Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.

6626151
Research Article

The Impact of Stress to the Quality of Life of the College Students During the
COVID-19 Pandemic
Patt Jerome Dela Cruz*, Agatha Maxine Aquino, Marienela Curioso, David John Tia,
Sabian Louis Samonte, Joanna Gabrielle Policarpio
For affiliations and correspondence, see the last page.

Abstract
This study investigates the impact of stress on the quality of life of college students during the
COVID-19 pandemic. Further, descriptive-correlational research design was employed to obtain the
respondents' profiles regarding their stress, physical health, psychological health, social relationships,
and environmental health. A total number of two hundred twenty-four (224) college students
participated in the study. The researcher utilized two standardized questionnaires to gather the data
from the respondents: The perceived Stress Questionnaire with thirty (30) items and the World Health
Organization Quality of Life – BREF with twenty-six (26) items. The null hypothesis was tested at
0.05 level of significance and was analyzed through multiple regression analysis. The statistical
analysis of the study presented a significant impact of the college students' stress on their quality of
life. Interpretations and conclusions were formulated from the research findings, and the researchers
provided recommendations at the end of the research for the beneficiaries of this study.

Keywords: Quality of Life, Stress, College Students, Online Learning, COVID-19 Pandemic

Introduction stressors (Son et al., 2020). With the COVID-19

pandemic emerging, studying the students’ stress is
necessary to lessen its adverse impacts on their health.
Stress is a reality present in every individual’s life With the current research study, this issue is discussed
(Kassymova et al., 2018). Although ill-defined, it is a
and assessed further.
common human experience that can have severe
physical and emotional health (Miaskowski et al.,
2018). Also, it is the body's general reaction to
stimulus in an attempt to restore homeostasis or
balance. However, this type of change may result in
physiological, emotional, or psychological strain.
When confronted with stressors, a person's stress level
rises. This process may become harmful if the body
does not restore balance as a mechanism of reacting to
these stressors (Silva et al., 2017). Over the last
century, the psychology of stress and coping has been
a prevalent issue of scientific study and widespread
interest (Wendorf & Brouwer, 2018).
Further, the current study will focus on the feelings
and perceptions of students regarding their personal
and academic life stress. When an individual perceives
a situation as dangerous while also believing that they
lack the resources to deal with it, the problem is
considered stressful (Mondo et al., 2021). Thus, the
conditions and circumstances felt by students as
stressful will be assessed by this study to obtain the
students’ stress levels.
The COVID-19 outbreak resulted in increased stress
and anxiety for students. Higher levels of stress and
anxiety among students were attributed to various
In the disciplines of health and medicine, quality of
life has established itself as an essential concept and
aim for research and practice. Over the past few
decades, greater attention has been given to research
on the quality of life. In addition, the usage of quality
of life measures has increased. Despite the necessity of
quality of life in health and medicine, there is still a
conceptual and scientific discussion about its meaning
and how it should be tested. The term has no
universally recognized definition (Haraldstad et al.,
2019).
According to the World Health Organization (1994, as
cited in Panzini et al., 2017), quality of life refers to a
person's perspective on their position in life about their
objectives, ambitions, values, and concerns in terms of
the systems of social and values they belong to.
Psychological health, bodily health, social
relationships, and environmental conditions all
contribute to the quality of life of an individual
(Malibary et al., 2019). These are the four components
of quality of life: bodily health, psychological health,
social relationships, and environmental health. These
four components determine an individual’s quality of
life.

Patt Jerome Dela Cruz

2/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
Physical health is the first component of quality of life,
and it includes a person's daily living activities, fatigue
and energy, sleep, discomfort and pain, and other
factors that affect an individual’s body (Ilić, 2019).
Physical health refers to the physical body's state and
its overall well-being. The biological processes and
functioning of the body are highlighted in this
component of quality of life.
Meanwhile, psychological health is the second
component of quality of life. It includes a person’s
positive and negative feelings, spirituality or personal
beliefs, self-esteem, body image, and other aspects of
their cognitive thinking (Ilić, 2019). This component
of quality of life refers to what it means to be healthy
on mental, emotional, and spiritual levels.
Next, the third component of quality of life is social
relationships, which includes a person’s relationships,
sexual activity, and social support (Ilić, 2019). The
connections that form between people who have
regular communication are involved in this
component, where the relationships are regarded to
have personal significance to an individual.
Lastly, the fourth component of quality of life is an
environmental health, which includes a person’s
safety, security, freedom, physical environment, social
care and health, and more factors present in a person’s
environment (Ilić, 2019). This component focuses on
the relationship between people and their environment
and how the environment affects a person’s overall
health and well-being.
In Labrague et al.'s (2018) research, stress perceptions’
effects on quality of life seem significant among
nursing students in the Philippines. Compared to
students from other countries, nursing students from
the Philippines experienced much greater stress levels.
Increased levels of stress among nursing students from
the Philippines could be attributed to the country's
nursing course, which requires students to go
through cli nical hours greater than other
countri es' r equir em ent s.
Kim (2021) stated that COVID-19 stress appears to
significantly affect university students’ quality of life
in South Korea. University students are becoming
increasingly stressed and anxious about their education
and career goals as COVID-19 progresses. The stress
that students face in school has an effect not only on
their academic performance but also on their overall
quality of life.
Similarly, according to Hawash et al. (2021), stress has
a significant negative relationship with both physical
Patt Jerome Dela Cruz
and psychological aspects of quality of life during the
COVID-19 pandemic in Saudi Arabia. The majority of
their study’s participants had moderate levels of stress
associated with COVID-19 during lockdowns, and the
respondents' reported high levels of stress have a
consistent inverse relationship with all areas of
physical and mental functioning in quality of life.
In addition, the research of Alkatheri et al. (2020)
states that perceptions of stress have a negative
relationship with scores in all four QOL dimensions,
implying that lower stress levels are firmly and
significantly connected to a higher quality of life. The
students' difficulties in terms of their quality of life are
linked to their stress perceptions.
On the other hand, Silva et al.’s (2017) study show that
the stress perceptions levels and the overall quality of
life score did not have a strong relationship when those
variables were assessed. However, the study states that
the perceived degree of stress was linked to the
physical health component in the quality of life. Apart
from the physical health aspect of quality of life, the
researchers stated that the levels of stress were not
significantly correlated to the overall quality of life.
Moreover, this study’s main goal is to assess the
impact of stress to the college students’ quality of life
amidst the COVID-19 pandemic. The college students
are the respondents of the study. It was found by Yang
et al. (2021) that academic stress, detachment from
school and concerns about contracting the COVID-19
virus all had negative impacts on college students'
well-being and their stress perceptions.
Research Question
The main objective of this study is to determine the
impact of stress on the quality of life of college
students during the COVID-19 pandemic.
Specifically, this study sought to answer the following
question: Do the students’ stress significantly impact
their quality of life?
Literature Review
Students’ quality of life is negatively impacted by their
stress. In the study of Abdulmalik et al. (2020), the
four components of quality of life are negatively
affected by stress levels. The research of Abdulmalik
et al. focuses on health sciences students from 2015 to
2016. The World Health Organization Quality of Life
(WHOQOL) – BREF was used to measure the quality
of life, and to measure stress, the Perceived Stress
3/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
Scale (PSS) was utilized. The study found that gender,
family size, income level, scholastic performance,
college and smoking habits all had a substantial impact
on quality of life ratings, however PSS scores were
unaffected by all the participants' demography or
academic variables. The study discovered a significant
negative connection between ratings in the PSS
and four WHOQOL-BREF domains. As a result, the
majority of students who participated in the
research seemed to identify issues in various parts of
their quality of life that were linked to their stress
perceptions. The researchers suggested that more
research is necessary to assess the impact of
establishing academic and counselling services plans
to enhance quality of life and decrease stress levels
among medical students.
Furthermore, Anjara et al. (2017) investigated the
quality of life’s factors including stress, management
style, and demographic and social characteristics in
their study. The survey of the study was conducted
with migrant domestic workers in Singapore. The
researchers used the Australian edition of the WHO
Quality of Life – BREF for the assessment of quality
of life and health of the participants. The results of the
study assert that in all four dimensions of quality of
life, lessened stress perceptions are closely related to a
greater quality of life. Also, it was found out that
majority of the participants felt stressed, and it was
strongly related to a lower quality of life. The
researchers argue that measures (such as rest days) are
needed to promote domestic workers' well-being and
quality of life, as well as to make coping strategies
more accessible to them.
Moreover, the study of Hirsch et al. (2020) examined
perceived stress, quality of life, and coping strategies
in medical students. The study was participated in by
PharmD students during the first three years of the
curriculum. The research made use of the following
instruments: the Brief COPE, the Perceived Stress
Scale, and the SF-36. The findings of this study
revealed that PharmD students at the school
experienced higher levels of stress, lower quality of
life, and utilized more maladaptive stress management
techniques throughout the first three years of the
curriculum when compared to levels reported at entry
to other schools. The study found that the increase in
the scores of stress was related to the worsening of
quality of life in its mental health component. For this
reason, researchers of the study suggested how it is
necessary to take a multi-pronged strategy to
implement beneficial stress reducing solutions and
identify the effect of these solutions with students'
stress, quality of life, and coping mechanisms.
