). Inability to manage adequately with a

stressful experience creates psychological distress, which can manifest as depression,

anxiety, acute stress, post-traumatic stress, burnout, and psychiatric illness, among

other psychological and psychiatric consequences. Although stress is often thought of

as a transient mood that affects everyday and social functioning, it can last for a long

time and have negative long-term effects on the psychological (Horwitz, 2007).

Work-related psychological disturbance in HCW is linked to a variety of short

- range and long negative effects in ordinary conditions. Psychological distress is

connected to negative professional effects, such as reduced patient care

quality (Stansfeld et al., 2009). HCWs who suffer emotional stress seem to be more

prone to having repercussions, such as substance abuse (Taylor et al., 2007) Such

repercussions may amplify and increase psychological suffering in the context of an

infectious disease outbreak. Sleep disturbances were reported by HCW who reported

high levels of stress during the COVID-19 pandemic (Xiao et al., 2020), Poorer
physical well-being (Kang et al., 2020), as well as an increase in the number of

debilitating symptoms, such as headaches (Chew et al., 2020)

According to Selye (1956), Stress is "any environmental incident or any

internal force that threatening to disturb the organism's homeostasis." Stress is a state

or feeling that occurs when a person thinks that demands are greater than his or her

ability to mobilize personal and social resources. Stress can be caused by a variety of

factors, including being under a lot of pressure, facing major changes, worrying about

something, not having much or any control over the outcome of a situation, having

overwhelming responsibilities, not having enough work, activities, or change in your

life, and times of uncertainty. As the world is in the midst of a major crisis. Illness or

injury, pregnancy and becoming a parent, bereavement, long-term health problems,

planning a complicated event, such as a group vacation, everyday tasks such as travel

or household chores, losing your job, long-term unemployment, retiring, worries

about money or salary benefits are all examples of situations that can cause stress

nowadays.

Stress has a negative impact on learning as well. The results of hippocampus-

dependent loading data show that after being exposed to a new environment,

participants are not as familiar with it (Bremner, 1999). Furthermore, adrenal

hormones cause changes in long-term potentiation (LTP), a critical memory-forming

process (Bliss and Lmo, 1973). During times of stress, memory is influenced by two

elements. The first is noradrenaline, which is produced in the basolateral amygdala

area and is responsible for emotional components of memories (Jols et al., 2011).

Corticosteroids, on the other hand, aid this process. However, if corticosteroids are

released a few hours early, the amygdala and associated behaviors are inhibited (Jols
et al., 2011). As a result, these two hormones work together to provide a reaction in

the memory process (Jols et al., 2011).

THEORETICAL FRAMEWORK

In this study two theories were examined: Holmes and Rahe Stress Scale,

Carol Ryff's Model of Psychological Well-Being, The Six Criteria of Well-Being.

Holmes and Rahe Stress Scale

The stress as a stimulus theory was first established in the 1960s, and it

described stress as a major life event or change that requires a response, adjustment,

or adaptation. The Social Readjustment Rating Scale (SRRS) was designed by

Holmes and Rahe (1967) and consists of 43 life events that are evaluated as per the

estimated degree of adjustment they will require of the individual experiencing them

(e.g., marriage, divorce, relocation, change or loss of job, loss of loved one). In the

health-stress-coping equation, Holmes and Rahe hypothesized that stress was an

independent variable — the cause of an experience rather than the event itself. While

some connections between SRRS scores and sickness (Rahe, Mahan, & Arthur, 1970;

Johnson & Sarason, 1979), there were issues with the stress as stimulus theory. The

following assumptions underpin the stress as stimulus theory:

 1. Change is stressful by nature.

2. Life events required a same rates of adjustment for everyone.

3. There is a common modification barrier beyond which sickness develops.

Initially, Rahe and Holmes have seen the human subject as a passive recipient

of stress, without a say over the degree, severity, or reactivity of the stressor. Later in

his research, Rahe proposed the concept of interpretation (Rahe & Arthur, 1978),

indicating that a change or life event could be viewed as a positive or bad experience

depending on cognitive and emotional aspects. However, essential elements such as

prior learning, environment, support systems, personality, and life experience were

remained overlooked by the stress as stimulus approach.

