|Year : 2022 | Volume
| Issue : 1 | Page : 2-8
Index of online teaching stress and quality of life among nurse educators during COVID-19
Shiv Kumar Mudgal1, Kavita Verma2, Suchpreet Kaur Gill2, Rakhi Gaur3, Digpal Singh Chundawat4, Ravikant Sharma5
1 Associate Professor, College of Nursing, AIIMS Deoghar, Jharkhand, India
2 Assistant Professor, Akal College of Nursing, Eternal University, Himachal Pradesh, India
3 Assistant Professor, College of Nursing, AIIMS, Deoghar, Jharkhand, India
4 Department of Nursing, AIIMS, Bhopal, Madhya Pradesh, India
5 Assistant Professor, Tirupati College of Nursing, Pacific Medical University, Rajasthan, India
|Date of Submission||05-Jun-2021|
|Date of Decision||03-Jul-2021|
|Date of Acceptance||12-Jul-2021|
|Date of Web Publication||05-Jul-2022|
Dr. Shiv Kumar Mudgal
Department of Medical Surgical Nursing, Tirupati College of Nursing, Pacific Medical University, Udaipur, Rajasthan
Source of Support: None, Conflict of Interest: None
Background: With sudden changes in the worldwide education system due to COVID-19 impact and limited available resources, nurse educators have been suffering from online teaching stress in this year, which is thought to affect their quality of life (QOL). The aim of this study was to ascertain the index of online teaching stress and QOL among nurse educators during COVID-19. Subjects and Methods: In this cross-sectional study 162 nurse educators were recruited through a convenient sampling technique. Online survey was employed using socio-demographic questionnaire, online teaching stress scale, and World Health Organization QOL BRIF-26 to collect data. IBM Statistical Package for the Social Sciences (SPSS) Version 23 was used for statistical analysis. Results: Among all participants, 22% and 51% of participants reported severe and moderate level of online teaching stress respectively. The highest and lowest overall QOL was reported in the social relationship (70.29 ± 20.5) and physical health (54.54 ± 13.73) domain. Online teaching stress scores were significantly associated with gender (P = 0.012), teaching experience (P < 0.001), salary (P < 0.001), job satisfaction (P < 0.001), satisfaction with organization (P < 0.001). Online teaching stress scores were significantly negative correlated with all four domains of QOL. Marital status and monthly salary were the indicators of online teaching stress. Teaching experience, salary, and job satisfaction appeared to be robust predictors for domains of QOL (P < 0.05). Conclusion: The findings suggest that effective interventions primarily focusing on improving the availability of resources, training, and empowerment activities are necessary to decrease the negative effect of stress on QOL.
Keywords: COVID-19, nurse educators, online teaching, quality of life, stress
|How to cite this article:|
Mudgal SK, Verma K, Gill SK, Gaur R, Chundawat DS, Sharma R. Index of online teaching stress and quality of life among nurse educators during COVID-19. Indian J Psy Nsg 2022;19:2-8
|How to cite this URL:|
Mudgal SK, Verma K, Gill SK, Gaur R, Chundawat DS, Sharma R. Index of online teaching stress and quality of life among nurse educators during COVID-19. Indian J Psy Nsg [serial online] 2022 [cited 2022 Nov 30];19:2-8. Available from: https://www.ijpn.in/text.asp?2022/19/1/2/349887
| Introduction|| |
The World Health Organization (WHO) has declared COVID-19 as pandemic on January 30, 2020, and this pandemic has had a significant impact on all most all the global sectors and systems, including but not confined to, health care sectors, energy, manufacturing, agriculture, and socio-economic system., There has not been any remedy to prevent the impact of COVID-19 on education sectors and this pandemic has tremendous effect on all level of education around the globe from primary to the university, as countries around the globe have been declared complete closure of educational institutes.,
As with other policies or interventions adopted by other global educational institutes to prevent the spread of this pandemic, all educational institutes across the South-East Asia were also ordered to close. Similarly, with the appearance of COVID-19 in India, traditional face-to-face classes were canceled and all educational institutes were placed on lockdown to protect students' and teachers' health.,
During this period, all efforts were initiated to shift online classes, and educators were asked to transfer their teaching online. Furthermore, they were forced to find the solutions for many issues raised because of this unplanned change in teaching. This turbulent situation due to online teaching created extremely challenging situation to the educators. Moreover, nurse educators were under stress and face challenges due to imparting education through online, which actually needs hands-on skills, practical learning, clinical teaching, real case presentation, and the management of quality in health care and patient safety.
