The Impact of COVID-19 Stress, Interpersonal Relations, and Information Literacy on the Adaptation of Nursing Students to College Life

Article information

J Korean Acad Psychiatr Ment Health Nurs. 2024;33(1):9-17

Publication date (electronic) : 2024 March 31

doi : https://doi.org/10.12934/jkpmhn.2024.33.1.9

Miran Jung¹, So Youn Yim², Young Mi Ryu^,3

¹Assistant Professor, Department of Nursing, Baekseok University, Cheonan, Korea

²Professor, Department of Nursing, Baekseok University, Cheonan, Korea

³Associate Professor, Department of Nursing, Baekseok University, Cheonan, Korea

Corresponding author: Ryu, Young Mi Department of Nursing, Baekseok University, 1 Baekseokdaehak-ro, Dongnam-gu, Cheonan 31065, Korea. Tel: +82-41-550-2458, Fax: +82-41-550-2458, E-mail: youngmiryu@bu.ac.kr

Received 2023 November 13; Revised 2024 January 17; Accepted 2024 March 13.

Abstract

INTRODUCTION

College life is a critical stage in the transition to adulthood, with an emphasis on developing self-identity, psychological independence, and adapting to various social changes [1]. In March 2020, after declaring a pandemic resulting from the spread of COVID-19, the World Health Organization recommended social distancing as a measure to minimize spreading of the infection [2]. The COVID-19 pandemic caused a rapid and involuntary shift in the field of education to a digital paradigm, with non-face-to-face classes beginning in the first semester of 2020. The academic progress and aspirations of many students have been seriously affected by the pandemic, which has also impacted their psychological well-being [3]. A meta-analysis of psychological well-being of undergraduate students during the pandemic revealed 29.1% for anxiety symptoms and 23.2% for depression symptoms, suggesting that the pandemic had a significant effect on the students' psychological well-being [4]. Students exposed to the new experience of online learning experienced confusion and chaos. Abrupt remote online learning was stressful and nursing students reported significant psychological burdens including helplessness, burdens, and burnout [5]. The pandemic has made adjusting to college life more difficult for nursing students. Adaptation to college life is an important factor for nursing students in development of a positive attitude and the skills necessary for practice in a clinical setting [6].

Nursing students' adaptation to college life was negatively impacted by the COVID-19 pandemic [6]. The stress on clinical practice for nursing students was greater than usual due to a limited clinical practice and fear of infection with COVID-19[7]. Stress was a significant concern in regard to online learning of nursing students during the pandemic [8]. Therefore, assessing the status of nursing students' stress related to COVID-19 pandemic is important.

Interpersonal relations are essential for nursing students to provide high-quality care to patients in clinical settings [9]. Interpersonal relations showed a positive correlation with adaptation to college life and were a significant predicting factor affecting adaptation to college life for nursing students during the COVID-19 condition [10] as well as before the pandemic [11,12]. However, students’ interpersonal relations were limited and encumbered by policies requiring social distancing during the COVID-19 pandemic. Therefore, additional studies should be conducted to examine the way interpersonal relations have influenced college life adaptation of nursing students during the pandemic.

As a consequence of the COVID-19 pandemic, college students have been required to improve their information literacy skills, which contributed to the success of students in the academic world [13]. Information literacy is defined as the capacity for recognizing and acquiring the information required for problem solving or decision making, and for analysis and utilization of the acquired information [14]. The latest information can change rapidly, thus learning the use of digital information is becoming a necessity rather than an option, unlike learning through books in the past. In addition, because clinical practice was replaced online due to the COVID-19 pandemic, nursing students reported having difficulty in utilizing more diverse online content [15]. The burden of assignments on students has increased to ensure fairness in grade evaluation. The importance of information literacy has increased as acquisition of information using online media has increased for working on assignments [16]. Therefore, cultivating information literacy is becoming more important.

According to previously reported studies, factors influencing adaptation to college life of nursing students include major selection motivation [6], self-efficacy [6], academic stress [10], interpersonal relations [11-13], nursing professionalism [17], major satisfaction [17], emotional awareness [18], social network service (SNS) addiction tendency [11], resilience [12], and perceived health [19]. However, it was difficult to find a study that examined the effect of information literacy on adaptation to college life in nursing students. With the increasing popularity of online learning, information literacy has become an important aspect of college life [16]. Therefore, the question regarding whether information literacy of nursing students can affect their adaptation to college life should be examined. In addition, non-face-to-face classes became the norm as the COVID-19 pandemic continued, affecting nursing students of all grades. This rapid change in the educational environment has resulted in substantial stress for nursing students, as well as numerous challenges with interpersonal relations. As a result, studies to determine the factors impacting adaptation to college life for nursing students of all grades is required. Therefore, this study was conducted as an attempt to determine the influence of COVID-19 stress, interpersonal relations, and information literacy on college life adaptation for nursing students of all grades.

