Stress and Coping Mechanisms of Staff Nurses Employed from 2000 to 2026 in Selected Government Hospitals in the First District of Batangas

This study determined the occupational stress and coping mechanisms of staff nurses hired from 2000 to 2026 and currently employed in selected government hospitals in the First District of Batangas. It examined occupational stress in terms of workload, work environment, interpersonal relationships, and organizational factors and identified the coping mechanisms utilized in terms of problem-focused, emotion-focused, and avoidant coping. A quantitative descriptive-correlational research design was employed among one hundred fourteen staff nurses. Data were collected using a validated survey questionnaire and analyzed using descriptive statistics, tests of significant differences, and Spearman’s rho correlation. The findings showed that occupational stress was experienced across the four dimensions, with workload, work environment, interpersonal relationships, and organizational factors identified as sources of workplace stress. Problem-focused, emotion-focused, and avoidant coping mechanisms were all often utilized by the staff nurses. Significant differences in coping mechanisms were found according to years of nursing service, particularly in problem-focused and emotion-focused coping, while avoidant coping did not significantly differ across the demographic and employment profiles. Significant positive relationships were found between occupational stress and all three coping mechanisms. Problem-focused coping demonstrated moderate positive relationships with all four stress dimensions, while emotion-focused coping showed weak to moderate and avoidant coping showed moderate positive relationships. Based on the findings, Project CARES (Coping, Adaptation, Resilience, and Employee Support) was proposed as a stress management intervention program to strengthen coping, workplace support, communication, workload management, and staff well-being.

coping mechanisms, government hospital, occupational stress, staff nurses, Project CARES

1. Abdoh, D. S., Shahin, M. A., Ali, A. K., Cheikh Ismail, L., Abdulrahman, M., & Ibrahim, M. (2021). Prevalence and associated factors of stress among primary health care nurses in Saudi Arabia: A multi-center study. Journal of Family Medicine and Primary Care, 10(7), 2692–2696. https://doi.org/10.4103/jfmpc.jfmpc_222_21 [Google Scholar] [Crossref]

2. Abou Hashish, E. A., & Atalla, A. D. G. (2023). The relationship between coping strategies, compassion satisfaction, and compassion fatigue during the COVID-19 pandemic. SAGE Open Nursing, 9, 23779608231160463. doi:10.1177/23779608231160463 [Google Scholar] [Crossref]

3. Abuatiq, A., & Borchardt, C. (2021). The impact of COVID-19: Nurses’ occupational stress and strategies to manage it. The Journal of Nursing Administration, 51(12), 600–605. https://doi.org/10.1097/NNA.0000000000001081 [Google Scholar] [Crossref]

4. Al-Yaqoubi, S., & Arulappan, J. (2023). Sources of work-related stress among Omani nurses: A cross-sectional study. Journal of Patient Experience, 10, 23743735231166504. https://doi.org/10.1177/23743735231166504 [Google Scholar] [Crossref]

5. Alibudbud, R. (2023). Addressing the burnout and shortage of nurses in the Philippines. SAGE Open Nursing, 9, 23779608231195737. https://doi.org/10.1177/23779608231195737 [Google Scholar] [Crossref]

6. Anarna, K. S., & Tomas, A. C. V. (2024). Assessment of emotions and stress coping mechanisms of healthcare workers from the Department of Pediatrics at the Philippine General Hospital a year after the coronavirus disease 2019 pandemic. Acta Medica Philippina, 58(7). doi: 10.47895/amp.v58i7.6343 [Google Scholar] [Crossref]

7. Armstrong, J. W., & Turne, L. N. (2022). Mindfulness-based interventions to reduce stress and burnout in nurses: An integrative review. British Journal of Mental Health Nursing, 11(1). doi: 10.12968/bjmh.2020.0036 [Google Scholar] [Crossref]

