RIVERSIDE COLLEGE BACOLOD CITY

THE EFFECTS OF ONLINE CLASSES TO THE OVERALL MENTAL HEALTH OF

THE NURSING STUDENTS OF RIVERSIDE COLLEGE A.Y. 2020-2021

A project paper presented

to the faculty of the College of Nursing,

Riverside College Bacolod City

In partial fulfilment of the

requirements for the degree

Bachelor of Science in Nursing

Donna Javelona

Florence Joy Octaviano

Miguel Daniel C. Chua

Mary Eunor A. Destajo

Klaudiya Dorothee Gatuslao

Alliah Joyce G. Ignacio

Jesca Mae T. Maravilla

Pole Mar Villanueva

May 28, 2021

 TABLE OF CONTENTS

I. CHAPTER 1

Introduction

Statement of the Problem

Theoretical Framework

Hypothesis

Significance of the Study

Scope and limitation

Definition of terms

II. CHAPTER 2

Review of Related Literature

III. CHAPTER 3

Research Design

Respondent of the study

Sampling Technique

Research Instrument

Validity of Research Instrument

Reliability of Research Instrument

Ethical Consideration

Data Gathering Procedures

Statistical Treatment Tools

IV. REFERENCES
 CHAPTER 1 INTRODUCTION

Background of the Study

Mental health is the overall well-being of a person. It includes emotional,

psychological, and social well-being. Mental health was initiated in the 19th century

where the goal was to improve the quality of treatment for the people. Mental wellbeing

is a state of becoming capable of achieving a satisfactory integration of one's own

potentially contradictory instinctive drives, shape and maintain harmonious relationships

with others, and engage in positive improvements in one's social and physical

environment, which is subject to fluctuations due to biological and social influences.

(Farreras, I. G. (2021).

The term "pandemic" refers to an epidemic that occurs globally, or across a very

wide region, crosses international borders, and typically affects a large number of people.

As the year 2020 begins, a new case of infection from the new strain of virus has been

discovered, it causes apprehension not just from the country of origin but as well as the

whole world. The WHO declares COVID19 as a global pandemic. It affects various

aspects from economy, tourism, and education. Covid-19 afflicted higher educational

institutions worldwide, not only in Wuhan, China, where the virus originated, but in all

188countries. (World health organization, (2021)

Most students are in difficult times during pandemic and on the implementation of

the new way of learning which is through online. According to (Keasberry et al., 2020)

In recent years, higher education institutions, including those in Asia, have paid more

attention to students' mental health and emotional well-being. The COVID-19 pandemic

has brought this issue to light, aggravating it. Admittedly, compelled online learning has
left many students around the world without the opportunity to socialize with their peers.

Their ability to bond emotionally and culturally with their peers has been harmed as a

result of online platform-mediated learning. Furthermore, recent studies on the effects of

working for long periods of time on a laptop or computer screen have revealed alarming

findings in terms of mental health, including insomnia, low mood, acute stress, and

symptomatic signs of mild depression. According to Bautista, Alvin Gino & Bautista, M

& Manuel, Elizabeth. (2020) pandemic and the home quarantines contributed a lot of

health anxiety and loneliness to the students. In the recent study entitled Mental health of

students in the Philippines during pandemic, it was revealed that student’s mental health

were affected by COVID 19 pandemic issues. Due to the global pandemic and the

protocol set by the IATF (Inter-Agency Task Force on Emerging Infectious Diseases) and

the government, face to face classes are cancelled. Riverside College Inc. is not exempted

to that. In fact, it’s been more than a year that collegians are having their classes and

return demonstrations online. Therefore, it is in this regard that the researcher would like

to conduct the study to determine and assess the end result of the implementation of the

online class to the students, especially to their overall mental health. The research tries to

determine the factors that deeply affect students while having online classes by

interviewing nursing students from Riverside College. This study will provide necessary

pieces of information about the mental health of the student which could be a great help

to the respondents in understanding themselves. It can also help them to be more aware

about mental and psychological health through the help of the recommendation of the

researchers.
Statement of the Problem

This study aims to assess and determine the effect of online classes to the overall

mental health of student nurses of Riverside College Specifically to answer the following

question:

1. To determine the mental health status of the BSN students of Riverside College

enrolled in AY 2020-2021 from:

a. BSN 1

b. BSN 2

c. BSN 3

d. BSN 4

2. To identify the effect of online classes on the following aspects:

a. Physical

b. Psychological

c. Emotional

3. To be able to enumerate and discuss the effect of online classes to the mental health

such as:

a. Stress

b. Anxiety

c. Exhaustion

d. Mental strain
Conceptual Framework

According to the World Health Organization, mental health is defined as “a state

of well-being in which an individual realizes his or her own abilities to cope up with the

stresses of life.” It can also be defined as the absence of any mental diseases. Being

mentally healthy is having the ability to cope up with stress. Stress is a universal

phenomenon in which all people experience it. Stress hits every age range, every

occupation, and every walk of life. Every person has his/her own perception of stress; a

challenge or threat to life. Each person has his own coping mechanisms, as well as

responses to stress.

In reference to the announcement of the pandemic, the global phenomenon

significantly causes stress and strain and affects the mental health of everyone,

specifically the students, especially when the Philippine government stated the urgent

change in education from traditional to distant learning. It afflicts learners on how they

are going to withstand the new way of learning and how they are going to deal with

uncertainty and stress.

According to Rensburg (2015), Student nurses experienced stress and emotional

discomfort that may negatively influence their mental health. During this unprecedented

time, there are many factors that could possibly influence the overall mental status of the

student nurses. Pietrewicz (2020) having exclusively online interactions and having a

zoom learning could cause difficulty, exhaustion and have a real impact on the mental
health of the learners. Beyond the difficulties of online learning platforms, almost every

aspect of education is affected.

Figure 1. Schematic Diagram Illustrating the Framework of the Study

Hypothesis

1. There is no significant relationship between online class and mental health of BSN.

2. There is no significant relationship between students of Riverside College as a whole

and when grouped according to level and mental health.

Significance of the Study

This study will be beneficial to both the school (Riverside College Inc.) and to the

students as it describes the mental health of the Nursing students towards online classes

and how it affects the performance of the students and the competence of the school. The

study on measuring the mental health of 4th year students towards online classes is

basically important to be taken in order to provide an appropriate teaching and learning

environment for them to prepare for the board examination.

The research will benefit the following:

1. Students – students will mold into mentally healthy and can adapt to any changes in

online learning. It may also help them to have an excellent performance as they have a

positive outlook in online class.

2. Clinical Instructors – This study will give them additional knowledge in giving

instructions and imparting the lessons to their nursing students. This will also help them

to provide an efficient and effective approach to teaching to the students to lessen the

factors that affect the mental health of the nursing students.

3. College of Nursing – This study will help them to be aware of the effects of online

classes on their mental health, and to establish a proper education system online to

produce globally competitive graduates in the College of Nursing.

4. Riverside College Inc. – The researchers of Riverside College will recommend the

school the possible solution to minimize the detrimental effects of online classes to the

4th year Nursing students. With that, it can help the school to address the issues of online

classes that need to improve and create an excellent environment quality for learning.

Also, it creates a mentally healthy and competent graduate nursing students.

5. Future Researchers – This study will serve as the basis of the future researchers in

doing their research study, especially related to the mental status of students dealing with

the difficulties of online class as a platform for learning.

6. Guidance Counselors – This study will help the guidance counselors to be aware of

the circumstances of the nursing students that are facing this pandemic and to provide

interventions to help them cope with the problems and effects of online classes on their

mental health.
Scope and Limitation

The coverage of the research study will focus only on the Effects of online classes to the

mental health of student nurses of Riverside college batch 2020-2021. The respondents of

the study should be all levels of nursing students of Riverside College Inc. who are

currently experiencing the different issues of online classes of the institution. The

respondents of the study limit only on the students who are enrolled in Bachelors Science

in Nursing AY 2020-2021. The researcher will choose a selected sample of the

population of the BSN students as the respondents of the study. This study will talk about

the effects of online class on the mental health of the nursing students in Riverside

College. The setting of the problem is online. This is where all the study activity will be

done. Other than that is not coverage of this study.