Patt Jerome Dela Cruz
In addition, Kołtuniuk et al. (2021) evaluated the
association between MS patients’ quality of life their
relationship to coping mechanisms and stress levels.
The researchers conducted the study among patients
with relapsing-remitting multiple sclerosis in
Wroclaw, Poland. The diagnosis assessment method
was used in the study, along with the authors' survey
and the structured questionnaires that follow: the
Perceived Stress Scale, Inventory for Measuring
Coping with Stress, and MS International Quality of
Life Questionnaire. The study’s findings indicate that
quality of life has a strong negative relationship with
stress levels, similar to earlier research. The
researchers suggested that the use of coping strategies
to lower perceived stress is correlated to improvements
in quality of life. Thus, the study recommended that
because effective methods of coping with challenging
conditions increase patients' quality of life, health
professionals, particularly hospital workers, must
assist patients in acquiring the ability to cope with
stress.
The study of BenGhasheer and Saub (2020) examined
how perceived stress, acculturative stress, and oral
health quality of life interacted. To obtain the needed
data, international college graduates attending
Malaysian public universities were investigated for
this study. The researchers employed a web-based
questionnaire that included perceived stress scale
(PSS-4), acculturative stress (ASSIS-36), and quality
of life in oral health measures (OHRQoL, OIDP-8).
The researchers found that those who had higher
degrees of acculturative stress had their quality of life
be affected negatively in oral health. As this study
expected, acculturative stress had an impact on quality
of life both directly and indirectly through perceived
stress. The researchers emphasize on the value of
psychological research in aiding the design and
management of tailored treatments to improve oral
health quality of life.
Likewise, Bishop-Fitzpatrick et al. (2017) stated in
their study that stress perceptions is negatively related
with one’s quality of life. This research investigated
the impact of social and recreational activities with the
correlation between quality of life and stress
perceptions. A broad, longitudinal sample of adults
and adolescents with autism spectrum disorder, as well
as their relatives, were included in the study. In this
study, the researcher utilized the WHO Quality of Life
Assessment’s short version and Perceived Stress Scale
as their instruments. The researchers' hypothesis that
stress perceptions have a major effect on adults with
ASD’s quality of life was confirmed by the study's
findings. The findings also demonstrated that
4/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
recreational activities, but not social activities,
influenced perceived stress and quality of life’s
relationship. The researchers suggest that therapies and
programs that can provide support and opportunity for
recreational activity participation must be
implemented to assist adults with ASD enhance their
quality of life and cope with different stressors.
Also, the research of Çelmeçe and Menekay (2020)
was conducted to determine the impact of anxiety,
fatigue levels, and stress on an individual’s quality of
life. The study's participants were healthcare
professionals who work in epidemic hospitals in
Turkey's Tokat city center. The researchers used the
Maslach Burnout Inventory, Quality of Life Scale,
Spielberg State-Trait Anxiety Inventory, and PSS to
gather the needed information from the respondents.
The researchers found out that the stress, anxiety, and
burnout levels of healthcare professionals were found
to have a high, moderate, and positive correlation in
their quality of life; quality of life and stress have a
negative and significant relationship. The researchers
recommend that mental wellbeing intervention teams
be formed, brochures be developed, and a range of
mental treatments, such as psychotherapy, be provided
to individuals and families, in order to lessen the
mental harm caused by COVID-19 among healthcare
workers.
Additionally, according to Abshire et al. (2018),
perceived stress and exhaustion were important
correlates of health-connected quality of life. The
study’s main goal is to look at the relationships with
quality of life and stress indicators. The study also
intended to define psychological stress indicators such
as perceived stress, fatigue, coping, and depression.
The study comprised patients with a Left Ventricular
Assist Device who were treated by the LVAD clinics
at two major tertiary hospitals in the United States'
mid-Atlantic portion. The researchers administered the
surveys on the respondents which were the Perceived
Stress Scale, Perceived Health Questionnaire,
Multidimensional Assessment of Fatigue, Brief COPE,
ENRICHD, and Kansas City Cardiomyopathy
Questionnaire. It was concluded by the study that low
quality of life was connected with high stress
perception and exhaustion, and this association was
mediated by social support. In addition, the study also
discovered that those with greater stress perception
experienced more symptoms of depression,
exhaustion, and employed maladaptive responses more
often when compared to individuals with lesser stress.
The researchers proposed that social support provided
to Left Ventricular Assist Device patients be evaluated
on a regular basis so that their quality of life could
Patt Jerome Dela Cruz
improve.
Correspondingly, Edman et al. (2017) investigated the
relationships between quality of life, stress, and
reported pain evaluations as indicators of symptom
treatment. The researchers selected patients diagnosed
with gastrointestinal diseases as the participants of the
study. The study made use of three instruments: the
Perceived Stress Scale was utilized to assess patients'
stress, the SF Health Survey for quality of life
assessment, and the Center for Epidemiologic Studies
Depression Scale for mood assessmnet. With the
gathered data, the results reported that quality of life
lessening on its psychological health aspect was
connected with higher stress perception. A vast scope
of quality of life indicators and signs, such as mood,
sleep quality, and exhaustion are strongly linked to the
patient's stress experience. It was recommended by the
researchers that integrated medicine therapeutic
interventions should be investigated since they would
be the most useful, particularly for individuals with
gastrointestinal illnesses.
Likewise, the study of Hawash et al. (2021) sought to
see if there was a connection with COVID-19 stress
and quality of life in Saudi Arabia. The subjects of the
study included residents and citizens of Saudi Arabia
who are 18 years old and above. The research
instruments were a sociodemographic and clinical
profiling, Standard Perceived Stress Scale, and SF-12,
which were distributed through social networking
sites. The study's findings revealed that total stress
perceptions scores and dimensions of health related-
quality of life had a significantly negative relation.
COVID-19 stress was found to have a considerable
negative correlation on both psychological and
physiological health-connected quality of life. The
researchers recommended evaluating the efficacy of
stress intervention programs and taking a
comprehensive approach.
In addition, Yorks et al. (2017) sought to see if there
was a link between quality of life, stress, and exercise.
Osteopathic medical students were chosen as study
participants in order to obtain the necessary
information. The Perceived Stress Scale and quality of
life questionnaires determined by visual analog scales
were used by the researchers as survey tools that were
presented to the participants. The study’s findings
show that learners who are engaged with a fitness
program on a regular basis saw a considerable
reduction in perceived stress and a gain in the
physiological, psychological, and emotional quality of
life. It shows that the quality of life and stress levels
possess a significant relationship as the quality of life
5/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
levels increase when the levels of stress decrease.
Therefore, the researchers suggested the addition of
group exercise programs to a population of students as
it has extra benefits, and engaging in community
exercise programs might lead to improvements on
students' and physicians' well-being.
Along with this, the study of Limbers et al. (2020)
analyzed the connections between quality of life,
exercise, and parenting stress. Mothers working at
home full-time from the US were taken as the study’s
participants. The participants completed the following
questionnaires in this study: a demographic survey,
WHO Quality of Life Scale - BREF, International
Physical Activity Questionnaire – short form and
Parental Stress Scale. The findings of the study
demonstrate that higher parenting stress is linked to
decreased quality of life of parents in all dimensions. It
was also discovered that the association between
parental stress and moderate physical exercise was
linked to the quality of social well-being and the
quality of the environment. The researchers proposed
that moderate physical exercise should be
implemented to reduce the detrimental effect with
parenting stress on working mothers’ quality of life.
Moreover, Labrague et al. (2018) performed a study to
assess nursing students' stress perceptions and quality
of life in three nations, in addition to the impact of
levels of stress on quality of life. Data in the study
were collected from students in nursing in various
countries, namely the Philippines, Greece, and Nigeria.
For the instruments of the study, the researchers used
the Quality of Life Evaluation Skill and the Perceived
Stress Scale. The results revealed that students’ views
of stress and their quality of life differed throughout
the three countries. Furthermore, increased stress
perceptions were detected from patient care, the
clinical setting, and interactions with peers, staff, and
faculty, all of which predicted a poor quality of life.
The study also highlighted the importance of empirical
investigation and culturally customized therapies for
reducing stress and improving QoL in nursing
students.
Further, Tseng et al. (2018) investigated the elements
that influence nursing staff's job stress, endurance, and
occupational quality of life, as well as their connection
with one another. The participants of the study were
nurses who had taken care of the patients with burn
during the dust explosion in Taiwan. The demographic
assessment, Professional Quality of Life Scale, Nurse
Stress Checklist, and Connor Davidson Resilience
Scale were among the structured surveys used by the
researchers. The study discovered strong connections
Patt Jerome Dela Cruz
with professional quality of life and job stress
perceptions, as expected, which is consistent with
previous research with the same topic on nurses
working in intense settings. The study's findings
revealed significant relationships between professional
quality of life and all components of job stress. It was
suggested by the study to hospitals that they should
always be equipped to respond to post-disaster
demands with nurse staff. It was also recommended
that interventions aimed at increasing resilience be
focused in order to decrease psychological trauma in
nurses who had been exposed to catastrophic large
casualty occurrences.
