Background and Aim: Quality of sleep is essential element for learning and memory. Students’ learning performance may be affected by sleep. The purpose of this study was to explore the relationship between quality of sleep and learning satisfaction on nursing college students. Design and Participants: A cross-sectional with correlation study design was employed. 200 students were recruited from the nursing college. Pittsburgh Sleep Quality Index and Learning Satisfaction Scale were used for data collection. SPSS for window 17.0 was used for data analysis. Results: Findings showed: 1) 53% of participants rated their sleep quality as poor; 2) the global learning satisfaction of participants varied between highly satisfaction and satisfaction; 3) the global learning satisfaction was significantly negative related to “subjective sleep quality”, “use the sleep pill”, and “daytime dysfunction” (p < 0.05), finally, students who were interested in nursing can be explained 10.2% of the total amount of variances in learning satisfaction. Conclusions: The findings can provide information regarding nursing students’ sleep status and learning satisfaction to school teacher. The information would be helpful as evidences when laying out nursing curriculum to strengthen students’ sleep hygiene and learning of affective domain in the future.
Learning satisfaction is an indicator for evaluating student learning effectiveness and the teaching quality of educators [
A study indicated that affective education developed morals, discipline, affection, and attitudes, etc., and that the affective performance of college students would affect their professional spirit and attitude in their future work [
However, it is noteworthy that given the freedom of study, the various activities in colleges, and universal internet availability, college students may be staying up late using the Internet, leading to increasing problems of sleep irregularity such as sleeping late [
Memory and learning abilities may be affected by sleep. Many studies regarding sleep-related issues among students have led to different results. Forquer et al. [
Fewer studies investigated the relationship between learning satisfaction and sleep quality. A great amount of research regarding sleep and learning effectiveness exists. Meijer et al. [
Lazaratou et al. [
This cross-sectional study adopted students of an Institute of Technology in 2010 as the study population. The class as a unit, stratified cluster random sampling based on the number of classes was used to recruit fourth and fifth year students. A structured questionnaire was used to collect data on the factors affecting sleep quality and learning satisfaction in nursing students. Power analysis was used to calculate the appropriate sample size. This study referred to Polit and Beck’s [
Demographic Data Questionnaire: The demographic questionnaire contained information on the year of study, participation in extracurricular activities, holding of part-time jobs, motivation to study nursing, semester scores, and interest in nursing of the students.
Chinese version of the Pittsburgh Sleep Quality Index (C-PSQI): We used the translated (Chinese) version of the Pittsburgh Sleep Quality Index of Chiang [
Learning Satisfaction Scale: The 22-item scale, which was developed by Wang and Lin [
This study was approved by the Institutional Review Board of the medical center (IRB approval number: 100- 2571D) and the administrative departments of the school before the authors began to recruit participants. To protect the rights of the study participants, the authors first explained the study purpose and the data collection procedure to participants in the class meeting. After signing a consent form, participants would receive the study questionnaire. If they felt any discomfort or inappropriateness during the study, participants could freely withdraw from the study at any time. The questionnaires were anonymous, and the collected data were coded for further statistical analysis. To ensure participants’ privacy, this study would not disclose the results of any participants.
SPSS for Windows (Version 17.0; SPSS, Inc., Chicago, IL, USA) was used for data analysis. To describe the distribution of demographic data, sleep quality, and learning satisfaction, we used descriptive statistics expressed in terms of frequency, percentage, mean, and standard deviation. We tested the differences learning satisfaction and demographic data using a t test or a one-way ANOVA and the Scheffe’s method. We tested correlation among sleep quality, and learning satisfaction using Pearson’s product-moment correlation. Stepwise multiple regression was used to identify predictors of learning satisfaction, and significance level p value was set at 0.05.
