EFFICACY OF NON-SUBSTANCE COPING MECHANISMS

IN ALLEVIATING SCHOOL-INDUCED STRESS

______________________

A Thesis
Presented to the Faculty of the
College of Nursing
University of Cebu—Lapu-Lapu and Mandaue Campus
Mandaue City, Philippines

______________________

In Partial Fulfillment
of the Requirements for the
Degree of Bachelor of Science in Nursing

By:

APOSTOL, KHAN XAVIER P., DUNGOG, SYDNEY LORENE A., PALARION,

SHAIRA C., SOLERO, EMMANUEL IVAN C., SOON, KYLAH E., TAMPUS,
RUCHELLE S., PO, BEVERLY P.

December 2023
 APPROVAL SHEET

IN PARTIAL FULFILLMENT of the requirements for the Degree of Bachelor of

Science in Nursing. The research entitled “A QUANTITATIVE ANALYSIS ON THE
EFFICACY OF NON-SUBSTANCE COPING MECHANISMS IN ALLEVIATING
SCHOOL-INDUCED STRESS”, prepared and submitted by APOSTOL, KHAN XAVIER P.
has been examined, accepted and approved for PROPOSAL HEARING.

BEVERLY P. PO, RN, MAN

Adviser

ACCEPTED AS partial fulfillment of the requirements for the Degree of Bachelor of Science in
Nursing.

MARCELO T. LOPEZ, Ed. D, DPA,MN,RN

Dean, College of Nursing

APPROVED by the tribunal at Oral Examination with the grade of PASSED.

PANEL OF EXAMINERS

VIVIAN AIMEE M. DIAMANTE., RN., MAN

Chairman

ARLENE L. GALON., RN.,MAN THELMA D. FELICIANO RN, PhD

Member 1 Member 2

HAZEL FAITH M. GENABE., RN., MAN

Program Research Coordinator

DR. MARCELO T. LOPEZ ATTY. MARICHU D. GARCIANO

Dean, College of Nursing Research Director

Date: December 16, 2023

 TABLE OF CONTENTS

PAGE

Approval Sheet i

CHAPTER

1 THE PROBLEM AND ITS SCOPE 1

INTRODUCTION 1

Rationale of the Study 2

Theoretical Background 4

THE PROBLEM 14

Statement of the Problem 14

Significance of the Study 15

RESEARCH METHODOLOGY 16

Research Design 16

Research Environment 16

Research Respondents/Participants 16

Research Instrument 17

Dry Run Procedures 17

 Research Procedure 17

Data Gathering 17

Data Analysis 18

Ethical Considerations 19

Trustworthiness of the Research 20

DEFINITION OF TERMS 21

REFERENCES 24

APPENDICES

A Transmittal Letter 27

B Informed Consent 28

C Survey Questionnaire 36

CURRICULUM VITAE
 CHAPTER 1
THE PROBLEM AND ITS SCOPE
INTRODUCTION

Rationale of the Study

School life can be overwhelming, leading students to experience high levels of stress. The
struggle to balance demanding schedules, academic obligations, work responsibilities, and
personal time with loved ones contributes significantly to the stress. For some, this becomes an
everyday companion. However, it's dangerous to normalize these kinds of stress because they
can have serious consequences that could negatively impact a student's life and even result in
failure.

According to Scott 2022, stress can be defined as any type of change that causes physical,
emotional, or psychological strain. Stress is your body's response to anything that requires
attention or action. College students are not exempt from this scenario. Most students often
struggle with their academic preparation since college is a challenging period for many
individuals as they adjust to new educational and social settings.

On a global scale, Gallup’s annual Global Emotions Report surveyed more than 2,400
college students in March 2023, 66% of them reported experiencing stress and 51% reported
feelings of worry "during a lot of the day." And emotional stress was among the top reasons
students considered dropping out of college in the fall 2022 semester. This shows the pressures
and challenges faced by individuals, who are navigating not only their academic responsibilities
like passing examinations or finishing projects; it's also profoundly connected with financial
demands, including school tuition and living expenditures, which may be overwhelming for
many (Kerr, 2023).

In the Philippines, the population is facing a variety of stresses, including financial

challenges, academic pressures, work responsibilities, natural calamities, and the aftermath of the
worldwide pandemic, all of which have contributed to heightened stress levels. According to the
World Health Organization (WHO), Filipino children aged 5 to 15, 10% to 15% are affected by
mental health problems and, 16.8% of Filipino students aged 13 to 17 have attempted suicide at
least once within a year before the 2015 Global School-based Student Health survey (Malolos,
2021).

Localized data from Cebu further underscores the local prevalence of stress levels.
Students from three different campuses of the University of Cebu, namely UC-Banilad, UC
School of Medicine, and UC-Lapulapu Mandaue, were interviewed. Out of 100 students, more
than 50% of the study population were moderately stressed, 35% were highly stressed, and only
10% were slightly stressed. The stress among college students in Cebu, reflects the broader
mental health challenges faced by young adults in educational settings. The pressures of
academic performance, future career prospects, and possibly the impact of social and economic
issues contribute to the high stress levels observed (Amodia, 2018).

To mitigate the stress experienced by individuals, there are certain factors, such as coping
skills, that can enable some students to excel academically. Coping mechanisms are the tactics
that people use to deal with stressful situations. Managing your stress well can help you feel
better physically and psychologically and impact your ability to perform your best. The efficacy
of coping mechanisms can vary among individuals. Understanding and tailoring interventions to
the unique needs and preferences of each person is essential for promoting mental well-being
(Morin, 2023).