Also, Won and Chang (2020) investigated the
connections with self-efficacy, work satisfaction,
stress of school violence, and teachers' quality of life,
with a focus on the moderating effect of job
satisfaction and coping self-efficacy on the teachers’
quality of life. The respondents in the study are school
teachers working at different schools. For the
instruments of the study, the study used the measures
of School Violence‑Related Stress, Satisfaction With
Life Scale - Korean Version, Job Satisfaction, and
Coping Self‑Efficacy. It was revealed in the study’s
findings that there were significant links in stress of
school violence and self-efficacy, quality of life, and
job satisfaction. Also, the negative correlation between
quality of life and stress of school violence was fully
moderated by coping self-efficacy and work
satisfaction. As a result, the study proposed that an
intervention procedure can be beneficial in assisting
teachers in reducing stress, improving coping self-
efficacy, and work satisfaction once they are
confronted with violence in schools that threatens their
quality of life.
Furthermore, the study of Khodami et al. (2021)
carried out an investigation into the relationship in
people's quality of life, mental changes, and perceived
stress as a result of the pandemic around the world.
The survey drew participants from all over the world
with the use of social media. The study utilized the
following instruments: □□the COVID-19 Quality of
Life Questionnaire, Perceived Stress Scale, Emotion
Regulation Questionnaire, and a demographic
assessment. The findings of the study show individuals
with a poor quality of life response found to have
higher stress and emotion control issues. It was shown
t h a t t h e r e is i n d e e d a n e g a t i v e and
significant relationship with stress and quality of life,
especially in younger individuals. The researchers
suggested that mental health treatments be
implemented to improve overall population's quality of
life.
6/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
Moreover, the study of Kim (2021) ought to see if
family health had an effect on the connection with
COVID-19 spread stress and university students'
quality of life. The study was conducted among
university students in South Korea. The instruments of
this study are Korean Family Health Scale Ⅱ, the
WHO Quality of Life Scale-BREF and Korean
Version, and the COVID-19 Student Stress
Questionnaire. The findings of this study determined
that the influence of COVID-19 spread stress on the
quality of life of university students was negative and
significant, whereas family health had a positive
impact. In the midst of the COVID-19 pandemic, this
study discovered that family health is significant in
lowering stress and boosting university students'
quality of life. As a result, the study suggested that
programs for communication with parents, such as
effective parent-child dialogue, be implemented.
The study of Kupcewicz et al. (2020) stated that the
goal of their research was to see if there was an
association connecting levels of stress, mechanisms of
coping, and quality of life. This study utilized nursing
students from the countries of Slovakia, Spain, and
Poland. The data was collected using the instruments
Mini-COPE Coping Inventory, the WHO Quality of
Life - BREF version, and Perceived Stress Scale. This
study's findings revealed a strong connection with
levels of stress and general quality of life and overall
health. The findings show negative correlations,
meaning that the greater the stress level, the poorer the
quality of life, and vice versa. As a result, it was
recommended by the study that psycho-educational
seminars incorporating assertive behavior and
intentional use of interpersonal communication
strategies should be implemented. To ensure adequate
protection against the consequences of stress and to
enhance the quality of life of medical students,
preventative and stress management programs were
recommended by the study.
Identically, Nam and Park (2020) aimed to see how
perceived stress and self-compassion impact the levels
of quality of life. Data for the study was gathered from
nursing students. The instruments used to obtain the
needed data are the Perceived Stress Scale, Self-
compassion Scale, and the WHO Quality of Life Scale
– BREF. The study’s findings demonstrated that
perceived stress, school satisfaction, self-compassion,
and general health were among the factors that
influence quality of life, with perceived stress having
the most significant effect. The findings of this study
recommended that for them to be able to enhance their
quality of life, nursing college students should look for
ways to lower their perceived stress levels and increase
Patt Jerome Dela Cruz
self-compassion through meditation programs.
Correspondingly, the study of Feltrin (2019)
investigated how stress affected the health behavior
and quality of life in residents within a hospital of a
university. The study is cross-sectional and
quantitative involving all multi-professional health
residents of a teaching hospital. The researchers used
the WHO Quality of Life – BREF to determine the
quality of life, the National College Health Risk
Behavior Survey was used to determine health
behaviors, and the Lipp Adult Stress Symptom
Inventory was used to assess stress. According to the
findings, stress-affected residents have a lower quality
of life. It was revealed by the study that stress affects
quality of life significantly. Managers of multi-
professional residentials are advised by the study to
recognize stress as a disease promoter and quality of
life reducer in their RMS. It was recommended that
hospitals should invest in assessing stress risk factors
that permeate RMS and multifactorial procedures for
lessening of sources of stressors and establish
residents' quality of life.
In addition, the study of Perveen et al. (2019) was
carried out to determine the connection between the
quality of life, mental stress, and death anxiety and
also the impact of stress and death anxiety on quality
of life in patients with renal and liver transplants.
Patients of liver and renal transplant recipients
participated in this study. The instruments used are the
Quality of life scale, depression, anxiety and stress
scale, and death anxiety scale. This study revealed that
stress was significantly and positively related to death
anxiety, while the quality of life had a negative
correlation with stress. The findings of this study
recommended that counselors for patients with renal
and liver transplants should be appointed by
policymakers. Also, it was stated by the study that the
involvement of a psychologist will be beneficial in
coping with stress, enhancing patients’ quality of life,
and lessening anxiety of death.
Additionally, Staunton et al. (2020) aimed to assess
quality of life and stress of children with mental
disabilities’ parents, as well as to evaluate perceived
levels of challenging behavior and gratification with
assistance. The study’s survey was carried out with
parents of children alluding to the Child and
Adolescent Mental Health Intellectual Disability
Service. To obtain the needed information, the study
used the Aberrant Behaviour Checklist, Parenting
Stress Index, Family Quality of Life Scale, and
modified Family Support Scale. The findings of the
study revealed that challenging behavior and autism
7/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
were linked to higher parental stress, whereas parental
support was discovered to have an inverse relationship
on stress. A decline in perceived family quality of life
was also linked to cognitive impairment, autism, and
parental stress. The researchers suggested that parental
programs catered to these parents' needs be created to
help them learn and deal with the stress factors of
bringing up a child with intellectual impairment and
psychological issues, as well as providing support
networks that these parents could not have experienced
presently.
Furthermore, Grabski et al. (2019) carried out their
research on the relevance of minority stress as a factor
in determining gay and bisexual male's quality of life
in its sexual dimension. This study’s participants were
heterosexual, bisexual and gay Polish men. The
researchers employed standardized questionnaires such
as the Sexual minority stress scale, the sexual quality
of life scale - men, IIEF-2, and the premature
ejaculation diagnostic tool. The findings of the study
reveal that minority stress, namely internal
homophobia and sexually abusive minority events,
was found to be a strong predictor of sexual life
quality among homosexual men. The study suggested
that homosexual men's sexual quality of life must be
evaluated and improved not just in terms of their
sexual dysfunction, but also in terms of stress in
minority, notably internal homophobia.
Sousa et al. (2020) stated that the goal of their research
is to ascertain the frequency of depression and stress in
individuals with kidney diseases, as well as the
correlation among quality of life and pain with stress
and depression. Data for the study were gathered from
individuals who experienced hemodialysis. The
researchers used the depression and stress anxiety
scale, Medical Outcomes Study Short-Form 12-Item
Health Survey, and brief pain inventory. This study
shows that people with kidney diseases are more
vulnerable to depression, anxiety, and stress. Higher
levels of pain are linked to stress, worry, and
depression, interfering with everyday activities and
resulting in a poor quality of life in both physiological
and psychological aspects. Stress, worry, and
depression had a major impact on various areas of
quality of life. The researcher suggests that nurses
should establish methods to enhance the mental health
of individuals with kidney diseases aimed at enhancing
their quality of life.
Furthermore, the research of Teixeira et al. (2019) was
conducted to assess and correlate job stress and work
quality of life among nursing staff. The researchers
conducted their study among nurse staff assigned for
Patt Jerome Dela Cruz
the Emergency Care Unit in Brazil. The instruments
utilized are the job stress scale, quality of life at work,
and a demographic assessment. The researchers found
that the majority of nursing staff in the Emergency
Care Unit are content with their quality of life at work
and are subjected to mild occupational stress.
However, it was discovered that nursing professionals
who took high pressure and sedentary jobs were
expected to be unsatisfied with their quality of life at
work, demonstrating the significant correlation
between quality of life at work and work stress. The
findings proved that greater stress levels lead to
discontent with quality of life at work. Therefore, the
study suggested developing and implementing
strategies to enhance workplace conditions. The
creation of worker benefit programs was also
recommended which could help to reduce workplace
stress and increase workplace quality of life.
Identically, Danilewitz (2017) aimed to see in
Canadian teachers whether different sources of stress
contain a strong impact on quality of life. Elementary
and secondary education teachers based in Canada
have been chosen to be the participants of the research
through emails and newsletters. The quality of life was
assessed with the WHO Quality of Life - BREF, while
stress was measured through the Sources of Stress
Inventory. Amongst the results, personal life stress
appeared to be the most significant predictor for
general health of quality of life while personal life
stress and work-life stress appeared to be significant
predictors for psychological health of quality of life.