Most of the study participants studying at the 5-year junior college were in their fifth year of study (52.5%), and a large proportion of the participants did not participate in any extracurricular activities (N = 133, 66.5%). Most of the students did not have a part-time job (83%), and half of the students studied nursing because their parents suggested them to do so. A total of 50% of students reported “neutral” interest in nursing (
. Demographic characteristics (N = 200)
Variables | n | % |
---|---|---|
Year of study | ||
4 | 95 | 47.5 |
5 | 105 | 52.5 |
Participation in extracurricular activities | ||
Yes | 67 | 33.5 |
No | 133 | 66.5 |
Holding of part-time jobs | ||
Yes | 34 | 17 |
No | 166 | 83 |
Motivation to study nursing | ||
Personal interest | 38 | 19.0 |
Influence from brothers/sisters | 10 | 5.0 |
Influence from classmates | 9 | 4.5 |
Parental suggestion | 100 | 50.0 |
Teacher suggestion | 5 | 2.5 |
School allocation based on the test scores | 17 | 8.5 |
A nursing background facilitates job hunting | 21 | 10.5 |
Semester grade | ||
60 - 69 points | 12 | 6.0 |
70 - 79 point | 76 | 38.0 |
Above 80 points | 112 | 56.0 |
Interest in nursing | ||
Highly interested | 11 | 5.5 |
Interested | 54 | 27.0 |
Neutral | 100 | 50.0 |
Not interested | 27 | 13.5 |
Not interested at all | 8 | 4.0 |
. Sleep quality and learning satisfaction (N = 200)
Variable | n (%) | M ± SD |
---|---|---|
Learning Satisfaction | 3.05 ± 0.37 | |
Cognitive Domain | 3.08 ± 0.34 | |
Psychomotor Domain | 3.04 ± 0.38 | |
Affective Domain | 2.97 ± 0.53 | |
Sleep Quality | ||
Subjective Sleep Quality | 1.32 ± 0.65 | |
Very Good | 14 (7.0) | |
Fairly Good | 115 (57.5) | |
Fairly Bad | 64 (32.0) | |
Very Bad | 7 (3.5) | |
Sleep Latency | 0.56 ± 0.72 | |
≤15 Minutes | 114 (57.0) | |
16 - 30 Minutes | 64 (32.0) | |
31 - 60 Minutes | 19 (9.5) | |
>60 Minutes | 3 (1.5) | |
Sleep Duration | 1.09 ± 1.06 | |
>7 Hours | 66 (33.0) | |
>6 ≤7 Hours | 90 (45.0) | |
≥5 and ≤6 Hours | 5 (2.5) | |
<5 Hours | 39 (19.5) | |
Habitual Sleep Efficient | 0.33 ± 0.72 | |
≥85% | 159 (79.5) | |
84% - 75% | 24 (12.0) | |
74% - 65% | 10 (5.0) | |
<65% | 7 (3.5) | |
Sleep Disturbances | 1.38 ± 0.65 | |
Not during the Past Month | 6 (3.0) | |
Less than Once a Week | 125 (62.5) | |
Once or Twice a Week | 56 (28.0) | |
Three or More Times a Week | 13 (6.5) | |
Use of Sleeping Medication | 0.07 ± 0.40 | |
Not during the Past Month | 193 (96.5) | |
Less than Once a Week | 3 (1.5) | |
Once or Twice a Week | 1 (0.5) | |
Three or More Times a Week | 3 (1.5) | |
Daytime Dysfunction | 1.05 ± 0.93 | |
No Problem at All | 65 (32.5) | |
Only a Very Slight Problem | 75 (37.5) | |
Somewhat of a Problem | 44 (22.0) | |
A Very Big a Problem | 16 (8.0) | |
C-PSQI Score | 6.17 ± 2.92 | |
≤5 | 94 (47.0) | |
>5 | 106 (53.0) |
study participants was 6.17 ± 2.92, representing that more than half of participants (53%) had poor sleep quality. The authors further analyzed the scores of each sub-dimension of sleep quality and found that 35.5% of participants had poor subjective sleep quality. Regarding sleep latency, more than half of participants could fall asleep within 30 min. The mean sleep duration among students was 6.19 ± 0.98 hours/day, and 19.5% of students slept fewer than 5 hours a day. Regarding habitual sleep efficiency, if ≥85% is taken as the standard for good sleep efficiency, 20.5% of students experienced poor sleep efficiency. About 34.5% of the study participants had experienced sleep disturbances more than once. With respect to use of sleep medication, only 4% of the study participants occasionally took sleeping pills, and 32.5% of participants reported that their daytime functions were not affected (
