CHAPTER I
THE PROBLEM
Introduction
Anxiety is part of the package of life. It's a natural byproduct of having a brain
that is capable of such high-wire acts as considering the future. A little anxiety is good,
even necessary, and a great motivator to get us to plan well and to perform ably.
Anxiety serves as one element in a wide range of flexible responses that are
essential for people to survive in a dangerous world. A certain amount of anxiety
introduces an appropriate element of caution in potentially dangerous situations. Most of
the time, a person’s level of anxiety makes appropriate and imperceptible shifts along a
spectrum of consciousness from sleep through alertness to anxiety and fear then back
again. Sometimes, however, a person’s anxiety response system operates improperly or is
overwhelmed by events; in this case, an anxiety disorder arises (Berkow et al, 1999).
All people experience anxiety to some degree. Most people feel anxious when
faced with a new situation, such as in the field of nursing, students on their first major
subject or when performing any clinical procedures new to them.
The physical symptoms of anxiety reflect a chronic “readiness” to deal with some
future threat. These symptoms may include fidgeting, muscle tension, sleeping problems,
and headaches. Higher levels of anxiety may produce such symptoms as rapid heartbeat,
sweating, increased blood pressure, nausea, and dizziness.
Levels of anxiety range from a state of euphoria to panic. On the euphoric stage,
there is an exaggerated feeling of well-being that is not directly proportionate to a
specific circumstances or situation. It precedes the onset of the first level which is mild
anxiety where individual experience is positive in which there is increase alertness to
inner feelings or the environment, such as increased ability to learn, become competitive
and the like. The second level is moderate anxiety wherein there is a narrowing of the
ability to perceive. The person is able to focus or concentrate on only one specific thing.
Severe anxiety may also arise as the next level in which there is further reduction in the
ability to perceive and focus is on small or scattered details. Sometimes anxiety explodes
in a panic attack as the fourth level of anxiety which marked by a general feeling of
terror. A person engulfed in a panic attack usually experiences a racing or pounding heart,
sometimes even pain or heaviness in the chest. Breathing becomes difficult. The body
trembles and hands turn clammy. The person may notice tingling in their hands and feet,
sometimes in their arms and legs. They may start to feel light-headed (Wikipedia.org).
Anxiety, worry, and stress are all a part of most people's life today. Anxiety is a
necessary warning signal of a dangerous or difficult situation. We should be responsive to
our level of anxiety. Without anxiety, we would have no way of anticipating difficulties
ahead and preparing for them.
To the respondents, that this output is hoped to be valued to them as it serves as a
mirror to their competence and confidence towards the classroom and clinical area. This
research hopes to let the respondents be aware of their current anxiety level, thus letting
them be able to increase or decrease it.
To the nursing students, the researcher hopes that this study will be able to show
them the level of anxiety of fellow students in the classroom and clinical setting, thus
preparing them for it. This research hopes to motivate them to plan ahead for upcoming
tasks in both the classroom and in the area of duty.
Statement of the Problem
This study will attempt to determine the level of anxiety among first year, nursing
students at the University of Northern Philippines. Specifically, it will seek to answer the
following:
1. What is the profile of the respondents in terms of:
A. Socio-demographic Factors
a. Age
b. Sex
c. Civil Status
d. Family Structure (e.g. nuclear, extended)
e. Family’s Total Monthly Income
B. Academic Factors
a. Participation in class
b. Knowledge about the subject
c. Study habits
d. Number of units enrolled
e. Number of classes a day
2. What is the level of anxiety among first year, nursing students?
A. 0 anxiety
B. Mild anxiety
C. Moderate anxiety
D. Severe anxiety
E. Panic anxiety
3. Is there a significant relationship between the level of anxiety among the
respondents and the following factors:
A. Socio-demographic Factors
a. Age
b. Sex
c. Civil Status
d. Rank Among Siblings
e. Family Structure
f. Family’s Total Monthly Income
B. Academic Factors
a. Participation in class
b. Study habits
c. Number of units enrolled
d. Number of classes a day
Scope and Delimitation
This study will be delimited to the first year, nursing students at the University Of
Northern Philippines. It will be conducted during the school year 2009-2010. The
respondents will be selected through simple random sampling. Questionnaires will be
distributed to all sections of the first year students of the College of Nursing and the
College of Health Sciences.
Data will be obtained through a questionnaire divided into two parts:
○ Part I- Socio-demographic factors
○ Part II- Academic Profile
○ Part III-Psychological Profile
Theoretical Framework
The researchers will base this study on a number of theories. One of them is the
Psychoanalytic Theory discovered by Sigmund Freud. It institutes that anxiety is the
appropriate mechanism of defense against certain danger situations. These danger
situations, as described by Freud, are the fear of abandonment by or the loss of the loved
one (the object), the risk of losing the objects love, the danger of retaliation and
punishment, and finally the hazard of reproach by the superego. Thus, symptom
formation, character and impulse disorders, and perversions, as well as sublimations,
represent compromise formations – different forms of adaptive integration that the ego
tries to achieve through more or less successfully reconciling the different forces in the
mind.