Carol Ryff's Model of Psychological Well-Being The Six Criteria of Well-Being

Carol Ryff was inspired by two factors: first, well-being should not be limited

to medical or biological definitions; rather, it is a philosophical inquiry about what it

means to live a meaningful life (Allport, 1961). Second, at the time, existing

psychological theories of  well-being lacked scientific discipline had not been tested

and could not be tested.

Ryff looked for building blocks in a diverse variety of well-being ideas and

research, from Aristotle to John Stuart Mill, Abraham Maslow to Carl Jung, to

establish a theory that integrates philosophical issues with empirical empiricism. She

recognized a pattern of repetition and integration among these different theories, and

these intersections served as the foundation for her new well-being model.

Carol Ryff's Psychological Well-being model.  In one essential way, well-

being varies from older designs: it is diverse, not only about happiness or pleasurable

emotions. Rather than being narrowly focused, a good life is balanced and entire,
involving all facets of well-being. This idea is based on Aristotle's Nichomachean

Ethics, in which the objective of life is to live virtuously rather than feeling good.

The six categories of well-being proposed by Carol Ryff are (Andrews &

Withey, 2012):

1) Self-Acceptance

High Self Acceptance: You have a good attitude toward oneself; you understand and

acknowledge various aspects of yourself, both good and poor; and you have an

optimistic perspective on your past life.

Low Self Acceptance: You are unsatisfied with yourself; you are disappointed by

events in your former life; you are bothered by specific personal characteristics; and

you seek to be someone other than yourself.

2) Personal Growth

Strong Personal Growth: You have a sense of continuous growth; you see yourself

as improving and developing; you are willing to try new things; you have a sense of

realizing your potential; you see yourself and your behavior improving over time; you

are adapting in ways that reflect more self-knowledge and effectiveness.

Weak Personal Growth: You feel trapped in your life; you don't feel like you're

improving or expanding; you're bored and uninterested in life; and you can't seem to

gain new attitudes or attitudes.

3) Purpose in Life

Strong Life Purpose: You have life goals and a feeling of direction; you believe your

present and past lives have meaning; you hold beliefs that give life purpose; and you

have goals and purposes for living.

Weak Life Purpose: You lack a sense of purpose in life; you have few objectives in

mind; you lose any sense of direction; you don't understand the purpose of your

previous life; and you miss the viewpoint or beliefs that give life meaning.

4) Positive Relations With Others

Strong Positive Relationships: You have warm, fulfilling, and trusting relationships

with people; you care about others' well-being; you have strong empathy, affection,

and connection; and you understand how give and take of human relationships.

Weak Relationships: You have a limited amount of close, trust - based relationships

with others; you find it difficult to be warm, allow access, and concerned about

others; you feel isolated and frustrated in interpersonal relationships; and you are

hesitant to make compromises in order to sustain important ties with others.

5) Environmental Mastery

High Environmental Mastery: You have a sense of mastery and competence when it

comes to managing the environment; you can manage a diverse collection of external

activities; you can improve the use surrounding opportunities; and you can choose or

create contexts that suit your personal needs and values.

Low Environmental Mastery: You struggle to manage daily affairs; you feel unable

to improve the current surrounding settings; you are unaware of nearby opportunities;

and you miss a sense of control over the external environment.

6) Autonomy

High Autonomy: You are self-determining and independent; you might reject

sociological factors to think and act in specific ways; you can self-regulate your

behaviour; and you can assess yourself using own standards.

Low Autonomy: You're bothered about other people's views and opinions; you rely

on other people's judgments to make good decisions; and you adapt to social pressures

to think and act in specific ways.