8. Calegari, J. G., Russo, S., Luciani, M., Strepparava, M. G., Di Mauro, S., & Ausili, D. (2022). Association between coping strategies and professional quality of life in nurses and physicians during COVID-19: A cross-sectional study. Journal of Nursing Management, 30(8), 4054–4063. doi:10.1111/jonm.13845 [Google Scholar] [Crossref]

9. Capili, J. T., Luis, L. M. G., Asuncion, J. E. L., Luyun, J. L., Canapi, J. B., & Rimban, E. L. (2022). Narratives of hospital health care professionals during the pandemic in the Northern Philippines: A phenomenological study. Jàmbá: Journal of Disaster Risk Studies, 14(1), a1284. doi: 10.4102/jamba.v14i1.1284 [Google Scholar] [Crossref]

10. Castro, J., Molo, J., Catalan, J. P. M., Magsingit, N. S., Palaganas, E., Rivera, R. R., & Norful, A. A. (2024). Work-related stress factors and psychological health of Filipino nurses during the COVID-19 pandemic. Philippine Journal of Nursing, 94(1), 21–30. [Google Scholar] [Crossref]

11. Dartey, A. F., Tackie, V., Lotse, C. W., Dziwornu, E., Affrim, D., & Akosua, D. R. D. (2023). Occupational stress and its effects on nurses at a health facility in Ho Municipality, Ghana. SAGE Open Nursing, 9, 23779608231186044. https://doi.org/10.1177/23779608231186044 [Google Scholar] [Crossref]

12. De los Santos, J. A. A. (2023). Compassion fatigue influences the mental health and turnover intention of nurses in the COVID-19 pandemic. Acta Medica Philippina, 57(8), 19–24. https://doi.org/10.47895/amp.vi0.5137 [Google Scholar] [Crossref]

13. De los Santos, J. A. A., & Labrague, L. J. (2021). The impact of fear of COVID-19 on job stress and turnover intentions of frontline nurses in the community: A cross-sectional study in the Philippines. Traumatology, 27(1), 52–59. https://doi.org/10.1037/trm0000294 [Google Scholar] [Crossref]

14. Falguera, C. C., Labrague, L. J., Firmo, C. N., De los Santos, J. A. A., & Tsaras, K. (2023). Relationship of work engagement with nurse work and patient outcomes among nurses in Central Philippines. Acta Medica Philippina, 57(4), 24–31. https://doi.org/10.47895/amp.vi0.4426 [Google Scholar] [Crossref]

15. Gonzales, R. V., Gonzales, M. K. D., & Ly-Uson, J. T. (2024). A comparison of psychological distress and coping styles among physicians and nurses in a COVID-19 referral hospital in Manila: A cross-sectional study. Acta Medica Philippina, 58(16), 85–102. doi:10.47895/amp.vi0.8308 [Google Scholar] [Crossref]

16. Jamebozorgi, M. H., Karamoozian, A., Bardsiri, T. I., & Sheikhbardsiri, H. (2022). Nurses’ burnout, resilience, and its association with socio-demographic factors during the COVID-19 pandemic. Frontiers in Psychiatry, 12, 803506. doi:10.3389/fpsyt.2021.803506 [Google Scholar] [Crossref]

17. Jiju, L., & Singh, M. (2022). Job stress among nurses in tertiary care hospital: Identifying risk factor of poor mental health. International Journal of Research in Medical Sciences, 10(11), 2573–2576. https://doi.org/10.18203/2320-6012.ijrms20222860 [Google Scholar] [Crossref]

18. Joseph, T., Angadi, S., & Natekar, D. S. (2021). A study to assess occupational stress among staff nurses at HSK Hospital and Research Centre, Bagalkot, with a view to develop an information guide sheet on stress management. International Journal of Science and Healthcare Research, 6(3), 13–18. https://doi.org/10.52403/ijshr.20210703 [Google Scholar] [Crossref]

19. Joy, G. V., Kunjavara, J., Larsen, M. K., & Tiwari, S. (2022). Coping with COVID-19: Strategies of frontline nurses. Babali Nursing Research, 3(3), 113–120. doi:10.37363/bnr.2022.33113 [Google Scholar] [Crossref]

