KNOWLEDGE AND SELF-ASSESSMENT ON COMPUTER VISION SYNDROME

AMONG NURSING STUDENTS

An Undergraduate Thesis

Presented to the Faculty of the School of Nursing

Adventist Medical Center College

Brgy. San Miguel, Iligan City

In Partial Fulfillment

of the Requirements for the Degree

BACHELOR OF SCIENCE IN NURSING

Arroyo, Eliza Danielle

Mondelo, Ara Mae

Villamor, Jan Daven

 DEDICATION

We would like to express our deepest appreciation to Adventist Medical Center College-School

of Nursing. We are also deeply indebted to all the passionate and most patient clinical instructors

who give non-stop support and care. Without their assistance and dedicated involvement in every

step throughout the process, this paper would have never been accomplished. We would like to

thank you very much for your knowledge, your caring, encouragement and all the sacrifices you

each made along the way! You are the key that enables us to do the impossible.

Villamor

Arroyo

Mondelo
 ACKNOWLEDGMENT

Above all the efforts of ourselves, we cannot begin to express our gratitude and

appreciation for this opportunity to be guided by instructors who have been instrumental in the

successful completion of this research study. We would like to express our appreciation to those

who gave support in the realization of this study:

Ma. Almira P. Nebres, RN, MAN, PhD, Thesis Adviser, for the tremendous support and

assistance. Thank you for the assistance and motivation, without you, this study would not have

been materialized.

Raymond Salvador, RN, MN and Shella Dello, RN, MAN, Panelists, for their

encouraging words when we had given up.

Junge B. Guillena, MS, Statistician, whose expertise was invaluable during the analysis

and interpretation of the data that has been collected.

The respondents, who extended their immense help by providing the required

information, which in turn helped in achieving the objective of this study.

We take this opportunity to express our gratitude to all of the faculty members for their

help and support. We also thank our parents for the unceasing encouragement, support and

attention. We are also grateful to my partner who supported me through this venture.

To our peers, thank you for your friendship, inspiration, and for bringing a breath of fresh

air to our journey. Each of you were always there to listen, provide your insights and never let us

lose sight of the light at the end of the tunnel.

 We also place on record our sense of gratitude to one and all, who directly or indirectly,

have lent their hand in this venture.

Above all, we praise God, the almighty, ever grateful, merciful and passionate, for giving

us the strength, knowledge, ability and opportunity to undertake this research study and to

persevere and complete it satisfactorily. Without His blessings, this achievement would not have

been possible.
 TABLE OF CONTENTS

Page

TITLE PAGE

APPROVAL SHEET i
DEDICATION ii
ACKNOWLEDGMENT iii
ABSTRACT iv
TABLE OF CONTENTS v
LIST OF TABLES vi
LIST OF FIGURES vii

Chapter

1 THE PROBLEM AND ITS SCOPE

Introduction 9-11
Theoretical Framework 12-13

Conceptual Framework 14-16

Statement of the Problem 17

Hypotheses 18

Significance of Study 18-19

Scope and Delimitation 19
Definition of Terms 19-21
2 REVIEW OF RELATED LITERATURE AND STUDIES

Related literature 22-24

Related Studies 24-31

3 RESEARCH METHODOLOGY

Research Design 32

Research Locale 32-33

Respondents of the Study 33

Sampling Design 33

Research Instruments 33-34

Scoring of the Instrument 34

 Data Gathering Procedures 35

Statistical tools 36-37

4 PRESENTATION, ANALYSIS, AND INTERPRETATION

OF DATA

5 SUMMARY, FINDINGS, CONCLUSIONS, AND

RECOMMENDATIONS

Summary

Findings

Conclusions

Recommendations

REFERENCES 45-47

APPROVAL SHEET 51

APPENDICES

Letter 49-50

Questionnaire 38-44
CURRICULUM VITAE

LIST OF TABLES

Table Page

1 Distribution of the Respondents in Terms of Age

2 Distribution of the Respondents in Terms of Gender

3 Distribution of the Respondents in Terms of Hobby

 LIST OF FIGURE

Figure Page

1 The Schematic Diagram Showing the Interplay of Independent 16

and Dependent Variables

 Chapter 1

PROBLEM AND ITS SCOPE

Introduction

Computer vision syndrome (CVS) or termed interchangeably as digital eye strain (DES)

is the most common reported eye and vision-related problem during pandemic. Computers have

paved the way as an everyday use to each individual as it offers accessible and efficient work.

Computers have made everything much faster and easier.

According to Thomas (2005), after a prolonged use of computers, it introduced new

health issues. American Optometric Association (2021) defined computer vision syndrome

(CVS), also referred to as digital eye strain (DES), a group of eye and vision-related problems

that resulted from prolonged computer use.

Prolonged computer use puts a lot of strain on the body's muscles and joints, especially

the eyes. Eye problems impact everyone who spends a substantial amount of time on the

computer on a daily basis (Thomas, 2005). On the other hand, computers do not cause hazardous
radiations neither ultraviolet nor ionizing radiation. Even daily use of computers or prolonged

exposure for years. And computers do not cause cataract or retinal burns, and no evidence for

permanent myopia or nearsightedness are reported (American Optometric Association, 2021).

Cedars-Sinai (2021) provided a list to diagnose a client for having CVS or DES, the

following symptoms noted are: blurred vision, double vision, dry eye, eye discomfort, eye

fatigue, eye itching, eye redness, eye tearing, headaches, and neck and shoulder pain. Most of the

symptoms noted are short-term or temporary. The severity of the symptoms may vary depending

on how long the client is using the computer, underlying eye problems, and factors that cause

CVS or DES (Cedars-Sinai, 2021).

Computer vision syndrome, according to Dhaliwal (2002), has an impact on mental and

physical well-being as well as productivity. By following a few basic, low-cost measures,

Computer Vision Syndrome can be practically eradicated. With so many people using computers

on a daily basis, and the number expanding by the day, such actions are well worth doing

(Dhaliwal, 2002).

According to Clapano et al. (2019), Over 50, 000 local gamers spend an average of 2

hours per day playing online games in a study done in Davao City (the acquired data did not

include other computer users who used computers for other purposes). A standardized CVS

symptom checklist was used in the research. With the help of an ophthalmologist to evaluate the

data, the checklist was able to diagnose CVS. CVS was identified in 23 of the 100 nursing

students who were chosen. Male students were the most frequently diagnosed as a result of

excessive computer use while playing online games. The authors then gave health promotion to

help students become more aware of CVS and how to handle it properly.

