Trends and Influencing Factors in Problematic Smartphone Use Prevalence (2012-2022): A Systematic Review and Meta-Analysis

Given that problematic smartphone use (PSU) has been researched for a long time, it becomes necessary to assess how the trends of PSU prevalence have evolved over time. In total, 106 articles from 2012 to 2022 with 109 studies covering 97,748 individuals were included in this systematic review and meta-analysis. The estimation of the global pooled PSU prevalence was 37.1% (95% confidence interval, 33.5 - 40.8%) and the PSU prevalence is growing over time in total. Although the PSU prevalence exhibited wide variation between regions and measurement scales, the increasing trend remained. In addition, the regression slope of the PSU prevalence trend in males was higher than that in females. Males initially had a lower prevalence of PSU than females, but this steadily changed over time until it was greater in males than in females. Moreover, the prevalence of PSU showed an increasing trend across all age groups, with a faster growth rate in the older age group. Considering the aforementioned results, it's necessary to implement proper interventions to do with this phenomenon. In addition, considering the differences in prevalence brought by regions, and measurement scales, in practice and research, we should not only take into account the disparities of PSU between countries or cultures, but also to concern about establishing unified standard and measurement tools to confirm it.

Learning styles, approaches and academic performance of second and third-year medical students of a medical college of Kathmandu: a descriptive cross-sectional study

Background

The research is based on a questionnaire to study the different learning styles among medical students, and their approach to intellectual development.

Methods

This is an observational, cross-sectional study conducted on 140 participants. Initially after the informed consent process, the second-year and third-year medical students were requested to respond to the questionnaire without consulting friends. Data were analyzed descriptively and comparison was made.

Results

In this study, the students were mostly visual learners, followed by solo learners, audio learners, verbal learners, and social learners. The majority of the students in our study (84.56%) studied less than 4 h per day beyond normal lecture hours. Similarly, 45.71% of students studied continuously for 30-60 min. During break, 63.57% of students used social media, watched television, and videos, and listened to music. Most students (75%) preferred to study in a hostel room and only 12.85% used the library as their study place. The majority of the students (65.71%) of students slept between six to eight hours. The University's suggested medical textbooks and reference materials were consulted by 94.3% of the students. The 47.85% of students favored self-directed learning with 56.42% preferring to read and write to retain the learned materials. Self-prepared notes were commonly used by the majority of students (60.7%).

Conclusions

This research evaluates the preferred learning preferences of medical students and their relationship to academic performance, which will improve the effectiveness of teaching and learning between teachers and medical students.

Effect of fear of missing out on learning burnout in medical students: a moderated mediation

Introduction

Learning burnout has a significant negative impact on students' academic performance and professional development, which has been exacerbated by the growing trend of problematic smartphone use, such as smartphone addiction, among young people. Recently, the literature on excessive social media use has revealed a critical role of fear of missing out. Objective The purpose of this study was to examine how fear of missing out affects smartphone addiction and its subsequent effect on learning burnout in college students.

Methods

In Study 1, 352 medical students were recruited to complete a cross-sectional survey. In Study 2, 2,948 college students were recruited to complete a cross-sectional survey. Further in Study 3, 30 medical students were recruited into a mindfulness-based intervention program.

Results

Study 1 preliminarily confirmed that fear of missing out was positively correlated with learning burnout. Study 2 then revealed a moderated mediation model showing that fear of missing out may increase smartphone addiction, which in turn affects their sleep quality and finally leads to learning burnout. This chain mediation model was moderated by the participants' level of mindfulness. To confirm the promoting role of mindfulness, Study 3 further confirmed that mindfulness training indeed can improve smartphone addiction and reduce learning burnout in medical students.

Discussion

Theoretical and practical contributions were discussed, highlighting the effects of fear of missing out on smartphone addiction and a moderating role of mindfulness training.