CONCEPTUAL FRAMEWORK

STRESS LEVEL PSYCHOLOGICAL WELL-BEING

 Health  Self-Acceptance
 Relationships  Personal Growth
 Work  Purpose in Life
 Family  Positive Relations with Others
 Lifestyle  Environmental Mastery
 Financial Resources  Autonomy

Independent Variables Dependent Variables

FIGURE 4. THE RESEARCH PARADIGM

The respondents' stress levels were divided into six categories: a. Health, b.

Relationships, c. Work, d. Family, e. Lifestyle, and f. Financial Resources, according

to the researchers. These are the independent variables, and the relationship between

the independent and dependent variables is depicted in this diagram. As a result, the

dependent variables are defined as psychological well-being measured in terms of

self-acceptance, personal growth, life purpose, positive interpersonal relationships,

environmental mastery, and autonomy.

STATEMENT OF THE PROBLEM

This study aims to assess the stress-level and psychological well-being of

HCW's in Brgy. Mamatid amidst the Covid-19 Pandemic. Specifically, it seek to

answer the following questions:

1. What is the stress level of the healthcare workers with regard to the

challenges brought by health crisis when it comes to:

A. Health;

B. Relationships;

C. Work;

D. Family;

E. Lifestyle; and

F. Financial Resources?

2. What is the level of psychological well-being of healthcare workers in

terms of:

A. Self-Acceptance;

B. Personal Growth;
C. Purpose in Life;

D. Positive Relations with Others;

E. Environmental Mastery; and

F. Autonomy?

3. Is the psychological well-being of the healthcare workers significantly

influenced by their stress level?

4. Based on the findings, what strategies may be formulated to improve the

psychological well-being or to manage the stress of HCW’s in Mamatid during

pandemic?

HYPOTHESES

The following hypotheses were addressed in the study:

1. There is significantly influenced of stress level and the

psychological well-being of healthcare workers.

2. The formulated strategies may improve the psychological well-

being or manage the stress of HCWs in Mamatid during the

pandemic

SIGNIFICANCE OF THE STUDY

The researchers would like to conduct the study to determine whether stress

levels influenced the psychological well-being of barangay health care workers, and

whether the formulated strategies may improve the psychological well-being or

manage the stress of HCWs in Mamatid during the pandemic.

Remarkably, this research will assist not just the students and instructors, but

also their parents, as well as the school and community as a whole.

 For the healthcare workers. They may be provided with activities that will

address their stress and nurture their psychological well-being through the result of

this study.

For the family of healthcare workers. Through this study, they can

understand the situation of their loveones whom they experienced stress and provide

them with the necessary support.

For the healthcare facilities. The result of this study will inform the current

psychological well-being of its barangay healthcare workers. This may in turn probe

the head of the barangay or one of its barangay official such as the barangay

chairwoman to implement program to ease the stress level of the barangay healthcare

workers.

For the community. In a broader sense, each individual must understand how

the COVID 19 virus is a huge factor of everything we previously valued, we won't

need to be selfish, and we won't need to defend ourselves from being immature, and

then we'll be able to provide freedom and positive psychological well-being to

barangay health care workers. In order for the community to have a productive

healthcare workforce.

For the goverment (local and national). The government should provide an

incentives and increasing of hazard pay/salary for the hardworking HealthCare

Workers in this time of Covid-19 pandemic.

SCOPE AND LIMITATION

For the clarify of focus, this research will be guided by the following scope

and limitations;
 The research will concerned only to the 30 HealthCare Workers respondents

in Barangay Mamatid.

The respondents of the study is limited to investigate the stress level and its

influence to the psychological well-being of HealthCare Workers in Barangay

Mamatid amidst the Covid-19 pandemic.

DEFINITION OF TERMS

Stress- It is the process whereby HCW’s perceives and responds to Covid-19

pandemic that one appraises as overwhelming or threatening to one’s well-being.