METHODS

RESULTS

1. General Characteristics of the Participants

The mean age of the participants was 24.51 years old, and the majority, 84.7% (n=105), were female. Second-year students represented the highest percentage at 32.3% (n=40), and 49.2%(n=61) of students were without religion. The reason that most students chose a nursing major was their aptitude (49.2%, n=61). Approximately 31% (n=38) of students exercised 3~4 days a week, and 55.6% (n=69) responded that their daily life was normal. Approximately 53% (n=66) of participants responded that their required quantity of sleep was not satisfied, and 44.4% (n=55) expressed dissatisfaction with quality of sleep, and 56.5% (n=70) responded that their diagnostic self evaluation was good (Table 1).

Table 1.

The Difference of College Life Adaptation according to Characteristic of the Participants (N=124)

2. The Degree of COVID-19 Stress, Interpersonal Relations, Information Literacy, and College Life Adaptation

The mean for COVID-19 stress was 2.05±0.81. The mean score for interpersonal relations was 3.96±0.61 and the mean score for information literacy was 3.97±0.54. The mean score for college life adaptation was 3.32±0.58 (Table 2).

Table 2.

The Level of COVID-19 Stress, Interpersonal Relations, Information Literacy, and College Life Adaptation (N=124)

4. Correlation between COVID-19 stress, Interpersonal Relations, Information Literacy, and College Life Adaptation

College life adaptation showed a significant negative correlation with COVID-19 stress (r=-.18, p=.043), and a positive correlation with interpersonal relations (r=.48, p<.001) and information literacy (r=.26, p=.003) (Table 3).

Table 3.

Correlations among COVID-19 Stress, Interpersonal Relations, Information Literacy, College Life Adaptation (N=124)

5. Factors affecting College Life Adaptation for Nursing Students

The number of exercise days per week, regular daily life, quantity of sleep, quality of sleep, and diagnostic self evaluation, which showed significant differences in adaptation to college life, were treated as dummy variables for identification of factors that affect adaptation to college life for nursing students. These dummy variables were input as independent variables for performance of a stepwise multiple regression analysis. The correlation coefficient between variables was less than .7, the tolerance limit of all variables was more than 0.1, and the Variance Inflation Factor was 1.03~1.43, less than 10, indicating that multicollinearity between independent variables was not an issue. The Durbin-Watson statistic was 2.03, a value close to 2, confirming that there was no autocorrelation and that the regression model was appropriate. Factors affecting college life adaptation include interpersonal relations (β=.38, p<.001), good diagnostic self evaluation (β=.41, p<.001), and fair diagnostic self evaluation (β=.28, p=.005), COVID-19 stress (β=-.16, p=.027). The regression model had statistical significance (F=16.30, p<.001) and an explanatory power of 38.0%(Adj. R²=.38) (Table 4).

Table 4.

Factors Affecting College Life Adaptation (N=124)

DISCUSSION

The long-term impact of the COVID-19 pandemic poses a significant challenge, potentially leading to significant changes in adaptation to college life [6]. The purpose of this study is to determine the factors affecting college life adaptation for nursing students during the COVID-19 pandemic. According to the findings of the study, COVID-19 stress, interpersonal relations, and diagnostic self evaluation are the main factors influencing adaptation to college life for nursing students in the COVID-19 pandemic.

In this study, the level of college life adaptation for nursing students was 3.32±0.58, slightly lower than the pre-COVID-19 college life adaptation level for nursing students reported by Choi [17], which was 3.34±0.63. This difference could be attributed to the impact of the COVID-19 pandemic. The pandemic has indeed been a cause of significant changes in the lives of university students, including barriers to attending in-person classes, restrictions on campus activities such as club involvement, the transition to online learning, etc. [25]. In particular, due to the numerous changes in the practical training curriculum, the COVID-19 pandemic caused further weakening of college life adaptation for nursing students. Jokar and colleagues reported on the potential for severe impairment of nursing practice skill competencies due to the challenges of adapting to online clinical training and conflicts associated with a reluctance to engage in clinical practice, supporting the potential for encountering such challenges in the future [26]. However, it should be noted that An and Lee [6] reported higher levels, 3.68±0.52, for adaptation to college life of nursing students during the COVID-19 pandemic. These differences could be related to support and contextual characteristics of the university, including how rapidly the university responded to educational changes resulting from the COVID-19 pandemic. When transitioning to non-face-to-face activities due to restrictions established as a result of the COVID-19 pandemic, maximizing educational efficiency and development of content for incorporation into active educational activities should be a priority. This study targeted nursing students at one university, therefore, conduct of comparative studies including students from various universities will be required.