Physical activity, problematic smartphone use, and burnout among Chinese college students

The aim of this study was to investigate the association between physical activity (PA), problematic smartphone use (PSU), and burnout, as well as to identify whether there is a mediating role for PSU. We recruited 823 college students (Mage = 18.55, SD = 0.83) from Wuhan, China, in December 2022, including 499 males and 324 females. Demographic information, the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Smartphone Addiction Scale-Short Version (SAS-SV), and the Maslach Burnout Inventory-Student Survey (MBI-SS) were used for assessments. Pearson correlation analysis showed that PA was significantly associated with PSU (r = -0.151, p < 0.001), PSU was significantly associated with burnout (r = 0.421, p < 0.001), and the association between PA and burnout was not statistically significant (r = -0.046, p > 0.05). The results of the mediation model test showed that PA could not predict burnout directly; it instead predicted burnout entirely indirectly through PSU. Furthermore, PSU mediated the predictive effect of PA on exhaustion and cynicism. In conclusion, there is no direct connection between PA levels and burnout. PA indirectly affects burnout through PSU, but does not fully apply to the three different dimensions of exhaustion, cynicism, and professional efficacy.

Prevalence of smartphone addiction among Asian medical students: A meta-analysis of multinational observational studies

BACKGROUND

High prevalence of smartphone addiction among medical students may contribute to adverse physical and mental health outcomes.

AIM

To estimate the prevalence of smartphone addiction, and explore the influencing factors and related mental health symptoms of smartphone addiction among Asian medical students.

DESIGN

Systematic review and meta-analysis.

METHODS

PubMed (MEDLINE), the Cochrane Central Register of Controlled Trials, and EMBASE were searched for relevant literature from the inception to September 10, 2021. Using Stata software 11.0, the meta-analysis of prevalence and the influencing factors of smartphone addiction were determined with 95% confidence intervals.

RESULTS

Nineteen articles, published between 2014 and 2019, were included, producing medical student studies from seven different Asian countries. The included studies were conducted in India (n = 11) and Malaysia (n = 3), with China, Saudi Arabia, Turkey, Nepal, and Iran each contributing one study. Among a total of 5,497 medical students, the participants included 3,214 females, of whom 2,181 were medical students with smartphone addiction. The prevalence of smartphone addiction among Asian medical students was 41.93% (95% CI [36.24%, 47.72%]). The influencing factors of smartphone addiction among medical students included gender, duration of smartphone use, smartphone function, and marital status. Ten studies (52.63%) explored related mental health symptoms of smartphone addiction among Asian medical students. Smartphone addiction was positively correlated with poor sleep quality (r = .17-.31), stress (r = .30-.40), anxiety, depression, neuroticism, and general health among Asian medical students.

CONCLUSION

Smartphone addiction is highly prevalent among Asian medical students. Smartphone addiction may adversely affect mental health, resulting in sleep disturbance, stress, anxiety, depression, and neuroticism. It is necessary to take appropriate precautionary actions and interventions to prevent smartphone overuse among medical students.

College Students' Learning Performance, Teaching Skills, and Teaching Innovation in Intercultural Communication Class: Evidence Based on Experiential Learning Theory

In China, the improvement of the learner performance is critical a challenge for the teaching staff and the management in intercultural communication class. Indeed, the administration of the Chinese schools is failed to provide effective learning to the students with innovative methods. The objective of this study was to identify the role of college students' learning performance, teaching skills, and teaching innovation in intercultural communication class. This study is based on the quantitative data collected on a five-point Likert scale from the target respondents who were the students of different colleges and 700 questionnaires distributed for it. The study concludes that there is a significant relationship among abstract conceptualization, active participation, and reflective observation in students' learning performance. Furthermore, this study highlights that the mediating role of teaching innovation is critical for students' learning performance. This study contributes to the literature with a significant theoretical framework. Finally, this study provides significant theoretical implications and practical implications which are key game-changers for improving the performance of the students in the intercultural communication class.

Psychological Distress, Burnout, and Academic Performance in First Year College Students

Background: The first years of university can be very challenging for students. Previous research has focused on the study of the prevalence of burnout and of psychological distress in medical students. The aim of this study was to investigate the prevalence of psychological symptoms and burnout reported by first-year students, the relationship between these variables and their academic performance, and the differences between health and non-health sciences students. Methods: An observational study with a cross-sectional design was performed. Students of health sciences (medicine, nursing, physiotherapy, psychology), and non-health sciences (biology, social sciences, business management, and engineering) undergraduate programs completed the Brief Symptom Inventory (BSI-18) and the Maslach Burnout Inventory-Student Survey (MBI-SS). Students’ grades for the first semester were collected. Results: A sample of 506 students participated. Prevalence of psychological distress was 27.1% and burnout was 7.3%. Academic performance was unaffected in relation to either psychological distress or burnout. Non-health sciences students showed a greater risk of depression. Conclusions: This study provides evidence of the high prevalence of psychological distress in the first year of college. Even when burnout prevalence was low, the results suggest the need to introduce prevention programs to improve the psychological wellbeing of these students.