Low- If the result convey a low stress level of healthcare workers. The

healthcare workers doesn't experience or feel the effects of stress.

High- If the study predict a high stress level of healthcare workers. It means

they experience some psychological problems such as anxiety, depression, physical

pain, and other personality disorders.

Psychological Well-Being- It talks about the HCW’s emotional health and

overall functioning.

Low- If the result convey a low psychological well-being of healthcare

workers. The healthcare workers experience negative emotion and poor self concept.

High- If the study predicts a high positive psychological well-being of health

care workers, high scores reflect the respondent’s engagement in meaningful

relationship with others that includes reciprocal empathy, intimacy and affection .

BHCW- (Barangay HealthCare Workers) the respondents of the study,

which the researchers identify the stress and its influence into their psychological

well-being of HealthCare Workers in Barangay Mamatid.

 Covid-19- It is a respiratory illness caused by a novel coronavirus and

characterized by fever, coughing, and shortness of breath. In some people, the disease

also damages major organs, as the heart or kidneys

Pandemic- It is an outbreak of an infectious disease that spreads across a wide

geographical area and has a high prevalence, generally affecting a significant

proportion of the world’s population over several months.

Autonomy- This refers to the print when HealthCare Workers come to a

decision on how to continue on with their duties amidst the Covid19 Pandemic.

Low- Is when you’re more controlled by what others do, think, and feel, and

adapt accordingly.

High- Can decide how work should be done. It tends to result in an increase in

job satisfaction,

Environmental Mastery- Despite the difficulties, healthcare workers have a

sense of achievement and skill as a result of the Covid 19 pandemic. Workers in the

health-care industry do not lose their responsibility to provide appropriate treatment.

(e.g., environmental mastery of COVID19 pandemic with HealthCare Workers).

Family- One of their strengths, to survive and fight the current situation of the

pandemic. Also, these are the persons whom they protect and avoid from the outbreak

of the virus.

Financial Resources- talks about the work of HealthCare Workers, which is

not easy to do and dangerous amidst of pandemic

Health- Concern about the stress and other psychological health of Barangay

HealthCare Workers that experience in this time of Pandemic.

Lifestyle- Healthcare workers play a central role in health promotion amidst

the covid-19 pandemic.

 Personal Growth- Challenges like Covid 19 pandemic are not very easy to

face within. However, an everyday situation that everyone encounters gives us strong

compassion to move forward and continue life. (e.g., efforts in helping one another

and accepting judgment make our personality grow).

Positive Relation With Others- Health care workers show their empathy and

affection to other people by doing their best in taking care of us and every day remind

us to obey the health protocols of our government. To avoid regrets that can push

from the negative impact of this pandemic into an individual's life.

Purpose in Life- The deep passion of our Barangay HealthCare Workers is to

provide basic health education and selected primary health care services (e.g.,

maternal and child health, first aid, environmental health).

Relationship- The Barangay HealthCare Workers must be able to connect

with their family, coworkers, and others in a safe manner.

Self-Acceptance- It is one of our characteristics that need to be the highlight.

Individuals should know to accept the truth about themselves in able to have progress

and becomes more productive.

Work- Barangay HealthCare Workers or Frontliners assist people who have

concerns about their physical health, other needs, and belongingness.

 CHAPTER 2

REVIEW OF RELATED LITERATURE

A review of related liteature on barangay health workers' stress levels and

psychological well-being. For a better understanding of the topic, it is presented in

these studies from foreign and local publications. Diverse linked literature presents

different information with regards to the variable that is one with the study.

LOCAL

As study by Janet A. Delos Santos, and Leodoro J, Labarague (2020) The

psychological challenges are increasing as the mortality toll of health personnel caring

for covid-19 patients rises. As of, June 22, 2020, the virus has infected 3,122 health

personnel in the country. The majority whom were nurses. Research finding showed

that nurses had moderate to high fear of covid-19, and fear of the virus was associated
with female gender. Furthermore, nurses’ fears affect their psychological discomfort

as well as their goals for organization and job performance.