The pandemic period requires flexible learning modality to maximize health and safety
protection of every nursing student and faculty. The flexible learning program requires more

time in the use of computer technology. The use of computers during online classes with

possibly less time and knowledge in utilizing CVS preventive measures will probably increase

CVS self-assessment risk. Thus, this study aims to determine the third year nursing students’

demographic profile regardless of age, gender, hobby, total number of hours of sleep in a day,

total number of years using computer, and total number of hours using computer per day, CVS

knowledge, and self-assessment. It further looks into the possible significant relationship

between the respondents’ demographic profile and the extent of their CVS knowledge and self-

assessment.

Theoretical Framework

The study made use of Nola J. Pender’s theory of Health Promotion Model (1982). (Pls

check the suggestion of the panel: is it to add another theory)

Nola Pender’s health promotion model is the movement to greater responsibility and

accountability for successful personal health practices that requires the support of the nursing

profession through development of evidence-based practice. According to Alligood (2018), “the

health promotion model evolved from a substantive research program and continues to provide

direction for better health practices’’. (p. 331).

According to Pender (2008), “Middle range theories that have been tested in research

provide evidence for evidence-based practice, thus facilitating translation of research into

practice”. (p. 323). It was formulated with the goal of integrating what is known about health-

promoting behavior to generate questions for further testing. According to Pender, Murdaugh, &
Parsons (2002), ‘’Nursing professionals find the health promotion model relevant, as it applies

across the life span and is useful in a variety of settings’’. (p. 329).

According to Pender et. al (2010), ‘’tThe model applies the formation of community

partnerships with its consideration of the environmental context and extends to global health

promotion’’. (p. 329).

According to Pender (1975), states that “‘’tThe foundation for researching how

individuals made decisions about their own health care in a nursing context is a Conceptual

Model for Preventive Health Behavior’’’. (p. 324).

Thomas (2005) conducted a descriptive study to assess computer vision syndrome and its

preventive measures among 60 computer specialists working from various parts of the software

center who matched the inclusion criteria,computer professionals working in F.C.G. Software (P)

Ltd, Brigade Road, Bangalore. Computers have made life much easier and faster, but they have

also brought with them new health concerns. According to the National Institute for

Occupational Safety and Health, Computer Vision Syndrome affects 50-90 percent of computer

users. At F.C.G Software Services, Brigade Road, Bangalore- 25, the study's purpose was to

assess Computer Vision Syndrome and its prevention among computer professionals. The study

was solely descriptive in nature. Simple random selection processes were utilized to choose 60

computer specialists from various parts of the software center who matched the inclusion criteria.

The study's conceptual framework was based on Pender's health promotion model.. The

prevalence of Computer Vision Syndrome among computer professionals was found to be high,

and the preventive measures taken by them were insufficient. Computers have made life much

easier and faster, but they have also brought with them new health concerns. According to the
National Institute for Occupational Safety and Health, Computer Vision Syndrome affects 50-90

percent of computer users.(Pls provide author and year)

According to Pender et. al (2010), ‘’The model fosters thinking about future opportunities

and influences the use of technological advances such as the electronic health records as a means

to achieve prevention and health promotion’’ (p. 331).

Conceptual Framework

Computer vision syndrome is the most common eye- and vision-related condition

especially for students nowadays as having flexible learning activities due to pandemic.

Throughout the period of Covid-19 pandemic, researches and other medical studies are

determined to investigate the global new normal setting which is e-schooling that affects students

globally as part of the continual educational learning of flexible learning (Gupta, Chauhan, and

Varshney, 2021).

The conceptual framework of the study focuses on the third year nursing student’s

demographic profile as the independent variables such as age, gender, hobby, total number of

hours of sleep in a day, total number of years using computer, and total number of hours using

computer per day. TIn addition the demographic profile provides the respondents’ computer

usage information (Thomas, 2005).

According to Nuez et. al (2019), age has an impact on computer usage because of the

flexible learning modality that has been implemented during this pandemic. In addition, the

author found out that more male computer users are engaged in computer online activity due to

gaming. Thomas (2005) emphasized that hobby modifies the computer usage activities of the

individuals whether online reading, online surfing, online gaming, or online watching shows or
films. Furthermore, Thomas (2005) found out that male computer users spent less time sleeping

due to online gamings which resulted in eye and healthcare deficit, and less prevention or

management in terms of their eye vision. Some of the respondents spend more than 3 years on

continual computer use with more time spent for more than 8 hours in a day due to online

schooling.

Demographic profile as the independent variable possibly influences the dependent

variable which include the respondents’ perceptions on computer vision syndrome knowledge

and self-assessment. In which Thomas (2005) believes that the demographic variables modify

the CVS knowledge and self-assessment variables. In addition, Gonzalo (2021) stated that

knowledge and self-assessment might modify health behavior towards CVS. Knowledge and

self-assessment as the dependent variables which are measured according to the responses in the

knowledge scale test of CVS and the assessment aspect of CVS questionnaires (Thomas, 2005).

Knowledge and self-assessment may reflect the extent of perception on proper eye management

and eye healthcare behavior. According to Thomas (2005), knowledge and self-assessment can

be determined by adequate knowledge and correct perception on CVS that makes an individual

have proper management practices leading to having healthy eyes.

Inadequate knowledge and incorrect perception on computer vision syndrome can lead

individuals to improper computer handling leading to complications blurred vision, double

vision, dry eye, eye discomfort, eye fatigue, eye itching, eye redness, eye tearing, headaches, and

neck and shoulder pain. This behavior can be prevented by having correct knowledge on CVS. It

can be corrected with the help of health promotion and health education (Thomas, 2005). The

study further looks into the possible relationship between the IV such as the demographic profile

(regardless of age, gender, hobby, total number of hours of sleep in a day, total number of years
using computer, and total number of hours using computer per day), and DV which is CVS

knowledge and self-assessment. Figure 1 shows the interplay between the independent and

dependent variables of the study.