The results of this study indicated that COVID-19 stress had a statistically negative impact on college life adaptation for nursing students. This finding was consistent with a previously reported study [6]. For nursing students who plan on working in a clinical practice setting, a situation involving a pandemic can become a reason for fear that extends beyond a significant stress factor and could pose a threat to their well-being [27]. Nursing programs have been regarded as high-stress due to their rigorous curriculum, intense competition, and clinical practice [18]. In a study reported by Thomas [27], who confirmed that the stress levels were significantly higher for nursing students in the COVID-19 pandemic compared with students in other majors, emphasized the importance of a sense of belonging for students' adaptation to college. Therefore, incorporation of a comprehensive program for stress management for nursing students, including preparation for national crises, as an essential component of the educational curriculum is recommended. This type of program should be included as a part of the college life adaptation program for nursing students. Design of a program to enhance emotional adaptation and promote stronger attachment to the college or department, with the aim of facilitating more effective adaptation to college life is recommended. Stress-related factors that may affect students from the time they are freshmen, and for tracking and management of the factors over time should be determined. In particular, management under a step-by-step professional counseling system for management of students’ mental health will be important.

This study’s findings also showed a positive relationship between interpersonal relations and college life adaptation of students in nursing in the COVID-19 pandemic and interpersonal relation was a factor affecting college life adaptation. This is in line with those described in the existing literature highlighting the significant influence of interpersonal relations on adaptation to college [11,12]. Therefore, establishing programs with the goal of enhancing interpersonal relations for nursing students to improve their ability to adapt to college life is important. The COVID-19 pandemic has imposed restrictions on in-person activities, resulting in various attempts to establish non-face-to-face programs with the goal of enhancing interpersonal relations. Non-face-to-face university activities, including programs that utilize social media platforms such as Instagram and other diverse programs [28,29], can have a positive impact in the effort to strengthen interpersonal relations among nursing students. In the setting of the COVID-19 pandemic, because many students have become accustomed to non-face-to-face learning and activities, the tendency to prefer non-face-to-face activities has also increased because interpersonal relations can be maintained regardless of physical distance [29]. As individual attitudes and thoughts regarding interpersonal relations can vary, there is a critical need for immediate establishment of tailored programs for enhancement of interpersonal relations. Development of programs with the goal of enhancing interpersonal relations is important in the effort to achieve this objective.

In addition, in the COVID-19 pandemic, a higher degree of college life adaptation was observed for nursing students who reported their diagnostic self evaluation as good or fair. Diagnostic self evaluation was a significant factor influencing college life adaptation. This finding is similar to the results of a study conducted by Chau and Saravis [19], who reported a positive correlation between college students' perceived health status and adaptation to college life. However, the study reported by Chau and Saravis [19] was not conducted during the COVID-19 pandemic. Considering that there are heightened concerns and anxiety regarding the health of an individual as a result of the COVID-19 pademic, consistent health management for nursing students is of utmost importance. Above all, monitoring and management of the physical and mental health of college students is essential. Thus, continuous health counseling should be available through various channels to provide support in students’ adjustment to college life. These efforts should be very helpful to students in their effort to adapt to college life.

Regarding the main variables in this study, information literacy was not considered a primary factor influencing college life adaptation. However, information literacy is regarded as a key factor for student success and an essential component of continuous learning, as emphasized by Petermanec and Sebjan [30]. In an era where generation of a massive amount of knowledge and information is a daily occurrence, information literacy is essential not only for adaptation to college life but also for adaptation to future society. Therefore, incorporating curricular and extracurricular programs designed to enhance these skills within the educational curriculum is essential. However, in this era college students have accumulated experience in using information from a young age, so that adapting to non-face-to-face online learning during the COVID-19 pandemic may not be difficult, which may be a reason why nursing students’ information literacy was not a decisive factor in their adaptation to college life. Therefore, in the conduct of future research, various types of studies on the impact of nursing students’ information literacy on college adaptation life will be required.

This study has several limitations. First, it was administered as a single survey to nursing students during the COVID-19 pandemic, thus, making a comparison with the pre-COVID-19 condition was challenging. Therefore, continuous monitoring of these factors may be required in the future. In addition, this study included participants at a single university, thus generalizing the results may be challenging. Therefore, future studies should include nursing students from various universities located in different regions in order to enhance the validity of the findings. The college life adaptation scale developed for general college students was used in this study. Use of a tool for measuring nursing students’ adaptation to college life would have been more appropriate.

CONCLUSION

According to the findings of this study, the key factors influencing the college life of nursing students under the conditions resulting from the COVID-19 pandemic include COVID-19 stress, interpersonal relations, and diagnostic self evaluation. Therefore, in preparation for a situation involving a national disaster such as the COVID-19 pandemic, inclusion of stress management, enhancement of interpersonal relations, and management of physical and mental health is critical when planning programs to enhance the college life adaptation of nursing students.

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