123 PSOCIAL 2422-619X Universidad de Buenos Aires Argentina psocial@sociales.uba.ar 1232267009 Sin sección Emotional Exhaustion and Mental Health in a Sample of Chilean Social Science Students During the COVID-19 Pandemic https://orcid.org/0000-0003-0774-2691 Martínez-Líbano Jonathan jonathan.martinez@zonavirtual.uisek.cl https://orcid.org/0000-0003-2138-3007 Yeomans María Mercedes maria.yeomans@edu.udla.cl https://orcid.org/0000-0003-3521-1150 González Campusano Nicol nicol.gonzalez.campusano@edu.udla.cl https://orcid.org/0000-0002-0489-2275 Campos Flores Eduardo eduardo.campos@edu.udla.cl Carrera de Psicología, Universidad SEK Carrera de Psicología, Universidad SEK Chile Facultad de Educación, Universidad de Las Américas, Chile/Universidad Internacional Iberoamericana, México Facultad de Educación, Universidad de Las Américas, Chile/Universidad Internacional Iberoamericana, México Chile Escuela de Psicología, Universidad de las América Escuela de Psicología, Universidad de las Américas Chile Escuela de Psicología, Universidad de las Américas Escuela de Psicología, Universidad de las Américas Chile July-December 2021 7 2 18 09 2021 09 12 2021 Abstract

Emotional exhaustion and mental health in university students are a public health problem given the harmful repercussions they have on their quality of life and the possible future consequences, even more so if in the academic period the students are affected by a pandemic like COVID -19. This research aimed to determine the presence and degree of emotional exhaustion and its possible repercussions on mental health in social science students during the COVID-19 pandemic. The design was descriptive and cross-sectional, and a questionnaire was used with sociodemographic variables, perception of the affectation of mental health, and the scale of emotional exhaustion (ECE). The results were that a high percentage of 90.2% reported a worsening of their mental health with the presentation of stress symptoms (64.1%), sensitivity (41%), anxiety/distress (39.7%), irritability (39.4%), and depressive symptoms (34.9%). The influencing factors were the pandemic (61.9%), confinement and social distancing (47.3%), economic problems (41.6%), and the news (23.8%). In addition, a high (65.7%); medium (29.2%) and low (5.1%) emotional exhaustion. We can conclude that social sciences students find themselves with high degrees of emotional exhaustion and a perception of a great deterioration in their mental health. These results should call our attention to continue studying the mental health consequences of COVID-19 to prevent possible mental pathologies in the future.

Keywords emotional exhaustion mental health university students pandemic
INTRODUCTION

COVID-19 is a disease that has wreaked havoc in all walks of life because of its high mortality and the political, social, psychological, educational, and economic consequences (Martínez, 2020). The loss of life will result in a more severe mental health crisis in patients, their families, communities, and health care workers (Omary, 2020). The COVID-19 pandemic has many elements that make it exceptionally stressful for students (Besser et al., 2020). Numerous factors may account for the increased risk to students in higher education, the mental health problems the pandemic may bring, the loss of important commencement and completion rites (Gruber et al., 2020). Studies conducted explicitly on college students in China reflect the high possibility of experiencing, witnessing, or facing various stressful events related to the occurrence of COVID-19, which resulted in negative psychological symptoms, such as feeling tense, fear of infection, insomnia, and low mood (Yang et al., 2020). Students who experience increased social isolation due to COVID-19 may have a higher risk of increased psychological distress (Hamza et al., 2020).

In non-pandemic time students face experiences that can be physically, emotionally, and psychologically challenging (Cushman & West, 2006). Despite the widespread prevalence of psychological distress affecting many students in higher education, the research on student stress remains largely theoretical (Williams et al., 2018). Students often experience high levels of stress and burnout (Humphrey, 2013). Stress often leads to burnout, which can seriously jeopardize a student's college experience (Schaufeli et al., 2020).

Burnout plays a fundamental role in students' lives (Cushman & West, 2006). In numerous works, the three dimensions of burnout syndrome have been studied: emotional exhaustion, depersonalization, and lack of personal fulfillment (Ramos et al., 2005).