Figure 1: The Schematic Diagram Showing the Interplay of Independent and Dependent

Variables
Statement of the Problem

The study aims to determine the demographic profile, computer vision syndrome
knowledge and self-assessment among the third year nursing students enrolled during the first
semester at Adventist Medical Center College in Iligan City AY 2021-2022.
Specifically, it obtained to answer the following questions:

1. What is the demographic profile of the third year nursing students in terms of:

1.1 Age

1.2 Gender

1.3 Hobby

1.4 Total number of hours of sleep in a day

1.5 Total number of years using computer

1.6 Total number of hours using computer per day?

2. What is the extent of the respondent’s perception of computer vision syndrome in terms

of knowledge and self-assessment?

3. What is the relationship between the respondents’ demographic profile (age, gender,

hobby, total number of hours of sleep in a day, total number of years using computer, and

total number of hours using computer per day) and the extent of their perceptions on

computer vision syndrome in terms of knowledge and self-assessment?

Null Hypothesis
 The following null hypothesis was tested at the 0.05 level of significance:

HO1: There is no significant relationship between the respondents’ demographic profile

(age, gender, hobby, total number of hours of sleep in a day, total number of years using

computer, and total number of hours using computer per day) and the extent of their perceptions

on computer vision syndrome in terms of knowledge and self-assessment

Significance of the Study

The study focuses on the importance of CVS knowledge and self-assessment during this

pandemic time wherein flexible learning is more encouraged due to the Covid-19 situation in

order to enhance and maximize health protocols.

This study will be beneficial to the following:

Nursing students. This study will help nursing students promote awareness of computer

vision syndrome (CVS) knowledge and self-assessment. The findings will help them find ways

on how to improve eye care and health while using computers especially during online classes as

part of flexible learning modality during this pandemic.

Nursing education. The outcome of the study will serve as a basis for in the

implementation of CVS student nurses to educate and to recognize the problem and will raise the

awareness towards their daily practice and implement preventive measures to avoid CVS-related

symptoms. And to improve student’s learning specially on the online both flexible learning

programs in theory, skills laboratory in and related clinicalclassroom and clinical experiences.

Nursing practice. This study e result will help nursesthem better understand the nursing

students’ perceptions regarding CVS knowledge and self-assessment. realize their noble task in

preparing and supporting nursing students and workers health preventive measurement to lessen
the risk for CVS. To recognize the importance of CVS interventionsknowledge and self-

assessment not only among nurses, nursing students but as well as to their clients.

Future Researchers. The ideas presented may be used as reference data in conducting

new research or in testing the validity of other related findings. This study may be used to

conduct a study that focuses on another variable which is adding preventive measures, doing

observational checklist, and determining the incidence of CVS.

Scope and Delimitations of the Study

The primary concern of the study is to determine the 94 (write the actual number of

respondents) third year nursing students’ demographic profile regardless of age, gender, hobby,

total number of years of using computer, total number of hours of sleep in a day, and total

number of hours using computer per day. The study further looks into the possible significant

relationship between the extent of the respondents’ demographic profile and their perceptions on

CVS knowledge and self-assessment. The respondents are currently enrolled duringfor the first

semester AY 2021-2022 at Adventist Medical Center College.

The data collection process will lasted approximately for 15 minutes last December

_____, 2021. (pls write the actual date of data collection)The data will be gathered before the end

of December 2021.

Definition of Terms

The following key terms are operationally defined for clarity and better understanding of

the study:
 Age. This variable determines the age group on the basis of Erik Erikson’s Stages of

Psychosocial Development. This refers to the number of years a respondent has existed.

Computer Vision Syndrome (CVS). Can be termed as Digital Eye Strain (DES). This

denotes aIt is the complex of eye and vision problems experienced associated with longer

computer use specially during online classes among the third year nursing students.related to

near work that are experienced during or related to computer use. It consists of a series of signs

and symptoms like blurred vision, watering and redness of the eyes, double vision, eye fatigue,

irritation in the eyes etc. which computer users experience and which are thought to be caused by

this type of near point activity.

Gender. This connotes whether the respondent is male or female.

Hobby. This denotes the respondent’s computer activity whether online gaming, online

surfing, online reading, online schooling, or online watching films or shows.

Total number of hours of sleep in a day. This refers to the respondent’s sleeping

pattern by hours. The respondent will be asked for a range of less than or equal to 3 hours, 4-6

hours, 6-8 hours, or more than 8 hours.

Total number of hours using computer per day. This refers to the number of hours an

individual spent using a computer in a day regardless of computer activities such as online

gaming, online surfing, online reading, online schooling or online watching films or shows. The

respondent will determine the hours spent on the computer with the range of less than or equal to

3 hours, 4-6 hours, 7-10 hours, or more than 10 hours.

Total number of years using computer. This refers to the number of years an individual

spent using a computer. The respondent will indicate the total number of years using the

computer regardless of the program whether online gaming, online surfing, online reading,
online schooling, or online watching films or shows with the range of less than or equal to 3

years, 4-6 years, 7-10 years, or more than 10 years.

Nursing students. This refers to an individual who is enrolled in a third year nursing

program in the first semester of AY 2021-2022 at Adventist Medical Center College. A total of

95 nursing students excluding the 3 nursing students researchers.

Knowledge on Computer Vision Syndrome (CVS). This refers to the opinions,

thoughts, or views of nursing students towards computer vision syndrome. Their knowledge can

be either adequate or inadequate. Adequate knowledge connotes that nursing students can easily

identify CVS symptoms, have proper management, and have eye care practices. Inadequate

knowledge denotes that nursing students have improper computer handling leading to a series of

eye complications. A total score of 9. A score of 6 and above reflects adequate CVS knowledge.

A score of 5 and below reflects inadequate CVS knowledge.

Self-assessment on Computer Vision Syndrome (CVS). This refers to an individual's

self-evaluation of computer vision syndrome. Nursing students are given a set of questionnaires,

particularly the third section of the questionnaire to assess themselves of the following symptoms

(vision problem, dryness, irritation, eye pain, eye redness, blurred vision, eye fatigue, eye strain,

neck pain, back pain, and/or headache). Self-assessment determines if nursing students acquired

the CVS symptoms by responding yes or no. A total score of 18. A score of 13 and above yes

responses reflects diagnosed CVS. A score of 6-9 yes responses reflects as probable CVS. A

score of 5 and below yes responses reflects normal.

 Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter discusses the importance of the study with the aid of related literature and

studies collected.

(pls segregate and label the Chapter 2 section for Related Literature and another section for

Related Studies. For Related Studies segregate International from Local studies if you have with

labels (International and Local)

Related Literature
 Klamm and Tarnow (2015) reported that computers and associated devices are important

in modern academic, professional, and social life. According to their data in 1997, 18% of

American households owned computers; in 2009, computer owners were 68.7%; and in 2013,

83.8% (Klamm and Tarnow (2015). Additional term was cited in this review, visual display

tenninals (VDT), a broad term to describe computers, cell phones, tables, and e-readers. Frequent

use of it may increase vision problems. Common symptoms reported by a medical student in

2011 are the following: dry eyes, blurred vision, and headaches. The student verbalized “I’m

pretty sure I’m going to need glasses soon because my eyes can’t keep up with the demands'' (C.

Tippy, personal communication, 2012) (as cited by Klamm and Tarnow, 2015).

As computers become part of every individual’s life, reports showed that people are now

experiencing a variety of ocular symptoms related to prolonged computer use (Blehm, Mitra,

Vishnu, and Yee, 2005). What collectively referred to as computer vision syndrome based on

Blehm, Mitra, Vishnu, and Yee (2005) review is the eyestrain, tired eyes, irritation, redness,

blurred vision, and double vision (major benefactor symptom: dry eye). In this article, the

authors reported the characteristics and treatment modalities that were accessible at this time.

According to the authors, the cause of CVS may be ocular-surface abnormalities or

accommodative spasms, and/or ergonomic etiologies. Treatment and eye therapy were yet to be

discussed but preventive measures and eye care practices were the most important to be assessed

(Blehm, Mitra, Vishnu, and Yee, 2005).

Maru (2019) from University of Gondar stressed the pathophysiologic mechanisms of

CVS and its prevention in his review. From a pathophysiologic point of view, Maru (2019)

explained that the development of computer vision syndrome was produced by vision related,

ocular surface, and digital screen related conditions. Causes of CVS were a combination of
associated factors such as prolonged working hours, inadequate breaks, and constantly staring at

a screen. The authors investigated clinical features of CVS and are categorized into four (4) main

groups: asthenopia, ocular surface-related, visual, and extraocular. (1) Asthenopic symptoms are

related to eye strain which resulted from prolonged computer use. (2) Ocular surface-related

symptoms are dry eyes, irritated eyes, and eye discomfort noted leading to reduced blinking rate

due to poor air condition and glare. (3) Visual symptoms are accompanied by blurring of vision,

double vision, headache, and difficulty to focus. (4) Extraocular symptoms are assessed as neck

pain, shoulder pain, psychosocial stress, and backache due to poor ergonomic positioning (Maru,

2019).

Alemayehu (2021) reported that computers are used at home, in schools, and in public
locations, causing ocular and nonocular problems. Asthenopia, fuzzy vision, double vision, neck
pain, back pain, and headache are just a few of the symptoms of computer vision syndrome.
Correcting refractive error is the most important technique to treat CVS since it lowers the
stimulus to accommodate. Specially designed computer glasses have been shown to reduce
computer vision when used at the proper distance. The risk of computer vision syndrome (CVS)
can be reduced by a number of simple strategies, such as changing the working environment and
increasing eye contact. Dry eye treatment is another method for preventing CVS. Supplementing
with omega 3 fatty acids improves tear stability and alleviates problems linked with using a
visual display unit.

In conclusion, computer vision syndrome is a growing public health concern since it is so

common among computer users. Computer vision syndrome is caused by a combination of
personal traits, computer attributes, and the working environment. As a result, avoiding or
reducing computer vision syndrome necessitates a multifaceted approach.

OseiFrimpong (2020) stated that computer vision syndrome is the combination of eye and

vision problems associated with the use of computers. A quantitative descriptive study was

conducted with students on Asante Akyem Campus, Agogo of the Presbyterian University
College with the use of questionnaires. The objectives of this study is to find out the prevalence

of Computer Vision Syndrome among university students, to assess the knowledge of university

students on Computer Vision Syndrome, to identify if students are knowledgeable on the

preventive measures of CVS using a sample of 306 respondents. The results revealed that,

majority of respondents (52.1%) indicated backache, neck pain/shoulder (55.9%), tiredness of

eyes (61.8%) and eye strain (52.6%). Backache, neck/shoulder pain, and eye strain (irritation)

were the most common symptoms of Computer Vision Syndrome among those who had used a

computer for 3-5 years. Respondents spent more than 5 hours every day on their computers and

utilized them constantly. This demonstrates that Computer Vision Syndrome is very common

among university students. The participants in this study agreed that using a computer had

negative consequences on their eyes, and that the symptoms they were experiencing were related

to using a computer. When used frequently, computer use proved detrimental to the eyes. The

majority of people had heard of computer vision syndrome from the radio, newspapers, or

magazines. The symptoms they were having were linked to the use of a computer, it was

discovered. Taking breaks between computer sessions was one technique to avoid computer

vision sickness. The use of a radiation filter on the screen and the use of computer lenses were

both agreed upon as preventative methods for computer vision syndrome. Respondents were

divided on whether playing a computer game, watching a video, or blinking their eyes

consciously were effective ways to avoid computer vision syndrome. This indicates that pupils

lack sufficient awareness on CVS prevention strategies. Because the majority of the students

agreed on only a few computer vision condition prevention strategies (OseiFrimpong, 2020).

In the study by Garg et al. (2021), computers have had a considerable impact on the

cognitive, social, physical, and other aspects of computer users' daily lives, particularly among
internet users. The majority of the day is spent in front of a computer, either working or playing

games. This study looked at the factors that contribute to eye and vision disorders in students, as

well as their link to computer use, and made recommendations for preventing or reducing their

occurrence. The goal of this study was to determine the prevalence of computer vision syndrome

among medical students, as well as their awareness and application of the syndrome. This was a

cross-sectional study, which was carried out amongst the MBBS students (1st, 2nd and 3rd year)

of Rama Medical College Hospital and Research Center, Kanpur, India. A pretested, semi-

structured questionnaire was used to collect the data. Students who gave their consent were

taken up for the study. A total of 214 medical students participated and majority of them were

below 22 years of age. The prevalence of Computer Vision Syndrome was found to be 83%

[95% CI = 67.9% - 91.6%]. More than 70% of students spend up to 4 hours in front of a

computer. Those who had symptoms experienced them within 2-3 hours of computer use.

