Is Satisfaction with Online Learning Related to Depression, Anxiety, and Insomnia Symptoms? A Cross-Sectional Study on Medical Undergraduates in Romania
Abstract
:1. Introduction
Recent Literature
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Context and Procedure
2.4. Instruments
- (1)
- Symptoms of depression were assessed with the patient health questionnaire (PHQ-9). The PHQ-9 is a 9-item self-reported scale that assesses the severity of several depressive symptoms over the past 2 weeks. Each symptom is rated on a Likert-scale ranging from 0 (not at all) to 3 (nearly every day) and then summed to a total score ranging from 0–27. The total score ranges from 0 to 27 and is subdivided into 5 categories: 1 to 4 is minimal, 5 to 9 is mild, 10 to 14 is moderate, 15 to 19 is moderate–severe, and 20 and above is severe. Cronbach’s alpha in this study was 0.83 [39,40,41].
- (2)
- Generalized anxiety disorder-7 (GAD-7) is a 7-item questionnaire asking participants how often they were bothered by each symptom, such as feeling nervous, trouble relaxing, irritable, and afraid that something awful might happen, during the last 2 weeks. The GAD-7 has also been identified as a screener for panic disorder, social phobia, and PTSD (Cronbach α = 0.92) [42,43].
- (3)
- The insomnia severity index (ISI) is a 7-item self-report questionnaire measuring subjective sleep difficulties. Items are rated on a 5-point response scale from 0 to 4 with higher scores corresponding to greater symptom severity, and their sum yields a global score ranging from 0 to 28. The first 3 items measure insomnia severity (difficulties in initiating and maintaining sleep and waking up too early) and the last 4 items assess sleep satisfaction, noticeability of the sleep problem to others, worry about the sleep problem, and sleep problem’s interference with daily functioning. The instrument showed acceptable reliability, convergent validity with other subjective and objective sleep measures, and sensitivity to change after treatment (Cronbach α = 0.90) [44,45].
2.5. Data Analysis
3. Results
3.1. Sociodemographic Data
3.2. Associations between Depression, Anxiety, Insomnia, and Average Number of Hours Studying (Predictors) with Online Learning Satisfaction (Criterion)
3.3. Satisfaction with Online Learning and Average Number of Hours Studying per Week as Predictors of Psychopathological Variables
3.4. Differences in Psychopathology and Satisfaction Depending on Interactivity, Academic Development Factors, and Communication Tools in Online Teaching
3.5. Pleasant Aspects and Barriers Perceived in Online Learning Satisfaction and Their Relationship with Psychopathology
4. Discussion
4.1. Associations between Depression, Anxiety, Insomnia, and Average Number of Hours Studying with Online Learning Satisfaction
4.2. Interactivity
4.3. Pleasant Aspects and Barriers Perceived in Online Learning and Their Relationship with Psychopathology
4.4. Limitations
4.5. Future Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Value |
---|---|
Age | 20.02 (4.04) |
Gender | n (%) |
Male | 113 (28.3%) |
Female | 285 (71.4%) |
Other | 1 (0.3%) |
Language of teaching | n (%) |
Romanian module | 324 (81.2%) |
English module | 75 (18.8%) |
Main variables of interest | M (SD) |
PHQ-9 | 14.68 (7.64) |
GAD-7 | 12.41 (5.74) |
ISI | 12.22 (6.56) |
DREEM | 25.43 (8.18) |
Average hours studying per week | 28.09 (16.1) |
Variables | n | 1 | 2 | 3 | 4 | 5 |
---|---|---|---|---|---|---|
1. DREEM | 399 | — | ||||
2. GAD-7 | 399 | −0295 ** | — | |||
3. PHQ-9 | 399 | −0382 ** | 0.745 ** | — | ||