There is also the Interpersonal Theory that states the cause of anxiety is fear of
interpersonal rejection. This theory was introduced by Harry Stack Sullivan. It holds that
personality development and mental disorder such as panic disorder are determined
primarily by the interplay of personal and social forces rather than constitutional factors
in the individual.
Another theory is the Behavioral Theory that says that anxiety is a product of
frustration. According to hardy et al, anxiety results when the individual doubts his or her
ability to cope with the situation that causes him or her stress (1996). The stress brought
about by his lack of confidence consequently turns into anxiety.
In addition, the researchers will also base this study on the Learning Theory by
Ivan Pavlov. In Learning Theory, anxiety is seen both as a response to learned cues and as
a drive, or motivator of behavior. Anxiety is caused by exposure to early life fearful
experiences. Under this theory, Pavlov mentions Classical Conditioning. He says that it
happens when an animal or human learns to associate a neutral stimulus (signal) with a
stimulus that has intrinsic meaning based on how closely in time the two stimuli are
presented. For example, if a child sees that a certain individual feels pain when getting
injected. As he gets older, he would feel anxious when he sees a syringe because he
associates it with pain through what he witnessed when he was younger.
Conceptual Framework
FIGURE 1
RESEARCH PARADIGM
The research paradigm shows the relationship between the dependent variable
which is the level of anxiety of the respondents and the independent variables which is
the socio-demographic and academic factors. This will serve as the guideline for the
research investigation. The figure explains that all these factors interplay to contribute to
the level of anxiety of the respondents.
Operational Definition of Terms
Age. This refers to the length of time that an organism has lived.
Anxiety. This refers to the emotional state arising from change and frequently
emanates from fear.
Civil Status. This refers to the position of an individual in relation to another or
others, esp. in regard to social or professional standing.
Extended Family. This refers to the a family that can include, aside from parents
and their children; spouses of children, in laws, cousins, aunts, uncles, nieces, nephews,
foster children or adopted children.
Family’s Total Monthly Income. This refers to the to the consumption and
savings opportunity gained by an entity within a specified time frame, which is generally
expressed in monetary terms.
Gender. This refers to the comprises a range of differences between men and
women, extending from the biological to the social.
Level 0 or no anxiety. The person has no negative reaction to certain stimuli.
Mild Anxiety. This level can be positive experience which a person has an
increased alertness to inner feeling and working under stress until their work is done. It
make a person to be a competitive and increased a person willingness to learn.
Moderate Anxiety. This level, the person focuses to only one specific topic and it
draw a conclusion about the expected danger occur. The person also may manifest
different negative attitudes that will enable the person not to focus other stimuli.
Nuclear Family. This refers to the a family group consisting of most commonly,
a father and mother and their children, from what is known as an extended family.
Number of classes a day. This refers to the period during which a group of
students meets for instruction.
Number of major subjects enrolled. This refers to a branch of knowledge as a
course of study with an academic unit of higher than four.
Panic Anxiety. This level involves difficulty verbalizing, unable to concentrate to
what he or she is doing, cannot focus on reality, the individual may experience a fear of
being alone in public places. The person manifest emotional and intellectual changes as
the individual experiences a loss of concentration.
Participation in class. This refers to an act or instance of participating in class.
Rank among siblings. This refers to the relative position or standing in the
family particularly on the children.
Severe Anxiety. This level the person cannot communicate clearly, inappropriate
response to the questions being asked, and decision making is altered. This manifestation
is due to the pressure the person is experiencing in response to the stimuli that make the
person experiencing anxiety.
Study habits. This refers to a particular practice, custom, or usage in terms of
studying.
Hypotheses
The hypothesis below will be considered in this study:
1. There is a relationship between the socio-demographic factors and the level
of the respondents’ anxiety.
2. There is a relationship between the academic factors and the level of the
respondents’ anxiety.
Methodology
This section presents the research design, population and sample, data gathering
instrument, data gathering procedure, and statistical treatment of data.
➢ Research Design
The researchers will utilize the descriptive-correlational method of research.
Specifically, it will be used to determine the level of anxiety of nursing students. In
addition, academic factors such as attitude of the respondents in the classroom toward the
subject will also be considered as a contributor in their level of anxiety.
➢ Population and Sample
The population of the study will be composed 121 students from the College of
Nursing and 221 students from the College of Health Sciences that will total to 341
students.
➢ Data Gathering Instruments
The study will utilize a questionnaire composed of four parts namely, Part I:
Socio-demographic Profile, Part II: Family Profile, Part III: Academic Profile, and Part
IV: Psychological Profile. Part I will consist of the personal profile of the respondent,
Part II consists of the family factors along with their family structure, Part III will include
the respondent’s academic factors such as the number of classes they have in one day and
number of hours of classes a day, and Part IV will be on the respondent’s psychological
profile on how they rate their feelings on a certain situation.
➢ Data Gathering Techniques
The researcher will ask consent from the Deans of the College of Nursing and the
College of Health Sciences. If permission will be granted, the researcher will coordinate
with the respective presidents of each section to distribute the questionnaires. The
secretaries per section will then collect the answered questionnaires. Subsequently, the
researcher will tally and interpret the data.
