A Study on Mental Health Issues in Nursing Students During E-Learning

This research paper, titled "MENTAL HEALTH ISSUES ON E-LEARNING AMONG NURSING STUDENT AT TARLAC STATE UNIVERSITY AMIDST PANDEMIC: A STUDY," examines the impact of the COVID-19 pandemic and the shift to e-learning on the mental health of nursing students at Tarlac State University. The study investigates the prevalence of stress, anxiety, sleep difficulties, depression, and suicidal ideation among students. It explores the effects of these mental health issues on students' knowledge acquisition, skill demonstration, and attitudes towards learning. Furthermore, the research aims to identify the coping mechanisms employed by nursing students to manage their mental health challenges during e-learning and proposes potential interventions to improve their well-being. The paper also provides definitions of key terms such as COVID-19, e-learning, stress, anxiety, depression, and mental health, and highlights the significance of the study for nursing students, faculty, parents, and future researchers. The study aims to understand the unique challenges faced by nursing students in the context of online learning and offer insights to support their mental health and academic success during the pandemic.

“MENTAL HEALTH ISSUES ON E-LEARNING AMONG NURSING STUDENT AT
TARLAC STATE UNIVERSITY AMIDST PANDEMIC: A STUDY”
A Research Paper Presented to
The Faculty of Nursing
Tarlac State University
Tarlac City
In Partial Fulfillment
of the Requirements in
Nursing Research 1 for
Degree Bachelor of Science in Nursing
Submitted to:
Prof. Jerelyn Victoriano
Submitted By:
Baligod, Bernadette
Dela Cruz, Erica
De Lazo, Patricia Lae R.
Lalu, Angelica
Mallari, Kristenz L.
Sunga, Keithlyn Nicole C.
Ursua ,Jana Nicole T.

TABLE OF CONTENTS

CHAPTER 1
THE PROBLEM AND ITS BACKGROUND
INTRODUCTION
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered
coronavirus. the coronavirus was discovered for the first time in Wuhan, China. According to
WHO, coronavirus has caused 232,075,351 confirmed cases and 4,752,988 million deaths
globally In September 2021, including 2,490,858 confirmed cases and 37,405 deaths in the
Philippines as of September 28, 2019. The heartbreaking milestone of million deaths has been
reached, and the human family is bearing an almost intolerable burden of loss (UNDP
Administrator Achim Steiner).
In addition, United Nations Educational, Scientific and Cultural Organization (2016) also
announced that the closing of higher education institutions is being implemented by about 61
countries. This includes Africa, Asia, Europe, America, the Middle East, and Higher education in
the Philippines was also affected by the COVID-19 pandemic. Universities are shifting to remote
education from conventional face-to-face education. According to Commission on higher
education, the COVID-19 pandemic has caused the largest disruption in education in history,
affecting learners and teachers worldwide.
However, at this time of pandemic, online classes are the only route that education has
offered, thus, students have no other choice but to either drop or go on with their studies. The

COVID 19 has made changes globally that resulted in shutting down schools across the world.
As a result, education has to be changed drastically for flexible learning, with the rise of E-
Learning. The E-learning system based on formalized teaching through the electronic devices
such as computers, tablets and phones that are connected to the internet. Due to the pandemic,
students have gone through a roller coaster from attending physical classes every morning to
studying online, the rapid transitions of Covid-19 pandemic have impacted students and lecturers
in higher education institutions critically. Teachers and students around the world have faced
many challenges using online platforms for teaching and learning the effects of this pandemic are
unpredictable and it gives impact to the education system; most of the countries had to adapt
with the new teaching and learning method. (Shahzad et al. (2020)
Furthermore, the mental health-related factors have not been explored in regard to their
influence on distance e-learning. In fact, various researchers are warning of the negative effects
of COVID-19 on mental health around the globe, such as stress; anxiety; depression or post-
traumatic stress disorder, which may result from long confinement; uncertainty; fear of
infection; moral distress; loneliness; grief; and economic crisis (Galea et al., 2020, Kaur et al.,
2020, Peteet, 2020, Torales et al., 2020).
According to (The Top Mental Health Challenges Facing Students) Mood disturbances
represent only some of the prevalent mental health issues experienced by college students.
Others include serious problems like suicide, eating disorders, and addiction. Mental health
professionals stress the importance of talking about such issues, but students tend to consider
these stresses a normal part of college life. In other cases, they may lack the time, energy, will,
and/or money to seek the support they need. This guide contains information to help students
identify potential mental health issues.

According to Kaup et al. (2020), poor mental well-being may affect students’
engagement and performance of distance e-learning during the pandemic; specifically, the
students may feel a lack of support from peers and resources as well as a sense of isolation and,
further, may experience anxiety or depression issues related to the public crisis. In particular, a
feeling of isolation has been determined to be one of the challenges of distance e-learning even
under more normal circumstances but these feelings of isolation may be exacerbated during the
pandemic, especially in students who are confined to or quarantined in their homes. Therefore,
in this study, focused on nursing students’ social-evaluative anxiety related to COVID-19 and its
influence on their learning mechanisms during distance e-learning.
According to Chung et al. (2020a), These sorts of rapid changes could somehow affect
their mental health or well-being. although it is undeniable that online learning is considered the
best solution to ensure consistency of learning in the era of the “new norm”, there may be
certain setbacks such as loss of human presence, detecting the incomprehension of students by
facial gestures, cracking small jokes to light up the mood, student participation and
communication that can be achieved more effectively in class
This pandemic does not only mentally affect adults but also students. they pointed out
the psychological effect of the public health crisis is long lasting. The worries about pandemic
usually will dissolve after a period of time. However, the impact of normalizing new things and
it might affect students’ academic achievement as well. Kamaludin et al. (2020) stated that fear
and the risk to the health of a person can gradually dissipate as the pandemic reaches its tail end.
Nevertheless, the idea of the disease itself and the desire to switch to a “new normal” will have a
long-term psychological effect on the students. In exchange, this can influence the academic
performance of the students.( Chang et al. (2020a)
Patsali et al. (2020) said, due to the impact of Covid-19 on their performance, abnormal
stress and depression among students are also associated with increased self-injury and suicide
attempts. The decision taken by most governments around the world to prevent the massive
spread and deaths has given a psychological effect on the public. Irfan et al. (2020) said the fear
of death due to COVID-19 causes the government to take initiatives to monitor the transmission
of the virus which has impacted people and students’ mental health.