Study will focus only on the online classes and its factors affecting the overall mental

health of nursing students from Riverside College.

Definition of terms

The effects of online class to the mental health of the student nurses has been affected

due to the new normal. To give further knowledge to understand the context of this study,

the following terms are hereby defined conceptually and operationally:

1.) Anxiety

Conceptually: Anxiety is the fear of a potential threat or unpleasant occurrence, which is

followed by feelings of dysphoria or physical stress symptoms. (Perotta, 2019)

Operationally: Feeling of uneasiness in checking the academic grades through online.

2.) Exhaustion

Conceptually: Exhaustion is defined as a subjective feeling of tiredness or low energy

that interferes with one's regular or routine activities. (Atalassi, 2015)

Operationally: Excessive tiredness of the body due to lack of sleep because of online

activities.

3.) Mental Health

Conceptually: Mental health is a state of well-being in which an individual realizes his or

her own abilities, can cope with the normal stresses of life, can work productively and is

able to make a contribution to his or her community. ( World health organization, 2018 )

Operationally: In this context, it is all about how student nurses think, feel, and behave

towards online classes

4.) Online Classes

Conceptually: Online class is a type of distance education in which a course or program

is purposefully designed to be delivered entirely online. (Erasmus, 2020)

Operationally: It is the online mode of continuing the study of nursing students where

they need to attend the class and comply with the requirements before graduating.

5.) Stress

Conceptually: the term defined as any factor that threatens the health of the body or has

an adverse effect on its functioning, such as injury, disease or worry. It is the subjective

feeling produced by events that are uncontrollable or threatening (Randy and David,

2008). Operationally: is the subjective feeling of the participants towards online class.

6.) Students

Conceptually: A person who is studying at a school, college, or university Cambridge

business English dictionary. (2011)

Operationally: Someone who is Studying BSN at Riverside College and they are the

respondents of the research study.

 Chapter 2

Review of Related Literature

The COVID19 pandemic began seriously disrupting educational systems not only

in the Philippines, but all throughout the world and had a profound impact on educational

delivery, especially for nursing students. Face-to-face classes were abruptly switched to

online platforms, and certain classes were cancelled entirely, as stay-at-home orders were

instituted due to social distancing provisions. Several student clinical placements, as well

as simulation and skills laboratory programs at the school of nursing, were cancelled or

changed. Nursing students faced challenges that created the potential for psychological

distress related to perceptions of their ability to fulfill academic and personal

responsibilities. At the start of the pandemic, the students were dealing with sudden and

extreme changes in nursing education as they knew it; disruptions that at times were

stressful and anxiety‐producing. They were concerned about how the pandemic affected

their lives both personally and academically (Fitzgerald & Conrad, 2021) During this

unprecedented time, lockdown is considered to be an effective measure in slowing the

spread of coronavirus around the globe (Barkur et al., 2020; Flaxman et al., 2020)

According to researchers Poudel and Subedi (2020) encouraging people to implement

social distancing so as to reduce interactions between people could eventually reduce the

possibilities of new infection; however, it has affected the overall physical, mental, social

and spiritual health of the people. This could further lead to neuropsychiatric issues such

as fear, anxiety, depression, panic attacks, psycho-motor excitement, suicidal deaths and a

general decrease in overall wellbeing (Brooks et al., 2020; Xiang et al., 2020). Although
the safety of students and teachers is important, online learning may have a negative

effect on a student's mental health. Face-to-face interactions can help reduce depression

and anxiety (Ehrenfeld, 2019) while on the other hand, social isolation can cause higher

rates of negative outcomes for the mental and physical health of individuals (Umberson

& Montez, 2020). According to National Geographic (2020), spending a significant

amount of time online can fatigue both students and their teachers. This impact is referred

to as “Zoom fatigue.” Part of the reason a day full of video interactions is so mentally

draining is because our brains are unable to process information in the way it’s

accustomed to. During these trying times, each of us finds ourselves in dire

circumstances as a result of COVID19-related healthcare issues, physical and mental

fatigue, and academic burnout. Due to various cases of COVID-19 since December 2019,

and considering the possible spread of COVID-19 in colleges, respective countries were

abruptly forced to move from face-to-face to online classes (Guillasper et al., 2020;