“Year of study”, “participation in extracurricular activities”, “holding of a part-time job”, “motivation to study nursing”, and “semester grades” were not found to be significantly related to overall learning satisfaction, while “interest in nursing” was significantly correlated. The authors further conducted a Scheffe’s post hoc comparison and found that compared to students who answered “not interested at all” for “interest in nursing”, those who answered “highly interested”, “interested”, “neutral”, or “not interested” had greater overall learning satisfaction. The study examined the relationships between demographic characteristics and the affective, cognitive, and psychomotor domains. The results show that interest in nursing was significantly associated with the affective and psychomotor domains. An additional Scheffe’s post hoc comparison suggested that compared to students who answered “not interested at all” in terms of their interest in nursing, those who answered “highly interested”, “interested”, “neutral”, or “not interested” had greater learning satisfaction in the affective domain, and those who answered “interested” had greater learning satisfaction in the psychomotor domain (
The study results showed no significant relationship between overall learning satisfaction and C-PSQI score. However, a significantly negative relationship was observed between the affective domain of learning satisfaction and C-PSQI score (r = −0.141, p < 0.05), representing that a higher score in the affective domain of learning satisfaction was associated with a lower C-PSQI, which indicated better sleep quality. Regarding the analyses between overall learning satisfaction and different dimensions of sleep quality, overall learning satisfaction was found to be significantly and negatively associated with “subjective sleep quality”, “use of sleep medication”, and “daytime dysfunction”. These findings indicated that lower scores in these three constructs were linked to greater overall learning satisfaction (
This study further adopted learning satisfaction as the dependent variable, and incorporated “demographic characteristics” and “sleep quality” as independent variables, which were significantly correlated with overall learning satisfaction. The variable “interest in nursing” was first converted into a dummy variable, and then included in a stepwise multiple regression model for identifying its predictive power on learning satisfaction. The results show that learning satisfaction was significantly correlated with “interest in nursing” (F = 23.59, p < 0.01). That is, 10.2% of the variance in learning satisfaction could be explained by interest in nursing (
The mean C-PSQI score among the study participants was 6.17 ± 2.92 points, and 53% of participants had poor sleep quality. This study showed a higher prevalence of poor sleep quality than found by Tsai and Li [
The results of this study showed that mean score of overall learning satisfaction level between “highly satis-
. Comparisons of demographic and learning satisfaction among subjects (N = 200)
Variable | Affective domain | Cognitive domain | Psychomotor domain | Overall learning satisfaction |
---|---|---|---|---|
Year of study | ||||
4 | 2.93 ± 0.58 | 3.07 ± 0.36 | 3.00 ± 0.40 | 3.00 ± 0.39 |
5 | 3.01 ± 0.49 | 3.09 ± 0.33 | 3.08 ± 0.37 | 3.06 ± 0.35 |
t = 1.24 | t = 0.23 | t = 2.10 | t = 1.39 | |
Participation in extracurricular activities | ||||
Yes | 2.96 ± 0.51 | 3.08 ± 0.37 | 2.99 ± 0.37 | 3.01 ± 0.37 |
No | 2.98 ± 0.54 | 3.08 ± 0.33 | 3.06 ± 0.39 | 3.04 ± 0.37 |
t = 0.053 | t = 0.001 | t = 1.66 | t = 0.28 | |
Holding of part-time jobs | ||||
Yes | 2.97 ± 0.64 | 3.05 ± 0.44 | 3.00 ± 0.43 | 3.01 ± 0.45 |
No | 2.98 ± 0.51 | 3.08 ± 0.32 | 3.05 ± 0.37 | 3.04 ± 0.35 |
t = 0.001 | t = 0.21 | t = 0.39 | t = 0.16 | |
Motivation to study nursing | ||||
Personal interest | 3.11 ± 0.35 | 3.11 ± 0.33 | 3.08 ± 0.28 | 3.10 ± 0.25 |
Influences from brothers/sisters | 3.07 ± 0.93 | 3.15 ± 0.37 | 3.26 ± 0.36 | 3.16 ± 0.52 |
Influences from classmates | 2.87 ± 0.54 | 3.04 ± 0.46 | 3.04 ± 0.21 | 2.98 ± 0.37 |
Parental suggestion | 2.89 ± 0.56 | 3.05 ± 0.35 | 2.98 ± 0.41 | 2.97 ± 0.39 |
Teacher suggestion | 2.97 ± 0.35 | 3.06 ± 0.51 | 3.08 ± 0.50 | 3.04 ± 0.43 |
School allocation based on the test scores | 3.01 ± 0.45 | 3.06 ± 0.28 | 3.04 ± 0.39 | 3.04 ± 0.34 |
A nursing background facilitates job hunting | 3.07 ± 0.52 | 3.16 ± 0.31 | 3.13 ± 0.42 | 3.12 ± 0.37 |