Emotional exhaustion is a significant problem among higher education students and a public health problem in general (Tlili et al., 2020). Emotional exhaustion or burnout alludes to the situation in which people feel that they can no longer give more of themselves on an affective level; it is a situation of depletion of one's energy or emotional resources (Marrau, 2004). The problem of emotional exhaustion among adolescent and college students has recently gained broader prominence in national education policy in many countries (Galbraith & Merrill, 2015). More than one-third of college students experience detrimental imbalances between the effort they put into their studies and the rewards they get in return (Williams et al., 2018). The consequences of emotional exhaustion in students are as complex as other factors of mental distress, such as those related to smoking and alcohol consumption or an unhealthy lifestyle (Tlili et al., 2020). Contextual burnout can also extend to depression (Al-alawi et al., 2017) and anxiety (Farrell et al., 2019), internet dropout and addiction, and compromise with overall life satisfaction and success in educational pathways (Salmela-aro, 2017). In addition, there might be consequences such as dropout, sleep disorders, depression, and suicide (Pagnin et al., 2020) and even symptoms associated with posttraumatic and dissociative stress (Boudoukha et al., 2017). The use of drugs and alcohol to reduce stress is of concern (Erschens et al., 2018). A student's level of burnout directly impacts that student's level of efficiency and productivity (Galbraith & Merrill, 2015). It also increases their intention to withdraw from college (Williams et al., 2018). A student with high burnout may study the same amount of hours as a student with low burnout but may not be as productive due to the various emotional, behavioral, cognitive, and physiological reactions caused by burnout (Galbraith & Merrill, 2015).

Given the importance of emotional exhaustion and its possible repercussions on students' mental health and performance, it is necessary to determine the presence of this phenomenon and its potential consequences on the mental health of social science students in Chilean higher education during the COVID-19 pandemic.

MATERIALS Y METHODS Study Design

It is a quantitative approach study. Its design was descriptive and cross-sectional.

Study Sample

The population consisted of 315 students in the area of social sciences in Chilean higher education. The selection criteria (inclusion and exclusion) were: university students, who are currently studying a social sciences degree in a higher education institution, over 18 years of age, and who freely agreed to participate in this research. The application of the instrument was carried out during November 2020, which was hosted on the GoogleForms platform.

Procedure

For the application of the instrument, a questionnaire with sociodemographic variables and one about the perception of their mental health and the Emotional Exhaustion Scale (ECE) was sent to the students e-mail addresses (Ramos et al., 2005). The participants were asked to give their informed consent in both questionnaires. It was made explicit that their answers were anonymous, voluntary and that the results would only be used for academic purposes. Once the data had been collected, we analyzed the results of this descriptive cross-sectional study (Hernández et al., 2015).

Data collection technique and instrument

The technique used was the survey, which is the most commonly used for data collection in descriptive and quantitative studies. For this study, a questionnaire was elaborated, which was validated through expert judgment, whose structure has the following characteristics: First, general information composed of general questions such as age, gender, career, in addition to questions regarding the perception of their mental health such as: "Do I think my mental health has worsened?", "At this time, I have presented symptoms of stress?" and "At this time, I have presented depressive symptoms?". In the end, the emotional exhaustion scale (ECE) was applied (Ramos et al., 2005). The Emotional Exhaustion Scale (ECE) is a specific scale that considers the last 12 months of student life; the MBI emotional exhaustion scale inspires these items (Maslach et al., 1997) as well as in Freudenberger's concept of burnout. To this base were added items specially designed to evaluate university students' exhaustion or emotional exhaustion, which derived from the level of demand and effort to overcome their studies (Ramos et al., 2005). The ECE is a unidimensional scale of 10 items. The items are scored from 1 to 5, depending on the occurrence of what the statement says: 1 = rarely, 2 = few times, 3 = sometimes, 4 = frequently, 5 = always. The score obtained on the ECE ranges from 10 to 50 points. Its level of internal consistency (an alpha coefficient of 0.893) and satisfactory item homogeneity (mean inter-item correlation = 0.33) for this application had a Cronbach's alpha of 0.877 (Table 1). For a more specific data analysis of the responses, degrees of emotional exhaustion were recorded as low from 10 to 23.33 points, medium from 23.34 to 36.66 points, and high from 36.67 to 50 points. SPSS version 25 was used for data analysis.

Table 1. Corrected item correlation and Cronbach's alpha if the item is removed

Total correlation of corrected elements Cronbach's alpha if the item is removed
Tests or evaluations cause me excessive stress. 0,548 0,869
I think I try too hard for the little I get out of it. 0,483 0,876
I feel down in the dumps, kind of sad, for no apparent reason. 0,539 0,871
There are days when I don't sleep well because of studying. 0,556 0,869
I have headaches and other discomforts that affect my performance. 0,681 0,859
There are days when I feel more exhausted, and I lack the energy to concentrate. 0,610 0,865
I feel emotionally drained by my studies. 0,738 0,855
I feel tired at the end of the day. 0,586 0,867
Working and/or studying with evaluations in mind causes me stress. 0,684 0,859
I lack time, and I feel overwhelmed by my studies. 0,644 0,862

Source: Own elaboration.