It was reported that COVID-19 pandemic has affected the educators' quality of life (QOL). In addition, some studies have revealed a moderate to high level of stress among educators in low- to middle-income countries., Furthermore, recent studies have shown a higher level of stress compared to level before COVID-19 pandemic., It has been reported that educators have a higher prevalence of physical like hypertension, headaches, other cardiovascular disorders and psychosomatic disorders compared with other workers., In addition, a poor QOL, higher occupational stress, and shorter life expectancy for teachers have been documented in studies., Therefore, it is important to know the level of stress and QOL among nurse educators as high level of stress contributes low QOL and poor teaching outcome.
Despite the growing research on knowledge, attitude, work/occupational stress, burnout, QOL among general population there is a scarcity of literature about the impact of online teaching during this pandemic on nurse educators in terms of their stress level and QOL. There is a dearth of literature exploring the level of anxiety and QOL among nurse educators due to online teaching and to the researchers' best knowledge, the present study is among the first attempt to ascertain the index of online teaching stress and QOL among nurse educators. It is hoped that this study increases the body of knowledge on the effect of online teaching on nurse educators.
| Subjects and Methods|| |
Research design and participants
As a cross-sectional survey, the present study was conducted in the month of December 2020 on nurse educators of various nursing colleges and universities in Himachal Pradesh. The study aimed to determine the index of online teaching stress and QOL among nurse educators during COVID-19. A total of 162 nurse educators were recruited through convenient sampling technique. Nurse educators who gave their consent for participation and had minimum of 3 months of online teaching experience were eligible in this study while participants who sent incomplete questionnaire were excluded.
Data were collected by a structured questionnaire, which had three sections. The first section included demographic characteristics (age, gender, marital status, qualification, salary, teaching experience, students taught, nature of institution, satisfaction with job and organization, and working hours in a week) and the second section contained self-structured 39 items Online Teaching Stress Assessment Scale wherein, the items are responded on a 3 point Likert scale (Almost never: 1; fairly often: 2; Very often: 3). The scores were considered between the range of 13–21, 22–30, and 31–39 for low, moderate and high level of stress, respectively. The tool was developed on the basis of exciting literature and its face and content validity was done by a panel of 11 experts. The reliability of the tool was computed by Cronbach's alpha and was found to be 0.873.
The third section consisted of the shorter version of the WHOQOL-BREF, which consists of four domains namely; physical health, psychological health, social relationships, and environmental health, and these domains covered by twenty-six items. The items are responded on a 1–5 point Likert scale (”Very Poor”: 1; to “Very good”; 5). In scoring, items under a particular domain are individually scored and after the sum-up of individual items score in each domain, the raw domain score was recorded. Based on the guidelines, the raw scores of each domain were transformed to a 4–20 score which was equivalent to the WHOQOL-100.
Sample size calculation
The sample size was estimated by using the formula N/1+Ne2; where N = total population of nurse educators in this region were 270; e = margin of error (assume 5%) and after considering 95% confidence interval, the calculated sample size was 161. Therefore, data were collected till sample size met.
Ethical approvals for this study were taken from the Institutional Ethics Committee of Pacific Medical College and Hospital with letter no IEC/PMCH/0118-21. Participants were ensured about the confidentiality of their data and their right to access study findings. In addition, they were ensured about anonymized them by name and institute. Electronic written informed consents were taken from each of the participants before they answered for the online questionnaire.