In a study from Rongrong Luan, Weidan Pu, Lilei Dai, Rui Yang, and Peng Wang

(2020) who surveyed 1,336 participants, they concluded that both healthcare and

frontline workers are experiencing higher levels of psychological stress compared to

general public, which may be associated to their perceptions of their own health and

infection risk. The psychological stress experienced by healthcare workers, frontline

workers, and individual in general public differs according to their particular

situation, experiences, and stress.

As stated by Nicholle Mae Amor Tan Maravilla and Myles Joshua Toledo Tan (2021)

As per their study some of Filipino mental health workers cannot fully utilize their

skills and value due to outdated practice guidelines, inappropriate curricula, and lack

of facilities here in the Philippines because of that people do not get treated properly.

Philippine mental health Act has been nothing over “just an act.” Nonetheless, there’s

still hope that the supply of mental health care is recognized as a significant need to

ameliorate life and economy. Government should value and provide their needs to

improve their importance service and value.

As study by Crystal Ameil Estrada et al. (2020). mental health problem can impact

children long after the disaster and provide bad effect for their body and mind, hence

providing mental health support is vital. Following the traumatic experiences such as

disasters, schools, especially teachers, can play a huge role for maintaining the well-

being of children and adolescents and ease the traumatic experience of theirs.
Psychological first aid is described as a “humane, supportive response to a fellow

human being who is suffering and who may need support”.

According to John Lally, John Tully & Rene Samaniego. (2019). In a recent

study mental healthcare in the Philippines faces continued challenges including under

investment, lack of mental health professionals, underdeveloped community mental

health services and lack of facilities due to the low support of the community.

Increased investment is urgently needed to improve the training and recruitment of

psychiatrists, nurses, psychologists, social workers and other multidisciplinary team

members, particularly as large numbers of skilled professionals continue to emigrate.

Community needs to start valuing the mental health for the better tomorrow.

According to Andrea B. Martinez, Melissa Co, Jennifer Lau, June S.L. Brown (2020)

In their review social support and problem severity were mentioned as prominent

facilitators in help-seeking. However, different structural, cultural, and practical

barriers and facilitators of psychological help-seeking between overseas and local

Filipinos were also found. This review has confirmed the low utilization of mental

health services among Filipinos regardless of their locations, with mental health

stigma as a primary barrier resilience and self-reliance as coping strategies, especially

in qualitative studies, but may be important in addressing issues of non-utilization of

mental health services. Filipino need to start help-seeking for their mental health

problems.

As mentioned by Oducado, R. M., Parreño-Lachica, G.,& Rabacal, J. (2021). In a

recent study COVID-19 stress, and fear have been shown to have a significant inverse
correlation with resilience. Resilience protects against fear of COVID-19 and it is

essential to cope with its stress. In the midst of pandemics and other stressful

situations, educational institutions may need to nurture and utilize the resilient feature

of Graduate students to assist poor mental states and harmful psychological

repercussions. Government need to start grow mental health institution to support the

graduate students in the Philippines and this can lead to better for the better service

among our graduate students.

As studied by Michael Tee et al. (2021). COVID-19 dilemma threatens to hit lower

and middle-income countries. In a recent study found that Filipino respondents

reported significantly higher levels of depression, anxiety, and stress than Chinese

respondents, however only the mean IES-R scores of Chinese respondents were above

the cut-off scores for PTSD symptoms. Physical symptoms resembling COVID-19

infection have been associated with poor mental health in both countries; this

correlation may be related to lack of confidence in the health care system and lack of

coronavirus testing. The study suggests a health education and literacy program is

necessary in the Philippines to improve appreciation of health information and start

recognizing the HCW’s and mental health workers here in the Philippines to provide a

better service in the community.

FOREIGN

As cited by Lili, et al. (2017) Nursing is widely seen as highly stressful occupation.