Majority of them complained of having watery eyes and blurred vision. These are young kids

and having this syndrome so early in life will have a detrimental effect on their health in future.

Hence the stakeholders involved, need to be sensitized regarding the importance of the regular

eye and health check-ups and proper rest to the eyes. Further research is recommended to know

the depth of the problem as it has the potential to become a modern-day pandemic. This study

shows the effect of computers on a daily basis (Garg et al., 2021).

According to Reddy et al., (2013), Computer vision syndrome (CVS) is a condition in

which a person experiences one or more of eye symptoms as a result of prolonged working on a

computer. The goal of their research is to determine the prevalence of CVS symptoms, as well as

computer expertise and habits, among students at various Malaysian universities, and to examine

the association between various computer-related characteristics and symptom incidence. In a

cross-sectional questionnaire survey study, data on demographics, spectacle use, duration of

daily continuous computer use, symptoms of CVS, preventive measures taken to reduce

symptoms, use of a radiation filter on the computer screen, and lighting in the room were

collected from college students. The prevalence of CVS symptoms (one or more) was found to

be 89.9%; the most bothersome symptom was headache (19.7%), followed by eye strain (10%).

(16.4 percent ). Ninety percent of university students in Malaysia had CVS symptoms, which

were more common among those who used the internet for more than two hours per day (Reddy

et al., 2013).

In the study by Tawil et al., (2018), published the prevalence of self-reported computer

vision syndrome symptoms and its associated factors among university students. This to

determine the prevalence of symptoms of computer vision syndrome and to identify its

associated factors. The secondary objective was to assess knowledge and practices related to

preventing computer vision syndrome symptoms. The data for this cross-sectional study were

collected through a self-administered questionnaire distributed to 713 female undergraduates

studying business and medicine in Saudi Arabia. The questionnaire included computer vision

syndrome validated symptoms and factors associated with computer vision syndrome

development. The most common symptom due to prolonged computer use was neck or shoulder

pain, reported by 82.2% of the subjects. Overall, 66.5% of the subjects suffered from headache

and 51.5% from dry eyes, in mild, moderate, or severe form. The prevalence of computer vision

syndrome symptoms was significantly higher among business students, who reported lower

awareness and poor practice measures of computer use recommendations. Relevant awareness

campaigns focusing on the appropriate use of computers are highly recommended (Tawil et al.,

2018).
 According to Nuez et al. (2019), among 100 selected respondents of BSN-4 students of

San Pedro College, concluded that more males were diagnosed with CVS due to the fact that

they spend more time using the computer, particularly in playing online games. Students at San

Pedro College, particularly in the nursing program, encode readings, nursing care plans, case

studies, and other tasks, as well as research, communication, and internet use for fun. Though

computers are extremely useful, they may also pose issues, one of which is computer vision eye

syndrome, a modern-day eye condition. Computer vision syndrome (CVS) is a term used to

describe a group of eye and vision issues caused by prolonged computer use. Anyone who works

on a computer for two or more hours each day is at danger. This research would be beneficial in

educating the public about computer vision syndrome. It can also help students understand the

precautions to take in order to avoid CVS, such as not using computers excessively, especially

for unneeded purposes, and getting enough nutrition, water, sleep, and good alignment before

and during computer use (Nuez, Soriano et al., 2019).

According to Kaya (2020), the new coronavirus was discovered in a seafood market in

Wuhan, China. SARS-zoonotic CoV-2's resource is unknown, but past research has pointed to

bats as the primary reservoir (Lu et al., 2020). Human coronaviruses have yet to be subjected to

any promising clinical treatments or preventative strategies. Coronaviruses are spread mostly by

direct or indirect human contact, as well as viral droplets (Yuan et al., 2006). The disease spreads

quickly as a result of these transmission channels. As a result, social isolation and hygiene are

critical in preventing the disease from spreading. The aim of this research is to evaluate the effect

of online education on eye health in Covid-19 pandemic and to present a new scale on this

subject. Between the 8th and 13th of July 2020, 402 students (257 females, 145 men) from

Pamukkale University's various faculties were emailed and asked about their eye health.
Construct validity analysis, reliability analysis, correlation, and simple linear regression analysis

are all included in this section of the study. In conclusion, the validity and reliability of the eye

health scale related to online education are sufficient in the Covid-19 period, which we prepared

for students who stayed at home during the Covid-19 period and were concerned that their eye

health would deteriorate due to the use of more screens in addition to their normal use. It was

found to be favorably connected with the eye tiredness questionnaire and to have good

predictability (Kaya et. al, 2020).

According to Gupta et al. (2021), severe acute respiratory syndrome coronavirus 2

infection associated respiratory disease-COVID-19 (2019-nCoV) has tremendously affected the

world. Online education is conducted in two ways. The first is through the use of pre-recorded

classes, which, when opened out to the public, are referred to as Massive Open Online Course.

The second one is through live online classes conducted as webinars or Zoom sessions, which

allow the advantage of an interactive exchange in real time. While faculty grapples with creating

content and delivery systems that harness and utilize technology to its fullest, students are left

clinging on to their mobile phones and computer screens. The aim of this research is to assess

digital eye strain (DES) among schoolchildren during lockdown. A cross-sectional study was

done using an online questionnaire. Students aged 5 to 18 were given an electronic questionnaire

that was validated and self-administered. The data collection period lasted from May 18, 2020

through May 24, 2020. The DES was assessed using the Rasch-based Computer-Vision

Symptom Scale. The survey was completed by 654 students (mean age: 12.02 3.9 years). The

average daily exposure to digital devices was 5.2 2.2 hours. At least one asthenopic/dry eye

symptom (AS/DS) was reported by 507 (92.8 percent) of the children. Eye redness (69.1%) and

heaviness of the eyelids were the most common symptoms (79.7 percent ). There was a
significant positive link between age and the amount of time spent using digital devices per day

(Pearson correlation 0.25; P 0.001). The majority of the students polled had at least one symptom

of asthenopic/dry eye symptom, indicating a need to educate them about the potential negative

consequences and assist them in adapting to the current educational system (Gupta et al., 2021).