F = 1.03 | F = 0.46 | F = 1.14 | F = 1.00 | |
Semester grade | ||||
60 - 69 points | 2.84 ± 0.53 | 2.90 ± 0.23 | 3.00 ± 0.26 | 2.91 ± 0.28 |
70 - 79 points | 2.90 ± 0.59 | 3.06 ± 0.36 | 2.97 ± 0.41 | 2.98 ± 0.40 |
above 80 points | 3.04 ± 0.49 | 3.11 ± 0.34 | 3.09 ± 0.37 | 3.08 ± 0.35 |
F = 1.99 | F = 2.26 | F = 2.04 | F = 2.40 | |
Interest in nursing | ||||
Highly interested | 3.22 ± 0.47 | 3.21 ± 0.49 | 3.12 ± 0.44 | 3.18 ± 0.43 |
Interested | 3.17 ± 0.46 | 3.15 ± 0.35 | 3.11 ± 0.35 | 3.15 ± 0.33 |
Neutral | 2.97 ± 0.47 | 3.05 ± 0.33 | 3.05 ± 0.40 | 3.02 ± 0.36 |
Not interested | 2.83 ± 0.54 | 3.04 ± 0.29 | 2.95 ± 0.31 | 2.94 ± 0.31 |
Not interested at all | 1.87 ± 0.42 | 2.86 ± 0.25 | 2.62 ± 0.32 | 2.45 ± 0.20 |
F = 14.46** | F = 2.06 | F = 3.41** | F = 7.85** | |
Scheffee’s , , , > | > | , , , > |
**p < 0.01.
. Relationships between learning satisfaction and sleep quality
Variable | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Affective Domain | 1 | |||||||||||
2. Cognitive Domain | 0.651** | 1 | ||||||||||
3. Psychomotor Domain | 0.671** | 0.681** | 1 | |||||||||
4. Overall Learning Satisfaction | 0.910** | 0.855** | 0.876** | 1 | ||||||||
5. Subjective Sleep Quality | −0.155* | −0.135 | −0.114 | −0.155* | 1 | |||||||
6. Use of Sleep Medication | −0.197** | −0.108 | −0.165* | −0.184** | 0.047 | 1 | ||||||
7. Sleep Latency | −0.033 | −0.048 | −0.077 | −0.057 | 0.352** | 0.171* | 1 | |||||
8. Sleep Duration | −0.112 | −0.063 | −0.077 | −0.099 | 0.306** | 0.125 | 0.185** | 1 | ||||
9. Habitual Sleep Efficient | 0.008 | −0.042 | 0.010 | −0.006 | 0.181* | 0.143* | 0.237** | 0.249** | 1 | |||
10. Sleep Disturbances | 0.062 | 0.063 | 0.037 | 0.062 | 0.348** | 0.032 | 0.415** | 0.206** | 0.224** | 1 | ||
11. Daytime Dysfunction | −0.202** | −0.072 | −0.062 | −0.140* | 0.169* | 0.451** | 0.197** | 0.264** | 0.144* | 0.199** | 1 | |
12. C-PSQI | −0.141* | −0.094 | −0.101 | −0.131 | 0.599** | 0.386** | 0.640** | 0.668** | 0.548** | 0.595** | 0.555** | 1 |
*p < 0.05, **p < 0.01.
. Stepwise multiple regression analysis for learning satisfaction and its related factors
Variable | B | β | t | R2 | F |
---|---|---|---|---|---|
Constant | 3.43 | 40.01 | |||
Interest in nursing | −0.14 | −0.32 | −4.85 | 0.102 | 23.59** |
**p < 0.01.
fied” and “satisfied”. This finding is consistent with that of the Wang and Lin [
This study found the lowest satisfaction toward the affective domain, which is consistent with the finding of the Feng et al. [
Additionally, Cronbach’s alpha, based on a set of items’ mean interitem correlation, is the most popular statistic testing internal consistency [
A significant relationship was found between affective domain of learning satisfaction and C-PSQI score, means that students with better sleep quality had a higher score in the affective domain of learning satisfaction, a finding similar to Feng et al. [