For data collection, the first researcher referred to the various nursing colleges and after obtaining permission from head of institutions, the link to an online Google form was provided to nurse educators. The first phase of this online survey was done from December 8 to December 14, 2020, with a follow-up from December 18 to December 21, 2020. The questionnaire took approximately 15–20 min to complete.
Descriptive and inferential data analysis was performed through Statistical Package for the Social Sciences Version 23 (SPSS Inc., Chicago, IL, USA). The data were checked for its normality by applying Kolmogorov–Smirnov test. Data were analyzed in two steps. In the first step, frequency, percentage, mean, standard deviation (SD), and Student's t-test and one-way analysis of variance or their nonparametric equivalents (Mann–Whitney U and the Kruskal–Wallis tests) were employed to measure the association of stress and QOL with demographic variables. Furthermore, Pearson or its nonparametric equivalent (Spearman correlation) based on data normality was used to measure the relationship between stress and QOL. The predictive value of online teaching stress and QOL was assessed by multiple linear regression analyses. A two-tailed probability value of <0.05 was considered to indicate statistical significance.
| Results|| |
A total of 162 nurse educators returned complete study questionnaire. Approximately three-fourth (73.5%) were female, aged between 26 and 35 years (61.1%) and married (53.1%). Nearly two-third (63.6%) had a postgraduation degree and 92% of them were working in private nursing institutions. Only 13% of them had more than 10 years of teaching experience and 43.8% were getting salary up to Rs. 20,000/month. In terms of their satisfaction, 70.4% and 69.8% of participants were satisfied with their jobs and organizations respectively [Table 1].
|Table 1: Association of stress scores and World Health Organization quality of life BREF score with demographic variables|
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Results for online teaching stress and domain-specific WHOQOL-BREF scores and their association with participants' demographic variables are presented in [Table 1]. It shows that more than half (51%) of participants reported moderated level of stress and overall mean ± SD was 24.93 ± 5.65. Except for gender, teaching experience, monthly salary, and satisfaction with job and organization online teaching scores were not significantly different by participants' demographic variables. Female participants reported significantly higher stress levels than males (25.7 vs. 22.6). Participants who had more teaching experience, higher salary, more satisfaction with jobs and their organization showed low-stress levels than others as indicated by their low online teaching stress scores.
With regards to domains of QOL, highest and lowest domains of QOL were reported on social relationships (70.29 ± 20.50) and physical domain (54.54 ± 13.73) respectively. Scores in a number of QOL domains were significantly different by gender, qualification, teaching experience, monthly salary, and satisfaction with jobs and satisfaction with organization.
[Figure 1]a, [Figure 1]b, [Figure 1]c, [Figure 1]d represents the correlation between the online teaching stress and QOL. Results show that online teaching stress has a negative relationship with all four domains of QOL; physical (r = ‒0.395), psychological (r = ‒0.434), social (r = ‒0.322), and environmental (r = ‒0.401). It indicates that nurse educators with higher online teaching stress have a poor QOL.
|Figure 1: (a-d) Correlation coefficient of online teaching stress with domains of quality of life|
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Results from multivariate linear regression models for the online teaching stress and the four WHOQOL-BREF domain scores are shown in [Table 2]. Only significant factors are displayed. Marital status and monthly salary were the strongest indicators of online teaching stress (P < 0.05). Monthly salary was significantly associated with psychosocial domain (P < 0.05). Teaching experience also appeared to be robust predictors for physical and environmental, while satisfaction with job was the most important indicators for all four domains of QOL except physical (P < 0.05).
|Table 2: Multivariate linear regression models for the four domain scores and online teaching stress scores|
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| Discussion|| |
The present study confirms that online teaching stress affects the nurse educators' QOL. This is a pioneer study in approaching the effect of the online teaching stress on the QOL of nurse educators. While there are no studies assessing stress and QOL due to online teaching among nurse educators for us to compare our findings with, studies on stress and QOL among educators from other disciplines, identifying a similar results in stress and QOL.