In the study by Wang et al. (2021), The ongoing pandemic of SARS-CoV-2 infection has

caused tremendous stress in the health care system and altered the daily lifestyle of ordinary

people. Episodes of lockdown and social distancing have cut face-to-face connections and

interrupted transportation, education, working, and traveling activities. The study is about

comparing the prevalence of computer vision syndrome in university students of different

teaching modes during the SARS-CoV-2 outbreak period. A cross-sectional survey study of

Chinese medical students at Sichuan University who attended classroom lectures and same-grade

foreign students from a Bachelor of Medicine and Bachelor of Surgery (MBBS) program who

attended online lectures with similar schedules using the validated Computer Vision Syndrome

Questionnaire. The prevalence of computer vision syndrome was 50.79 percent among Chinese

students and 74.32 percent among MBBS students, respectively (P = 0.004). According to the

findings, online learning may play a role in the frequency of computer vision syndrome among

university students (Wang et al., 2021).

In the study by Babu et al., (2021), Over the past few months due to COVID-19

lockdown our society has been in indoor settings where education, work and entertainment are

through digital platforms. Digital screens are inevitable for our day to day existence since it

turned out to be a part of each movement today. This created an increase in the rate of digital

eye strain.. An epidemiological observational study conducted during the lockdown period

among people of Kerala with a structured and validated questionnaire using Google form. The
main aim of this study was to analyze the usage of digital screens and the associated vision

related problems occurring in people residing in Kerala, during lockdown due to COVID

pandemic. A total of 584 participated in the study where more than 86% reported at least one

symptom. Headache, eye redness, burning, etc. were correlated with duration of use. Their study

concluded that digital screens demand high visual strain, much attention and care should be

taken for vision problems and related issues. Since we are depending on digital screens for many

of our daily activities, the information related to CVS and associated discomfort along with the

prevention strategies should be explained by health professionals (Babu et al., 2021).

The related literature and studies show that prolonged computer use can lead to computer

vision syndrome which is a common eye- and vision-related problem among individuals,

specifically students who are in flexible learning during pandemic in order to maximize health

protocols. Literature and studies show that demographic profiles, CVS knowledge, and CVS

self-assessment are examined to determine eye health behavior, proper eye management, and to

diagnose CVS.

Chapter 3

RESEARCH METHODOLOGY

This chapter presents the research design, research locale, respondents of the study,

research instrument , sampling design, data gathering procedure, and statistical tools of the study.

The study will utilize quantitative research design.

Research Design

The study will utilized descriptive correlation research design to determine the

respondents’ demographic profile such age, gender, hobby, total number of years using

computer, total number of hours sleep in a day, and total number of hours using on a computer

per day, and their CVS knowledge and self-assessment. It further looks into the possible

relationship between the respondents demographic profile and their perceptions on CVS

knowledge and self-assessment. Descriptive research “examines a situation as it is” and “does

not involve changing or modifying the situation under investigation” (Leedy & Ormrod, 2004, p.

179). It is used to obtain information concerning the current status of the phenomena to describe

what exists with respect to variables under study.

This is also correlating research that scrutinizes the possible relationship and/or

association between respondents’ personal profile and the respondents’ computer vision

syndrome knowledge and self-assessment.

Research Locale (pls edit the tenses of your manuscript)

The study waswill be conducted at Adventist Medical Center College, formerly the

Mindanao Sanitarium and Hospital College, a Seventh-Day Adventist institution located at the

Brgy. San Miguel, Tibanga, Iligan City, Lanao Del Norte. This place is selected for knowing the

efficiency of the said study among nursing students and for them to feel comfortable, this study

will be implemented on the 3rd year Bachelor of Science in Nursing students. It offers the

following courses Bachelor of Science in Nursing, Physical Therapy, Medical Technology,

Pharmacy, Radiology, Nutrition and Dietetics, Information Technology, Computer, Secondary

and Elementary Education.

 Map

Respondents of the Study

The respondents of the study comprised ofwill be the 95 (write the actual number of

respondents in the manuscript) third year nursing students regardless of age, gender, hobby,

total number of years using computer, total number of hours sleep in a day, total number of

hours using computer per day, CVS knowledge and self-assessment perceptions. The

respondents wereare currently enrolled in the first semester of Academic Year 2021-2022 at

Adventist Medical Center College.

Sampling Design
 The sample will utilize the complete enumeration sampling approach wherein all third
year nursing students wereill be taken as respondents of the study. According to Glen (2021), a
complete population sampling technique is a sort of genetic study in which the entire population
of interest (i.e., a group of people who all share the same attribute) is studied for indications of a
certain gene or behavioral pattern, rather than just a few individuals.

Research Instruments

The study will consist of a 33 item survey questionnaire to be answered by each student

through Google Form. The questionnaire has three sections. Section A consists of 6 items which

includes the demographic profile of the third year nursing students such as age, gender, hobby,

total number of years using computer, total number of hours sleep in a day, and total number of

hours using on a computer per day. Section B are items adapted from Heiting (2021) which

consists of 9 item statements to assess knowledge of CVS such as identifying CVS symptoms,

knowing the American Optometric Association (AOA) statistics of affected Americans by CVS,

eye response to computer image, vision test to diagnose CVS, how often people blink their eyes

during computer use, ways to improve eye comfort, the relationship between workplace

productivity and proper vision prescription, and how to reduce CVS risks. Section C consists of

18 statements adapted from Thomas (2005) of the questionnaire reflecting the self-assessment

aspect of CVS answerable by yes or no. The sections includes statements such as vision

problems, having whole day classes, eye dryness, eye irritation, eye pain during computer use,

teary-eyed, eye redness at the end of scheduled online class, blurred vision during computer use,

difficulty in focusing far objects, changed vision in afternoon or evening than in the morning,

and fatigue or strain during computer use.

 A letter was sent to the author of CVS last ______(pls state what happened with your

letter). If there was no response pls. include it in the delimitation section also.