Moralista & Oducado, 2020; Silva, 2020). Owing to the lockdown, classes were

rescheduled. Digital learning was also a concern for the majority of colleges and

universities in the Philippines (Talidong & Toquero, 2020). The problem is, how are the

students going to cope up with it and how it will affect their mental health. Because of the

abrupt changes in their daily lives, the pandemic has caused students, teachers, and

faculty to suffer psychological distress. COVID19 has had a huge effect on nursing

students (Usher et al., 2020). These pandemic-related adjustments, especially in regards

to online classes, social distancing - because social support plays a significant role in

easing risks and is recognized as a coping strategy - and anxiety related to health and

economic concerns are likely to remain as a long-term stressor (Liu et al., 2020).
According to UNESCO (2020b), the nationwide closure of schools, colleges, universities

and other educational institutions, caused by the COVID-19, are adversely impacting

over 60% of the world’s student population. It has negative consequences on students’

academic study, including learning interruptions, disruption to assessment, and the impact

is more severe on students from disadvantaged backgrounds (UNESCO, 2020a). Based

on the study conducted by Journal of Psychosomatic Research (2020) 7.7% of college

students showed depressive symptoms during the COVID-19 pandemic. College students

with depressive symptoms had low regulatory emotional self-efficacy. In research from

García-González et al. (2021) the sudden change that occurred during the pandemic has

impeded students from learning and caused stressful workloads that began to lead to

anxiety and depressive symptoms.

Many nursing students have had to cancel classes, exams, and clinical placement

activities, lose part-time jobs, or work or attend clinical placements in hospitals where

they may be required to care for people who are positive for COVID-19, and/or risk

exposure to infected patients and staff (Cao et al. 2020). Nursing students in certain

countries have reportedly been pressured to take on clinical positions in order to help

with the rising number of critically sick patients, putting them at risk for negative mental

health outcomes such as post-traumatic stress disorder (Hayter & Jackson 2020). Many

nursing students believe they have been forced to choose between the safety of their

families and pursuing a profession in nursing as a result of the COVID-19 outbreak,

according to (Fowler & Wholeben 2020). During pandemics, nurses and other health

workers are at a high risk of suffering burnout, compassion fatigue, poorer job
satisfaction, decreased morale, and workplace stress, as we know from prior global

disease outbreaks such as Ebola and SARS (Kim & Choi 2016).

Online Class

The pandemic has caused significant interruption to education systems in history,

according to data from the United Nations, 2020, and UNESCO, 2020. School closures

have affected 1.6 billion students (94 percent of the global student population) in over

190 countries. Some of these closures began in January, but the majority began in March,

when the transmission engulfed the majority of the world.

Online classes refer to any type of learning that takes place partly or entirely over

the Internet. However, scholars have drawn a distinction between purposely designed

online learning and the emergency measures that were used to transfer all instruction

online in the summer of 2020 during the Covid-19 pandemic.

According to (Erasmus, 2020) online classes can be classified as Emergency

Remote Teaching. A direct quote from Erasmus paper, he defined it as “a temporary shift

of instructional delivery to an alternate delivery mode due to crisis circumstances. It

involves the use of fully remote teaching solutions for instruction or education that would

otherwise be delivered face-to-face or as blended or hybrid courses and that will return to

that format once the crisis or emergency has abated.” On the other hand, the other

definition of online class is a type of distance education in which a course or program is

purposefully designed to be delivered entirely online. Faculty employ virtual

learning-specific pedagogical strategies for instruction, student engagement, and

assessment.
Benefits of Online Class

The researchers reported that the usage of online courses originates from a desire

to provide quality education to all students, regardless of location or circumstance.

Integrating online classes in higher education can benefit both students and lecturers.

