Smartphone use and the quality of life of medical students in the Kumaun Region, Uttarakhand

Reduced Health-Related Quality of Life Due to Mobile Phone Dependence in a Sample of Chinese College Students: The Mediating Role of Chronotype and Sleep Quality

PURPOSE

Presenting a chain mediation model to investigate whether mobile phone dependence results in a reduction in health-related quality of life (HRQoL) among Chinese college students, through the mediating effect of chronotype and sleep quality.

DESIGN AND SETTING

A cross-sectional survey was conducted on students from a Chinese university using a validated structured questionnaire.

SAMPLE

2014 freshmen.

MEASURES

The study measured the students' level of mobile phone dependence using the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use. Chronotype and sleep quality were measured by the Chinese version of the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburgh Sleep Quality Index (PSQI), respectively. HRQoL was evaluated using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L), including a descriptive system and a visual analog scale (VAS).

ANALYSIS

Descriptive statistical analysis, correlation analysis, and mediation analysis.

RESULTS

Mobile phone dependence had a significant negative effect on HRQoL as indicated by both the EQ-5D-5L index score and EQ-VAS score (P < .001 for both). Additionally, it was found to significantly predict chronotype (MEQ score) (β = -.546, P < .001) and sleep quality (PSQI score) (β = .163, P < .001). Chronotype negatively predict sleep quality (β = -.058, P < .001), and sleep quality was a significant negative predictor of HRQoL (EQ-5D-5L index score, β = -.008, P < .001; EQ-VAS score, β = -1.576, P < .001).

CONCLUSION

Mobile phone dependence negatively impacts students' HRQoL through chronotype and sleep quality, and there is a chain mediating effect. Students should consider making lifestyle changes to improve their HRQoL and promote health.

Impact of smartphone on mental health among medical undergraduates: A cross-sectional study

BACKGROUND

Smartphones have become an indispensable part of almost everyone's life. India has now become the leading and second-largest Smartphone market in the world. It has been noted that the purpose of Smartphone usage has exceptionally changed over the past few years, especially among students, professionals, and the common man. Smartphones have now become essential and the need of the hour, and medical students are no exception. Smartphones can make "smart students smarter"! There are now 10,275 unique applications labeled under the "Medical" and "Healthcare and Fitness" categories. The common medical applications used are MedCalc, Drug Infusion, Flashcards, Encyclopedia, Merck Manual, Medscape, PubMed, Epocrates, MedlinePlus, Lab test applications, Medical Dictionary, Eponyms etc. Despite the advantages and needs of smartphones, they have proven to be a source of potential hazard to human health, not only physical but also mental, social, and emotional well-being. There is consistent evidence for co-morbidity (such as obesity, heart diseases, neck and back pain, etc.) between excessive smartphone use and other psychiatric disorders, such as depression, anxiety, obsessive and compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD) similar to internet addiction. The significant association of this addiction with poorer sleep quality and higher perceived stress has been a cause for concern. Hence, further investigation to explore the association between smartphone addiction and mental health, this study was undertaken.

MATERIALS AND METHODS

Our study was undertaken in Dr VMGMC, Solapur, from June to August 2022, after obtaining approval from the ethical committee, approval number 172/22. Total voluntary participation for the study was 600 (from first to final year), and accordingly convenient sample size was taken.

RESULTS

We found that out of the total participants, 42% of the participants had an average screen time of 4-6 h daily. A very small percentage of participants (4%) spent less than two hours in front of a screen. Alarmingly, 65% of the participants had an average screen time of more than 4 hours, which puts them at risk for the negative health impacts of prolonged screen time. Around 12% of them had symptoms of mild stress, 10.3% for mild anxiety, and 15.6% for mild depression. 10.6% had symptoms of moderate stress, 23.3% for moderate anxiety, and 16% for moderate depression. A small proportion of undergraduates, that is, 5%, 16%, and 11.6%, had symptoms of severe and extremely severe stress, anxiety, and depression, respectively.