Thus, it was discovered that stress possesses a strong
effect on quality of life in teachers. The study
suggested applying mediation to the three stress levels
so that quality of life of the teachers may improve
positively.
Moreover, Pisula et al. (2017) studied the correlation
with the parenting stress, parents’ quality of life, and
family functioning on children that have autism
spectrum disorders. Pairs of parents that have children
with autism were made as the respondents of the study.
The respondents were asked to answer the following
instruments: Family Assessment Measure III,
Questionnaire of Resources and Stress for Families
with Chronically Ill or Handicapped Members - Short
Version, and WHO Quality of Life - BREF. The
study’s results have shown that the parents reported
higher parental levels of stress wherein quality of life
was lowered. Significant connections with parenting
stress, family functioning, and quality of life were also
discovered. The study recommended to future
researchers that they should include viewpoints of
other members of the family, especially healthy
8/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
siblings of kids with autism.
Furthermore, Qi et al. (2020) conducted a study among
Chinese adults which looked to provide insight into
their levels of perceived stress, physical participation,
and quality of life in its health dimension during the
COVID-19 pandemic. The study's participants were
Chinese Ethnic adults living in China gained through a
mobile communication app. The Chinese versions of
the SF-8, Perceived Stress Scale, and the International
Physical Activity Questionnaire were used for the
study’s instruments. The study showed that more than
half of the respondents had intermediate stress levels.
The study’s results showed the strong relationship of
quality of life in its health dimension, perceived stress,
and physical participation amongst the participants.
The study recommended public well-being programs
to improve physical activity in Chinese citizens to be
able to maintain well-being.
In addition, Li et al. (2019) looked into the state of
occupational stress and its correlation on miners'
quality of life, so that theoretical foundation for
reducing work stress and enhancing their quality of life
can be developed. The study included mining
personnel who were enrolled with a mining HR
department and were on the job for at least a year. The
instruments they were given are the Effort–Reward
Imbalance survey and the SF-36 health questionnaire.
This study discovered that miners are generally
subjected to job stress, and that age, gender, education,
monthly salary, and the specific working unit are all
affecting factors. Further, all miners' quality of life
was influenced by work stress. To improve the quality
of life of copper and nickel miners, researchers have
recommended that interventions should be done to
reduce work stress.
Additionally, Chakraborty et al. (2017) looked into
assessing the role of work stress and their impact to the
quality of life of employees. Construction workers are
analyzed in the study. To obtain the necessary data, a
self-designed general questionnaire was used. Other
questionnaires were also employed including the
Nordic Musculoskeletal Questionnaire, Occupational
Stress Index, and World Health Organization Quality
of Life - BREF. According to the findings of this
study, construction workers are individuals who suffer
significant stress levels at work. These construction
employees received a poor grade in all aspects of their
quality of life. Overall job stress was found to have a
negative and very significant association with general
quality of life. It was advised by the study that workers
be informed about well-being and safety risks related
to their jobs on a regular basis. Also, it was suggested
Patt Jerome Dela Cruz
that to limit the incidence of injuries, more protective
equipment should be required.
Likewise, the study of Mardea and Kristina (2020) was
implemented to investigate the relation between levels
of stress and quality of life. Students in pharmacy from
Yogyakarta, Indonesia are the participants in the study.
The instruments used for the study were the Perceived
Stress Scale to gather data regarding stress and WHO
Quality of Life Scale - BREF to obtain data regarding
quality of life. It was revealed that a strong
relationship with quality of life and stress among
medical students was present. Thus, it was
recommended by the study that educational institutions
should create policies that observe medical students’
stress management and mental health by assessing the
activities and tasks included in medical education to
enhance the students’ quality of life.
Furthermore, Assana et al. (2017) aimed to lay out the
relationships between depression, anxiety, and
educational stress with quality of life. Students from
grades 10, 11, and 12 in the Northeast of Thailand
were the chosen respondents. The instruments used to
gather data was the Educational Stress Scale for
Adolescents, a Thai version of the WHO Quality of
Life scale, Thai Hospital Anxiety and Depression
Scale, Center for Epidemiological Studies–Depression
Scale, and a Thai version of the WHO-5 Well-being
Index. The results of the study show that educational
stress, anxiety, and depression greatly influences a
student’s quality of life. It was also found that the
presence of academic stress, worry, and depression in
high school students was great, which is consistent
with other studies' findings. The study suggested that
counseling skills should be developed, as well as
activities that foster parent-child understanding and a
reduction in expectations.
In addition, Al‐Smadi et al. (2017) conducted a study to
identify anxiety and stress in the Kingdom of Jordan
and assess its relationship with quality of life. Iraqis
who were refugees are the study’s participants. The
instruments used were the Perceived Stress Scale,
Hamilton Anxiety Rating, and the Quality of Life
Index. The study has revealed that half of the
respondents experienced high levels of anxiety and
stress, and that it was directly impacting their quality
of life. It also revealed that the three primary factors to
quality of life reducing were loss of jobs, having
members of family below three, and anxiety levels. It
was recommended by the study that the three factors
be considered in future interventions towards the
displaced refugees in order to develop their quality of
life.
9/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
Moreover, Li et al. (2019) studied the connections with
stress of infertility and quality of life in its fertility
aspect. The respondents of the study were women with
infertility in China and they completed the following
questionnaires: Fertility Problem Inventory, Connor-
Davidson Resilience Scale, and Fertilitity Quality of
Life Scale. The data revealed that women with higher
stress of infertility had a lower fertility quality of life
score. Also, the strong connections with stress related
to infertility and quality of life was modulated by
resilience. It was recommended by the study to further
examine the mental statuses of infertile individuals and
give more support to the said individuals by
developing interventions that promote resilience.
Likewise, the study of Mikkelsen et al. (2020)
intended to see if sociodemographic characteristics,
self-confidence, self-efficacy, discomfort, sleep,
isolation, quality of life related to health, and stress
had any relationships. This study was conducted
among adolescents aged 14 to 15 years old in a school
setting. The instruments used in the study are the
KIDSCREEN-27 measure, Rosenberg Self-Esteem
measure Generalized Self‐Efficacy Scale, Brief Pain
Inventory, School Sleep Habits Survey, UCLA
Loneliness Scale, and Perceived Stress Questionnaire.
The results of the study demonstrated that adolescents
have high reported quality of life related to health
levels in general. Results of the study have also shown
how stress, self-efficacy, loneliness, and self-esteem
are all significant factors of every dimension in quality
of life in health. The study recommended that future
interventions should strive to promote self-confidence
and self-efficacy for improving quality of life related
to health in teenagers.
Conversely, Silva et al. (2017) revealed that no
significant connection with the stress perception levels
and the total quality of life was found. Researchers
performed the study among healthcare professionals in
the city of Palmas, Brazil. The Perceived Stress Scale
was utilized to evaluate individual general stress while
the WHO Quality of Life – bref was utilized to get the
perceived quality of life. According to the study, there
was no link between stress perceptions and the many
dimensions of quality of life. The researchers also
identified a connection in stress and physical health of
medical professionals. As a result, interventions to
improve quality of life were recommended in order to
avoid future expenses and promote a more humane and
healthy life.
Im et al. (2019) investigated the associated in quality
of life and parenting stress, including the moderating
effect of family management styles. It was revealed in
Patt Jerome Dela Cruz
their study that the direct impact on quality of life of
parenting stress was not significant. The researchers
conducted an exploratory and descriptive study on
parents with children who are epileptic. To measure
and collect the data, three standardized questionnaires
were used in the study: the Korean edition of the QOL
in Childhood Epilepsy Questionnaire for identifying
quality of life, the Korean edition of the Parenting
Stress Index to measure a parent's stress while taking
care of a child with a continuing condition, and The
Korean edition of the Family Management Measure
(FaMM) to evaluate familial management frameworks
in families of a child with a chronic disease. The
findings of the study show that the parenting stress
does not significantly affect quality of life. Only easy
family management styles have a strong effect in
quality of life when all variables were assessed.
Therefore, the study recommended that the most
successful plans for improving quality of life in
children affected by disorders were to foster good
dimensions of familial management frameworks.
Moreover, Ahmad et al. (2018) investigated the
relationship between different types of stress and
quality of life among working adults. The respondents
who participated in the study are working adults in
Malaysia. The data collection was conducted with the
use of standardized questionnaires. The results of the
study have shown that perceived stress had a poor
relationship with quality of life across working
individuals. It was discovered that an individual's
feelings or ideas of how much stress they have has no
effect on their quality of life. On the other hand,
organisational and job environment stress were found
to have a strong relationship with quality of life among
employees. As a result, the study recommended that
attention should be paid to the different aspects of
stress so that the current situation can be enhanced and
present problems can be solved in working adults.