In 2017, the Department of Health introduced “The 12S for Stress,” a set of strategies
designed to assist anyone navigating a stressful period. These guidelines offer a comprehensive
approach to stress management, emphasizing the significance of personalized interventions for
individuals facing challenging circumstances (Dellosa, 2017).
To address overlap among the 12S's, or non-substance coping alternatives, by DOH, they
have been grouped into four based on what they focus on and what they're meant to achieve. (1)
‘Speak to me’, socials, and smile are put under the emotional expression and connection group as
these lean towards open, interpersonal communication and social interaction when dealing with
stress. (2) Scheduling, stretching, and sports are categorized within the time management and
physical activity groups, as these variants are more directed at structuring daily routines and
incorporating physical movement into one's schedule. (3) Sounds and songs, sensation
techniques, and siesta fall under the sensory and relaxation group in light of these being more
oriented towards engaging the senses and promoting relaxation. Lastly, (4) self-awareness, stress
debriefing, and spirituality are categorized as part of the mind-body harmony group because
these are more directed toward self-reflection and fostering a holistic connection between the
mental and physical realms. Each group has its own unique ways of dealing with stress, giving us
a variety of strategies that students might use in their academic lives.

Researchers have observed a significant prevalence of stress among nursing students at

the University of Cebu Lapu Lapu and Mandaue, evident in their online posts and within the
vicinity of the university. Social media displays often depict nursing students experiencing stress,
contributing to the normalization and visibility of stress within their academic and social circles.
Additionally, the proximity of numerous stress-inducing factors, such as challenging coursework
and demanding clinical placements, establishes an environment conducive to heightened stress
levels among nursing students. The knowledge derived from this study has the potential to foster
healthier stress management practices among nursing students, creating a safer and more
nurturing academic environment.

This exploration of the efficacy of non-substance coping mechanisms in school-induced stress

presents a multifaceted approach to enhancing students' well-being. By identifying viable non-
substance alternatives. Addressing this gap in the literature, our research aims to provide
valuable insights that can inform academic discourse and practical interventions to support
students' mental health and well-being in the educational context.

Theoretical Background

This study is anchored on the Dynamic Model of Stress. It helps us understand how people
deal with stress, like the pressure felt by students in school. This model says stress is a back-and-
forth process between people and their surroundings. It means stress isn't just one event; it
changes over time as people react to it and cope with it. For students, this could mean how they
feel about schoolwork and tests, and how they try to manage these feelings. This stress comes
from adjusting to college life, dealing with lots of schoolwork, and trying to fit in socially. The
Dynamic Model helps us understand how students see these challenges and how they try to
handle them. By looking at how students cope with stress, we can find ways to help them feel
better. This might involve things like finding support from friends, learning time management
skills, or practicing relaxation techniques. The research aims to find out which of these coping
strategies work best for students, based on the Dynamic Model. Understanding stress and coping
in students can help us support them better. By knowing what helps students deal with stress, we
can create programs and resources that really make a difference. This research wants to find
simple, effective ways to help students feel less stressed and more confident in school (Folkman,
2019).

Incorporating the Theory of Well-being into the Dynamic Model allows us to consider
the broader implications of stress and coping for students' overall well-being. Well-being
encompasses not only the absence of stress but also the presence of positive experiences and a
sense of fulfillment in various life domains. Hedonic well-being refers to the subjective
experience of pleasure, happiness, and positive emotions. Within the context of the Dynamic
Model, students' coping strategies may influence their day-to-day mood and emotional
experiences. For example, students who effectively manage their stress may experience greater
happiness and enjoyment in their academic pursuits. Eudaimonic well-being is derived from
living in accordance with one's values, pursuing meaningful goals, and experiencing personal
growth and fulfillment. In the context of school, students' coping strategies may contribute to
their sense of purpose and engagement with their academic endeavors. For instance, students
who find meaning in their studies and extracurricular activities may experience greater
fulfillment and satisfaction with their lives (Deci, 2020).

Social well-being pertains to the quality of individuals' social relationships and their
sense of belongingness, support, and connection with others. Coping with stress in school may
involve seeking support from friends, family, or teachers, which can enhance students' social
connectedness and overall well-being. Positive social interactions and relationships may serve as
protective factors against the adverse effects of stress. Physical well-being involves the
maintenance of physical health and vitality, including factors such as exercise, nutrition, and rest.
Effective coping strategies may promote students' physical well-being by reducing stress-related
symptoms and fostering healthy lifestyle behaviors. For example, engaging in relaxation
techniques or physical activities may help students manage stress and maintain their physical
health. Environmental well-being relates to the quality of individuals' surroundings, including
factors such as safety, sustainability, and access to resources. Coping with stress in school may
involve creating a supportive and conducive learning environment that promotes students' well-
being. This could include initiatives to reduce academic pressure, improve school climate, and
provide access to mental health resources (Ryan, 2020).

The Theory of Well-Being expands the focus of the "Dynamic Model of Stress and
Coping" beyond stress management to encompass students' overall satisfaction and fulfillment in
various domains of their lives. By considering the interplay between stress, coping, and well-
being, educators and researchers can develop interventions and support systems that foster
students' holistic development and flourishing in school.

Review of Related Studies

Stress is the body's general reaction to various demands placed upon it. This definition
implies that stress isn't confined to specific triggers but encompasses the body's overall response
to any form of demand, whether physical, mental, or emotional. The body's response is not
necessarily tailored to the specific nature of the demand but rather represents a generalized
reaction. This recognition is crucial in understanding how stress can manifest in various ways,
affecting physical health, mental well-being, and overall quality of life. (Scheiner, 2023).