CONCLUSION

The study participants did not feel a lot of stress, anxiety, or depression symptoms when smartphones were used judiciously and mostly for non-social purposes (such as studying, listening to music, or watching videos). This investigation led us to the conclusion that there are some positive effects of smartphones on mental health. However, those who spent an excessive amount of time on their smartphones for social contact, with an average screen time of 5 h, showed signs of mild to moderate sadness, moderate anxiety, and tension, demonstrating that social media had a negative impact on the mental health of medical undergraduates. Therefore, efforts should be made to inform medical students about how using a smartphone is harming their mental health.

The relationship between mobile phone addiction and depression, anxiety, and sleep quality in medical students

This study investigates the prevalence of mobile phone addiction among medical students and its relationship with depression, anxiety, and sleep quality. The study was conducted at Mashhad University of Medical Sciences from 2019 to 2021, and it included medical students at four different levels of training. Participants were selected using a stratified random sampling method. All subjects completed the Mobile Phone Addiction Scale, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory, and Beck Anxiety Inventory through online electronic self-report questionnaires. Overall, 355 medical students were included in the study, with 203 (57.2%) being female. Mild and severe mobile phone addiction was reported by 83.7 and 2.5% of the students, respectively. Furthermore, the study's findings revealed significantly higher sleep quality disorder, depression, and anxiety scores among students with severe mobile phone addiction compared to other participants ( P  < 0.001, P  = 0.007, and P  < 0.001, respectively). Although mobile phone addiction was prevalent, severe addiction was rare among medical students. Nevertheless, severe addiction was associated with an increased prevalence of mental health problems and sleep disturbances, emphasizing the importance of interventions aimed at reducing mobile phone addiction and improving mental health.

Exploring the Relationship between Smartphone Addiction, Quality of Life, and Personality Traits in University Students

Objective: This study aimed to explore the dynamics of the relationship among smartphone addiction, quality of life, and personality characteristics in university students. Method : This correlational and descriptive research was conducted to investigate the relationship between smartphone addiction, quality of life, and personality traits among university students. Using a nonprobability random sampling method, 496 university students were selected. Data collection involved the Student Information Form, Smartphone Addiction Scale, Symptom Checklist (SCL-90-R), Revised Eysenck Personality Questionnaire-Abridged Form (EPQR-A), and the WHO Quality of Life Scale-Short Form (WHOQOL-BREF). Statistical analysis was conducted with SPSS 25.0, utilizing Chi-square tests, independent sample t-tests, and Pearson's correlation analysis. Results: Out of 496 students (average age of 20.52), 59.87% were identified as smartphone addicts based on the Smartphone Addiction Scale-Short Version. A notable difference was found by study year (P = 0.009) and socioeconomic status (P = 0.003). Participants with smartphone addiction registered higher SCL-90-r scores for conditions like Obsessive Compulsive Disorder, Interpersonal Sensitivity, and Psychoticism. The Eysenck Personality Inventory highlighted that the Psychoticism score was significantly higher in the group with smartphone addiction (P = 0.001). A negative correlation between smartphone addiction scores and general health (WHOQoL) was identified, whereas a positive correlation with SCL-90-R's Psychoticism dimension score was observed (P < 0.001). Conclusion: Smartphone addiction is widespread among university student population. The study indicates that smartphone addiction not only impacts the individual's quality of life but also is associated with personality disorders, and these problems intensify with the severity of addiction. The findings underscore the need for interventions and educational programs to address smartphone addiction in this population.

Prevalence of Nomophobia and Its Association with Academic Performance Among Physiotherapy Students in Saudi Arabia: A Cross- Sectional Survey

Background

Nomophobia is common among students in many healthcare disciplines, and its association with academic performance has been explore before. However, there is no available data on its prevalence and association with academic performance among undergraduate physiotherapy (PT) students in Saudi Arabia.

Methods

Between 22 December 2022 and 30 January 2023, a cross-sectional survey was conducted by dissemination using an online platform (Survey Monkey).