Scoring of the Instrument

The Section B and C of the questionnaire will be scored accordingly: The second

section of the tool consists of 9 questions about a knowledge scale test on computer vision

syndrome that will be surveyed on their knowledge assessment regarding the information of

computer vision syndrome by providing questionnaires with multiple choices. A total score of 9.

A score of 6 and above reflects adequate CVS knowledge. A score of 5 and below reflects

inadequate CVS knowledge.

The third section of the survey is responded to by a yes or no response. It consists of 18

questions about the assessment aspect of CVS. The responses contain a specific description that

will evaluate nursing students of CVS symptoms. A total score of 18. A score of 13 and above

yes responses reflects diagnosed CVS. A score of 6-9 yes responses reflects as probable CVS. A

score of 5 and below yes responses reflects normal.

Data Gathering Procedure

The study will follow a step-by-step process to ensure that the data gathering procedure

adheres according to the guidelines concerned and involved. The process are depicted below:

Step 1: A letter of approval is written by the researchers to be noted by the thesis

adviser.
 Step 2: The letter of approval is addressed to the school of nursing dean. All signatures

affixed are also stipulated on the letter of the respondents.

Step 3: After gathering the signatories, the implementation process is followed on the

designated data when it is conducted.

Step 4: During the period of data collection, a letter of approval for the instructors in

level 3 is written and provided for permission. Answering the questionnaires will last

approximately at 15 minutes.

Step 5: After the period of data collection, calculation and tallying of data is performed

and is subjected for analysis and interpretation using defined and appropriate statistical tools.

Statistical Tools

These are the statistical tools used in computing, analyzing and interpreting the data

results of the study.

1. Frequency and Percentage Distribution

Frequency and percentage distribution is used in sections A, B, and C of the survey.

Frequency and percentage distribution determine how frequent the number of responses the

respondents responded to each particular answer per question.

Formula:

p = f / n (100)

Where:
 p = percentage

f = frequency

n = total number of respondents

2. Mean and Mean Percentage

Mean and mean percentage are utilized in sections B and C. Mean and mean percentage

determine the number of responses in each particular answer per question.

Formula:

Where:

W = Weighted Average

n = Number of terms to be averaged

Wi = Weights applied to x Values

Xi = Data values to be averaged

3. Chi-square

Chi-square formula is used to investigate the relationship between the respondents’

demographic profile and the extent of their perceptions on CVS knowledge and self-assessment.

Formula:
Where:

W = Weighted Average

n  = Number of terms to be averaged

Wi = Weights applied to x Values

Xi = Data values to be averaged

 Letter to the Respondents

Adventist Medical Center College

COLLEGE OF NURSING

Andres Bonifacio Avenue Brgy. San Miguel, Iligan City

Dear Respondents:

We are going to conduct a study entitled, “Knowledge and Self-assessment on

Computer Vision Syndrome among Nursing Students”. This is in partial fulfillment of the
requirements for the degree of Bachelor of Nursing.

Your participation and support will make this study a successful one. Rest assured that
your answers will be treated with utmost privacy and confidentiality.

Thank you and God bless!

Sincerely,

Arroyo, Eliza Danielle M.

Mondelo, Ara Mae V.

Villamor, Jan Daven P.

Researchers

Noted by:
Ma. Almira P. Nebres, RN, MAN, Ph.D
Research Adviser
 QUESTIONNAIRE

Section A: Demographic Data

Instruction: Check the corresponding answer of your choice.

1. Age

◯ ≤ 18 ◯ 19-2 ◯ 22-24 ◯ ≥ 25

2. Gender

◯ Male ◯ Female

3. Hobby

◯ Online reading ◯ Online gaming ◯ Online schooling

◯ Watching shows/films online ◯ Online surfing

4. Total number of years of using computer

◯ ≤ 3 years ◯ 4-6 years ◯ 7-10 years ◯ > 10 years

5. Total number of hours of sleep in a day

◯ < 4 hours ◯ 4-6 hours ◯ 6-8 hours ◯ > 8 hours

6. Total number of hours using computer per day

 ◯ ≤ 3 hours ◯ 4-6 hours ◯ 7-10 hours ◯ >10 hours

Section B: Knowledge scale test on computer vision syndrome

Instruction: Please answer the following questions according to your knowledge on

computer vision by checking the circle of your choice.

1. What are the symptoms of computer vision syndrome or CVS?

◯ eye strain ◯ headaches ◯ blurred vision ◯ neck and shoulder pain

◯ all of the above

2. According to the American Optometric Association, what percentage of Americans who use

computers are affected by CVS?

◯ 10-15% ◯ 25-30% ◯ 50% ◯ 70-75%

3. The eye responds to a printed work similarly to the way it responds to a computer image.

◯ true ◯ false

4. What is the primary reason for computer vision syndrome?

◯ glare on the computer screen ◯ an inability to focus properly on computer

images

◯ images that are too small computer stations that are not set up ergonomically
5. Studies show that the “Big E” vision test that most people are familiar with is the most

reliable way to diagnose CVS.

◯ true ◯ false

6. How often do people blink their eyes when using a computer, compared with how often they

blink when engaged in face-to-face conversation?

◯ twice as frequently ◯ the same amount

◯ half as frequently ◯ ⅓ as frequently

7. Compared with the brightness level of your surrounding workplace, you can improve your

eye comfort by adjusting your computer screen’s brightness to be:

◯ significantly brighter ◯ significantly darker

◯ about the same ◯ it makes no difference

8. A relationship exists between workplace productivity and a proper vision prescription for

computer use.

◯ true ◯ false

9. Which of the following can help reduce the risk for CVS?

◯ position your display so the top of the screen is just below eye level

◯ position your display at a distance that is approximately arm’s length from your eyes

◯ every 20 minutes, take at least a 20-second break and look at something at least 20

feet away

◯ wear special-purpose computer glasses, especially if you have a bifocal prescription

◯ all of the above

◯ none of the above

 Adapted from Heiting, G. (2021). How much do you know about digital eye strain?

All About Vision. https://www.allaboutvision.com/cvs/computer-vision-self-test.htm.

Section C: Assessment aspect of computer vision syndrome

Instruction: When you are completing these items, assess and evaluate your current eye health

status. Tick the box either yes or no.