School-induced stress in particular, is commonly associated with maladaptive changes to

health behavior practices among college students, including decreased physical activity and
increased sedentary behavior. It often leads to disrupted sleep patterns, irregular eating habits,
and neglect of self-care routines. The high-pressure academic environment, coupled with social
and personal expectations, contributes to heightened stress levels, resulting in poor lifestyle
choices (Schultchen et al., 2019).

Persistent or intense stress can have detrimental effects on various aspects of academic
life, including academic performance, dropout rates, sleep quality, mental health issues such as
depression, procrastination tendencies, difficulties in social and contextual adjustment,
anticipatory anxiety regarding stressful situations, and even thoughts of suicide. Intense stress
may affect a student's ability to adapt to social and environmental demands within the school
setting, potentially leading to feelings of isolation or alienation. In severe cases, overwhelming
stress may lead to thoughts of self-harm or suicide as individuals struggle to cope with their
circumstances. (Flores-Buils, 2023).

Nursing students may experience stress due to the demanding nature of their coursework,
clinical placements, and exams. High levels of stress can impair concentration, memory
retention, and critical thinking abilities, ultimately affecting their academic performance. The
stress experienced during nursing education can also influence students' performance in clinical
settings. Nursing students must apply theoretical knowledge to real-life patient care scenarios,
and stress can interfere with their ability to make sound clinical judgments, communicate
effectively with patients and colleagues, and maintain composure in high-pressure situations.
Stress can lead to emotional exhaustion, burnout, and decreased empathy, which are essential
qualities for providing high-quality patient care. Additionally, stressed students may exhibit
behaviors such as irritability, impatience, or avoidance, which can negatively impact their
interactions with patients and colleagues. Ultimately, the decline in professionalism resulting
from stress can affect the quality of care delivered by nursing students. Patients rely on nurses
for competent, compassionate, and safe care, and any factors that compromise nurses' well-being
and performance can potentially jeopardize patient outcomes (Nguyen, 2023).

These insights highlight the complex relationship between stress and unhealthy coping
behaviors among college students, emphasizing the need for targeted interventions and support
systems to address these challenges. Recognizing the profound impact of stress on students' well-
being and academic performance, researchers have turned their attention to non-substance coping
mechanisms as potential interventions to alleviate school-induced stress. Thus, the introduction
of 12S’s of the Department of Health (DOH). In 2017, the DOH started to introduce the 12s that
will help anybody who is going through a stressful time because when left untreated, stress can
lead to depression, which is a harder illness to cure, oftentimes entailing therapy and medication
(Dellosa, 2017).

This comprehensive review delves into the efficacy of non-substance coping mechanisms
categorized into four (4) major types: emotional expression and connection (‘speak to me,
socials, and smile), time management and physical activity (scheduling, stretching, and sports),
sensory and relaxation (sound and songs, sensation techniques, and siesta), and mind-body
harmony (self-awareness, stress debriefing, and spirituality), in alignment with the 12 stress
management strategies from DOH. For students, emotional expression and connection (‘speak to
me, socials, and smile) plays an essential part in reducing stress and fostering resilience. This
support can originate from a range of connections, including family and friends, peers, mentors,
faculty members, and professional organizations or support groups. The ‘speak to me’ phrase
primarily pertains to communication within the emotional and expressive realm. Communication
is a fundamental aspect of human interaction, allowing individuals to convey thoughts, feelings,
and ideas. 'Speak to me' implies a desire for verbal engagement or connection. Emotionally, it
can indicate a need for understanding, empathy, or a wish to engage in a meaningful
conversation. It could also denote a plea for emotional support or a desire for someone to share
their feelings. Correspondingly, 'socials' typically refers to social gatherings or events. In the
context of emotional connection and expression, 'socials' represent the social aspect of human
behavior. These gatherings provide opportunities for individuals to interact, form relationships,
and express themselves socially. Social interaction can act as a counter to the “fight or flight”
response. Interacting with other people triggers your body to release hormones that create a sense
of calm and other positive feelings. It's your body's way of encouraging you to drop your guard
and relax. As this happens, your nervous system returns to a more normal and balanced state
(Reid, et al., 2022).

A study on Perceived Social Support and Stress: a Study of 1st Year Students in Ireland,
found that those with higher levels of social support reported lower levels of stress. This is
because social support can provide students with a sense of belonging, security, and support.
Supportive social relationships, positive family function and positive coping style plays an
important role in reducing the stresses and improving their mental well-being. Optimistic
individuals tend to use more problem-focused coping strategies, such as seeking social support,
for controllable stressors. This highlights the interplay between social support, family dynamics,
coping styles, and mental well-being, emphasizing the importance of cultivating positive
relationships and adaptive coping mechanisms for overall stress reduction and psychological
resilience. Having a strong support system can provide students with a sense of belonging,
validation, and understanding, which can contribute to their overall well-being (Wongtongkam,
2019).

Smiling is a universal facial expression associated with various emotions and social
interactions. It is often considered a sign of happiness, friendliness, or approval. Additionally,
smiles can be contagious, positively influencing the emotional atmosphere by encouraging others
to feel more at ease or joyful. Smiling is a social cue that can positively affect interactions with
others. Positive social interactions and social support have been linked to reduced stress levels.
While different studies and research methods have a range of results, overall the answer is yes.
Smiling reduces stress, and being forced to furrow the brow makes people feel sadness, anger,
and disgust. So when our facial muscles become tight and keep us stuck in certain expressions,
we’ll tend to be stuck in that emotional state. Additionally, according to the facial feedback
hypothesis, facial expressions can influence emotions. So, even if you don't genuinely feel like
smiling, the act of smiling can still signal the brain to release neurotransmitters associated with
happiness, thus improving emotional health (Coles, et al., 2019).