Role of politically motivated internet addiction and ideological passion in linking college student's mental health education and wellbeing

College students are increasingly reporting common mental health issues like depression and anxiety, raising severe concerns for students' psychological wellbeing. Specifically, after the emergence of Post-COVID-19, digitization caused a potential role in mitigating students' psychological concerns. Therefore, the role of mental health education has been regarded as a topic of interest in managing the issue of Chinese college students' mental wellbeing. This study intends to look into the relationship between mental health education and psychological wellbeing, along with the moderating role of politically motivated internet addiction and the ideological passion of college students. For the given reason, the random sampling method was employed for collecting data from target respondents. The study uses 750 questionnaires prepared on a five-point Likert scale that were distributed to the respondents with an expected response rate of 50%. The partial least square (PLS) software was used to analyze the data for this study. The study concludes that there is a significant moderating role of politically motivated internet addiction and ideological passion in the relationship between college students' mental health and wellbeing. The study meaningfully contributes to the body of knowledge by establishing the unique, positive moderating role of Politically motivated internet addition in strengthening the relationship which undoubtedly will assist in improving the psychological wellbeing of college students through mental health education policies and implications.

The influence of mobile phone addiction and work procrastination on burnout among newly graduated Chinese nurses

PURPOSE

The study was conducted to explore the relationship between mobile phone addiction, work procrastination, and burnout among newly graduated nurses.

DESIGN AND METHODS

A cross-sectional survey involving 220 newly graduated nurses in China was conducted from June to July 2020.

FINDINGS

Approximately 60.9% of newly graduated nurses experienced occupational burnout; 72.7% of newly graduated nurses were characterized by moderate or greater procrastination and mobile phone addiction was at a moderate level. Mobile phone addiction and work procrastination were significant factors leading to emotional exhaustion and cynicism. Work procrastination was also an independent predictor of reduced professional efficacy.

PRACTICE IMPLICATIONS

Reducing the level of mobile phone addiction and work procrastination among newly graduated nurses might be effective for burnout prevention.

The role of extracurricular activities and lectures in mitigating medical student burnout

CONTEXT

Strong evidence throughout the literature highlights burnout as a significant and increasing problem among medical students, impacting students' ability to effectively care for and empathize with patients.

OBJECTIVES

To examine how involvement in extracurricular activities and attendance at burnout lectures can impact burnout among medical students.

METHODS

An anonymous digital survey including the Maslach Burnout Inventory (MBI) was sent to all students (n=765) at Rowan University School of Osteopathic Medicine. The survey included questions regarding the number of burnout/wellness lectures respondents had attended, the number of clubs in which the respondents participated, the number of hours spent in these clubs, and any leadership positions held by the respondents.

RESULTS

Of the 765 students enrolled, 597 completed the survey. Results indicated that women participated in significantly more clubs than men (t[456]=-4.30; p<0.001). Men had higher scores on the depersonalization subscale of the MBI than women (t[463)=2.98; p<0.01]. There were no gender differences in emotional exhaustion or personal accomplishment. Linear regression analyses including gender and club participation as predictors of each of the burnout subscales indicated a significant interaction between gender and number of clubs (β=0.34; p<0.05), in that more club participation was associated with higher depersonalization scores for women, but lower depersonalization scores for men. The number of wellness/burnout prevention lectures attended was not predictive of scores on any of the burnout subscales.

CONCLUSIONS

Our results indicate the importance of understanding what drives burnout on the individual level and adapting interventions to suit the needs of individual students, rather than the student body as a whole.

Does the smartphone use affect the determination of daily goals: A nursing students' example?

PURPOSE

To examine how the risky use of smartphone in nursing students affects their daily goals.

DESIGN AND METHODS

A total of 419 nursing students participated in this study. A Descriptive Data Form, Smartphone Addiction Scale-Short Version, and Daily Goals Scale were used to collect the data.