20. Khade, D., Gokhe, S. B., Karia, S., & Shah, N. (2022). A cross-sectional descriptive study of effects of occupational stress on mental health of staff nurses of a tertiary care hospital in a metropolitan city. Annals of Indian Psychiatry, 6(3), 229–232. https://doi.org/10.4103/aip.aip_133_21 [Google Scholar] [Crossref]

21. Kundrata, D., Pukljak, Z., Repušić, M., et al. (2022). Coping with stress of nurses employed in the internal medicine and surgical departments. Croatian Nursing Journal, 6(1). doi: 10.24141/2/6/1/3 [Google Scholar] [Crossref]

22. Labrague, L. J., & de los Santos, J. A. A. (2021a). Fear of COVID-19, psychological distress, work satisfaction and turnover intention among frontline nurses. Journal of Nursing Management, 29(3), 395–403. https://doi.org/10.1111/jonm.13168 [Google Scholar] [Crossref]

23. Labrague, L. J., & de los Santos, J. A. A. (2021b). Resilience as a mediator between compassion fatigue, nurses’ work outcomes, and quality of care during the COVID-19 pandemic. Applied Nursing Research, 61, 151476. https://doi.org/10.1016/j.apnr.2021.151476 [Google Scholar] [Crossref]

24. Labrague, L. J., Ballad, C. A., & Fronda, D. C. (2021). Predictors and outcomes of work–family conflict among nurses. International Nursing Review, 68(3), 349–357. https://doi.org/10.1111/inr.12642 [Google Scholar] [Crossref]

25. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company. https://books.google.com/books?id=i-ySQQuUpr8C [Google Scholar] [Crossref]

26. Lorente, L., Vera, M., & Peiró, T. (2021). Nurses’ stressors and psychological distress during the COVID-19 pandemic: The mediating role of coping and resilience. Journal of Advanced Nursing, 77(3), 1335–1344. doi: 10.1111/jan.14695 [Google Scholar] [Crossref]

27. Maddigan, J., Brennan, M., McNaughton, K., Reid, M., & Timmons, D. (2023). The prevalence and predictors of compassion satisfaction, burnout and secondary traumatic stress in registered nurses in an Eastern Canadian province: A cross-sectional study. Canadian Journal of Nursing Research, 55(4), 458–469. https://doi.org/10.1177/08445621221150297 [Google Scholar] [Crossref]

28. Maphangela, T. (2022). Investigating the effects of occupational stress on nurses working in referral hospitals in Botswana to reduce health risk. Texila International Journal of Public Health, 10(4), 126–131. https://doi.org/10.21522/TIJPH.2013.10.04.Art012 [Google Scholar] [Crossref]

29. Michalak, M., Przybył, K., & Kazimierska-Zając, M. (2022). Strategies for coping with stress among medical staff who work in the operating theatre. Journal of Neurological and Neurosurgical Nursing, 11(2). doi: 10.15225/pnn.2022.11.2.3 [Google Scholar] [Crossref]

30. Mohamed, S., Hariedy, N., Adam, S., Mohamed, A., & El-Sayed, S. (2022). Effect of psychological intervention on stress coping mechanisms and burnout syndrome among critical care nurses. Assiut Scientific Nursing Journal, 10(29), 148–159. doi:10.21608/asnj.2022.128621.1347 [Google Scholar] [Crossref]

31. Noor, N. H. M., Rehman, S., & Gull, M. (2023). Determinants of work-related stress among nursing professionals. Pakistan Journal of Humanities and Social Sciences, 11(2), 1791–1804. https://doi.org/10.52131/pjhss.2023.1102.0486 [Google Scholar] [Crossref]

32. Philippine Statistics Authority. (2025). Highlights on the population of legislative districts in the Province of Batangas based on the 2024 Census of Population. [Google Scholar] [Crossref]

33. Pignata, S., Bezak, E., Childs, J., & Austin, D. W. (2023). Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: A systematic review. BMJ Open, 13(6), e071203. doi:10.1136/bmjopen-2022-071203 [Google Scholar] [Crossref]