Time management and physical activity (scheduling, stretching, and sports) contributes to
stress relief, especially to college students who are most prone to stress. Scheduling is a
fundamental aspect of time management. It involves planning and organizing activities within a
specified timeframe to maximize efficiency and productivity. Effective scheduling allows
individuals to allocate time for various tasks, commitments, and activities, ensuring that each
gets the necessary attention and is completed within the available time. Scheduling or time
management plays a crucial role in mitigating stress levels among individuals, particularly
students facing academic demands. Effective time management skills enable individuals to
prioritize tasks, allocate sufficient time for studying, and maintain a balanced schedule. When
students proficiently manage their time, they experience reduced feelings of being overwhelmed
or rushed, which can contribute to a significant decrease in stress. Research has consistently
shown a strong correlation between poor time management and heightened stress levels among
students. Challenges in allocating adequate time for studying, procrastination, or struggling to
meet deadlines often lead to increased anxiety and pressure. The ability to effectively manage
time not only aids in completing academic responsibilities but also allows for adequate rest,
relaxation, and participation in other activities. This balance is instrumental in alleviating stress,
promoting mental well-being, and fostering a healthier, more manageable academic journey.
Therefore, cultivating strong time management skills is not only beneficial for academic success
but also plays a pivotal role in reducing stress and enhancing overall well-being among students
(Lolandes et al., 2020).

Proper time management is shown to have influence on effective learning in that there is
a positive relationship between time management practice and academic performance. Effective
time management is one of the many significant factors that determines the self-regulated
learning competence of a student. Other factors may impact learning performance more directly,
and these include self-regulated learning strategies such as (among others) reading, writing,
listening, asking, note-taking, memorisation techniques and collaborating with peers (Adams et
al., 2019).

Recent research has also shown that students’ learning and studying processes are related
to their well-being and that organized studying has a positive relationship to well-being . Self-
regulated learning, including skills such as time management and making an effort. These
findings underscore the interconnectedness between academic success, self-regulated learning
strategies, and the holistic well-being of students, thereby highlighting the importance of
promoting structured, well-timed study habits for a healthier and more productive educational
experience (Asikainen et al., 2020).
 It is well-established that physical activity or exercise is essential to improve and/or
maintain physical and mental health and improve the quality of life. Physical activity, equally
stretching, such as participation in sports has many well-established mental health benefits.
Regular physical activity and higher fitness levels appear to have a beneficial effect on stress
reactivity, as measured by cortisol, heart rate, and psychological responses, potentially reducing
the risk of stress-related health issues. Participating in physical activity offers a way to divert
attention from stressors, enabling individuals to concentrate on the exercise rather than their
concern (Barney et al., 2020).

Sensory and relaxation encompassing sounds and songs, sensation techniques, and siesta
have emerged as promising tools in this domain. This approach recognizes the power of sensory
experiences, relaxation practices, and brief rest periods in managing stress and promoting well-
being. By harnessing the impact of sensory stimuli and relaxation techniques, individuals can
find effective ways to cope with the pressures and overwhelming demands of academic life or
stressful environments. Incorporating these creative techniques into counseling programs can
benefit students and even staff members seeking mental health support (Brockway, 2023).

The psychological effects of music can be powerful and wide-ranging. Music therapy is
an intervention sometimes used to promote emotional health, help patients cope with stress, and
boost psychological well-being. Countless experts have investigated how listening to music can
potentially have therapeutic effects on a range of mental and physical health conditions, or just as
a way to cope with everyday life. Contemporary research suggests music has significant power
to help reduce stress and anxiety, relieve pain, and improve focus among many more benefits
(Collins, 2021).

Siesta means “sixth hour” and has been used to indicate the period of time in the day
when shops in Spain and other hot climates would close for a few hours in the afternoon. This
closing allowed for people to eat, rest, and escape the heat. The typical work day in Spain would
span from 9 a.m. to 2 p.m. with a two hour break for the siesta, then work would resume from 4
p.m. to 8 p.m. The term siesta is also used casually to refer to an afternoon nap. A short nap that
can boost alertness, mood, memory, and reduce stress. It's often associated with cultures that
have a tradition of taking a break during the hottest part of the day. The act of taking a siesta can
offer both physical and mental relaxation (Mantua et al., 2017).

Mind-body harmony refers to the integration and balance between mental, emotional, and
physical aspects of an individual's well-being. The mind, body, and soul conception is a way of
understanding ourselves as "whole people." A Whole Person has personal and professional lives
that interconnect — mental, physical, and spiritual components not only influence both spheres
but also interact with each other. In our fast-paced world, finding balance and harmony has
become essential for overall well-being. The holistic lifestyle embraces the interconnectedness of
the mind, body, and spirit, offering a comprehensive approach to living a fulfilling life
(Vidyapeeth, 2023).

Practices that foster mind-body harmony, such as self-awareness, stress debriefing, and
spirituality, have been studied for their effects on stress reduction and overall well-being.
Religion constitutes an integral part of the lives of many people around the world and has a
beneficial effect on their personal adaptation. It is a testament to humanity's enduring search for
meaning and purpose, religion has long served as a cornerstone for personal growth and a
wellspring of strength as individuals face life's challenges. A sense of harmony between mind
and body might function to ameliorate stress responses and enhance a sense of authenticity. The
insular cortex receives signals from the heart and other bodily systems and integrates them with
other sensory information to shape our emotional experiences. This means that our bodily states,
such as an elevated heart rate, can directly influence our emotions, including anxiety and stress.
By becoming more aware of your thoughts, feelings, and bodily sensations, you can develop
effective coping mechanisms and achieve a sense of calmness, which can be seen as a form of
self-debriefing (Kamikura, et al.,2020).

