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INTRODUCTION
With the COVID-19 pandemic, humanity has faced significant challenges. The COVID-19 pandemic began with the emergence of a new strain of coronavirus at the end of 2019, which was officially declared by the World Health Organization (WHO) in March 20201,2. Acute respiratory infections, known as COVID-19, are caused by a beta-coronavirus called SARS-CoV-23. The infection originated in Wuhan, a district in the region of China, and rapidly spread worldwide3. In some countries, such as Brazil, the population has suffered severe consequences and many deaths as a result of neglect of the disease and the spread of fake news.
This situation represents a global threat, and combatting the consequences of the virus is now a challenge for governments and civil society in general. Social distancing became mandatory as a measure to contain the spread of the virus, leading to the adoption of Emergency Remote Learning (ERL)6. Teachers and students from all parts of the world had to adapt to a new way of learning and teaching with the mediation of technology7.
The effects of implementing social isolation, with widespread adoption of home confinement, still need to be better understood. However, there are indications that it has been detrimental to people’s physical and mental health11. The collective hysteria created by the pandemic and disseminated on a large scale through social media has negatively affected our lives15. The long-term consequences of social isolation and media hysteria on physical and mental health are very worrying and can make the situation even worse.
As a consequence of the actions adopted to contain the spread of the virus since the pandemic has repeatedly occurred, among other things, people have become prone to fatigue, paralysis, carelessness, blind optimism, and even compromising the population’s mental health16. Turning the focus to the context of this research, the teachers adopted ERL without receiving the necessary training beforehand7,8,10. Furthermore, many education professionals did not have access to appropriate equipment for this new teaching modality8,17. This situation became even more complex when we considered the students’ case, which was even more precarious, generating even more frustration for the educators.
While people were required to stay at home to avoid infection, institutions needed to keep functioning18. Schools rapidly adopted remote learning systems as an immediate response to the need to deliver education, despite uncertainty about the impact on the teaching and learning process, and on the health of teachers17. As the pandemic evolved, schools gradually returned to normal functioning, although uncertainty remained about what the “new normal” would be19.
According to the motto “taking care of those who take care”, many projects were designed to serve teachers and other professionals in educational institutions at various levels1,23. This is because Quality of Life (QoL) directly impacts the quality of classes and other academic activities17,26. The term “quality of life” is a broad concept encompassing various aspects of people’s lives, not just their work29. It is important to note that studies have reported interference with quality of life in one domain can affect the quality of life in another domain, so the effects of low Quality of Work Life (QWL) can reverberate in the family environment and vice versa22,29.
Several studies have investigated the well-being of educators32, even focusing on improving teacher training to ensure professionals are better prepared for the profession’s challenges33. QoL is an outcome measure that has been widely used by researchers in various fields, as well as in the context of public and private organizations11,34. Several evaluation instruments have been developed to target specific objectives and audiences.
Research has shown how the pandemic has negatively impacted the QoL of teachers29. Studies conducted in various parts of the world have demonstrated professionals’ worsening of physical and mental health conditions across different economic activities35. However, among teachers, the demand for results even at a distance, inadequate working conditions, job insecurity, and abrupt changes in routine have led to increased illness and absenteeism22,38. Therefore, it is essential to conduct a systematic review to identify teachers’ perceptions of their QoL.
Thus, this protocol describes the method for assessing teachers’ perceptions of their QoL during the COVID-19 pandemic and after returning to face-to-face activities. Furthermore, we will also seek to compare the perception of QoL before, during, and after the pandemic.
METHODS
Protocol and Registry
The protocol for this research was developed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P 2015)41. PRISMA-P 2015 comprises a set of checklist items to be considered in the preparation and development of a systematic review protocol41 (Supplementary Material 1).
To ensure transparency and reproducibility in this research, the protocol was submitted and registered in the International Prospective Register of Systematic Reviews (PROSPERO; reference number CRD42022365861). Any changes made to this protocol during the study will be reported to PROSPERO and specified in the article’s final version before publication.
Search Strategy and Databases
A systematic search will be conducted in the following databases: Cumulative Index to Nursing and Allied Health Literature® (CINAHL®) via the EBSCOhost™ interface, Embase™, Latin American and Caribbean Health Science Literature (LILACS) via the Virtual Health Library (BVS), MEDLINE/PubMed® via the National Library of Medicine® (NLM®) interface, Scopus™, Web of Science™ (WoS) Core Collection. The databases searches will be conducted in Abril 2024 to identify potential studies for inclusion in the systematic review.