RESULTS

Table 2 shows the sociodemographic characteristics of the students of the various social science majors, which are distributed as follows:

Table 2. Sociodemographic characteristics of the sample

Sociodemographic Variables n %
Age
18 to 20 68 21.6
21 to 29 129 41
30 to 39 67 21.3
40 to 49 31 9.8
50 to 59 20 6.3
Gender
Male 68 21.6
Female 247 78.4
Civil Status
Single without a partner 111 35.2
Single with partner 140 44.4
Married 45 14.3
Separated 18 5.7
Widowed 1 0.3
Children
No 207 65.7
Yes, 1 42 13.3
Yes, 2 39 12.4
Yes, 3 18 5.7
Yes, 4 or more 9 2.9
Major
Psychology 162 51.4
Law 93 29.5
Social Work 47 14.9
Political Science 5 1.6
Sociology 8 2.5
Academic Progress
First-year 75 23.8
Second-year 69 21.9
Third-year 69 21.9
Fourth-year 52 16.5
Fifth-year 40 12.7
Graduated (or in the process of graduation) 10 3.2

Source: Own elaboration.

Table 3 shows the perception of students in the social sciences concerning their mental health: 284 (90.2%) reported that their mental health has worsened, 202 (64.1%) reported stress symptoms, 124 (39.4%) irritability, 129 (41%) increased sensitivity, 125 (39.7%) anguish and/or anxiety, 110 (34.9%) depressive symptoms.

Table 3. Perception of Mental Health

Mental Health Perception n %
Mental Health Worsening
Yes 284 90.2
No 31 9.8
Stress Symptoms
Yes 202 64.1
No 113 35.9
Irritability Symptoms
Yes 124 39.4
No 191 60.6
Increased Sensitivity
Yes 129 41
No 186 59
Symptoms of Distress and/or Anxiety
Yes 125 39.7
No 190 60.3
Depressive Symptoms
Yes 110 34.9
No 205 65.1

Source: Own elaboration.

Table 4 shows that among the factors that most affected social science students were the pandemic (61.9%), confinement and social distancing (47.3%), economic problems (41.6%), and news and media about COVID-19 (23.8%).

Table 4. Factors contributing to the decline in mental health

Factors Decrease Mental Health n %
Pandemic
Yes 195 61.9
No 120 38.1
Confinement
Yes 149 47.3
No 166 52.7
Economic Problems
Yes 131 41.6
No 184 58.4
Social Distancing
Yes 149 47.3
No 166 52.7
News and Media
Yes 75 23.8
No 240 76.2

Source: Own elaboration.

Table 5 shows that the careers that belong to the area of social sciences present high levels of emotional exhaustion. Psychology high (59.9%), medium (34.6%) low (5.6%); Law high (74.2%), medium (21.5%) low (4.3%); Social Work high (70.2%), medium (25.5%) low (4.3%); Political Science high (100%); Sociology high (37.5%), medium (50%) low (12.5%).

Table 5. Major and emotional exhaustion

Major Low Emotional Exhaustion Medium Emotional Exhaustion High Emotional Exhaustion
Psychology n 9 56 97
% 5.6% 34.6% 59.9%
Law n 4 20 69
% 4.3% 21.5% 74.2%
Social Work n 2 12 33
% 4.3% 25.5% 70.2%
Political Science n 0 0 5
% 0.0% 0.0% 100.0%
Sociology n 1 4 3
% 12.5% 50.0% 37.5%
Total n 16 92 207
% 5.1% 29.2% 65.7%

Source: Own elaboration.

DISCUSSION

This research shows the pandemic's complexity on the mental health of higher education students, generating a high level of emotional exhaustion. The perception of social science students is that more than 90% of them consider that their mental health has worsened in the period of the COVID-19 pandemic and that the main reason has been the COVID-19 pandemic with 61.9%. These findings are consistent with other findings that the general perception of higher education students is that their mental health has been impaired, even more so in students who had pre-existing mental illnesses before the pandemic (Banerjee, 2020; Hamza et al., 2020). This can lead to severe psychological decompensation (Y. Sun et al., 2020). It is increasingly evident that the pandemic confers serious and potentially complex long-term mental health consequences (Gruber et al., 2020).