4. ISI | 399 | −0247 ** | 0.609 ** | 0.711 ** | — | |
5. Average hours per week | 324 | 0.119 * | 0.038 | 0.082 | 0.054 | — |
Variable | B | SE | 95% CI | β | t | p | |
LL | UL | ||||||
GAD-7 | −0.061 | 0.111 | −0.278 | 0.157 | −0.042 | 0.58 | 0.582 |
PHQ-9 | −0.351 | 0.095 | −0.538 | −0.165 | −0.326 | 3.71 | 0.001 ** |
ISI | 0.053 | 0.096 | −0.135 | 0.241 | 0.042 | 0.55 | 0.579 |
Average hours studying per week | 0.072 | 0.026 | 0.021 | 0.123 | 0.145 | 2.76 | 0.006 ** |
Predictor Variables | ϪR2 | R2 | B | SE | 95% CI | β | t | p | |
---|---|---|---|---|---|---|---|---|---|
LL | LL | ||||||||
Step 1 | 0.64 | 0.64 | <0.001 *** | ||||||
GAD-7 | 0.62 | 0.05 | 0.51 | 0.73 | 0.47 | 11.32 | <0.001 *** | ||
ISI | 0.5 | 0.04 | 0.4 | 0.6 | 0.42 | 10.26 | <0.001 *** | ||
Step 2 | 0.01 | 0.65 | 0.001 *** | ||||||
DREEM | −0.11 | 0.03 | −0.18 | −0.05 | −0.12 | −3.71 | <0.001 *** | ||
Average hours studying per week | 0.02 | 0.01 | −0.003 | 0.05 | 0.05 | 1.75 | 0.81 |
“Are These Online Teaching Sessions Interactive?” | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Responses a | Pairwise Comparisons: Sidak Post Hoc Test and Cohen’s d | ||||||||||||||
4 | 3 | 2 | 1 | 4-3 | 4-2 | 4-1 | 3-2 | 3-1 | 2-1 | ||||||
n = 59 | n = 116 | n = 180 | n = 41 | ||||||||||||
M (SD) | M (SD) | M (SD) | M (SD) | M4–M3 | d | M4–M2 | d | M4–M1 | d | M3–M2 | d | M3–M1 | d | M2–M1 | |
GAD-7 | 10.54 (6.09) | 11.88 (5.21) | 12.90 (5.66) | 14.17 (6.2) | −1.34 | −2.36 * | 0.41 | −3.63 * | 0.59 | −1.02 | −2.29 | −1.27 | |||
PHQ-9 | 11.83 (7.81) | 13.87 (6.84) | 15.27 (7.48) | 18.14 (8.54) | −2.05 | −3.45 * | 0.46 | −6.32 * | 0.78 | −1.4 | −4.27 * | 0.58 | −2.87 | ||
ISI | 11 (7.48) | 11.86 (6) | 12.2 (6.29) | 15.07 (7.30) | −0.86 | −1.2 | −4.07 * | 0.55 | −0.34 | −3.21 * | 0.5 | −2.87 | |||
DREEM | 34.11 (7.69) | 27.44 (7.42) | 22.68 (6.13) | 19.92 (7.77) | 6.67 * | 0.89 | 11.43 * | 1.75 | 14.19* | 1.84 | 4.75 * | 0.71 | 7.51 * | 1 | 2.76 |
“Does the Online Learning Replace the Physical One?” | |||||||||
---|---|---|---|---|---|---|---|---|---|
Responses | Pairwise Comparisons: Sidak Post Hoc Test and Cohen’s d | ||||||||
3 | 2 | 1 | 3-2 | 3-1 | 2-1 | ||||
n = 22 | n = 92 | n = 260 | |||||||
M (SD) | M (SD) | M (SD) | M3–M2 | d | M3–M1 | d | M2–M1 | d | |
GAD-7 | 11.5 (6.9) | 11.32 (5.86) | 12.81 (5.64) | 0.17 | −1.32 | −1.48 | |||
PHQ-9 | 13.36 (9.72) | 11.64 (7.31) | 15.72 (7.46) | 1.72 | −2.36 | −4.08 * | 0.55 | ||
ISI | 11.45 (8.85) | 10.56 (5.84) | 12.81 (6.53) | 0.89 | −1.36 | −2.25 * | 0.35 | ||
DREEM | 36.81 (8.81) | 31.13 (7.44) | 22.38 (6.44) | 5.68 * | 0.74 | 14.43 * | 2.17 | 8.74 * | 1.3 |
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Ionescu, C.G.; Chendea, A.; Licu, M. Is Satisfaction with Online Learning Related to Depression, Anxiety, and Insomnia Symptoms? A Cross-Sectional Study on Medical Undergraduates in Romania. Eur. J. Investig. Health Psychol. Educ. 2023, 13, 580-594. https://doi.org/10.3390/ejihpe13030045
Ionescu CG, Chendea A, Licu M. Is Satisfaction with Online Learning Related to Depression, Anxiety, and Insomnia Symptoms? A Cross-Sectional Study on Medical Undergraduates in Romania. European Journal of Investigation in Health, Psychology and Education. 2023; 13(3):580-594. https://doi.org/10.3390/ejihpe13030045
Chicago/Turabian StyleIonescu, Claudiu Gabriel, Anca Chendea, and Monica Licu. 2023. "Is Satisfaction with Online Learning Related to Depression, Anxiety, and Insomnia Symptoms? A Cross-Sectional Study on Medical Undergraduates in Romania" European Journal of Investigation in Health, Psychology and Education 13, no. 3: 580-594. https://doi.org/10.3390/ejihpe13030045