Additionally, the study by Feng et al. (2019) explored
the relationships with perceived stress, mindful self-
care, and health-connected quality of life. Its survey
was conducted on students in West Virginia who were
18 years old or older. Data for the study was gathered
through an online survey using a structured
questionnaire, which included the SF12v2, Perceived
Stress Scale (PSS)-10, and mindful self-care scale-
SHORT. According to the collected data, both mindful
self-care and perceived stress were not significantly
correlated to the physical well-being domain of health-
connected quality of life. On the contrary, the domain
of psychological well-being was affected by both
perceived stress and mindful self-care. This study
proposed that more mindfulness-based interventions
10/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
aimed at the students and young adult population be
implemented in order to improve psychological
wellness.
In conclusion, stress and quality of life have been
important concepts in the field of medicine, education,
and research. It is an important topic for students as
they face stress constantly in their daily tasks and
activities. The numerous related studies show that
stress has a strong influence in quality of life. It affects
one’s overall well-being and health with every
dimension of quality of life being affected
significantly. However, a gap in scientific knowledge
was also revealed. Several studies have shown that
stress and quality of life do not have a significant
relationship. It was also presented that stress does not
significantly impact an individual’s overall quality of
life but it only affects some of its components.
Previous researchers have conducted their studies on
civilians, patients, professionals, and university
students, but there is little knowledge of this concept
on the population of college students. With this present
study, the concept of quality of life and stress would
be applied to the population of college students, which
provides support to the existing knowledge. This
chapter gives students related studies that would make
them understand the impact of stress to their quality of
life. It gives them the guidance on how they could
improve their total health through management of their
stress in life.
Methodology
Research Design
This study employed the descriptive-correlational
design to demonstrate how one variable is related to
another when the researchers have no control over
independent variables. It is a simple, low-cost, and
efficient research method (Lappe, 2000, as cited in
Hancock, 2018). Descriptive-correlational is a study
method that deals between variables that allow future
predictions to be valid from the present situations. It
consists of data gathering techniques, analysis of data,
and interpretation. This approach is relevant to this
study because it reveals the relationship of the
presented factors in a clarified way. □□Correlational
research is a non-experimental design research that
uses statistical analysis to investigate the relationship
between two variables (Price et al., 2017). Results of
correlational research could show a positive, negative,
or no correlation. These descriptions of the
descriptive-correlational design show that this design
is appropriate to be utilized by this research as it could
Patt Jerome Dela Cruz
identify stress’ impact on college students’ quality of
life.
The study sought to identify the impact of stress on
college students’ quality of life. This study will utilize
the descriptive-correlational method to gather, analyze,
and interpret the data by the end of the research
process. The researchers used survey questionnaires to
acquire the required data from the respondents. Also,
the researchers distributed two questionnaires to
measure the two variables of the study. Lastly, the
study’s process was reviewed carefully to ensure that it
can fully answer the research problems and ensure that
the information gathered from the questionnaires is
provided by the respondents sincerely and truthfully.
Respondents of the Study
The respondents of this study were college students
enrolled for the school year 2021-2022. Thus, a
convenience sampling technique is used to select the
participants to be able to quickly and easily gather
readily available samples. This is particularly helpful
in the online setup of the present study.
Instrument of the Study
The study administered two instruments to determine
the impact of stress on the quality of life of college
students during the COVID-19 pandemic. The first
questionnaire used is the Perceived Stress
Questionnaire (PSQ). This questionnaire was used in
Erschens et al. (2018) study entitled “Differential
determination of perceived stress in medical students
and high-school graduates due to private and training-
related stressors.” However, this questionnaire was
first developed by Levenstein and colleagues in 1993.
The instrument contains thirty (30) items describing
the stressful life situations and circumstances present
in an individual’s life. The questionnaire used a 4-
point Likert Scale representing the answers in the
following order: one for almost never, two for
sometimes, three for often, and four for usually. The
internal consistency of the questionnaire was measured
by Cronbach's alpha of 0.93 (Østerås et al., 2018). The
present study will utilize this questionnaire to assess
the level of stress of the respondents.
The second questionnaire used is the World Health
Organization Quality of Life-BREF (WHOQOL-
BREF). This questionnaire is used to measure an
individual’s quality of life, and it was used in the study
of Medvedev and Landhuis (2018), entitled “Exploring
constructs of well-being, happiness and quality of
life”. This questionnaire, however, was originally
11/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
developed by the World Health Organization in 1996.
The instrument is a shorter form of the WHOQOL-100
and it consists of twenty-six (26) questions addressing
the four domains of quality of life: physiological
health (7 items), mental health (6 items), social well-
being (3 items), and environmental health (8 items).
The other two items are used to measure the overall
well-being and quality of life. The questionnaire made
use of a 5-point Likert Scale to represent the answers
which ranged from one for never/very dissatisfied/very
poor/not at all to five for always/very satisfied/very
good/an extreme amount. The instrument’s internal
consistency as measured by Cronbach’s alpha of 0.896
(Ilić et al., 2019). This instrument is utilized in the
present study to identify the college students’ level of
quality of life.
Ethical Considerations
This research gives due credit to the other literature
and studies that have been stated and reviewed in this
present study. Every author has been properly cited
and appropriate paraphrasing measures have been
conducted to avoid plagiarism and improper use of
information. This research has also received direct
approval from the research advisor as well as the
research leader who oversees this study.
The respondents who participated in this research were
informed of their study participation. They will be
assured that their information will remain anonymous
and will only be used for research purposes by the
research team. The respondents themselves can also
choose to remain anonymous in the questionnaires
they would answer. Furthermore, a quick and detailed
summary of the goals and descriptions of the research
will be given to the respondents before they are given
the data gathering instruments to let them know what
they will be taking part in. At any point before the
research is published, the respondents will also be
allowed to withdraw or omit their parts should they
firmly wish to. In case of these circumstances, the
researchers personally communicated to the mentioned
participants so that they would understand the
importance of their responses in the study. The
researchers will take this course of action to make the
said participants agree to cooperate and help with the
essential purposes of the present study. The
respondents will also have chosen to participate
willingly and without the use of force. Additionally,
the researchers have considered the convenience and
availability of the respondents throughout the whole
data gathering procedure.
This study practices the Republic Act 10173, the Data
Patt Jerome Dela Cruz
Privacy Act of 2012. The Philippines’ Data Privacy
Act of 2012 was created to safeguard individuals'
personal information from being shared without
permission (Ching et al., 2018). It also protects the
citizens' private information in communications and
information systems in both the state and corporate
sectors. The researchers will only see the data and
personal information that was provided by the
respondents to abide by the Data Privacy Act.
The data gathered will be the sole source to derive the
study's findings and will not be manipulated or
misrepresented. Proper data processing and statistical
methods were conducted appropriately and accurately
to showcase the findings with the respondents' data.
Data Gathering Procedure
In order for the researchers to obtain all the data
required to identify stress’ impact on the quality of life
of college students, they were obliged to go through
the following procedures to properly conduct this
study and gather the data which will be used to create
conclusions by the end of the research process.
Before officially starting the research writing process,
the researchers searched and acquired two
standardized instruments with the help of their
research advisor which are necessary to measure and
assess the variables of the study. The researchers will
explain to the respondents the background, goal, and
significance of the present study they are participating
in. Furthermore, the researchers will orient the
respondents in the questionnaires they would be
answering and will deliver precise instructions on how
to answer the questionnaires, ensuring that they could
easily recognize and comprehend what they would do.
The researchers will also emphasize that their identity
and privacy would be protected and that their
responses to the questionnaires will be kept
confidential. The respondents will be given enough
time to answer the questionnaires genuinely and with
no urgency. This procedure will enable the
respondents to accurately answer the questions,
allowing the researchers to obtain the most accurate
findings necessary for their research. Due to the
current health crisis brought by the COVID-19
pandemic, the researchers will utilize Google Forms,
an online survey distribution software, to gather the
needed information at the safety of their homes.
The data gathered from the research instruments will
be collected and organized according to the answers
given by the participants. The researcher will tally the
responses precisely and responsibly after all of the data
12/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
was collected. The computation of the data that will be
gathered was the last process in the data collection
procedure.
The data gathered from the respondents would form
the basis for the entire development of analyses,
presentations, and interpretations of research findings.
Result and Discussion
Impact of Stress on Quality of Life
The study investigates if there is a significant impact
of stress on college students’ quality of life. The
results from the questionnaires, Perceived Stress
Questionnaire and World Health Quality of Life -
BREF, were studied and analyzed using regression
analysis to uphold this primary objective.
With the identified high level of stress and average
quality of life among the study respondents, Table 1
contains the statistical analysis that was carried out to
determine whether the null hypothesis is rejected or
accepted.
Results of the statistical analysis in table 2 reveal that
the perceived stress (B= -.21) does significantly
impact the quality of life among students. Therefore,
the null hypothesis is rejected.
In support of this finding, the research of Mardea and
Kristina (2020) investigated the levels and relation
between stress and quality of life among pharmacy
university students. After obtaining the data from the
students and conducting the statistical analysis, the
study discovered that there was a significant
relationship between stress and quality of life.
Therefore, the finding of this research is supported by
other research studies also investigating the
relationship between stress and quality of life.