Self-awareness lives at the core of who you are. It radiates an energy that lives on a
cellular level in your body and affects everything about your life. Being self-aware is a major
conscious shift in your life. It is a practice that helps you become more mindful of the way your
mind works with your body so you can create optimal health and well-being. The concept exists
mainly in the preconscious to the unconscious, and that it would connect the sense of self and
sensation of self (Siebiel, 2021).

Spirituality has been incorporated into treatment interventions with mindfulness-based

therapies which focus on awareness of an experience and its consequent effects.Spiritual
meditation has also been shown to reduce stress reactivity through feelings of spiritual
connection, feelings of peacefulness and calmness, and increased self-efficacy. Irrespective of
the stressor type (e.g., death of loved ones, personal challenges, etc.), oftentimes individuals use
their religiosity to cope. Putting their fate “in God’s hands” and accepting their experiences as
“God’s will” gives them a sense of safety, support, and tenacity to persevere through stressful
situations. The prevalence of religious coping is not surprising, given the omnipresence of
religious and spiritual beliefs and practices throughout the history of human civilizations and
cultures, from animism to poly- and monotheism (Bahadorani, et al., 2021).
 THE PROBLEM

Statement of the Problem

This study seeks to comprehensively determine the efficacy of non-substance coping

mechanisms in alleviating school-induced stress experienced by nursing students aged 18 to 25
at the University of Cebu Lapu-Lapu and Mandaue.

This research attempts to explicitly provide answers to the following questions:

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

1.1 age;
1.2 gender;
1.3 preferred non-substance adaptive coping strategy for managing school-induced
stress?
1.3.1 emotional expression and connection
1.3.2 time management and physical activity
1.3.3 sensory and relaxation
1.3.4 mind-body harmony

2. What is the efficacy of the selected non-substance coping mechanisms for alleviating school-
induced stress?
3. Is there a significant relationship between the profile of the respondents and the efficacy of the
selected non-substance coping mechanisms in alleviating school-induced stress?
4. Based on the findings, what recommendations may be proposed?

Statement of Null Hypothesis

 There is no significant relationship between the profile of the respondents and the
efficacy of the selected non-substance coping mechanisms in alleviating school-induced stress.

Significance of the Study

The outcome of the study will be beneficial to the following groups and stakeholders:

Nursing Students. The findings of this study will provide insights into effective non-substance
coping mechanisms, empowering nursing students to better manage and alleviate school-induced
stress.

University of Cebu Lapu-Lapu and Mandaue (UCLM). The university can use the study's
results to enhance support services for students, initiating enhancements that cater to the specific
needs of students, creating an atmosphere that promotes well-being and academic success.

The Researchers. The insights gained from this study will empower the researchers to
contribute meaningfully to the field of stress management in educational contexts. The study will
equip the researchers with practical knowledge on the preferred non-substance coping
mechanisms of nursing students.

Future Researchers. The study provides a foundation for future research on the efficacy of non-
substance coping mechanisms, allowing researchers to expand and refine the investigation. It
serves as a resource for those interested in exploring the intersection of stress, coping, and health.

RESEARCH METHODOLOGY

Research Design

This study will employ a descriptive-correlational research design to determine the

efficacy of non-substance coping mechanisms in alleviating school-induced stress among nursing
students.
 The research will utilize a survey questionnaire to collect data, emphasizing a thorough
examination of the effectiveness of various non-substance coping mechanisms. Meticulous
analysis and accurate reporting of the findings will be prioritized, ensuring that the presentation
of results aligns with the study's emphasis on non-substance coping strategies for managing
academic stress.

The information acquired during the survey will be instrumental in providing valuable
insights into the effectiveness of these coping mechanisms.

Research Environment

The study is to be conducted at the Nursing Department of the University of Cebu Lapu-
Lapu and Mandaue. The chosen area has a high population, which prompts the researchers to
perform a study on the efficacy of non-substance coping techniques in alleviating school-induced
stress.

Research Respondents/Participants

The study's participants would be nursing students, aged 18 to 25, who are enrolled at the
University of Cebu Lapu-Lapu and Mandaue. The researchers chose random sampling to
determine the respondents, and a total of 280 nursing students were selected to assess their non-
substance coping mechanisms. The selection process involved identifying and approaching
nursing students in common areas such as cafeterias, libraries, and outside lecture halls.

Research Instrument

A researcher-designed survey questionnaire was meticulously crafted to undergraduate

nursing students to determine the efficacy of non-substance coping mechanisms in alleviating
school-induced stress. The first part of the questionnaire is the respondents demographic profile.
The collected data will include age, gender and preferred non - substance coping strategy. In the
second part, participants will answer a Likert scale questionnaire that has been carefully
developed to assess the effectiveness of various non-substance coping mechanisms employed by
the researchers in managing academic-related stressors. The questionnaire aims to delve into the
strategies and techniques utilized by participants to cope with the challenges posed by academic
stress, determining the relationship of non-substance coping mechanisms to the participants
academic performance.

Dry Run Procedures

The researchers will conduct pilot testing and will carry out respondents that are to be
determined within the selected/focused department at the University of Cebu Lapu-Lapu and
Mandaue. The data were gathered through a researcher-made survey questionnaire using a close-
ended interview and observation style format.

