# The Relationship of Happiness and Quality of Educational Services with Academic Burnout Among Students of Zahedan University of Medical Sciences, Iran

AUTHORS

Omolbanin Rahdar 1 , Azizollah Arbabisarjou 2 , * , Somayeh Shahroudi 3

2 Department of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran

3 Department of Biostatistics and Epidemiology, Zahedan University of Medical Sciences, Zahedan, Iran

How to Cite: Rahdar O, Arbabisarjou A, Shahroudi S. The Relationship of Happiness and Quality of Educational Services with Academic Burnout Among Students of Zahedan University of Medical Sciences, Iran, Strides Dev Med Educ. 2019 ; 16(1):e82679. doi: 10.5812/sdme.82679.

ARTICLE INFORMATION

Strides in Development of Medical Education: 16 (1); e82679
Published Online: November 10, 2019
Article Type: Research Article
Revised: March 2, 2019
Accepted: March 16, 2019
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### Abstract

Background: Paying attention to students’ academic burnout and identifying the factors affecting it is one of the concerns of higher education authorities.

Objectives: The purpose of this study was to investigate the effect of quality of educational services and happiness on students’ academic burnout.

Methods: In this descriptive-analytical study, 477 students of Zahedan University of Medical Sciences participated in the academic year 2017 - 2018. The sampling method was stratified. Data were collected using the SERVQUAL Questionnaire, Isfahan-Fordyce Happiness Inventory (IFHI) and Breso Burnout Questionnaire. Then, they were analyzed by Pearson’s correlation coefficient, independent t-test, One-way ANOVA and Multiple linear regression using SPSS. P value less than 0.05 was considered significant.

Results: According to Pearson correlation coefficient, there was a significant relationship between students' happiness and academic burnout (P < 0.001), but there was no significant relationship between the quality of educational services and academic burnout (P = 0.060). The level of academic burnout was higher in male students than in female students (P = 0.003). Multiple linear regression analysis showed that only the students’ happiness variable significantly predicted variations in academic burnout (P = 0.001).

Conclusions: In order to reduce students’ academic burnout, effective factors such as happiness should be considered by the respective authorities and educational packages should be used to promote happiness and increase the quality of educational services.

Keywords

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### 1. Background

Higher education is one of the most important institutions for education and human resources provision and the main pillar of the country’s comprehensive development. As a dynamic and purposeful system, it faces serious challenges and its sustained development requires balanced and appropriate growth of its quantitative and qualitative aspects (6, 7). A glance at the current developments in the higher education system suggests that higher education should maintain and improve the quality of services along with addressing the crisis of financial problems (8). Students’ evaluation of the quality of the provided services yields useful results for the decision makers of the educational system (1).

One of the methods used for measuring service quality is the SERVQUAL model developed by Parasuraman et al. (9) with the five aspects of tangibles, reliability, responsiveness, assurance, and empathy (10). Among the studies that have used this model to evaluate the quality of educational services in Iranian universities, we can refer to Changyzi Ashtiyani and Shamsi research in which this tool was used among 400 students of Arak University of Medical Sciences. In that study, they came to the conclusion that from the students’ point of view, there is a gap in the quality of services offered and students’ perceptions of the status quo is lower than their expectations. This gap was reported in all educational dimensions (11). Also, in their research using the SERVQUAL evaluation model, Tabarraei and Mohebi concluded that from the point of view of students of Qom University of Medical Sciences, the quality of educational services was poor in all dimensions (12).

Happiness denotes a person’s evaluation of one's life in general, such as satisfaction with particular areas of life including marriage, work, and emotions (13). It is clear that happiness and optimism affect the body in addition to spirit and social relationships. The concept of happiness includes emotional, social and cognitive components. The emotional component generates positive emotional states, the social component leads to extensive and positive social relationships with others and the cognitive component produces a mental framework that interprets everyday events positively (14).