Table 1
Results of the Regression Analysis
Patt Jerome Dela Cruz
Conclusion
The overall stress level of students was found to have a
high level, meaning that its intervention and
management must be handled through proper methods
and procedures. It was determined that with the
majority of average scores of qualities of life, stress
was found to significantly impact the respondents’
quality of life. The findings suggest that in order to
improve the well-being of college students, their stress
levels and coping abilities must first be studied and
identified. This known relationship between the two
concepts can help college students understand the
negative effects of stress on themselves and thus, they
will be more inclined to know the sources of stress in
their lives. In addition, these research findings can be a
basis for future researchers to study this phenomenon
further. As stress was found to be a significant factor
for quality of life, future researchers could formulate
effective methods to address and mitigate this
significant relationship.
With the findings of the research, it has been deduced
by the researchers that parents, teachers, guidance
counselors, and academic institutions must address the
issue of stress prevalent within college students. It
must be addressed as the quality of life or well-being
of students in all aspects of life is significantly affected
by their stress levels perceptions. This means that
when students are stressed and they are not able to do
the correct measures to address it, their physical,
psychological, environmental health, and social
relationships would suffer. It is therefore necessary for
college students to be educated on the different stress
coping mechanisms so that their health can prosper
and they could fulfill their tasks with less burden on
them.
With the examination of the findings of the study
through comprehensive analysis, recommendations are
also formed for the various beneficiaries of the study:
1. For students, the researchers recommend finding
and building as many healthy coping mechanisms that
could help them alleviate the high level of stress they
are experiencing. The researchers suggest searching
for different stress-relief methods can help one
develop a healthy coping mechanism and improve
students' quality of life. Researchers noted that having
a mental health break, meditation, healthy lifestyle,
getting a good sleep, keeping busy and active, having a
regular schedule/routine, and maintaining a positive
attitude by staying optimistic could enhance one’s
well-being.
13/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
2. For parents, it is suggested that they must support
their children in every aspect of their lives, which will
improve their children's well-being. The researchers
believe that family social support plays an essential
role in enhancing one's quality of life. Programs for
parent communication, such as effective parent-child
dialogue, should be executed. Fostering positive
aspects of family management style is also suggested
since it is one of the most effective strategies in
enhancing their children's quality of life. Additionally,
parents should not pressure their children excessively
but give them the proper motivation through
communication and understanding.
3. For teachers, the researchers recommend that they
must acknowledge the aspects that could affect a
student's quality of life. Strategies such as intervention
programs and giving the students suggestions on
handling stress amidst schoolwork may improve the
students’ quality of life. They should be able to
address the concerns students have with regard to their
tasks and to communicate with the students with
patience and understanding. Moreover, it is
recommended to teachers that deadlines for the
students’ works must be kept fair and realistic as it
contributes to students’ level of stress greatly.
4. For guidance counselors and school administrators,
it is suggested that they provide the necessary aid for
students who are under a lot of stress, consequently
damaging their quality of life at the moment.
Interventions and discussions should be made for the
students to help them express what things are causing
them stress to determine what types of solution they
would need. With this, they should be able to
communicate with the students and their parents to
effectively implement solutions even outside school
and to better understand the situation of students at
home. Guidance counselors and school administrators
should be flexible in their response to the stress levels
of students, especially in the present time when
changes are constantly happening.
References
Aafreen, M., Priya, V., & Gayathri, R. (2018). Effect of stress on
academic performance of students in different streams. Drug
Invention Today, 10(9).
Abshire, M., Russell, S. D., Davidson, P. M., Budhathoki, C., Han,
H. R., Grady, K. L., ... & Himmelfarb, C. D. (2018). Social support
moderates the relationship between perceived stress and quality of
life in patients with a left ventricular assist device. The Journal of
cardiovascular nursing, 33(5), E1.
Ahmad, M., Maon, S. N., & Aziz, N. I. S. A. (2018). The
relationship between job stress and quality of life among working
Patt Jerome Dela Cruz
adults. In Proceedings of the 2nd Advances in Business Research
International Conference (pp. 261-270). Springer, Singapore.
Al Smadi, A. M., Tawalbeh, L. I., Gammoh, O. S., Ashour, A. F.,
Alshraifeen, A., & Gougazeh, Y. M. (2017). Anxiety, stress, and
quality of life among Iraqi refugees in Jordan: A cross sectional
survey. Nursing & health sciences, 19(1), 100-104.
Alkatheri, A. M., Bustami, R. T., Albekairy, A. M., Alanizi, A. H.,
Alnafesah, R., Almodaimegh, H., ... & Qandil, A. M. (2020).
Quality of life and stress level among health professions students.
Health Professions Education, 6(2), 201-210.
Anjara, S. G., Nellums, L. B., Bonetto, C., & Van Bortel, T. (2017).
Stress, health and quality of life of female migrant domestic workers
in Singapore: a cross-sectional study. BMC women's health, 17(1),
1-13.
Aslan, I., Ochnik, D., & Çınar, O. (2020). Exploring perceived stress
a mong s tu de n ts in T urke y during the C O V ID - 19
pandemic. International Journal of Environmental Research and
Public Health, 17(23), 8961.
Assana, S., Laohasiriwong, W., & Rangseekajee, P. (2017). Quality
of life, mental health and educational stress of high school students
in the northeast of Thailand. Journal of clinical and diagnostic
research: JCDR, 11(8), VC01.
BenGhasheer, H. F., & Saub, R. (2020). Relationships of
acculturative stress, perceived stress, and social support with oral
health-related quality of life among international students in
Malaysia: A structural equation modelling. Journal of International
Society of Preventive & Community Dentistry, 10(4), 520.
Bhargava, D., & Trivedi, H. (2018). A study of causes of stress and
stress management among youth. IRA-International Journal of
Management & Social Sciences, 11(03), 108-117.
Bishop Fitzpatrick, L., Smith DaWalt, L., Greenberg, J. S., &
Mailick, M. R. (2017).
Participation in recreational activities buffers the impact of
perceived stress on quality of life in adults with autism spectrum
disorder. Autism Research, 10(5), 973-982.
Çelmeçe, N., & Menekay, M. (2020). The Effect of Stress, Anxiety
and Burnout Levels of Healthcare Professionals Caring for COVID-
19 Patients on Their Quality of Life. Frontiers in psychology, 11,
597624. https://doi.org/10.3389/fpsyg.2020.597624
Chakraborty, T., Das, S. K., Pathak, V., & Mukhopadhyay, S.
(2018). Occupational stress, musculoskeletal disorders and other
factors affecting the quality of life in Indian construction workers.
International Journal of Construction Management, 18(2), 144-150.
Cheung, Y. B., Yeo, K. K., Chong, K. J., Khoo, E. Y. H., & Wee, H.
L. (2019). Measurement equivalence of the English, Chinese and
Malay versions of the World Health Organization quality of life
(WHOQOL-BREF) questionnaires. Health and quality of life
outcomes, 17(1), 1-6.
Ching, M. R. D., Fabito, B. S., & Celis, N. J. (2018). Data Privacy
Act of 2012: A Case Study Approach to Philippine Government
Agencies Compliance. Advanced Science Letters, 24(10), 7042-
7046.
Danilewitz, J. R. (2017). Quality of life and sources of stress in
teachers: A Canadian perspective.
Davis, J., & Damron, K. (2018). Stress and stress hormones. The
14/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
Oxford Handbook of Evolution, Biology, and Society, 349.
Edman, J. S., Greeson, J. M., Roberts, R. S., Kaufman, A. B.,
Abrams, D. I., Dolor, R. J., & Wolever, R. Q. (2017). Perceived
stress in patients with common gastrointestinal disorders:
associations with quality of life, symptoms and disease management.
Explore, 13(2), 124-128.
Erschens, R., Herrmann–Werner, A., Keifenheim, K. E., Loda, T.,
Bugaj, T. J., Nikendei, C., ... & Junne, F. (2018). Differential
determination of perceived stress in medical students and high-
school graduates due to private and training-related stressors. PLoS
One, 13(1), e0191831.
Feltrin, F., Cabral, L. P. A., Bordin, D., & Fadel, C. B. (2019).
Impact of stress on the quality of life and health conducts of
multiprofessional residents. Revista de Gestão em Sistemas de
Saúde, 8(3), 395-404.
Feng, X., Mosimah, C. I., Sizemore, G., Goyat, R., & Dwibedi, N.
(2019). Impact of mindful self-care and perceived stress on the
health-related quality of life among young adult students in West
Virginia. Journal of Human Behavior in the Social Environment,
29(1), 26-36.
Ganesan, Y., Talwar, P., Fauzan, N., & Oon, Y. B. (2018). A study
on stress level and coping strategies among undergraduate
students. Journal of Cog niti ve Sciences and Human
Development, 3(2), 37-47.
Goldfarb, E. V. (2020). Participant stress in the COVID-19 era and
beyond. Nature Reviews Neuroscience, 21(12), 663-664.
Grabski, B., Kasparek, K., Müldner-Nieckowski, Ł., & Iniewicz, G.
(2019). Sexual quality of life in homosexual and bisexual men: the
relative role of minority stress. The journal of sexual medicine,
16(6), 860-871.