➢ Statistical Treatment Of Data
1. Frequency count and percentage will be used to describe the personal profile
of the respondents.
2. Mean will be employed to determine the level of anxiety of the respondents
3. Standard Deviation will be applied to determine the amount of students who
experience a level anxiety above normal
BIBLIOGRAPHY
A. Books
Hardy, L., Jones, J. G., and Gould, D., Understanding Psychological Preparation.
Chichester, England: Wiley, 1996
Gapuz, R.A., The ABC’s of Psychiatric Nursing. Ed. Sion, Rommel. Manila: Gapuz
Publishing, 2007
Berkow, R., Beers, M., and Fletcher A., Merck Manual of Medical Information. New
York: Simon & Schuster Inc., 1999
B. Others
“Anxiety.” Wikipedia, the free encyclopedia. 26 May 2009
Level of Anxiety among First Year College of Nursing
and College of Health Sciences Students
You have been randomly selected to be a part of our study. Please answer the
following questions truthfully. Through this questionnaire, we can determine your level
of anxiety and identify the factors that contribute to it.
Part I Socio-demographic Profile
○ Name: _______________________________________________
○ Address: _____________________________________________
○ Age: ________ years old
○ Gender
✔
✔ Female___
✔ Male___
○ ○ Civil status
✔
✔ Single ___
✔ Married ___
✔ Separated___
✔ Widower/ed
Part II Family Profile
1 Do your parents have high expectations for you? __ yes __ no
.
2 Did your parents choose your course? __ yes __ no
.
3 Do you confide in your parents when you have a __ yes __ no
. problem at school?
4 Do your parents or first degree relatives experience __ yes __ no
. anxiety?
5 What is your position among your siblings? __ eldest
. __ middle child
__ youngest
__ only child
__ others:________
6 What is the type of family that you have? __ nuclear __ extended
.
7 How many of them are depending on your parents for __ please specify
. finances?
__________ people
8 What is your family’s total monthly income? __ below 10,000
. __ 10,000-20,000
__ above 20,000
Part III – Academic Profile
1 Do you actively participate during class? __ yes __ no
.
2 Do you voice out your doubts or ask questions about __ yes __ no
. the topic?
3 Do you have an advance read on lessons? __ yes __ no
.
4 Do you take down notes during classes? __ yes __ no
.
5 Do you study your lessons after classes even if there is __ yes __ no
. no quiz or test coming up?
6 How many major subjects are you in enrolled in for ______ subjects
. this semester?
7 How many classes do you have in one day? ______ classes
.
8 If there is a test coming up, when do you review? __ a week before
. __ a few days before
__ a day before
__ on the day of the test
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Part IV Psychological Profile
This questionnaire has 42 questions that will test your level of anxiety. For each
statement in the questionnaire, please indicate how often you feel that way by checking
the appropriate circle. Answer each question truthfully.
Never Rare Sometimes Often Always
1. I am able to relax.
I tend to focus on upsetting
2. situations or events happening in
my life.
3. I feel fearful for no reason.
I am as happy as the people
4.
around me.
I have diarrhea, constipation, or
5.
other digestive problems.
6. I have a dry mouth
When someone snaps at me, I
7. spend the rest of the day thinking
about it.
No matter what I do, I can’t get
8.
my mind off my problems.
I am easily alarmed, frightened,
9.
or surprised.
I experience shortness of breath
10.
or choking feelings.
My muscles are tense, aching, or
11.
sore.
I have sweaty or cold, clammy
12.
hands.
I spend time wondering why I
13.
feel the way I do.
I am afraid of crowds, being left
14. alone, the dark, of strangers, or of
traffic.
15. I faint or feel like fainting
I have difficulty swallowing or
16.
have a “lump in throat” feeling
11
I experience twitching, trembling
17.
or shaky feelings.
18. I think a lot about the things I do.
19. I am easily irritated.
20. I feel futile.
21. I have hot and/or cold flashes.
I think about all the things I have
22.
not yet accomplished
I have trouble falling or staying
23.
asleep.
24. I feel dizzy or light-headed.
25. I feel tired.
26. I am decisive.
I am afraid of what awaits me in
27.
the future.
I get numbness and/or tingling
28. feelings in my extremities (i.e.
hands, feet, etc.).
I have difficulty concentrating or
29.
remembering things.
I have palpitations, pounding
30.
heart, or accelerated heart rate.
I have to empty my bladder
31.
frequently.
I can think about a problem for
32. hours and still not feel that the
issue is resolved.
I think about how unsatisfied I am
33.
with my life.
34. I worry a lot.
35. I feel tense or on edge.
36. I have headaches or neck pain.
37. I worry about my health or dying.
38. I have nightmares.
12
I have less interest in activities
39.
that I normally enjoyed.
40. I feel good about myself.
41. I feel I am losing control.
42. To me, the world is a scary place.
___________________________
Signature over Printed Name
___________________________
College
___________________________
Date
Dummy Table
College of Nursing College of Health Sciences
Total Population
Sample Population
Total
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