According to (Tareen & Haand,2020), a significant number of postgraduate students

believe that online learning is convenient because it simplifies the learning process when

compared to traditional learning methods. Participants agreed that online learning

encourages better student participation because students wouldn't need to appear

physically in class but can still engage with one another through online and group

discussion.

Disadvantages of Online Class

Mental Health

According to (Felman, 2020) the term "mental health" refers to a person's

cognitive, behavioral, and emotional well-being. It all comes down to how people think,

feel, and act. The term "mental health" is often used to define the absence of a mental

disorder. Based to the Mental Health Foundation report, 20% of teenagers may

experience a mental health problem in a given year, and 75% of mental health problems

begin before the age of 24. According to the Young Minds March 2020 survey, more than

83 percent of students with pre-existing mental health conditions feel more depressed as a

result of the recent COVID-19 crisis.

Synthesis

The readings by the researchers from books, magazines, and from various sources

and related studies presented in this chapter have further enlightened the present

investigation in terms of content or concerns, methodology, subject respondents, and the

like. These materials provided enrichment for the researcher‟s study. They help in the

formulation of the conceptual framework, analysis, as well as the interpretation of data. A

comparison and contrast in relation to other works have provided further insights into the

study of the effect of online classes to the overall mental health of the nursing students of

Riverside College.
 Chapter III

METHODOLOGY

This chapter is the research methodology of the study wherein it presents the methods of

research used to gather information needed by the research. To further elaborate, this

study indicated the research design, population, sampling size, sampling technique, the

description of the respondents, research instrument, data gathering and statistical

treatment of data.

Research Design

The researchers utilized descriptive research design to determine the effects of

online class on the mental health of BSN students of Riverside College Inc. Descriptive

research design describes data and characteristics about the population or phenomenon

being studied. Also, descriptive research answers the questions who, what, where, when

and how(Birion, et.al., 2005). This research design is helpful in gathering the data needed

to answer the statement of the problem of this study.

Respondent of the study

The respondents of this study focused only on selected Bachelor of Science in

Nursing students of Riverside College Inc. for the Academic year 2020-2021 who

experienced the different effects of online class on mental health. The respondents are
from the selected BSN 1 to BSN 4 students that are currently enrolled in online class

mode of learning.

Sampling Technique

The respondents of the study are sampled through random sampling technique.

All members of the populations have an equal chance of being selected. The selected

sample represented the target population. Each year level from BSN 1 to BSN 4 have the

equal chance to represent their population. This will help researchers to narrow down the

participants with the results. Also, it is helpful to approach the selected participants rather

than handling the total population as the participants which make the study time

consuming.

Research Instrument

To obtain the needed data in this study, the researcher will use self-made

questionnaires via google forms as an instrument to conduct the study. The questionnaire

will determine the year level of the respondent and factors that contribute stress during

their online classes. This method saved the time and effort for both respondents and

researchers since there is no need to visit the respondents personally.

Validity of Research Instrument

 The 2 research instructors will validate the questionnaire. Their corrections and

suggestions will be incorporated in the draft for the next stage of validation.

Questionnaires will be sent via google forms for the safety of both the researcher and

respondents.

Reliability of Research Instrument

Ethical Consideration

The research study will imply an ethical concept in which the questionnaire will

only answer the needed data of the objectives. In this concept, the safety and autonomy of

the participants is preserved. Researchers will secure informed consent to conduct the

study and allow the participants to willingly participate in the study which allows them to

make their own decisions to avoid biased data findings. All the data gathered from the

respondents are secured and will hold locks for confidentiality to avoid being harmed or

targeted.

Data Gathering Procedures

To gather the needed data, the researcher administered a questionnaire. The

questionnaire was formulated based on the ideas and insights taken from the authorities

as reflected in the related literature. It was composed of two parts. First part, dealt with

the personal background of respondents that included the respondents‟ sex and year
level. Part two, intended to know the perceived effect of online classes in terms of the

following aspects; Physical, Psychological & Emotional. To collect data, the researcher

administered the questionnaire after proper coordination was made with the faculty and

staff of the Nursing Department. The questionnaires were administered individually into

the selected sample of the population of Nursing Students. Instructions were given to

students that will answer as honestly and spontaneously as possible to all questions.