The results of this study showed that lower scores of subjective sleep quality, use of sleep medication, or daytime dysfunction brought higher overall learning satisfaction, a finding consistent with prior studies [
There was a significant difference between interest in nursing (demographic characteristics) and learning satisfaction in this study. Students who were more interested in nursing had greater learning satisfaction in the affective and psychomotor domains. This finding was consistent with Wang and Lin [
The major predictor of learning satisfaction was “interest in nursing”, accounting for 10.2% of learning satisfaction variance in this study. This finding indicates that individual with more concerned about their personal interests, sense of achievement, self-development, social interaction, and health and leisure activities, and therefore value their jobs in terms of its achievement, development, and material rewards [
The present study found that 53% of students had poor sleep quality, and that the level of overall learning satisfaction among students was between “highly satisfied” and “satisfied”. In addition, the lowest learning satisfaction toward the affective domain. Results showed “interest in nursing” to be significantly associated with learning satisfaction. The application of several interventions might facilitate the learning satisfaction: 1) course design emphasize affective domain of teaching objectives, strengthen students’ self-perceptions, humanistic education, the nurturing of moral character; 2) applications of affective teaching strategies such as problem solving, experiential learning, and concerns for humans could be addressed; 3) assist nursing students in planning their nursing career, cultivating the interest of nursing students toward nursing practices is a priority.
Based on the results of this study, a larger sample size is recommended to strengthen the significance of the finding. As the study targeted a nursing college, it may be subject to regional limitation. Also, subjects recruited form different college population are recruited. Additionally, this study was a cross-sectional design and used questionnaires, which may have been subjective to bias from respondents when answering question, could not identify changes in learning satisfaction over time. Moreover, utilizing an objective instrument such as students’ score and polysomnography are recommended for further study. A longitudinal study with physiologic analysis is recommended for further study to find the correlation between learning satisfaction and sleep quality.
The authors would like to thank the participants who completed the questionnaire. We also sincerely thank the Ministry of Science and Technology, for financially supporting this research (NSC 99-2815-C-255-004-S).