Data Gathering

Data collection will commence upon obtaining approval from the dean of the College of
Nursing and the ethics committee. Participants will be given a questionnaire prepared by the
researchers. Consent will be obtained before the distribution of the questionnaire, assuring
participants' voluntary involvement while protecting their rights and privacy. After obtaining
consent, participants will be given the questionnaire to complete at their convenience. All
responses will be collected and managed with the utmost confidentiality.

Data Analysis

Simple percentage will be used to summarize the demographic profile of the respondents
(e.g., age, gender) as it allows for quick comparisons and insights into the distribution of
respondents across different categories. Simple percentages allow for a concise summary of the
data, making it easier to identify trends and patterns within the respondent profile. For instance,
by calculating the percentage of respondents within each age group or gender category, we can
quickly discern any notable variations or disparities in the data. When examining the preferred
non-substance adaptive coping strategies for managing school-induced stress, using simple
percentages enables us to effectively compare the popularity of different strategies among
respondents. This can help identify which coping mechanisms are most commonly utilized and
provide valuable insights into potential areas for intervention or support. Weighted mean
analysis assigns different weights to responses on an efficacy scale, reflecting the perceived
importance or effectiveness of non-substance coping mechanisms. It provides a nuanced
evaluation by considering both the frequency and intensity of respondents' preferences, offering
a more detailed understanding of the perceived efficacy of each coping strategy in alleviating
school-induced stress. Chi-square analysis is employed to assess whether there is a significant
association between categorical variables, specifically investigating the relationship between the
profile of respondents (e.g., age, sex) and the perceived efficacy of selected non-substance
coping mechanisms for alleviating school-induced stress. It helps determine if there is a
meaningful connection between demographic characteristics and preferences for coping
strategies.

Ethical Considerations

Ethics in research defines guidelines for conducting professional research, teaching and
regulating researchers to ensure they follow a strict code of ethics when conducting research
(Hasan et al., 2021).The significance of these considerations lies in their facilitation of research
objectives, notably in the realms of error prevention, truth pursuit, and knowledge acquisition.
Ethical considerations play a pivotal role in holding researchers accountable for the
methodologies employed throughout the research process (Ayenew, 2022). In research, it
encompasses a set of fundamental principles designed to safeguard the rights of research
participants, optimize research validity, and uphold scientific or academic integrity (Bhandari,
2023).

In alignment with these ethical principles, before conducting the research interview, the
researchers will request approval from the University's Research Ethics Committee to ensure that
the students will not suffer any harm from this study. Also, the participants were involved in the
study voluntarily, providing informed consent without any external influence or pressure. They
were given the freedom to decide whether to participate or not, and there was no coercion
involved. The well-being of the respondents was safeguarded, ensuring that they did not
experience any harm. Furthermore, strict measures were taken to protect the privacy of the
research participants. Their voluntary involvement was regarded as essential, and they retained
the right to withdraw from the study at any point if they chose to do so.

The researchers maintained a sufficient level of confidentiality while handling the data.
In compliance with Republic Act 10173, also known as the Data Privacy Act of 2012, the
researchers upheld privacy rights and treated the collected data with confidentiality. Before
commencing the study, the researchers sought approval from the University's Research Ethics
Committee.

Trustworthiness of the Research

The researcher's credibility was affirmed, and data collection was carried out via
survey questionnaires. The study's results were derived solely from the participants' responses,
without any inherent bias or subjective opinion. The researchers took measures to guarantee that
the drawn conclusions aligned with the data obtained from the respondents. Participants retained
the option to terminate the survey at any point. The confidentiality of their identities,
backgrounds, and responses was maintained, with a commitment to respecting their privacy.

The researcher's confirmability was affirmed, and emphasis was placed on deriving data
from participants' responses rather than the researcher's personal objectives or potential bias. The
researchers drafted an approval letter to conduct the study at the University of Cebu Lapu-Lapu
and Mandaue, College of Nursing.
 DEFINITION OF TERMS

School-induced Stress. The type of stress that originates from academic environments,
including pressures from coursework, exams, practical assessments, and the high expectations
associated with nursing programs.

Coping Mechanisms. Refer to the tactics that students use to deal with stressful situations.
These mechanisms can vary widely and may include strategies such as socializing, time
management, physical activity, sensory engagement, self-awareness, stress debriefing,
spirituality, among others.

Non-Substance Coping Mechanisms. Non-substance coping mechanisms are strategies for

managing stress that do not involve the use of drugs or alcohol. Examples include emotional
expression and connection, time management and physical activity, sensory engagement and
relaxation, and fostering mind-body harmony.
The 12S for Stress. Set of strategies introduced by the Department of Health to assist
individuals in navigating stressful periods. These guidelines offer a comprehensive approach to
stress management, emphasizing personalized interventions tailored to individual needs and
preferences.

Emotional expression and connection. Involve tactics such as open communication, social
interaction, and smiling, which can help students cope with stress by fostering support, empathy,
and positive social relationships.

Time management and physical activity. Time management and physical activity encompass
strategies such as scheduling, stretching, and engaging in sports, which promote stress relief by
enabling students to structure their time effectively and incorporate physical movement into their
routines.
Sensory and relaxation. Offer avenues for stress reduction by engaging the senses, promoting
relaxation, and providing opportunities for rest and rejuvenation.

Siesta. A short nap or rest taken early in the afternoon, often after the midday meal.
Incorporating a siesta into the daily routine of nursing students could be examined in the study as
a way to reduce fatigue, enhance well-being, and thus mitigate the effects of school-induced
stress.

