Association between Online Learning Predictors and Psychological Distress among Nursing Students during the COVID-19 Pandemic

ABSTRACT

BACKGROUND: The global coronavirus disease-2019 pandemic has forced nursing schools in Indonesia to implement online learning. The association between online learning variables and psychological distress among nursing students is not fully understood. AIM: This study aimed to assess psychological distress among nursing students and the association between online learning variables and psychological distress. MATERIALS AND METHODS: A cross-sectional study was conducted from November 2020 to February 2021. Six hundred and thirty-five nursing students from four universities in Indonesia participated in this study and were recruited through a consecutive sampling method. The measurement of psychological distress used the 10-item Kessler Psychological Distress Scale. Ordinal logistic regression was used to analyze the association between online learning predictors and psychological distress. RESULTS: Most of the respondents had severe psychological distress (n = 194;30.6%). Older age was found to act as a protective factor against psychological distress (adjusted odds ratio [aOR] = –0.159, p = 0.035;95% confidence interval [CI] (–0.307)–(–0.011)). Contrarily, not living at their own home during lockdown (aOR = 1.019, p = 0.001;95% CI 0.657–1.382), always feeling that online learning is expensive (aOR = 1.387, p = 0.001;95% CI 0.645–2.130), always experienced poor Internet connection during online learning (aOR = 3.380, p = 0.001;95% CI 1.935–4.826), and having no motivation toward online learning (aOR = 3.154, p = 0.001;95% CI 2.372–3.936) acted as risk factors for having psychological distress. CONCLUSION: Cost and Internet access barriers as well as low motivation during the abrupt shift to implementation of online learning in the current pandemic situation acted as risk factors for psychological distress among nursing students.