FINDINGS

According to our study results; students who are afraid of forgetting or losing their phone have a higher risk of being smartphone addiction. As the risks of students' smartphone addiction increase, their daily goal setting levels decreased.

PRACTICE IMPLICATIONS

The risky use of smartphone effects negatively daily goals setting. Education and counseling programs that will prevent the risky use of smartphones and the associated risk of addiction should be provided for nursing students.

Sleep and occupational well-being in active duty special operations soldiers: A replication and expansion

OBJECTIVE

To assess the relationship between sleep quality and occupational well-being in active duty military Service Members.

DESIGN

Longitudinal prospective analysis.

SETTING

An annual military training event.

PARTICIPANTS

US Army special operations Soldiers (n = 60; 100% male; age 25.41 ± 3.74).

INTERVENTION

None.

MEASUREMENTS

The Pittsburgh Sleep Quality Index (PSQI) was administered prior to the training event, and the Emotional Exhaustion Scale, the Role Overload Scale, the Walter Reed Army Institute of Research Soldier-Specific Functional Impairment Scale, and the Perceived Stress Scale were administered after the event. Linear regression models were used to assess the relationship between sleep and occupational wellness measures, and the outcome measures of "good" and "poor" sleepers (per the PSQI scoring criteria) were compared with Student's t tests.

RESULTS

Higher (poorer) PSQI Global Scores predicted poorer occupational wellness of all measures (emotional exhaustion: B = 1.60, P < .001, R² = 0.25; functional impairment: B = 0.29, P = .03, R² = 0.14; role overload: B = 0.28, P = .008, R² = 0.12; and perceived stress: B = 0.34, P = .004, R² = 0.20). There were additional relationships between specific PSQI component scores and occupational wellness measures, which is a replication of This team's previous work. Furthermore, emotional exhaustion (t(58) = -4.18, P < .001), functional impairment (t(59)= -3.68, P = .001), role overload (t(58) = -3.20, P = .002), and perceived stress (t(58) = -2.43, P = .02) were all higher in poor sleepers.

CONCLUSIONS

The findings of this study suggest that US Army special operations Soldiers who have poorer sleep quality may be at increased risk for having poorer occupational well-being.

Mobile phone addiction and its association with burnout in Chinese novice nurses: A cross-sectional survey

AIM

To explore the levels of mobile phone addiction and burnout and their relationships among novice nurses.

DESIGN

A cross-sectional investigation design.

METHODS

Questionnaires were distributed to 400 novice nurses in five public hospitals in China. A total of 366 participants completed the survey. Data collected in 2020 were analysed by using descriptive statistics, an independent t test and Pearson's correlation analysis.

RESULTS

The results showed that the frequency of nursing adverse events was associated with higher level of mobile phone addiction in novice nurses, and 52.46% of the participants (N = 366) presented a high level of occupational burnout. Moreover, the results indicated that there was a positive correlation between the novice nurses' mobile phone addiction level and burnout (r = .33, p < .01).

CONCLUSION

The level of mobile phone addiction may affect nursing adverse events and nurses' burnout. Education on novice nurses' mobile phone use seems necessary to ensure patient safety and burnout prevention.

IMPACT

Findings of this study expanded important knowledge about mobile phone addiction and its potential influence on nursing safety and nurse burnout and may place significant implications to staff nurse management and in-service education.

Patterns and Perceptions of Smartphone Use Among Academic Neurologists in the United States: Questionnaire Survey

Background

Smartphone technology is ubiquitous throughout neurologic practices, and numerous apps relevant to a neurologist’s clinical practice are now available. Data from other medical specialties suggest high utilization of smartphones in routine clinical care. However, the ways in which these devices are used by neurologists for patient care–related activities are not well defined.

Objective

This paper aims to characterize current patterns of smartphone use and perceptions of the utility of smartphones for patient care–related activities among academic neurology trainees and attending physicians. We also seek to characterize areas of need for future app development.

Methods

We developed a 31-item electronic questionnaire to address these questions and invited neurology trainees and attendings of all residency programs based in the United States to participate. We summarized descriptive statistics for respondents and specifically compared responses between trainees and attending physicians.