Students are among the most important strata of the society that are likely to achieve greater success in all academic pursuits and then in employment if they enjoy genuine happiness (15). Evidence suggests that factors such as personality dimensions, income level, marital status and field of study significantly explain students’ happiness (4, 16). Studies confirm that there is a significant positive relationship between happiness and progress and academic performance (17, 18). The results of a study conducted by Rostamzadeh and Narimani among students of Mohaghegh Ardabili University showed that there is a significant negative relationship between students’ happiness and academic burnout (19). On the other hand, their research showed that the quality of educational services also affects students’ academic burnout. In this regard, we can refer to the study by Nasiri et al., whose results revealed a significant negative relationship between the quality of educational services and students’ academic burnout (1).

### 2. Objectives

Paying attention to academic burnout by university officials is important as it is not only related to students’ academic prospects but also increases students’ mental health. Thus, in addition to identifying the factors affecting academic burnout, knowing the strategies to cope with it seems necessary. The purpose of this study was to determine the relationship of the quality of educational services and happiness with academic burnout among students of Zahedan University of Medical Sciences in the academic year 2017 - 2018.

### 3. Methods

This was a descriptive, analytical, cross-sectional study. The samples were students of Zahedan University of Medical Sciences (n = 477 students). To calculate the sample size, we used Equation 1, where the values of type I (α) and type II (β) error were 0.05 and 0.2, respectively.

Equation 1.$ω=12log⁡(1+r1-r)$
$n0=(z1-α2+z1-βω)2+3$

The Pearson correlation coefficient (r) between the two variables of happiness and aspects of creativity was 0.12 according to a similar research (20). Based on these values, the sample size was estimated to be 542. Since the total number of university students was about 4,000, the sample size was calculated at 477, using Equation 3, which is the equation for limited community correction.

Equation 3.$n=n0Nn0+N-1$

To select the samples, the stratified random sampling method was used. Zahedan University of Medical Sciences was divided into six strata according to the faculties of Medicine, Nursing and Midwifery, Health, Rehabilitation Sciences, Paramedicine and Dentistry. Then, from each stratum, samples were selected proportionate to their students. Questionnaires were distributed and then collected after coordination with the faculty authorities and explaining to the students about the research and assuring them of the confidentiality of the data.

The data collection tool was a four-section questionnaire consisting of demographic questions, SERVQUAL model educational service quality questionnaire, Isfahan-Fordyce Happiness Inventory (IFHI) and Breso Burnout Questionnaire. The demographic information included age, gender, marital status, living in dormitory, nativeness to the province and type of school, which were completed by self-report. The inclusion criteria included studying at Zahedan University of Medical Sciences and informed consent to participate in the study. Also, the questionnaires that were not thoroughly completed for various reasons were excluded.

To collect information on the quality of educational services, we used the Quality of Services in Higher Education Questionnaire based on the SERVQUAL model, which consists of 20 items and the five sub-scales of tangibles (4 questions), reliability (3 questions), responsiveness (5 questions), assurance (4 questions) and empathy (4 questions). The questionnaire is rated on a five-point Likert scale, with scores of 1 to 5 for the “strongly disagree, disagree, disagree, agree and strongly agree” options, respectively. The lower limit is 20, the average score is 60 and the upper limit is 100. A score of 20 to 40 denotes poor services, a score of 41 to 79.5 shows average services and a score of above 80 was considered good.

To obtain the score for each subscale, the scores for that subscale’s questions are summed up and calculated. The face and content validity of the questionnaire was confirmed by several faculty members of the Educational Management and Psychology Department of Islamic Azad University. The reliability of the tool for the whole questionnaire using Cronbach’s alpha coefficient was reported 0.93 (10). The reliability of the questionnaire in this study was calculated at 0.93 using Cronbach’s alpha coefficient.

Data related to happiness were collected using the IFHI. This tool consists of 38 four-point items including “Very Low, Low, Medium, and High” rated from 1 to 4, respectively. Scores range from 38 to 152 and higher scores mean greater happiness. Content validity of the IFHI has been confirmed by behavioral sciences experts. Its Cronbach’s alpha coefficient reliability was found to be 0.92 in a sample of 200 students from Isfahan universities (21). In the present study, the reliability of the instrument calculated using the Cronbach’s alpha coefficient was 0.90.