Despite this, the researcher decided to conduct this study in order to determine the
Mental health issues on e-learning among nursing student at Tarlac State University amidst
pandemic especially that it is the first time that online classes have been conducted nationwide
as precautionary measures taken to contain the COVID-19 disease. The purpose of this study is
to answer whether there are various academic and environmental problems among college
students especially now that we are currently facing a pandemic.
STATEMENT OF THE PROBLEM
This study aimed to know the Mental Health Issues on e-learning among Nursing student
at Tarlac State University amidst the Covid 19 pandemic.
1. How are the Mental Health Issues that the Nursing students of Tarlac State University
experiences during e-learning amidst the Covid 19 pandemic can be describe based on the
following:
1.1 Stress
1.2 Anxiety
1.3 Sleep difficulties
1.4 Depression
1.5 Suicide
2. What is the impact of the mental health issues of the Nursing students in terms of following:

2.1 knowledge
2.2 skills demonstration
2.3 attitude
3. How do the nursing students of tsu address and cope up with their mental health issues on e-
learning during Covid-19 pandemic?
4. What interventions could be proposed to improve the coping mechanism of the Nursing
Students in terms of their mental health during e-learning amidst of Covid 19 pandemic?
DEFINITION OF TERMS
The terms used, defined from operational point of view of the researchers, to help the readers
comprehend the study efficiently.
COVID-19, the disease caused by the new coronavirus that emerged in China in December
2019. (WHO 2020). In this study, covid-19 is defined as an infectious disease caused by a newly
discovered coronavirus.
Infectious disease, remain a leading cause of morbidity, disability, and mortality. The lower
respiratory infections are third leading causes of death worldwide. (WHO 2008) In this study,
infectious disease is defined as disorder caused by pathogenic microorganisms, such as bacteria,
viruses, para sites or fungi that can be spread directly or indirectly form one individual to
another.

Pandemic, the worldwide spread of a new disease. (WHO, 2010) . In this study pandemic refer
as the current event when this study is being conducted.
Remote education, across the country, schools have rapidly transitioned to providing remote
services in response to the COVID-19 crisis. (EdReports 2020). In this study Remote education,
the “new normal” is not normal. Nursing student are trying to adjust to the disruption in the
education landscape caused by the COVID-19 pandemic.
E-learning, a term to describe an emerging approach to learn at students ‘own premise through
advanced information communication technologies either asynchronous or synchronously.
(Dabbagh and Bannan-Ritland, 2005). In this study, E-learning is learning utilizing electronic
technologies to access educational curriculum outside of a traditional classroom.
Stress, can be defined as any type of change that causes physical, emotional or physical strain.
Stress is your body’s response to anything that requires attention or action. (Scott, 2020). In this
study, suicide is one of the emotional responses that are experienced during pandemic.
Anxiety, may become symptomatic at any age when it prevents or limits developmentally
appropriate adaptive behavior (Klein & Pine, 2001). In this study was carried out to determine
the relationship between the anxiety levels and the coping methods of nursing students during the
COVID-19 pandemic.
Depression, a mood disorder that causes a persistent feeling of sadness and loss of interest.
(WHO 2016). In this study, depression is one of the emotional responses that are experienced
during pandemic.

Suicide, death caused by oneself with the intent to die. Suicide ideation is pervasive thinking of
committing suicide. Suicide attempt is the unsuccessful act of committing suicide. (WHO, 2019).
In this study, suicide is one of the emotional responses that are experienced during pandemic.
Mental Health, is a state of well-being in which an individual can realize his or her own
potential, cope with the normal stresses of life, work productively and make a contribution to the
community. (WHO 2001)
Grief, is a strong, sometimes overwhelming emotion for people, regardless of whether their
sadness stems from the loss of a loved one or from a terminal diagnosis they or someone they
love have received. (MFMER 2016). In this study, grief typically follows a wave-like pattern,
which tends to ease over time as people adapt to their changed circumstances and regain a sense
of control in their lives.
Deleterious effects, harmful often in a subtle or unexpected way deleterious effects deleterious
to health. (M.W 2021). In this study deleterious outcomes have been associated with high levels
of stress among nursing students
SIGNIFICANCE OF THE STUDY
This study aimed to assess the Mental health issues on e-learning among Nursing Students at Tarlac
State University amidst Covid 19 Pandemic. The results of the study will be of great benefit to the
following:
 Nursing Students, This research will be able to give implications for a better learning for
students during online classes.
 Faculty, This research would provide them specific knowledge with regards to the effect of
online learning to the students.
 Parents, This research will benefit the parents to understand the situations of their children in
online class during this pandemic and the result might help their children in academic aspect.

 Future Researchers, This research may be a basis for new theories in learning, it will serve as a
reference for their future research connected to its effect in mental health status of online
learning.