Based on the identified gaps on the current literature, the construction of this systematic review protocol was guided by the following research questions: (a) What is teachers’ perception regarding their QoL? (b) What are the implications of remote education (ERL) on the QoL of teachers due to the COVID-19 pandemic? (c) What are the implications of COVID-19 on QoL before, during, and after the pandemic?
To answer these questions, we defined a search strategy. Thus, the search strategy comprises keywords and specific terms related to the focus theme of this study, based on the PECO framework (Population, Exposure, Comparison, Outcome) for questions related to exposure with health outcomes42. With this in mind, the following guiding strategy was defined: P = teachers who work in educational institutions; E = associated factors (environmental, socioeconomic, workload, level of physical activity, sleep, and nutrition); C = age, sex, and institution where they work; and O = quality of life. When conducting searches in databases, the following fields will be considered43: title, abstracts, and keywords.
The search terms will include “teacher”, “quality of life”, and “pandemic”, along with their synonyms and derivations. The Boolean operator “OR” will be used to group the synonyms for each term, and the Boolean operator “AND” will be used to combine the blocks formed by the descriptors43, as outlined in table 1.
Table 1 : Keywords that make up the search strategy organized in blocks
| Blocks: | Keywords used: |
|---|---|
| #1 | (teacher OR professor) AND (faculty OR college OR university OR undergraduate OR “higher education”) |
| #2 | pandemic OR “sars-cov-2” OR “covid-19” OR “novel coronavirus” OR “coronavirus disease” OR “coronavirus infection” OR “severe acute respiratory syndrome” |
| #3 | “life quality” OR “quality of life” OR “quality of working life” OR wellbeing OR “personal satisfaction” OR qol OR hqol OR hrqol OR “value of life” OR whoqol OR “whoqol-bref” OR “SF-36” OR “SF36” |
| Search string: | (#1) AND (#2) AND (#3) |
The search strategy was customized for each database, and specific refinement filters were applied to exclude studies that do not meet the eligibility criteria for the objective of this systematic review (Supplementary Material 2). The process of extracting metadata from the databases will adhere to the guidelines of the PRISMA-Search checklist (PRISMA-S)43,44. This PRISMA extension covers various aspects of the literature search process for systematic reviews, documenting the specifics of each database, including the search strategy used (registration of limits, restrictions, filters used, etc.), the registration of returns obtained, and the duplication process43,45.
Eligibility Criteria
We will identify studies published in any language without time restrictions46. The study design to be screened will include quantitative and qualitative observational studies, cross-sectional, cohort, case-control, and controlled clinical trials based on the following criteria.
Inclusion criteria
(i1) Original studies already published and peer-reviewed47,48.
(i2) Studies including a sample of professors affiliated with higher education institutions.
(i3) Studies that have evaluated QoL or QWL in the context of the COVID-19 pandemic.
Exclusion criteria:
(e1) Studies that have simultaneously addressed teaching and non-teaching professionals unless the data have been reported separately or can be calculated from the provided data.
(e2) Duplicate studies found in more than one database. In this case, the most comprehensive study will be selected. Any duplicate indications will be manually reviewed to confirm their exclusion49.
(e3) Studies with incomplete data, review articles, opinion articles, case reports, commentaries, editorials, dissertations, theses47,50; articles in press, journal letters, and books50.
(e4) Studies that were not accessible even after attempting to contact the authors47,48.
(e5) Articles written in a restricted language that cannot be adequately translated44. This criterion will only be applied if we exhaust all translation possibilities, such as i) seeking support from our international collaboration network, ii) employing artificial intelligence tools, and iii) hiring specialized companies for the necessary translations. We will indicate this in the findings of our systematic review43.
(e6) Studies with any record of retraction44,47.
Some studies meeting the inclusion criteria may be excluded if any exclusion criteria apply. Once selected for the systematic review, eligible studies will undergo validation of their evidence and will be checked for any associated retraction records using the Scite tool43,44 (available at: https://scite.ai/).
Review Process
The metadata extracted from the databases using the search strategy will be grouped, and duplicate articles will be removed using EndNote Desktop X9 software51. After removing duplicates, the metadata will be imported into Rayyan® software to conduct the systematic review.
The initial analysis will involve reading the titles and abstracts of the articles. Only after this stage has been completed will the full text of articles meeting the eligibility criteria be read. Two reviewers (ED and MF) will independently conduct this screening process, and disagreements will be resolved by a third senior reviewer (MN or PN)43.