Results

In total, 806 PT students, with males accounting for 494 (61%), responded to the survey. The prevalence of nomophobia among PT students was 98.4% (793). The mean (±SD) of the total NMP-Q items scores was 49 (±17), indicating a mild level of nomophobia. Female PT students had significantly higher nomophobia scores than the males (47 (39-65); 44 (38-52); (p < 0.001)). Non-smokers had significant higher nomophobia scores than smokers (46 (38-61); 44 (38-49); (p = 0.004)). Regarding grade point averages (GPA), the students with a GPA of less than 3.49 had the highest nomophobia score (51 (43-74); p <0.001)). Concerning the stage of their studies, bridging students had the highest nomophobia score (51 (34-76); p = 0.023)). Regarding academic warnings, those who reported no academic warnings had the highest nomophobia score (46 (42-50); p = 0.023)). Finally, regarding study hours, the students who spent ≥ five hours studying per week had the highest nomophobia score (54 (42-68); p < 0.001)).

Conclusion

Nomophobia is common among PT students, with the majority experiencing a mild level. Being female, non-smoker, and having a higher academic performance were risk factors associated with higher nomophobia levels.

Medical Student Experiences of Engaging in a Psychological Flexibility Skill Training App for Burnout and Well-being: Pilot Feasibility Study

BACKGROUND

Medical students are at higher risk of burnout than the general population. Interventions that facilitate adaptive coping behaviors (eg, Psychological Flexibility) in the context of inherent stressors associated with medical training could mitigate burnout risk and improve well-being. Delivering these interventions using smartphone apps offers advantages such as accessibility, scalability, mitigation of time and stigma barriers, and facilitation of individual tailoring (individualization). There is a need for feasibility trials with medical students in this emerging field. Formal evaluations of user experiences of app-based psychological skill training are required to identify barriers to and facilitators of engagement and optimize intervention development before implementation in efficacy trials and real-world settings.

OBJECTIVE

This study aimed to assess the feasibility of delivering an individualized Psychological Flexibility skill training intervention (Acceptance and Commitment Training [ACTraining]) to medical students using an app-based delivery format. We further aimed to explore how formal evaluation of user experiences might inform and guide the development of this app before implementation in an efficacy trial and future research involving app-delivered psychological skill training for medical students.

METHODS

This single-arm study was an early-phase feasibility trial of a stand-alone ACTraining app conducted with a sample of Australian medical students (n=11). We collected app usability and user experience data across a broad range of domains (eg, perceived helpfulness and relevance, learning experiences, and self-efficacy) using self-report questionnaires (quantitative and qualitative) and behavioral engagement outcomes.

RESULTS

Behavioral engagement data demonstrated that the app delivered the assessment procedures and individualized ACTraining intervention to medical students as intended. The subjective feedback provided by students who actively engaged with the app was generally positive across several indicators, including usability, perceived relevance and helpfulness, accessibility, maintenance of privacy, and opportunity for self-reflection. Disengagement from the app was an identified challenge throughout the trial. Participant feedback identified several factors that may have affected engagement, such as time, expectations regarding app interface functioning, and individual differences in confidence and self-efficacy when implementing skills.

CONCLUSIONS

This study reports user experience data that have been largely absent from the literature on digital psychological interventions for medical students. Our findings demonstrate the preliminary feasibility of an app-delivered ACTraining intervention for medical student well-being and burnout and support the value of future assessment of the efficacy of this approach with larger samples. We consider subjective feedback from medical students in relation to observed engagement and propose how this information might be used to inform the development of this app and future research in this nascent field.

Relationships of Mobile Phone Use with the Functions and Disabilities of Neck and Upper Extremity

Aim: To determine the effects of mobile phone use on fine motor functions, neck, and upper limb disability values.Methods: Time duration of mobile phone use was recorded for a week. Rapid Upper Limb Assessment (RULA) was used to determine the risk level about posture while texting message on phones. Neck Disability Index (NDI) for neck pain and functional disability of neck on activities of daily life, Disabilities of the Arm, Shoulder, and Hand-Function/Symptom (DASH-FS) for the limitation in the functions of upper limb, Jebson Taylor Hand Function test for fine motor function.Results: Two hundred and seventy individuals (141 women, 129 men) whose mean ages were 21,48±1,86 years were included. While a significant correlation between duration of phone use and NDI score was specified (r=0,172; p=0,005), no significant correlation was found between duration of phone use and DASH-FS scores (r=0,092; p=0,130). It was found that there was a negative significant relationship between the duration of phone use and the total function score of the left hand and throwing small objects (p&lt;0,01). According to RULA 95,6% of individuals have unacceptable phone usage postures, but no significant relationship was found between ergonomic risk level and NDI values, DASH-FS values, and hand functions (p&gt;0,05).Conclusion: Although increased duration of phone use could cause neck problems, manual ability may be positively affected. In addition, since most participants have a poor posture while using a mobile phone, it is thought that this may be a risk factor for more musculoskeletal problems in older ages.