SI. No. Items Yes No

1 Do you have any vision problems?

2 Do you have classes the whole day?

3 Do you feel dryness in your eyes?

4 Do you feel irritation in your eyes?

5 Do you get pain in your eyes while using the computer?

6 Do you have watering from the eyes?

7 Does your eye get red at the end of your scheduled online class?
 8 Do you have blurred vision while using computers?

9 Do you have double vision while using computers?

10 Do you feel difficulty in focusing on far objects?

11 Have you experienced a change in your vision in the

afternoon/evening than in the morning?

12 Do you get eye fatigue/strain when you use computers?

13 Have you encountered any change in vision after having online

class?

14 Do you get neck pain while using the computer?

15 Do you get back pain while sitting on your computer chair?

16 Have you experienced shoulder pain when you use computers for a

prolonged period of time?

17 Do you get a headache after a few hours of use?

18 Have you taken any additional responsibility like doing a part time

job on the computer other than having online class?

Adapted from Thomas, S. (2005). A Descriptive Study to Assess Computer Vision

Syndrome And Its Preventive Measures Among Computer Professionals Working In

F.C.G. Software (P) Ltd, Brigade Road, Bangalore. Rajiv Gandhi University of Health
 Sciences, Karnataka, Bangalore.

http://52.172.27.147:8080/jspui/bitstream/123456789/3059/1/SD%20Thomas.pdf.

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 Letter to the Respondents

Adventist Medical Center College

COLLEGE OF NURSING
Andres Bonifacio Avenue Brgy. San Miguel, Iligan City

Dear Respondents,

We, the third year nursing students of Adventist Medical Center College, Iligan City are
presently working on a study entitled, “KNOWLEDGE AND SELF-ASSESSMENT ON
COMPUTER VISION SYNDROME AMONG NURSING STUDENTS” as part of the
requirements for the degree of Bachelor of Science in Nursing.
Your participation and support will make this study possible. Please be assured that all
data gathered will be handled with utmost confidentiality. Your cooperation will be greatly
appreciated and treasured.
Thank you and God bless!

Sincerely,

Arroyo, Eliza Danielle M.

Mondelo, Ara Mae V.

Villamor, Jan Daven P.

Researchers
Noted by:

Ma. Almira P. Nebres, RN, MAN, PhD

Thesis Adviser

ADVENTIST MEDICAL CENTER COLLEGE

SAN MIGUEL, ILIGAN CITY

December 28, 2021

Ma. Almira P. Nebres, RN, MAN, PhD

Dean, School of Nursing

AMC College

San Miguel, Iligan City

Dear Ma’am,

We, the third year nursing students of Adventist Medical Center College, Iligan City
conducting a survey on the “KNOWLEDGE AND SELF-ASSESSMENT ON COMPUTER
VISION SYNDROME AMONG NURSING STUDENTS” as part of the requirements for the
degree of Bachelor of Science in Nursing.

With your permission, the researchers will be distributing questionnaires to the third year
students in AY 2021-2022. It will take about 10-15 minutes to answer the questionnaire.

Hoping for a positive response from the request and thank you for your generous support.
God bless and more power!

Respectfully yours,

Arroyo, Eliza Danielle M.

Mondelo, Ara Mae V.

Villamor, Jan Daven P.

Researchers
Noted by:

Ma. Almira P. Nebres, RN, MAN, PhD

Thesis Adviser

Letter of Author’s Approval

ADVENTIST MEDICAL CENTER COLLEGE

SAN MIGUEL, ILIGAN CITY

Rajiv Gandhi University of Health Sciences

Karnataka, Bangalore

Dear Mrs. Seena P Thomas,

Greetings!

We, Arroyo, Mondelo, and Villamor, a Bachelor of Science in Nursing at Adventist

Medical Center College, Brgy. San Miguel, Iligan City, Philippines.
Presently, we are working on our research paper entitled “Knowledge and Self-assessment on
Computer Vision Syndrome among Nursing Students” at Adventist Medical Center College
(AMCC). The study aims to determine the selected demographic profile, knowledge and self-
assessment among third year nursing students currently enrolled at AMCC for AY 2021-2022.

We have read and like a study that you published in google scholar. We are interested in
using your questionnaire on “A Descriptive Study to Assess Computer Vision Syndrome And Its
Preventive Measures Among Computer Professionals in our study”.

We would really appreciate it if you could send us a copy of your tool with your
approval.
Hoping for your positive response on this request. Thank you very much.

Respectfully yours,

Villamor, Jan Daven P.

Arroyo, Eliza Danielle M.

Mondelo, Ara Mae V.

Researchers

Noted by:
Ma. Almira P. Nebres, RN, MAN, PhD
Thesis Adviser

CURRICULUM VITAE

Name : Eliza Danielle M. Arroyo

Nickname : Dani

Home Address : Lluch Compound, Camague, Iligan City

Gender : Female

Civil Status : Single

Religion : Born Again Christian

Date of Birth : September 12, 2000

Place of Birth : Iligan City

Father’s Name : Hector S. Arroyo

Occupation : Deceased

Mother’s Name : Ma. Joyce M. Arroyo

Occupation : Teacher

Educational Background

Elementary : Corpus Christi Parochial School of Iligan

High School : La Salle Academy

College : Adventist Medical Center College

CURRICULUM VITAE

Name : Ara Mae V. Mondelo

Nickname : Arami

Home Address : P3 TCES, Poblacion Tubod, Lanao del Norte

Gender : Female

Civil Status : Single

Religion : Roman Catholic

Date of Birth : October 24, 1999

Place of Birth : Cebu City

Father’s Name : Molo Mondelo

Occupation : Deceased

Mother’s Name : Arlyn A. Vergara

Occupation : Nurse

Educational Background

Elementary : Tubod Central Elementary School

High School : Mercy Junior College

College : Adventist Medical Center College

CURRICULUM VITAE

Name : Jan Daven P. Villamor

Nickname : JD

Home Address : Zone 4 Del Carmen, Iligan City

Gender : Male

Civil Status : Single

Religion : Roman Catholic

Date of Birth : November 12, 1999

Place of Birth : Iligan City

Father’s Name : Eric G. Villamor

Occupation : Civil Engineer

Mother’s Name : Juvyline P. Villamor

Occupation : Housewife

Educational Background

Elementary : La Salle Academy

High School : St. Michael’s College

College : Adventist Medical Center College