More than 65% of the students presented high emotional exhaustion in our research. This refers to the situation in which people feel that they can no longer give more of themselves at an affective level; it is a situation of depletion of energy or emotional resources (Marrau, 2004) with consequences such as feelings of abandonment, sleep disorders, depression, and suicide (Pagnin et al., 2020). This emotional exhaustion may be due to the high demands of studies, cynical and distant attitudes towards their studies, and feelings of academic incompetence (Schaufeli et al., 2020). They have increased during the pandemic of COVID-19, given the changes from face-to-face to online study, which generates great wear to be in front of a screen without greater environmental stimulation. Therefore it is necessary to continue studying how the transition from face-to-face to online classes affects mental health since such a sudden transition could have harmful consequences for students (Besser et al., 2020; Gurung & Stone, 2020), especially for those in vulnerable situations. These interruptions can be especially traumatic (Lancaster & Arango, 2021). Therefore due to the global pandemic of COVID-19, students now face new and unprecedented challenges (e.g., significant academic changes and interruptions, stay-at-home orders, etc.) (Hamza et al., 2020).

Within our research, it can be observed that social science students perceive that 64.1% of them would present symptoms of stress. The above correlates with other analysis where perceived stress has increased, generating physical consequences and sleep disorders (Lancaster & Arango, 2021). These results are of concern given that a recent review strongly correlates stress with increased alcohol consumption (Acuff et al., 2021) and is associated with increases in anxiety and fear of getting sick (Danzi et al., 2021), as well as increases in emotional exhaustion (Chan et al., 2021). The degree of stress and adversity that people experience due to COVID-19 depends on economic, social, and health factors (Lancaster & Arango, 2021). As presented in our study, 41.6% of the students refer that financial problems have affected them, which could lead to relevant psychological issues given the insecurity that has brought the virus and the economic stability in general (Marler et al., 2021).

The perception of the presence of depressive symptoms and irritability reported by students in the social sciences was 34.9% and 41%, with greater sensitivity, which is in line with other studies in which they say that depressive symptoms are in the order of 20% to 30% in university students (Wang et al., 2020). The findings support the primary hypothesis that the prevalence of probable moderate to severe depression, self-harm, suicidal ideation, and emotional distress due to COVID-19 was significantly higher among quarantined participants than non-quarantined participants (Xin et al., 2020).

In our study, more than 39% of the students reported presenting anxiety and/or distress symptoms, which is consistent with other research where 20% to 35% of the respondents reported anxiety and over 25% reported high levels of stress after the onset of the outbreak (Cao et al., 2020; Huang & Zao, 2020). Furthermore, the findings corroborate the interaction between ongoing pandemic-related stress and fear of COVID-19 (Chan et al., 2021). This can be associated with our results: 61.9% of students refer the pandemic itself had affected their mental health the most and that 23.8% of students felt that the news had affected them. Along these same lines, 47.3% of students identified that confinement and social distancing had affected them. In particular, young adult college students may be a population vulnerable to psychological distress during quarantine (S. Sun et al., 2021). A recent meta-analysis of 25 empirical studies found that those in quarantine were more likely to be anxious (odds ratio, OR) (OR = 2.0) and depressed (OR = 2.8) (Henssler et al., 2021). This may lead to increased suicidal thoughts and ideation (Martínez-Líbano & Yeomans Cabrera, 2021; Pandey et al., 2020). However, other research has shown that wellbeing was not affected by concern about the consequences of the virus. Although respondents showed some fear of infection and severe illness in someone in their networks and had doubts about the efficiency of medical care, these factors did not negatively affect their wellbeing (Lukacs, 2021).

Addressing the consequences of emotional exhaustion is necessary to preserve good mental health, which can be defined as a state of wellbeing that enables people to cope with life's everyday stresses and function productively (Fusar-Poli et al., 2020). Findings have consistently demonstrated the importance of psychosocial factors and mental health in the academic success of college students (Kivlighan et al., 2020). Psychological problems, such as depression and anxiety, are common among students (Kim et al., 2015). College students have long-standing mental health conditions and suicide risks (McLaughlin & Gunnell, 2020).

It is essential that the authorities address this issue and urgently seek solutions to mitigate the psychological impact of home confinement (anxiety, stress, depression, frustration, among others) (Yeomans & Silva, 2020). Universities have a responsibility to advocate for students, especially for those students who are vulnerable (Benner et al., 2018). Fostering resilience is a promising way to mitigate the adverse effects of stressors, prevent burnout and help students thrive after difficult experiences (Houpy et al., 2017).

CONCLUSION

The COVID-19 pandemic has profoundly impacted the mental health of social science students, generating a high level of emotional exhaustion. In this research, 90.2% of the students reported that their mental health has worsened, developing stress, irritability, anxiety, anguish, and depressive symptoms. This is mainly caused by the pandemic, confinement, economic problems, social distancing, and the news. Concerning emotional exhaustion in the students, these presented high (65.7%), medium (29.2%), and low (5.1%). These results should call the attention of government authorities and higher education institutions since the mental health of university students is fundamental. They will be the future professionals to lead our society, so possible adverse consequences should be addressed to mitigate harmful potential implications for our community.

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