Academic burnout was measured using the Breso Burnout Questionnaire (22). The instrument consists of 15 items in the three domains of academic burnout, namely academic exhaustion (5 items), academic disinterest (4 items), and academic inefficacy (6 items), rated on a seven-point Likert scale. Scores of questions ranged from 1 to 7 and the minimum and maximum scores obtained from the questionnaire were 15 and 105, respectively. Scores between 15 and 37 denote low academic burnout, scores between 37 and 60 represent moderate academic burnout and scores above 60 indicate high academic burnout. The validity of the questionnaire was confirmed by Marzoghi et al. reliability coefficients for the three domains were estimated 0.70, 0.82 and 0.75, respectively (23). In the present study, the reliability of the questionnaire as calculated by Cronbach’s alpha coefficient was 0.87.

Pearson correlation coefficient was used to investigate the correlation between quantitative variables. Independent t-test and one-way ANOVA tests were run to examine the quantitative variables separately, and multiple linear regression (Enter method) was used to model and predict academic burnout. All these analyses were performed using SPSS, version 21 (IBM Corporation, version 21, Armonk, NY). P-value less than 0.05 was considered significant.

### 4. Results

In the present study, 477 questionnaires were completed by the students, 23 of which were incomplete and were excluded. In terms of gender, 45.4% were male and 54.6% were female. The minimum and maximum GPAs were 12 and 20, respectively, with a mean of 16.46 ± 1.25 (Table 1).

Table 1. Students’ Distribution Based on Demographic Characteristics
VariablesNumber (%)
Age, y
Less than 25360 (79.3)
Between 25 and 3576 (16.7)
Between 35 and 454 (0.9)
Marital status
Single354 (78)
Married69 (15.2)
Nativeness to the province
Native to the province268 (59)
Non-native to the province114 (25.1)
Place of residence at the dormitory
Yes177 (39)
No95 (20.9)
Faculty
Medicine101 (22.3)
Dentistry69 (15.2)
Nursing and midwifery106 (23.3)
Rehabilitation54 (11.9)
Health49 (10.8)
Paramedicine72 (15.9)

The mean score of quality of educational services was 56.23 ± 12.15, and the minimum and maximum scores were 21 and 94, respectively. The mean score of happiness was 106.06 ± 12.76 with the minimum and maximum scores of 43 and 152, respectively, and the mean score of academic burnout was 56.39 ± 12.49 with the minimum and maximum scores of 15 and 99, respectively.

According to the findings, 11.2% of the students described the quality of educational services as poor, 87% as moderate and 1.8% as good. The level of academic burnout was found to be low in 8.4% of the students, moderate in 56.2% and very high in 35.4%. Happiness status was low in 1.5%, moderate in 82.8% and high in 15.6%.

The rate of academic burnout was higher in male students than in female ones, and there was a significant difference between the two sexes (P = 0.033). However, the difference in academic burnout was not significant for other demographic variables (P < 0.05; Table 2).