Workplace stress is characterized as mismatch between an individual and their

surroundings. In general, the higher the disparity between external expectations and

an individual capability, he higher the level of stress that will be experienced.

An article by Morgantini et al. (2020). In a study and global survey factors about

psychological distress of HCW’s that affect their work and productivity during this

pandemic. Burnout can affect not only mental health but can also correlate with

physical ailments. A study review discovered that burnout became a predictor for

conditions including musculoskeletal pain, extended fatigue, headaches,

gastrointestinal and respiratory issues. Some factors included an increased workload

hours or lack of updated guidelines, contributed to higher rates of infection among

HCWs. Their study reported burnout was significantly associated with limited access

to PPE as well as making life-or-death decisions due to medical supply shortages.

Current and future burnout among HCWs could be mitigated by actions from

healthcare institutions and other governmental and non-governmental stakeholders

aimed at potentially modifiable factors, including providing additional training,

organizational support, support for HCWs’ families, PPE, and mental health

resources.

Nunye Celmece and Mustafa Menekey (2020). determined that the stress, anxiety, and

burnout of healthcare professionals working during the COVID-19 pandemic had a

negative effect on their quality of life, their everyday production like their social life

and HCW’s mental health. It is known that the risk of getting the virus, which spreads

gradually during the epidemic, increases the anxiety of getting sick both for

themselves and their families and can lead to burnout in carrying out tasks that require

endurance. One of the issues mention in the study that countries must prepare for

possible future outbreaks such as COVID-19 is taking the necessary protective and

supporting mental-social measures to protect the mental health of healthcare

professionals working on the front line as well as their physical health so that they can

provide a well and functional service to the community.

An article by Fateme Mohammadi et al. (2021) due to lack of equipment of public and

private hospital and work overload of HCW’s, HCW’s personnel are subjected to

many psychological issues, which adversely affect of quality of healthcare emergency

provided by them in the current health crisis. Facility and HCW’s Should be one of

the priorities of the administrator are preserving the psychological health of the

personnel who are dealing with COVID-19 patients. As today the HCW’s is the

modern hero that we need to protect and value their mental health for them to provide

the best service available in the of this pandemic.

According to Zerbini G, Ebigbo A, Reicherts P, Kunz M, Messman H. (2020) As

mentioned in the study that healthcare workers, particularly those in constant and

direct contact with COVID-19 patients, are at higher risk for psychological burden

and distress. Given the healthcare worker is more affected and more at risk at their

field given this virus are dangerous, some HCW’s are undergo at the burnout stage

because of their workload and fear. HCW’s service is needed to this modern era and

their mental health needed to protect too. Special programs addressing their needs

should be address. Psychosocial support at work looked as if it would be another

important resource. Keeping working groups stable, improving communication and

recognition, providing clear guidelines and social support are samples of however the

working environment could be improved during epidemics. Their mental health

should be in care for better working during pandemic.

As study by Shah K, Chaudhari G, Kamrai D, Lail A, Patel RS. (2020) the healthcare

workers frontline that responding to the COVID-19 outbreak are most needed today

because of their critical work for the community to ensure the safety and health of the

people, it is very important that we need to keep their mental and physical health to

work at hardest. Investing immediately in the wellness of the healthcare workers to

avoid shortage or miscommunication due to burnout. The study proposes necessary

basic measures for the authorities and organizations towards identifying and

managing the healthcare workers burnout threats in the early stages of the COVID-19.

It is in the best interest of public health to start acting on this dreadful issue now

instead of reacting it later when it deepens further.

In addition, Healthcare workers sleep and other mental health problems are

associated with an increased risk of work related-stress symptoms. Because of their

increasing workload due to increase rate of COVID-19 some of the healthcare

workers experiencing burnout, physical exhaustion, and lack of sleep this can affect

their service. The major cause of insomnia is considered to be stress. The findings

revealed that STS is both favorably and negatively associated to mental health

problems, which are mediated by insomnia and exhaustion.

