Impact of COVID-19 pandemic on mental and physical health of students (schools and colleges) and teachers

INTRODUCTION

Mental health issues are the leading impediment to academic success. Mental illness can affect student’s motivation, concentration, and social interactions-crucial factors for students to succeed in higher education.¹ During the COVID-19 pandemic, a decrease in well-being and an increase in mental health problems were noticed.² Younger people and women were particularly affected by the isolation strategies adopted to contain the pandemic and also lead to development of psychological distress, loneliness, anxiety, depression, panic states.^3,4 Due to lockdown all the schools, colleges, universities were closed. Due to closure of schools and colleges, teaching was shifted from face to face student teacher interaction to online classes.⁵ India has the world’s second largest school system, after China. According to UNESCO, 63 million teachers were affected in 165 countries. A total of 1.3 billion learners around the world were not able to attend schools or universities, and approximately 320 million learners were affected in India alone.⁶ Since the Indian education system was dominated by classroom study only, the present scenario had made the functioning of the educational institutions very difficult. Class room teaching was shifted abruptly to online classes.⁶ For attending online classes basic requirements were availability of smart phone, uninterrupted internet connection and continuous electricity supply.⁷ According to the key indicators of household social consumption on education in India report, based on the 2017-18 NSSO, fewer than 15% of rural Indian households have smart phones and internet access (as opposed to 42% urban Indian households).

In a recent survey (2017-18), the ministry of rural development found that only 47% of Indian households receive more than 12 hours of electricity and more than 36% of schools in India operate without electricity. This suggests that while students from families with better means of living can easily bridge the transition to remote learning, but students from underprivileged backgrounds were likely to accede to inefficiency and a lack of adaptation, either because of the inaccessibility of the technology or the low education of their parents to guide them through tech-savvy applications. Non-availability of technical infrastructure and irregular interrupted internet connectivity all across India was the biggest challenge in front of the students and teachers.⁸

Aims and objectives

The objectives of the present study were; to assess the occurrence of core symptoms of depression (frustration), anxiety (sleep disturbances) and stress (change in behavior) in students (college and school) and their teachers from north India (Punjab) during the lock-down period of covid pandemic and to estimate the impact of time spent on their mobile screen/TV screen with negative emotions and to analyze the association of various negative emotional states with other factors.

METHODS

The present study is an online survey. An E-Performa was created at Google as a Google form. It was in the form of a semi structured questionnaire which included questions about demography, the time spent on screen, and mass media during the period of lock-down. Questions regarding changes in behaviour, personality and sleep pattern were asked. Any weight loss/gain due to faulty food habits during lockdown. Negative emotional states arising from COVID-19 virus infection in family/friends/neighborhood and death from covid virus infection in family/friends/neighborhood were widely used in epidemiological studies. Auto translation of the questionnaire was done in Hindi and Punjabi to circulate amongst rural students to avoid any understanding difficulties in them. Questionnaire was same for the teachers and students to avoid any discrepancy in responses.

Although no structured depression, anxiety, stress scale was used but the questions regarding core symptoms of depression, stress and anxiety were included. As sleep disturbance is the core symptom arising from depression, anxiety and stress. Question regarding sleep disturbances and use of medication for sleep induction is included. Similarly in depression there is lack of interest and concentration/ inattention, frustration and heated arguments with parents/frequent fights in siblings are the core symptoms. In anxiety there is phobias, scared feeling, excessive sweating, disturbed eating habits, weight gain/loss. Head teacher/principal of respective schools (one from rural area and one from urban area of Punjab) and one college were explained about the aims and objectives of the study telephonically. Telephonically permission was sought to share this Google form with students along with their homework. All the students were directed by their teachers to fill this form and submit. Teachers were also requested to fill the Performa by themselves and submit.

The study period was April 2021 to May 2021 (2^nd wave of covid pandemic). All the responses were collected and an Excel sheet was prepared. Data analysis was done using SPSS Statistical software. Data was presented as frequency tables and the associations of the negative emotional states with other factors were assessed using chi squared test. A p<0.05 was considered statistically significant. The survey was conducted adhering to the ethical principles for medical research involving human subjects of WMA Declaration of Helsinki, 2013.

RESULTS

In present study a total of 483 responses were received. Out of this 381 (78.8%) were schools students, 69 (14.2%) college students and 33 (6.8%) were teachers. Females 368 (76.1) participation was more than males. Students from urban and rural areas responded almost equally (Table 1).

Majority 246 (54.7%) of students and teachers (60.6%) had covid virus infected persons either in family /friends or neighborhood and they were scared of the disease whenever they hear such news. Death from covid virus infection was reported in 122 (27.1%) students’ and Teachers’ (45.5%) family/friends/neighborhood which further stressed them and it was statistically significant. Because of lockdown, all schools and colleges were closed.