Table 2. The Mean Scores of Academic Burnout, Happiness and the Quality of Educational Services Based on Demographic Variablesa
Demographic VariablesAcademic Burnout (Mean ± SD)Statistical TestP ValueHappiness (Mean ± SD)Statistical TestP ValueThe Quality of Educational Services (Mean ± SD)Statistical TestP Value
Gendert = 2.130.033*t = 0.0020.990t = 0.3500.720
Female55.24 ± 12.92106.08 ± 17.5456.04 ± 12.64
Male75.57 ± 11.84106.08 ± 15.8256.45 ± 11.55
Age, yF = 0.0550.940F = 0.920.390F = 0.690.500
Less than 2556.39 ± 12.9106.15 ± 16.9356.63 ± 12.19
Between 25 and 3556.81 ± 9.55105.78 ± 14.2255.06 ± 11.61
Between 35 and 4555.25 ± 2.50117.25 ± 9.5352.75 ± 19.61
Marital statust = 1.310.190t = 0.290.760t = 1.670.090
Single56.68 ± 12.37105.69 ± 16.1055.77 ± 12.15
Married54.56 ± 11.84106.33 ± 18.2658.46 ± 12.21
Native statust = 0.050.950t = 0.480.630t = 2.86*0.004
Native to the province57.54 ± 12.78105.29 ± 16.9157.87 ± 12.40
Non-native to the province59.61 ± 11.31106.21 ± 7.4053.92 ± 12.25
Residence at the dormitoryt = 0.560.570t = 0.080.930t = 1.730.080
Yes56.61 ± 12.08106.60 ± 16.4754.46 ± 11.67
No57.50 ± 12.94106.42 ± 16.6757.05 ± 11.92
FacultyF = 1.090.360F = 1.470.196F = 1.240.280
Medicine58.00 ± 12.81109.83 ± 16.7355.34 ± 10.22
Dentistry57.31 ± 12.44106.08 ± 18.4754.11 ± 14.83
Nursing and midwifery54.66 ± 13.07105.57 ± 17.3258.30 ± 12.05
Rehabilitation56.49 ± 10.10103.48 ± 14.0556.50 ± 10.92
Health57.25 ± 14.52104.16 ± 17.8655.32 ± 13.16
Paramedicine54.81 ± 11.00105.00 ± 15.3156.86 ± 12.00

aIndependent t-test is significant at 0.05.

The highest level of happiness was related to students aged 35 - 45 years, and students of medicine had higher mean scores of happiness than those studying in other faculties, but the difference in the mean score of happiness was not significant at any of the levels of demographic variables (P > 0.050; Table 2).

Independent t-test showed that the evaluation of the quality of educational services by native university students was higher than that of non-native students and there was a significant difference between the two groups (P = 0.004). No difference was observed in other demographic variables (P > 0.050; Table 2).

According to the results of Pearson correlation test, there was a significant inverse relationship between academic burnout and students’ GPA (P = 0.02). The relationship between academic burnout and happiness was also inverse, which was statistically significant (P < 0.001), and there was a significant positive relationship between educational service quality and GPA (P = 0.004), while no significant relationship was found between other variables (P > 0.050; Table 3).

Table 3. The Matrix of Pearson Correlation Coefficients of the Studied Variablesa
VariableGPAHappinessThe Quality of Educational ServicesAcademic Burnout
Happinessr = -0.039, P = 0.4131
The quality of educational services*r = 0.136, P = 0.004r = -0.002, P = 0.9561
Academic burnout*r = -0.108, P = 10.022*r = -0.22, P < 0.001P = 0.060, r = -0.0881

aCorrelation is significant at the level of 0.05.

According to multiple linear regression analysis, about 6% of variations in students’ academic burnout (dependent variable) is explained by independent variables, namely happiness, educational service quality and demographic variables.

Happiness was the only significant variable in the model, such that per one unit increase in students’ happiness score, their academic burnout score decreased by an average of 0.18 (P = 0.001). Other independent variables were not significant for prediction in the multiple linear regression model (P > 0.050; Table 4).

Table 4. Multiple Linear Regression Analysis to Predict Students’ Academic Burnout Using Happiness, Educational Service Quality, and Demographic Variablesa
VariableBtP Value95% Confidence Interval for B
Upper LimitLower Limit
Happiness-0.182-3.3010.001-0.07-0.29
The quality of educational services-0.125-1.5200.1300.03-0.28
Gender
Female (basic group)
Male2.1101.0030.3106.21-2.11
Marital status
Married (basic group)
Married-2.248-0.8170.4103.20-7.65
Age, y
Less than 25 (basic group)
Between 25 and 351.0130.3910.6906.10-4.13
Between 35 and 456.1350.4820.63031.7-18.42
Residence at the dormitory
Yes (basic group)
No-1.480-0.5740.5603.54-6.62
Nativeness status
Native to the province (basic)
Non-native-1.310-0.5260.6003.55-6.28
Faculty
Nursing and midwifery (basic)
Medicine3.8701.1690.24010.41-2.67
Dentistry0.8890.2620.7907.58-5.80
Paramedicine0.9600.3100.7507.07-5.16
Health1.7400.5200.6008.35-4.86
Rehabilitation1.2300.3550.7308.07-5.61