 CHAPTER 3

RESEARCH METHODOLOGY

This chapter presents the research design, and respondents. It further discusses the

instrument to be used for the research and how it will be administered and analyzed.

Ethical considerations and the statistical treatment to be used for the study are also

elucidated here.

RESEARCH DESIGN

The researcher will use the quantitative descriptive method since the study

focuses on the Stress Level and Psychological Well-Being of HealthCare Workers in

Barangay Mamatid Amidst the Covid-19 Pandemic which are current condition and

situation. According to Calmorin (2010),descriptive-status seeks the real facts in

relation to a current situation. in addition , the purpose not only to find the truth but to

find new one. This same truth could take different forms and Paler-Calmorin
explained that the descriptive method is valuable as well as indispensable to discover

of the truth and all its nuances. Likewise , quantitative research is a mean for testing

objective theories by examining the relationship among variables (Polit and Hungler

2013; Maxham 2012). Furthermore, this is also involves describing, researching,

comparing, contrasting and interpreting conditions that exist. The design is also

appropriate to the study since it seeks the Stress Level and Psychological Well-Being

of Barangay HealthCare Workers in Barangay Mamatid Amidst the Covid-19

Pandemic. 1

7
RESEARCH LOCALE

The researchers chose Barangay Mamatid to conduct their study due to its near

location from the school of the researchers. This will help the researchers to gather

necessary data easily.

POPULATION AND SAMPLING

A purposive sampling procedure will be used in limited respondents of the

study. This technique will be employed to ensure a fairly equal representation of the

variables for variables for the study. There will be a total of 30 healthcare workers in

Barangay Mamatid.

RESPONDENTS OF THE STUDY

The study population will be composed of 30 barangay healthcare workers of

the Barangay Mamatid.

INSTRUMENTS
 The study was done through the method of collecting data from the subjects

which are the barangay healthcare workers. This was done through the use of self-

administered questionnaire that the participants are subject to in order to collect data

for the study.

The research instruments needed to be validated by psychometricians

knowledgeable in the field of psychology for a more effective and efficient gathering

and interpretation of essential data.

Through these, the researchers were able to determine possible solutions and

recommendations if there were an existing psychological impact.

In order to support the study, the researchers gathered the necessary

information that were relevant and significant for this study through the use of

information found in book, research, articles, journals, internet etc.

DATA GATHERING PROCEDURE

In order to achieve smooth investigation about Stress Level and Psychological

Well-Being of HealthCare Workers in Brgy. Mamatid. The researchers will seek first

the permission of Head Administration of the College Department to conduct the data

gathering. After this approval, the letter of approval will be given to the Barangay

Chairwoman in Brgy. Mamatid together with the validated self-administered

questionnaire to be distributed to the respondents. The validated questionnaire will be

collected on the agreed date and consolidation and tabulation of data will follow.

Then consolidated data will be submitted to statistician for the treatment.

VALIDATION OF INSTRUMENT
 The researchers will utilized self-administered research

instrument/questionnaire and will seek 30 Barangay HealthCare Workers experienced

Stress and Psychological Well-Being, the study to check the internal consistency of

the instrument will seek the guidance of statistician to be treated using likert scale.

ETHICAL CONSIDERATION

The researchers will be considering the ethical principles in conducting

research throughout the study. Asking the consent of the barangay, respondents and

explaining the importance of the objective of the study will be employed. The data

and information that will be collected from the survey will be kept confidential. As

for the works of other researchers and authors, the researchers will see to it will be

properly recognize.

TREATMENT OF QUANTITATIVE DATA

The study will utilize the following statistical tools to obtain the results of the

study:

1. For the teachers’ level of knowledge and research skills the five-point likert

scale and simple mean will be applied

2. For the relationship between the stress level and psychological well-being

of health care workers in barangay mamatid.