Guruprakash, K. V., Mehta, S. G., Atul, B., Prakash, J.,
Divinakumar, K. J., Khan, S. A., & Patra, P. (2018). A study of
relationship between perceived stress, coping pattern, burnout, and
general psychopathology among the postgraduate medical students.
I n dus t ri a l ps y c h ia tr y j ou r n a l, 27(1) , 1 4 1 – 14 6.
h t t p s : / / d oi . o r g /1 0 . 41 0 3 / ip j . i pj _ 2 0_ 1 8
Haraldstad, K., Wahl, A., Andenæs, R., Andersen, J. R., Andersen,
M. H., Beisland, E., ... & Helseth, S. (2019). A systematic review of
the quality of life research in
medicine and health sciences. Quality of life Research, 28(10),
2641-2650.
Hawash, M. M., Alhazmi, A. H., Wafik, W., Muzammil, K.,
Mushfiq, S., & Ahmed, H. A. (2021). The Association of COVID-19
Pandemic Stress With Health-Related Quality of Life in the
Kingdom of Saudi Arabia: A Cross-Sectional Analytical
Study. Frontiers in Public Health, 9.
Hirsch, J. D., Nemlekar, P., Phuong, P., Hollenbach, K. A., Lee, K.
C., Adler, D. S., & Morello, C. M. (2020). Patterns of stress, coping
and health-related quality of life in doctor of pharmacy students.
American journal of pharmaceutical education, 84(3).
https://www.ajpe.org/content/84/3/7547
Hopper, E. (2020). Maslow’s Hierarchy of Needs Explained.
ThoughtCo, ThoughtCo, 24.
Ilić, I., Šipetić-Grujičić, S., Grujičić, J., Živanović Mačužić, I.,
Kocić, S., & Ilić, M. (2019). Psychometric properties of the world
health organization’s quality of life (WHOQOL-BREF)
Patt Jerome Dela Cruz
questionnaire in medical students. Medicina, 55(12), 772.
Im, Y., Cho, Y., & Kim, D. (2019). Family management style as a
mediator between parenting stress and quality of life of children
with epilepsy. Journal of pediatric nursing, 45, e73-e78.
Kansky, J. (2017). Benefits of well-being: Health, social
relationships, work, and resilience. Journal of Positive Psychology
and Wellbeing, 1(2), 129-169.
Kassymova, K., Kosherbayeva, N., Sangilbayev, S., & Schachl, H.
(2018). Stress management techniques for students.
Khodami, M. A., Seif, M. H., Koochakzadeh, R. S., Fathi, R., &
Kaur, H. (2021). Perceived stress, emotion regulation and quality of
life during the Covid-19 outbreak: A multi-cultural online survey. In
Annales Médico-psychologiques, revue psychiatrique. Elsevier
Masson.
Kim, H. G., Cheon, E. J., Bai, D. S., Lee, Y. H., & Koo, B. H.
(2018). Stress and heart rate variability: a meta-analysis and review
of the literature. Psychiatry investigation, 15(3), 235.
Kim, H.-K. (2021). The effect of stress caused by the spread of
covid-19 on the quality of life in university students: The
moderating effect of Family Health. The Journal of Korean Society
for Sc hool & C ommunity H ea lth Educ a tion.
https://www.koreascience.or.kr/article/JAKO202125862988824.pag
e.
Knowlton, K. (2019). Globalization and Environmental Health.
Enc yc lope dia of Environme nta l H e a lth, 3 2 5– 330.
https://doi.org/10.1016/b978-0-12-409548-9.11705-1
Koipysheva, E. A., Lebedinsky, V. Y., & Koipysheva, M. A. (2018).
Physical health (definition, semantic content, study prospects). In
The European Proceedings of Social & Behavioural Sciences
EpSBS (pp. 601-605).
Kołtuniuk, A., Kazimierska-Zając, M., Cisek, K., & Chojdak-
Łukasiewicz, J. (2021). The Role of Stress Perception and Coping
with Stress and the Quality of Life Among Multiple Sclerosis
Patients. Psychology Research and Behavior Management, 14, 805.
Kupcewicz, E., Grochans, E., Kadučáková, H., Mikla, M., &
Jóźwik, M. (2020). Analysis of the relationship between stress
intensity and coping strategy and the quality of life of nursing
students in Poland, Spain, and Slovakia. International journal of
environmental research and public health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344765/.
Labrague, L. J., McEnroe Petitte, D. M., Papathanasiou, I. V., Edet,
O. B., Tsaras, K., Christos, K. F., ... & Lucas, K. V. S. (2018). A
cross country comparative study on stress and quality of life in
nursing students. Perspectives in psychiatric care, 54(4), 469-476.
Labrague, L. J., McEnroe-Petitte, D. M., Papathanasiou, I. V., Edet,
O. B., Tsaras, K., Christos, K. F., Fradelos, E. C., Rosales, R. A.,
Cruz, J. P., Leocadio, M., & Lucas, K. (2018). A cross-country
comparative study on stress and quality of life in nursing students.
Pe rs pe c tive s in ps yc hia tric ca re , 54(4), 4 6 9– 476.
https://doi.org/10.1111/ppc.12248
Levenstein, S., Prantera, C., Varvo, V., Scribano, M. L., Berto, E.,
Luzi, C., & Andreoli, A. (1993). Development of the Perceived
Stress Questionnaire: a new tool for psychosomatic
research. Journal of psychosomatic research, 37(1), 19-32.
Li, Y., Sun, X., Ge, H., Liu, J., & Chen, L. (2019). The status of
occupational stress and its influence the quality of life of copper-
15/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article
nickel miners in Xinjiang, China. International journal of
environmental research and public health, 16(3), 353.
Li, Y., Zhang, X., Shi, M., Guo, S., & Wang, L. (2019). Resilience
acts as a moderator in the relationship between infertility-related
stress and fertility quality of life among women with infertility: a
cross-sectional study. Health and quality of life outcomes, 17(1),
1-9.
Limbers, C. A., McCollum, C., & Greenwood, E. (2020). Physical
activity moderates the association between parenting stress and
quality of life in working mothers during the COVID-19 pandemic.
Mental Health and Physical Activity, 19, 100358.
Lodhi, F. S., Montazeri, A., Nedjat, S., Mahmoodi, M., Farooq, U.,
Yaseri, M., ... & Holakouie-Naieni, K. (2019). Assessing the quality
of life among Pakistani general population and their associated
factors by using the World Health Organization’s quality of life
instrument (WHOQOL-BREF): a population based cross-sectional
study. Health and Quality of life Outcomes, 17(1), 9.
Lovallo, W. R., & Buchanan, T. W. (2017). Stress hormones in
psychophysiological research: Emotional, behavioral, and cognitive
implications.
Malibary, H., Zagzoog, M. M., Banjari, M. A., Bamashmous, R. O.,
& Omer, A. R. (2019). Quality of Life (QoL) among medical
students in Saudi Arabia: a study using the WHOQOL-BREF
instrument. BMC medical education, 19(1), 1-6.
Mardea, N. A., and Kristina, S. A. (2020). Stress Levels and Quality
of Life among Pharmacy Students in Yogyakarta, Indonesia.
International Journal of Pharmaceutical Research, 12(2).
Maslow, A. H. (1943). A theory of human motivation. Psychological
review, 50(4), 370.
McLeod, S. A. (2020). Maslow's hierarchy of needs. Simply
Psychology. https://www.simplypsychology.org/maslow.html
Medvedev, O. N., & Landhuis, C. E. (2018). Exploring constructs of
well-being, happiness and quality of life. PeerJ, 6, e4903.
Miaskowski, C., Paul, S. M., Mastick, J., Abrams, G., Topp, K.,
Smoot, B., ... & Levine, J. D. (2018). Associations between
perceived stress and chemotherapy-induced peripheral neuropathy
and otoxicity in adult cancer survivors. Journal of pain and symptom
management, 56(1), 88-97.
Mikkelsen, H. T., Haraldstad, K., Helseth, S., Skarstein, S.,
Småstuen, M. C., & Rohde, G. (2020). Health-related quality of life
is strongly associated with self-efficacy, self-esteem, loneliness, and
stress in 14–15-year-old adolescents: a cross-sectional study. Health
and Quality of Life Outcomes, 18(1), 1-17.
Mondo, M., Sechi, C., & Cabras, C. (2021). Psychometric
evaluation of three versions of the Italian perceived stress
scale. Current Psychology, 40(4), 1884-1892.
Nam, Jeong-Hui & Park, Hyun-Suk. (2020). The Impacts of
Perceived Stress and Self-compassion on Quality of Life of Nursing
Students. Journal of Korean Academic Society of Nursing
Education. 26. 67-77. 10.5977/jkasne.2020.26.1.67.
Norman, A. W., & Henry, H. L. (2022). Hormones. Academic press.
Orley, J., & Kuyken, W. (1994). Quality of life assessment:
international perspectives (pp. 41-60). Berlin: Springer-Verlag.
Østerås, B., Sigmundsson, H., & Haga, M. (2018). Psychometric
properties of the perceived stress questionnaire (PSQ) in 15–16
Patt Jerome Dela Cruz
Years old Norwegian adolescents. Frontiers in psychology, 9, 1850.