aF (12 & 227) = 1.77, P = 0.045, R2 = 0.13, R2 (modified) = 0.057, DW = 1.81

### 5. Discussion

The aim of this study was to determine the relationship of happiness and quality of educational services with academic burnout among students of Zahedan University of Medical Sciences. The results showed a significant inverse relationship between the variables of happiness and academic burnout of students, that is, academic burnout was lower in students with higher happiness. These results were in line with the findings of the Rostamzadeh and Narimani study, which examined the role of social intimacy and happiness in predicting students’ academic burnout (19), and in some ways, our results were consistent with the findings of the Veiskarami and Yousefvand (20) and Sharififard et al. (24).

Evidence suggests that there is a direct relationship between happiness and mental health (24). Therefore, factors such as stress, distrust to the system, poor quality of life and concern for occupational future that threaten students’ mental health can directly affect students’ happiness, and in turn, influence their academic performance and accountability.

In the present study, a negative relationship was observed between the quality of educational services and academic burnout, which was not statistically significant. These results were in line with the findings of Mohammadi et al. who examined the relationship between university environment quality and students’ academic burnout (25). It was also in part consistent with the results of Nasiri et al., who reported a significant relationship between educational service quality and academic burnout in only one dimension of emotional exhaustion (1), but our findings were contradictory to the results of Naami (3) and Azizzadeh Forouzi et al. (26).

According to the results of this study, there was a significant positive relationship between the quality of educational services and students’ academic performance, which was measured using students’ GPA, and improving the quality of educational services led to an increase in academic performance and GPA. Although there is little research in this area, it can be concluded that improving the educational environment and the quality of its services can affect students’ motivation and academic achievement, which is itself a major impetus for increasing the quality and quantity of students’ study and research.

The mean score of academic burnout in the present study was about 56 and its level was reported moderate in most students. Also, the level of academic burnout was higher among male students than female students. Many studies have been conducted in this area, including the studies of Zaregar et al. (27) and Ghadampour et al. (28) who evaluated students' academic burnout with similar instruments. The results of the mentioned studies were in line with the findings of the present study. On the other hand, the study by Hosseinpour et al. reported students’ academic burnout to be below average (29), which is inconsistent with the results of the present study, which may be due to differences in research conditions and environment.

In the present study, the quality of educational services was assessed using the SERVQUAL model and most of the students (87%) reported it as moderate, while the results of the Yarmohammadian et al. study, which aimed to evaluate the quality of educational services at Isfahan University of Medical Sciences, showed that more than half of students (57.7%) evaluated the quality of educational services as poor (30), which is contradictory to the results of the present study. This difference in results may be due to differences in data collection tools.

According to the results of our study, most students had a moderate level of happiness. Also, there were no significant relationships between students’ happiness and GPA and the quality of educational services and happiness. These findings were in agreement with the results of Tavan et al. (31) and Raisi et al. (32) and the results of our research contradicted with the results of Barati et al. (33). They rated students’ happiness relatively high, but there was a significant difference in the degree of happiness in the demographic variables of gender, place of residence and interest in the field (33), which may be due to differences in the study population and environment.

#### 5.1. Conclusions

Overall, the results of the present study showed that happiness significantly predicts variations in students’ academic burnout. Therefore, considering students’ average level of happiness, psychological educational interventions, positive changes in the educational environment and implementation of appropriate programs to promote vitality, mental health and motivation for academic achievement seem to be necessary.

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