34. Profit, J., Adair, K. C., Cui, X., Mitchell, B., Brandon, D., Tawfik, D. S., Rigdon, J., Gould, J. B., Lee, H. C., Bischoff, K., Timpson, W., McCaffrey, M., Ziniel, S., Rehder, K. J., Sexton, J. B., & the WISER Study Group. (2021). Randomized controlled trial of the WISER intervention to reduce healthcare worker burnout. Journal of Perinatology, 41(9), 2225–2234. doi:10.1038/s41372-021-01100-y [Google Scholar] [Crossref]

35. Rangaig, N. D., & Bangcola, A. A. (2023). Behind the curtain: A narrative inquiry into nurses’ working experience in the COVID-19 referral facility in Southern Philippines. Journal of Healthcare Administration, 2(2), 116–131. doi: 10.33546/joha.2843 [Google Scholar] [Crossref]

36. Republic Act No. 10673. (2015). An act reapportioning the Province of Batangas into six legislative districts. Official Gazette of the Republic of the Philippines. [Google Scholar] [Crossref]

37. Rizany, I., Sihombing, Y. E., & Setiawan, H. (2022). Factors affecting nurses’ workplace stress in hospitals: A systematic review. KnE Life Sciences, 7(2), 218–237. https://doi.org/10.18502/kls.v7i2.10317 [Google Scholar] [Crossref]

38. Saher, N., Imran, M., Dhamani, K.-U.-N., Siddiqui, M. A., Khan, M. A., & Batool, S. (2022). Stress among critical care nurses: A cross-sectional study. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 2(2), 172–178. https://doi.org/10.55735/hjprs.v2i2.79 [Google Scholar] [Crossref]

39. Sari, D. O. K., Marchianti, A. C. N., & Kusumastuti, I. (2023). The correlation of coping strategies and burnout syndrome among health workers in Regional Hospital Dr. Soebandi Jember. Journal of Agromedicine and Medical Sciences, 9(1), 21–27. doi:10.19184/ams.v9i1.30484 [Google Scholar] [Crossref]

40. Shahzadi, A., Adina, S., Bashir, R., et al. (2022). Stress management strategies used by nurses to regain energy at workplace. Saudi Journal of Nursing and Health Care, 5(10). doi: 10.36348/sjnhc.2022.v05i10.011 [Google Scholar] [Crossref]

41. Suryati, D. P., Putri, N. K., & Ibrahim, N. (2023). Systematic review: Factors affecting nurses’ work stress in hospital emergency rooms during the COVID-19 pandemic. Journal of Public Health Research and Community Health Development, 6(2), 117–126. https://doi.org/10.20473/jphrecode.v6i2.34422 [Google Scholar] [Crossref]

42. Velana, M., & Rinkenauer, G. (2021). Individual-level interventions for decreasing job-related stress and enhancing coping strategies among nurses: A systematic review. Frontiers in Psychology, 12, 708696. doi: 10.3389/fpsyg.2021.708696 [Google Scholar] [Crossref]

43. Weret, Z. S. (2023). Occupational stress and associated factors among nurses working at public hospitals of Addis Ababa, Ethiopia, 2022: A hospital-based cross-sectional study. Frontiers in Public Health, 11, 1147086. https://doi.org/10.3389/fpubh.2023.1147086 [Google Scholar] [Crossref]

44. West, D. J., Krcmery, V., Szydlowski, S. J., et al. (2022). Preventing the burnout syndrome by creating a healthy and healing environment. Clinical Social Work and Health Intervention, 13(6). doi: 10.22359/cswhi_13_6_13 [Google Scholar] [Crossref]

45. Zenani, N. E., Gause, G. P., & Sehularo, L. A. (2022). Strategies to enhance resilience to cope with workplace adversities post-COVID-19 among ICU nurses. Curationis, 45(1), a2345. doi: 10.4102/curationis.v45i1.2345 [Google Scholar] [Crossref]

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