Panzini, R. G., Mosqueiro, B. P., Zimpel, R. R., Bandeira, D. R.,
Rocha, N. S., & Fleck, M. P. (2017). Quality-of-life and spirituality.
International Review of Psychiatry, 29(3), 263-282.
Park, G., & Evans, G. W. (2019). Environment and health.
Cambridge University Press.
Park, S. H., Song, Y. J. C., Demetriou, E. A., Pepper, K. L., Norton,
A., Thomas, E. E., ... & Guastella, A. J. (2019). Disability,
functioning, and quality of life among treatment-seeking young
autistic adults and its relation to depression, anxiety, and stress.
Autism, 23(7), 1675-1686.
Pascoe, M. C., Hetrick, S. E., & Parker, A. G. (2020). The impact of
stress on students in secondary school and higher education.
International Journal of Adolescence and Youth, 25(1), 104-112.
Pequeno, N. P. F., de Araújo Cabral, N. L., Marchioni, D. M., Lima,
S. C. V. C., & de Oliveira Lyra, C. (2020). Quality of life
assessment instruments for adults: a systematic review of
population-based studies. Health and quality of life outcomes, 18(1),
1-13.
Perveen, N., Batool, I., Asghar, M., & Malik, G. (2019). Quality of
life, psychological stress and death anxiety among liver and renal
transplant recipients. Stress, 1(31), 21.
Pisula, E., & Porębowicz-Dörsmann, A. (2017). Family functioning,
parenting stress and quality of life in mothers and fathers of Polish
children with high functioning autism or Asperger syndrome. PloS
one, 12(10), e0186536.
Piwowar-Sulej, K., & Bąk-Grabowska, D. (2021). The Impact of
Mandate Contract and Self-Employment on W orke rs’
Health—Evidence from Poland. International Journal of
Environmental Research and Public Health, 18(6), 3138.
Price, P., Jhangiani, R., Chiang, I., Leighton, D., & Cuttler, C.
(2017). Correlational research. In Research methods in psychology
(3rd ed., pp. 107–112). https://opentext.wsu.edu/carriecuttler.
Qi, M., Li, P., Moyle, W., Weeks, B., & Jones, C. (2020). Physical
activity, health-related quality of life, and stress among the Chinese
adult population during the COVID-19 pandemic. International
journal of environmental research and public health, 17(18), 6494.
Rachmawati, S., Djaniar, U., Putra, A. S., & Aisyah, N. (2021). THE
EFFECT OF THE COVID 19 VIRUS AND ONLINE LEARNING
ON ENGLISH SUBJECTS IN SENIOR HIGH SCHOOL. Journal
of Innovation Research and Knowledge, 1(3), 435-440.
Rodríguez-Fernández, A., Zuazagoitia-Rey-Baltar, A., & Ramos-
Díaz, E. (2017). Quality of life and physical activity: their
relationship with physical and psychological well-being. AA Vilas
Boas, Quality of Life and Quality of Working Life, 53-70.
Rogowska, A. M., Kuśnierz, C., & Bokszczanin, A. (2020).
Examining anxiety, life satisfaction, general health, stress and
coping styles during COVID-19 pandemic in Polish sample of
university students. Psychology Research and Behavior
Management, 13, 797.
Ross, R., Shahrour, G., Stidham, A. W., & Delahanty, D. (2017).
The psychometric properties of the World Health Organization
quality of life BREF among Thai women who have experienced
intimate partner violence. Journal of nursing measurement, 25(3),
389-399.
Shahrawat, A., & Shahrawat, R. (2017). Application of Maslow’s
16/17
Psych Educ, Document ID: PEMJ0, doi: 10.5281/zenodo.6626151
Research Article

hierarchy of needs in a historical context: Case studies of four World Health Organization. (1996). WHOQOL-BREF: introduction,
prominent figures. Psychology, 8(07), 939. administration, scoring and generic version of the assessment: field
trial version, December 1996 (No. WHOQOL-BREF). World
Silva, B. K. R., Quaresma, F. R. P., da Silva Maciel, E., dos Santos Health Organization.
Figueiredo, F. W., Sarraf, J. S., & Adami, F. (2017). Correlation
between stress and quality of life experienced by caregivers: World Health Organization. (1998). The World Health Organization
perception of a group of healthcare professionals. The open nursing quality of life assessment (WHOQOL): development and general
journal, 11, 135. psychometric properties. Soc Sci Med, 46(12), 1569-85.
Singh, J. A. (2019). Quality of Life. Gout, 119 –139. Won, S. D., & Chang, E. J. (2020). The relationship between school
doi:10.1016/b978-0-323-54823-6.00011-7 violence-related stress and quality of life in school teachers through
coping self-efficacy and job satisfaction. School Mental Health,
Sirgy, M. J. (2002). The psychology of quality of life (Vol. 12).
12(1), 136-144.
Dordrecht: Kluwer Academic Publishers.
Wong, F. Y., Yang, L., Yuen, J. W., Chang, K. K., & Wong, F. K.
Son, C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020).
(2018). Assessing quality of life using WHOQOL-BREF: A cross-
Effects of COVID-19 on College Students' Mental Health in the
sectional study on the association between quality of life and
United States: Interview Survey Study. Journal of medical Internet
neighborhood environmental satisfaction, and the mediating effect
research, 22(9), e21279. https://doi.org/10.2196/21279
of health-related behaviors. BMC public health, 18(1), 1-14.
Sousa, L., Valentim, O., Marques-Vieira, C., Antunes, A. V.,
Yang, C., Chen, A., & Chen, Y. (2021). College students’ stress and
Severino, S., & José, H. (2020). Association between stress/anxiety,
health in the COVID-19 pandemic: The role of academic workload,
depression, pain and quality of life in people with chronic kidney
separation from school, and fears of contagion. PloS one, 16(2),
disease. Rev Port Enferm Saude Mental, 23.
e0246676.
Staunton, E., Kehoe, C., & Sharkey, L. (2020). Families under
Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar,
pressure: Stress and quality of life in parents of children with an
A. (2017). The impact of stress on body function: A review. EXCLI
intellectual disability. Irish journal of psychological medicine, 1-8.
journal, 16, 1057.
Stillwell, S. B., Vermeesch, A. L., & Scott, J. G. (2017).
Yorks, D. M., Frothingham, C. A., & Schuenke, M. D. (2017).
Interventions to reduce perceived stress among graduate students: A
Effects of group fitness classes on stress and quality of life of
systematic review with implications for evidence‐based practice.
medical students. Journal of Osteopathic Medicine, 117(11), e17-
Worldviews on Evidence‐Based Nursing, 14(6), 507-513.
e25.
Suárez, L., Tay, B., & Abdullah, F. (2018). Psychometric properties
Zhang, C., Ye, M., Fu, Y., Yang, M., Luo, F., Yuan, J., & Tao, Q.
of the World Health Organization WHOQOL-BREF quality of life
(2020). The psychological impact of the COVID-19 pandemic on
assessment in Singapore. Quality of Life Research, 27(11), 2945-
teenagers in China. Journal of Adolescent Health, 67(6), 747-755.
2952.

Teixeira, G. S., Silveira, R. C. D. P., Mininel, V. A., Moraes, J. T., Affiliations and Corresponding Information
& Ribeiro, I. K. D. S. (2019). Quality of life at work and
occupational stress of nursing in an emergency care unit. Texto & Corresponding: Patt Jerome DelaCruz
Contexto-Enfermagem, 28. Email: patt.delacruz16@gmail.com
Ph
Tripathi, N. (2018). A valuation of Abraham Maslow's theory of
self-actualization for the enhancement of quality of life. Indian
Journal of Health and wellbeing, 9(3), 499-504.
Patt Jerome DelaCruz
St. Paul College of Bocaue, Philippines
Tseng, H. M., Shih, W. M., Shen, Y. C., Ho, L. H., & Wu, C. F.
(2018). Work stress, resilience, and professional quality of life
among nurses caring for mass burn casualty patients after Formosa Agatha Maxine Aquino
color dust explosion. Journal of Burn Care & Research, 39(5), 798- St. Paul College of Bocaue, Philippines
804.

Van Tongeren, D. R., Hill, P. C., Krause, N., Ironson, G. H., & Marienela Curioso
Pargament, K. I. (2017). The mediating role of meaning in the St. Paul College of Bocaue, Philippines
association between stress and health. Annals of Behavioral
Medicine, 51(5), 775-781.
David John Tia
Wendorf, A. R., & Brouwer, A. M. (2018). Psychology of stress and St. Paul College of Bocaue, Philippines
coping. obo in Psychology. doi: 10.1093/obo/9780199828340-0203.
Sabian Louis Samonte
WHOQoL Group. (1994). The development of the World Health
St. Paul College of Bocaue, Philippines
Organization quality of life assessment instrument (the WHOQOL).
In Quality of life assessment: International perspectives (pp. 41-57).
Springer, Berlin, Heidelberg. Joanna Gabrielle Policarpio
St. Paul College of Bocaue, Philippines

Patt Jerome Dela Cruz

17/17