Mind-body harmony. Refers to the integration and balance between mental, emotional, and
physical aspects of a student’s well-being. Practices such as self-awareness, stress debriefing,
and spirituality aim to cultivate harmony between the mind and body, facilitating stress reduction
and overall wellness.

Self-awareness. The conscious knowledge of one's own character, feelings, motives, and
desires. It involves being mindful of thoughts, emotions, and bodily sensations, which can aid in
understanding oneself and developing effective coping mechanisms.
Stress debriefing. Sessions could be beneficial for nursing students, providing them with
strategies to cope with the stresses associated with their rigorous academic and clinical training.

Spirituality. Refers to the search for meaning, purpose, and connection to something greater
than oneself. It encompasses beliefs, practices, and experiences that transcend the material realm
and may include aspects such as faith, prayer, meditation, and a sense of interconnectedness with
others and the universe.

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 APPENDIX C - 1

SURVEY QUESTIONNAIRE IN ENGLISH

I. RESPONDENT’S PROFILE:

Instruction: Please read each question carefully and indicate your response by placing a
(✓) on the option that best describes you or your preferences. Your responses will remain
confidential.

1.1 Age
● 18
● 19
● 20
● 21
● 22
● 23
● 24
● 25

1.2 Gender
● Female
● Male

1.3 Preferred non-substance adaptive coping strategies for managing school-induced stress.
● Emotional Expression and Connection (‘speak to me’, socials, and smile)
● Time Management and Physical Activity (scheduling, stretching, and sports)
● Sensory and Relaxation (sound and songs, sensation techniques, and siesta)
● Mind-Body Harmony (self-awareness, stress debriefing, and spirituality)

II. EFFICACY OF NON-SUBSTANCE COPING MECHANISMS

Instruction: Put a check (✓) mark on what applies to you.
1 - Not Effective at All (No noticeable impact or benefit.)
2 - Slightly Effective (Minimal impact; some positive effect, but not substantial)
3 - Moderately Effective (Average impact; brings about a noticeable positive change without
being exceptionally impactful.)
4 - Very Effective (Significant impact; produces a substantial positive result.)
5 - Extremely Effective (Exceptional impact; highly successful with a profound and remarkable
positive outcome.)
 (1) (2) (3) (4) (5)
Emotional Expression and Connection NEA SE ME VE EE
 1. Engaging in activities that help you express
your emotions effectively
2. Doing creative outlets, such as art or writing
3. Actively seeking emotional support from others
who may have faced similar challenges
4. Participating in volunteer work
5. Engaging in silent activities with others, like
reading together
6. Trauma and expression groups participation
7. School clubs or school organizations
participation
8. Connecting with others through digital
platforms for emotional well-being
9. Going out for small talk and movie marathons
with friends.
Time management and Physical activity (1) (2) (3) (4) (5)
NEA SE ME VE EE
1. Planning a daily or weekly schedule to manage
academic tasks
2. Allocating specific time slots for breaks and
leisure activities during study sessions
3. Prioritize tasks based on their importance and
deadlines
4. Utilizing tools or apps to help organize and
manage time effectively
5. Integrating short breaks for physical activity
(e.g., stretching, walking) into my study routine
6. Following your planned schedule on a typical
day
7. Managing distractions to stay focused on your
tasks (e.g., turning off phone notifications and
 removing clutter)
8. Energizers and stretching before class
9. Going to the gym, attending zumba, or going
mountain hiking
Sensory and Relaxation (1) (2) (3) (4) (5)
NEA SE ME VE EE
1. Practicing mindfulness or meditation techniques
such as deep breathing
2. Using sensory techniques (e.g., aromatherapy
and listening to calming music)
3. Creating a calm environment, such as dim
lighting and comfortable seating
4. Engaging in outdoor activities, such as nature
walks or gardening
5. Crocheting
6. Taking warm baths or cold showers
7. Using fidget toys or stress balls
8. Making an appointment for a body massage
9. Having a full and restful sleep
Mind-Body Harmony (1) (2) (3) (4) (5)
NEA SE ME VE EE
1. Participating in yoga and tai chi sessions
2. Engaging in activities that involve both mental
and physical components, such as puzzles or
charades
3. Going to a retreat house or joining prayer
groups
4. Understanding your own emotions and reactions
in various situations
5. Taking time to check in with yourself and assess
your current mental and physical state
6. Receiving feedback as a means of increasing
self-awareness
7. Debrief or reflect on stressful situations to
identify the lessons you have learned
8. Being aware of your thought patterns and how
they influence your emotions
9. Engaging in acts of kindness and compassion as
a reflection of your spiritual beliefs (giving food
to homeless people)
 APPENDIX C - 2
SURVEY QUESTIONNAIRE IN VERNACULAR

I. DEMOGRAPIKO NGA DAGWAY:

Instruksyon: Palihug basaha ang matag pangutana ug itandi ang imong tubag pinaagi sa
pagsulat sa marka nga (✓) sa opsyon nga labing mo aplikar kanimo.
1.1 Edad
● 18
● 19
● 20
● 21
● 22
● 23
● 24
● 25

1.2 Kinatawhan
● Babae
● Lalaki

1.3 Gipili nga mga pamaagi nga wa nigamit og mga makadaot sa lawas alang sa pag-atubang sa
kalisod nga gibati gikan sa eskwelahan.
● Pagpahayag sa emosyon ug pagkakonekta (paghisgot bahin sa mga problema sa mga
higala o pamilya, pakighigala, ug pagngisi)
● Pagdumala sa oras ug pisikal nga kalihokan (pag-iskedyul sa mga buhatunon, pag-
pakondisyon, ug pag-apil sa mga isport)
● Sensasyon ug pagpahulay (kanta ug musika, pagtandog sa mga sensasyon, ug pagpahulay
sa makadali)
● Pagkahiusa sa utok ug lawas (pagsusi sa kaugalingon, pagpamalandong sa mga ‘stressor’,
ug pagka-espirituhanon)