Necessary and very important for the completion of questionnaires was the assurance that

the researcher will respect the confidentiality of their responses. Furthermore,

administration of the questionnaire was mostly done during the vacant period of the

researcher to facilitate data gathering and retrieval.

Data Treatment and Analysis Statistical Treatment Tool

Responses to the questionnaire by BSN students will statistically analyze the data

requirements of the study. Students will statistically analyze with the data instrument of

the study. To interpret the gathered data the researchers will use the descriptive statistics

such as measures of frequency which include count, percent and frequency.

 References

Felman, A. (n.d.). Mental health: Definition, common

disorders, early signs, and more.

Retrieved from

https://www.medicalnewstoday.com/articles/154543

Asanov, I., Flores, F., McKenzie, D., Mensmann, M., &

Schulte, M. (2020, October 22). Remote-learning,

time-use, and mental health of ECUADORIAN

high-school students during the Covid-19 quarantine.

Retrieved April 19, 2021,

from

https://www.sciencedirect.com/science/article/abs/pii/S0305750X20

303521
 Tareen, H., & Haand, M. T. (2020, June 6). A Case Study of

UiTM Post-Graduate Students’ Perceptions on Online

Learning: Benefits & Challenges. Retrieved April 19,

2021, from www.ijarp.org

United Nations, 2020United Nations (2020). Policy brief:

Education during COVID-19 and beyond.

Retrieved October 10,

2020,

https://www.un.org/development/desa/dspd/wp-content/uploads/site

s/22/2020/08/sg_policy_brief_covid-19_and_education_august_202

pdf.

United Nations, 2020United Nations (2020). Policy brief: Education during

COVID-19 and beyond. Retrieved

October 10, 2020,

https://www.un.org/development/desa/dspd/wp-content/uploads/site

s/22/2020/08/sg_policy_brief_covid-19_and_education_august_202

pdf.
Keasberry, C., Phan, L. H., CY , H., Alam, M., Alas, Y., & Noorashid

, N. (2020, December 5). Facing the mental health challenges

of COVID-19 in HE. University World News.

https://www.universityworldnews.com/post.php?story=20201

201133134894.

Bautista, Alvin Gino & Bautista, M & Manuel, Elizabeth. (2020).

Mental Health of Students in the Philippines during

Pandemic: An assessment. Journal of Humanities and Social

Sciences. 2. 316-323. 10.22161/jhed.2.5.2.

García-González, J., Ruqiong, W., Alarcon-Rodriguez, R.,

Requena-Mullor, M., Ding, C., & Ventura-Miranda, M. I.

(2021). Analysis of Anxiety Levels of Nursing Students

Because of e-Learning during the COVID-19 Pandemic.

Healthcare, 9(3), 252.

https://doi.org/10.3390/healthcare9030252

Usher, K., Wynaden, D., Bhullar, N., Durkin, J., & Jackson, D.

(2020). The mental health impact of COVID‐19 on

pre‐registration nursing students in Australia. International

Journal of Mental Health Nursing, 29(6), 1015–1017.

https://doi.org/10.1111/inm.12791
Cao, W., Fang, Z., Hou, G. et al. (2020). The psychological impact of

the COVID-19 epidemic on college students in China.

Psychiatry Research, 287, 112934.

Hayter, M. & Jackson, D. (2020). Pre-registration undergraduate

nurses and the COVID-19 pandemic: Students or workers?

Journal of Clinical Nursing, 9, 3115–3116.

Fowler, K. & Wholeben, M. (2020). COVID-19: Outcomes for

trauma-impacted nurses and nursing students. Nurse

Education Today, 93, 104525.

Kim, J. S. & Choi, J. S. (2016). Factors influencing emergency

nurses’ burnout during an outbreak of Middle East respiratory

syndrome coronavirus in Korea. Asian Nursing Research, 10,

295–299.

Farreras, I. G. (2021). History of mental illness.

In R. Biswas-Diener & E. Diener (Eds), Noba textbook

series: Psychology.

Champaign, IL: DEF publishers. Retrieved from

http://noba.to/65w3s7ex