The Italian version of the mobile phone problematic use scale for adults (MPPUS): A validation study

The Mobile Phone Problematic Use Scale (MPPUS) is a self-report measure developed to identify the problematic use of mobile phones (PSU) among adults. The purpose of this study was to create an Italian version of this scale. A sample of 568 Italian adults completed the MPPUS, presented in association with another validated scale for the assessment of smartphone addiction. We carried out exploratory factor analyses on the MPPUS. Findings emphasised that the Italian version of the MPPUS fits a bi-factor model, in which the general factor 'PSU' was found, including two additional specific factors (i.e., 'Withdrawal and social aspects' and 'Craving and escape from other problems'). The MPPUS was correlated with the Smartphone Addiction Scale short version. With respect to criterion-oriented validity, the MMPUS was also evaluated in relation to socio-demographic variables (i.e., age and gender). The internal consistency and temporal stability of the scales (test-retest assessment after three months) were confirmed.

Is Problematic Internet and Smartphone Use Related to Poorer Quality of Life? A Systematic Review of Available Evidence and Assessment Strategies

Purpose of Review

Previous studies have explored the links between problematic Internet use (PIU) or problematic smartphone use (PSU) and quality of life (QOL). In this systematic review, we (i) describe the instruments used to assess QOL or health-related quality of life (HRQOL) in these studies, (ii) critically examine the content validity of the instruments used, and (iii) examine the relationships between PIU, PSU, QOL, and HRQOL.

Recent Findings

We identified 17 PIU and 11 PSU studies in a systematic search. Evidence suggests that PIU and PSU negatively correlate with either QOL or HQOL and most of their domains (especially mental and physical health). Multiple instruments were used to assess QOL or HRQOL in these studies. Our analysis showed an important heterogeneity in the domains covered by these instruments.

Summary

Because of the widespread prevalence of PIU and PSU, which tend to be linked with lower QOL or HRQOL, in particular poor mental and physical health, a more systematic public health campaign is required to target the healthy use of these communication devices. Prevention programs should also target vulnerable individuals, focusing on the most affected domains of QOL and HRQOL (i.e., physical and psychological health). Among the existing instruments, the World Health Organization Quality of Life for adults and the Pediatric Quality of Life Inventory for adolescents (aged 13-18 years) proved to be the most relevant, although new measurement instruments are needed to target domains that are specifically relevant in the context of PIU and PSU (e.g., physical and psychological health domains such as sleep, loneliness, and quality of familial relations).

Prevalence of smartphone addiction and its relation with sleep disturbance and low self- esteem among medical college students

BACKGROUND

Use of smartphone is on the increase worldwide. They have revolutionized our lives to an extent that was unimaginable before the pandemic. Excessive use of smartphones reaching the levels of potential addiction among medical students and its relation to individual's sleep quality and self-esteem led us to study this prevalence.

AIM

This stuay aimed to study the prevalence of smartphone addiction and its relation with self-esteem and sleep disturbance in medical college students.

MATERIALS AND METHODS

A cross sectional analytical study was carried out and the prevalence of smartphone addiction, self- esteem, and sleep disturbance was measured using standardized questionnaires smartphone addiction scale short form, Rosenberg self esteem scale, Pittsburgh sleep quality index assessment respectively.

RESULTS

Prevalence of smartphone addiction among medical college students was 52%. Smartphone addiction was seen more in boys than girls. There was a significant association between the smartphone addiction and sleep disturbance. However, there was no significant association between smartphone addiction and low self-esteem.

CONCLUSION

The prevalence of smartphone addiction among medical students is found to be high and is associated with poor sleep.