II. PAGSUKOD SA KAEPEKTIBO SA MGA ALTERNATIBONG DILI MUGAMUT

UG SUBSTANSIYA SA PAG-ATUBANG SA ‘STRESS’
Instruksyon: Ibutang ang tsek (✓) marka ubos sa mosunod nga mga pangutana.
1 - Dili Epektibo (Walay nabati nga epekto o benepisyo.)
2 - Medyo Epektibo (Gamay nga epekto; pipila ka positibo nga epekto, apan dili igo)
3 - Kasamtangang Epektibo (Sakto nga epekto; naghatag og nabati nga positibong pagbag-o
nga dili kaayo dako)
4 - Labing Epektibo (Dako nga epekto; naghatag og kasamtangang positibong resulta.)
5 - Pinaka Epektibo (Labawng epekto; sobra ka dakong pag-nindot sa kahimtang og sobra ka
dako nga positibong resulta.)

Pagpahayag sa Emosyon ug Pagkakonekta (1) (2) (3) (4) (5)

DE GE KE LE PE
1. Pag-apil sa mga aktibidad nga makatabang sa
pagpagawas sa imong mga emosyon
2. Paghimo og mga likhang seni, sama sa pag-arte
o pagsulat
3. Aktibong pagpangita og suporta gikan sa uban
nga nag-atubang og parehas nga mga kalisdanan
4. Pag-apil sa boluntaryong buluhaton
5. Pag-apil sa kalihokan nga hilom, sama sa
pagbasa kauban imong mga kaila
6. Pag-apil sa mga grupo para sa mga naay trauma
nga magpahigayon sa ekspresyon
7. Pag-apil sa mga organisasyon sa eskwelahan
8. Pagkonektar sa uban pinaagi sa digital nga mga
plataporma alang sa emosyonal nga kaayohan
9. Pag gawas sa balay para makig halubilo ug
makig tan-aw ug sine kauban ang mga higala..
Pagdumala sa Oras ug Pisikal nga kalihokan (1) (2) (3) (4) (5)
DE GE KE LE PE
1. Pagplano ug matag adlaw o matag semana nga
iskedyul aron makamaneho sa mga buluhatong
akademiko
2. Pagtakda og oras nga mupahuway kada sesyon
sa pagtuon
3. Pag-una sa mga buluhaton base sa ilang
importansya ug takna sa pagpasa
 4. Paggamit og mga kasangkapan o mga apps aron
makatabang sa pag-organisar sa oras sa mga
buluhaton
5. Paghatag og gamayng pahulay para sa aktibidad
sa lawas (hal., stretching, paglakaw) sa akong
rutina sa pagtuon
6. Pagsunod sa imong giplano nga eskedyul sa usa
ka tipikal nga adlaw
7. Pagdumala sa mga distraksyon aron
magpabiling naka-focus sa imong mga
buluhaton (e.g., pagpalong sa celpon, pag
panghipos)
8. Mga paglihok-lihok sama sa energizer ug
stretching sa dili pa ang klase
9. Pag-adto sa gym, pagtambong sa zumba, o pag-
hyking sa bukid
Sensasyon ug Pagpahulay (1) (2) (3) (4) (5)
DE GE KE LE PE
1. Pagpraktis sa mga teknik sa pagkalma sa huna-
huna o pagmeditar sama sa paginhawa og
lawom
2. Paggamit og mga sensory teknik (sama sa
pagsimhot ug makapakalmang pahumot ug
papaminaw ug musika nga makapakalma)
3. Kalmado nga palibot, sama sa pagpahinay o
pagpalong sa siga sa suga ug komportable nga
lingkoranan/paglingkod
4. Pagsalmot sa kalihokan sa gawas, sama sa
paglakaw lakaw o pag pananom
5. Paggansilyo
 6. Pagkaligo
7. Paggamit sa mga fidget toys or stress balls
8. Pagpa-eskedyul og pamasahe sa lawas
9. Pagtulog ug taas ug walay disturbo
Pagkahiusa sa Utok ug Lawas (1) (2) (3) (4) (5)
DE GE KE LE PE
1. Pag-apil sa yoga ug tai chi nga mga sesyon
2. Pag-apil sa mga kalihokan nga naglakip sa
panghuna-huna ug pisikal nga mga paglambo,
sama sa mga puzzle o charades
3. Pag-adto sa balay-pamalandungan o pag-apil sa
mga grupo sa pag-ampo
4. Pagsabut sa imong kaugalingon nga mga
emosyon ug reaksyon sa lainlaing mga
sitwasyon
5. Paggahin ug panahon sa pagsusi sa imong
kaugalingon (panghuna-huna ug pisikal nga
kahimtang)
6. Pagdawat og komentaryo isip usa ka paagi nga
makatabang sa pagtabang sa pagkaila sa
kaugalingon
7. Pagpamalandong sa mga makapaguol nga mga
sitwasyon aron mahibal-an ang mga leksyon
nga imong nakat-unan
8. Ang pagkahibalo sa imong laraw sa
panghunahuna ug kung giunsa niini pag-
impluwensya ang imong mga emosyon
9. Pag-apil sa mga kalihukan nga makapakita sa
imong kompasyon ug kaluoy nga
magpagpamalandong sa imong espirituhanon
nga mga pagtuo (paghatag pagkaon sa mga
walay puy-anan)