Class room teaching was shifted to online classes. 233 (51.8%) school students, 71% college students and 90.9% teachers did not like teaching through online teaching methods. Sleep pattern was disturbed in 246 (54.6%) students, 57.6% teachers and 105 (39.7%) students and 21.2% teachers had to take medicine for sleep induction. Sleep disturbances and use of medicine for sleep induction was more in college students 49 (71.1%). This was statistically significant (Table 4).

Due to lockdown, participants had no meeting with friends and no outings. 92.7% school students and 95.7% college students were missing their school/college friends. Because of lack of emotional support from peer groups, 73% students and 54.8% teachers were feeling frustrated and had heated arguments with children/parents /frequent fights with siblings. This was statistically significant.

Due to decreased movement out of the house, screen time was reported to be increased. Screen time of 6-10 hours was responded by 43.3% (students) and 42.4% (teachers) but 54.2% of students and 51.4% teachers were doing yoga/exercise regularly to keep them fit. This was statistically significant (Table5).

Negative emotional states like change in behavior, disturbed sleep pattern and arguments with parents were significantly associated with other factors like age of students, screen time, COVID infection and death in family/friends/neighborhood (Table 6).

DISCUSSION

COVID-19 virus infection was perceived worldwide as a major threat to health and a danger to the global economy. It affected people's lives with feelings of panic, anxiety, stress and depression. In the present study the vulnerable population is students from schools, colleges and their teachers. Female responded more than males (76.9%). but in contrast to our study Jiao et al reported that age group of study participants were 6-18 years, male/female participation was equal. But Ravichandran et al reported that males responded more than females (64.7%/32.3%), all the participants were between 17-25 years of age group. Because of the lack of emotional support from peer groups, most of the students were feeling frustrated and had heated arguments with parents/family members were reported amongst students and teachers (73% and 54.8%) also.

This was statistically significant. But as against the positive aspects of lock-down spending more time with family mentioned by Saha and Dutta, in a study by Ravichandran 20.9% said that in this lock-down, quarrels and fights within family had increased and 46.1% said it was same as before.^12,14,18 This could be because the psychological distress doesn't find any other exit, but their own family members only. In present study 64,7% students and 72.9% teachers had change in behavior in lockdown period. Though schools were closed, students were attending their classes through various education initiatives like online classrooms, radio programs. Though it is a good thing happening on the other side, but there are lots of students who didn’t own the resources to attend the online classes and suffer a lot.

Many students are struggling to obtain the gadgets required for online classes.¹⁶ Educated parents are supporting their children throughout the pandemic, but we require understanding that there are some illiterate parents and their feeling of helplessness to help their children in their education.¹⁷ This was the main cause of anxiety, stress and depression in students. Similar was the case of teachers. In our study 51.8% students and 90.2% teachers do not like teaching through online classes. Sleep, as a very important health-related factor, has been found to play a role in the development of many diseases.^17-18 As for the role of night sleep duration in incidence of depression, a recent meta-analysis of prospective studies concluded that excessively short or long sleep duration was associated with incidence of depression in adult. Ravichandran reported that 402 (55.3%) slept more in the day and this was found to be significantly associated with anxiety and stress, 68.4% students said that their sleep duration is increased and but this was not associated with the negative emotional states.¹² Disturbed sleep pattern (n=258) was associated with depression and stress, consistent with the study by Zhang et al. Also, as in the study by Yujie decreased night time sleep was associated with depressive symptoms.^20,21 In our study sleep pattern was disturbed in 64.9% students and 57.6% teachers. Out of this 42.9% students and 21.2% teachers were taking medicine for sleep induction. It had statistically significant association with age, COVID infection in, death from covid infection in family/friends/neighborhood and screen time of 6-10 hours.

Anxiety, stress and depression also presents with changes in behavior and personality.²² Students were feeling frustrated, had frequent fights with siblings and had heated arguments with parents also. In present study 64.9% students had changes in behavior and personality, 73.8% were feeling frustrated but only 24.4% of students had heated arguments with parents. This was significantly associated with COVID infection, death in family/friends /neighborhood, stress of online classes, increased screen time. Sood.¹⁶ Depression and stress were more common in those who reported that the time they spend with their family makes them sad and irritated and those who said that the time they spend with their friends is now reduced.

There is a general belief that physical activity and exercise have positive effects on mood and anxiety and a great number of studies describe an association of physical activity and general well-being, mood and anxiety.²³ Instead of lockdown 54.9% students responded to had been doing yoga/exercise regularly, female students (56.4%) responded more than males. This was statistically significant. With such measures this period could be made productive and happy instead of getting mentally affected by the situations around. For those, who are feeling affected, psychologically interventions must be carried out quickly.

Limitations

Since this study was conducted in limited number and that too amongst students mainly, who are considered to be the happier lots, results could not be generalized for opinion making.

CONCLUSION

Everyone around the Globe was distressed and scared of deadly covid virus. But students and their teachers were more effected mentally and some physically also. Measures to deal with such psychological distresses should be encouraged in schools and colleges. Teachers as well as students should be trained to deal with such type of situations.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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