During COVID-19 crisis, more stress level is commonly reported. The overall mean (M = 24.93) of stress related to online teaching was obtained in this study was somehow close comparable to the results of those previous studies done among Colombian adults (M = 16.5) and a survey conducted with participants from 25 countries (M = 17.4). The proportion of participants (22%) reported a high level of stress related to online teaching during COVID-19 in this study. The finding is in loop with other studies where a high level of stress was obtained among 30.2% of Saudi Arabian students, 15% of Columbian adults, and 9.6% of Iranian doctors. The difference in results of studies is probably because of the variation in the studies' population and nature of work. Nurse educators are at risk for stress and face multiple stressors due to various work demands such as clinical teaching, community interaction, and research and management activities. Furthermore, the unpredictability and sudden changes in teaching methods without prior training may be probable factors for higher stress level.
Moreover, the results of the present study reported that the higher impact of the online teaching among nurse educators was on their physical domain than the psychological domain. This result is in loop with a study reported the highest impact of the COVID-19 crisis was found on physical health and the least impact on the mental health aspect. According to the authors, it could be assumed that educators had spent more quality time with their families during lockdown and may have developed coping mechanism to deal with stress and tend to concentrate more on their physical health during this pandemic.,
In our study, female nurse educators had poorer QOL and higher online teaching stress than male nurse educators. The finding is congruent with other previous studies,, wherein women reported significantly more stress level than men. This is probably because, in India, female nurse educators are usually expected to take more responsibility in teaching than males. They are allotted more workload and expected to communicate more efficiently with their students. Furthermore, female educators may also have to perform a variety of domestic duties and take care of their family, social and environmental challenges which may result in physical health problems. In addition, biological and hormonal dissimilarities, the difference in the psychological characteristics, the expression of emotions and thoughts regarding sociocultural situation, and gender differences in dealing with stress.,
Teaching experience was negatively associated with stress and QOL. This may be probably due to less experienced educators felt weaker abilities to manage their classes and routine work. In addition, they sensed a lower level of personal accomplishment and difficulties to cooperate with other members. The consequences due to inability to cope with the sudden changes in teaching methods leads to stress and poor QOL. Meanwhile, educators with more experience were able to resolve issues independently and proficient in their work. Experienced educators may feel less stressed because changing working conditions and environment.
In this study, stress and QOL were significantly associated with monthly salary, satisfaction with jobs, and their organization. The results are in line with study reported that QOL and burnout among faculty members are influenced by financial issues, safety of the work environment, their work organization, job satisfaction, and faculty members' satisfaction with their institution.
Our findings corroborate previous studies reporting a negative effect of stress on QOL among healthcare faculty members. The above findings imply the need to arrange counseling and stress management services for nurse educators and make it compulsory for educators with lower QOL. Such intervention can focus on improving teaching strategies and prioritization of educators' need according to changing situation.
This study carries the limitations that it includes convenience sampling technique and collected information was self-reported. In addition, participants were from a single state in India, which may limit the generalizability of the present study to other parts.
However, despite the above limitations, the present study has notable strength. First, to the best of authors' knowledge, this study was novel study to provide unique opportunity to ascertain the index of stress and QOL related to online teaching. In addition, our study used reliable and valid scale to assess QOL and stress levels through self-structured, pilot tested, reliable and valid scale among nurse educators.
Implication and contribution
Sudden changes in teaching method have detrimental effect on the QOL that could in turn increase anxiety, poor concentration, descend adjustment, and feeling of less connected. The results of the study warrant the need to sensitize the nurse educators regarding their anxiety and QOL due to online teaching.
| Conclusion|| |
Study reported that nurse educators had a stress due to online teaching. Also, stress is more in female educators than male educators. Online teaching stress induces worsening QOL for nurse educators while coping resources could promote their QOL and reduce stress. The present study suggests that providing adequate resources in the workplace may be an important factor for enhancing the QOL of nurse educators. Moreover, counseling and educational programs, especially for educators who report a higher level of stress and poor QOL should be provided to deal with stress and improve QOL.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]