The selected articles (i.e., those that pass through the stages detailed above) will be included in the systematic review. The reference lists of the articles will also be consulted to identify possible omissions by the search strategy43. The flowchart for selecting articles for this systematic review52 is shown in figure 1.
Figure 1 : PRISMA 2020 flowchart for the study identification, screening, and inclusion process in the review
Inter-rater reliability for classifying individual components will be calculated using the percent agreement between the reviewers and Cohen’s Kappa coefficient43,53,54.
Data Extraction, Synthesis, and Analysis
Data extraction will be conducted using an electronic spreadsheet considering the aspects listed in Supplementary Material 2. Two independent reviewers (ED and MF) will extract and evaluate the data, and any discrepancies will be resolved by a third senior reviewer (MN or PN). If relevant data are unavailable in the manuscript, a researcher (ED) will contact the authors directly to fill in any gaps55.
Assessment of Quality and Risk of Bias
The articles included in this study will undergo evaluation for the quality of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) recommendations56. The evidence will be categorized as high, moderate, low, or very low quality56,57. Additionally, we will report whether the studies disclosed conflicts of interest and whether ethical approval for the research was obtained57.
The risk of bias will be assessed independently by two reviewers (ED and MF). Any disagreement will be resolved by a third senior reviewer (MN or PN). The Downs and Black scale, which comprises 27 items, will be used to analyze the risk of bias in quantitative studies58. For qualitative studies, the 10-item Critical Appraisal Skills Program (CASP) checklist will be used to classify the studies59.
Reviewer Training
The reviewers conducting the systematic review will demonstrate the eligibility of the studies to be used by analyzing 50 articles and considering their respective titles and abstracts. This training will serve as preparatory training for the inclusion and exclusion criteria60. They will also undergo training on using methodological quality and risk of bias instruments in five articles and on employing standardized analyses using EndNote Desktop X9 and Rayyan® software43,64.
Data extraction will be conducted using an electronic spreadsheet considering the aspects listed in Supplementary Material 3. Two independent reviewers (ED and MF) will extract and evaluate the data, and any discrepancies will be resolved by a third senior reviewer (MN or PN). If relevant data are unavailable in the manuscript, a researcher (ED) will contact the authors directly to fill in any gaps55.
The articles included in this study will undergo evaluation for the quality of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) recommendations56. The evidence will be categorized as high, moderate, low, or very low quality56,57. Additionally, we will report whether the studies disclosed conflicts of interest and whether ethical approval for the research was obtained57.
DISCUSSION
This study’s theme is relevant because emergency remote learning was adopted in several regions of the world as a necessary measure during the pandemic in response to the social distancing recommended by the WHO65. However, the vast majority of teachers were not prepared for this mode of teaching, which caused significant anxiety, fear of contracting COVID-19, and mental illness. Therefore, our systematic review will indicate the pandemic’s impact on this category of professionals and how it was perceived and disseminated in different journals. We also intend to publish the data from the systematic review in specialized journals.
Limitations are expected in a systematic review. If no studies meet our eligibility criteria, the review will be reported as an “empty review”. However, even an “empty review” can be relevant as it may stimulate appropriate future investigations66. If the review identifies studies that meet our eligibility criteria, they will be considered to map the evidence, serving as an updated guide available to public health policymakers67.
Limiting the search to a period closer to the pandemic may result in a smaller number of studies on QoL. Furthermore, the diversity of methodologies used in research on QoL can also be considered a further limitation. Finally, the search strategy may not identify relevant studies due to authors not using the term “quality of life” or not using updated and properly validated instruments to measure it. The absence of language restrictions represents a strength of this study as it may generate more comprehensive results.
FINAL CONSIDERATIONS
This study protocol aims to identify possible gaps related to QoL, specifically teachers’ perceptions of QoL, in the context of the COVID-19 pandemic. By transparently reporting these gaps in the knowledge, we hope to contribute to this area and stimulate new research. It is important to note that the results of the systematic review may be influenced by a series of factors, such as those related to social, economic, cultural, religious, level of educational institution, the workload of the teacher, and other variables inherent to the countries in which the studies were conducted. Once teachers’ perception of their QoL and QWL is known, the information obtained through this systematic review can be used to enable the development and implementation of new guidelines in the daily life of educational institutions and support public health programs aimed at this specific audience.