Results

We received 213 responses, including 112 trainee and 87 attending neurologist responses. Neurology trainees reported more frequent use of their smartphone for patient care–related activities than attending neurologists (several times per day: 84/112, 75.0% of trainees; 52/87, 59.8% of attendings; P=.03). The most frequently reported activities were internet use, calendar use, communication with other physicians, personal education, and health care–specific app use. Both groups also reported regular smartphone use for the physical examination, with trainees again reporting more frequent usage compared with attendings (more than once per week: 35/96, 36.5% of trainees; 8/58, 13.8% of attendings; P=.03). Respondents used their devices most commonly for the vision, cranial nerve, and language portions of the neurologic examination. The majority of respondents in both groups reported their smartphones as “very useful” or “essential” for the completion of patient care–related activities (81/108, 75.0% of trainees; 50/83, 60.2% of attendings; P=.12). Neurology trainees reported a greater likelihood of using their smartphones in the future than attending neurologists (“very likely”: 73/102, 71.6% of trainees; 40/82, 48.8% of attendings; P=.005). The groups differed in their frequencies of device usage for specific patient care–related activities, with trainees reporting higher usage for most activities. Despite high levels of use, only 12 of 184 (6.5%) respondents reported ever having had any training on how to use their device for clinical care. Regarding future app development, respondents rated vision, language, mental status, and cranial nerve testing as potentially being the most useful to aid in the performance of the neurologic examination.

Conclusions

Smartphones are used frequently and are subjectively perceived to be highly useful by academic neurologists. Trainees tended to use their devices more frequently than attendings. Our results suggest specific avenues for future technological development to improve smartphone use for patient care–related activities. They also suggest an unmet need for education on effectively using smartphone technology for clinical care.

A Comparison of Selected Items Found in Graduation Survey Instruments from MD and DO Schools. What It Reveals About Satisfaction with Career Choice

Selected items in graduation survey instruments from MD and DO schools were compared using a novel combined approach which revealed meaningful information about career choice. Although the student satisfaction with medical education had remained steady during the past decade for both MD and DO programs, the dissatisfaction with medical programs at time of graduation was different (p < 0.001). The level of unhappiness with career choice was also different (p < 0.001). An analysis of the Year Two Questionnaire, introduced in 2015 by the American Association of Medical Colleges, showed dissatisfaction with career choice in MD programs increased after graduation.

A brief intervention to reduce burnout and improve sleep quality in medical students

BACKGROUND

Perceived stress, burnout, and poor sleep quality are high among medical students. Interventions designed to target these issues are necessary to promote the health and well-being of medical students. The purpose of this study was twofold: 1) to assess the feasibility of implementing a sunrise alarm clock intervention with medical students and 2) to evaluate the impact of the intervention on perceived stress, burnout scores, and sleep quality.

METHODS

We conducted a feasibility study to evaluate the efficacy of a two-week, sunrise alarm clock intervention in combination with electronic device removal at bedtime. We assessed first- and second-year medical students' perceived stress, burnout scores, including Emotional Exhaustion, Depersonalization, and Low Sense of Personal Achievement, and sleep quality before and after the intervention. In addition, we measured smartphone addiction prior to the intervention.

RESULTS

A total of 57 students consented to participate, of which 55 completed both the pre- and post-assessments (3.5% attrition). The mean age of the participants was 24.8 ± 1.9 years, 50.9% (n = 29) identified as women, and 68.4% (n = 39) identified as white. Pre-intervention, 42.1% (n = 24) of students met criteria for smartphone addiction and 77.2% (n = 44) met criteria for poor sleep quality. In addition, 22.8% (n = 13) of participants had high emotional exhaustion, 64.9% (n = 31) high depersonalization, and 42.1% (n = 24) low sense of personal accomplishment prior to the intervention. Following the two-week intervention, participants showed improvements in emotional exhaustion (p = 0.001, Cohen's d = 0.353), depersonalization (p = 0.001, Cohen's d = 0.411) low sense of personal accomplishment (p = 0.023, Cohen's d = 0.275), perceived stress (p < .001, Cohen's d = .334), and sleep quality (p < 0.001, Cohen's d = 0.925). The number of participants who reported poor sleep quality decreased to 41.8% (n = 23), demonstrating a significant decline (p = 0.026). Participants also improved subjective sleep quality (p < 0.001, Cohen's d = 1.033), sleep duration (p = 0.001, Cohen's d = 0.431), sleep latency (p < 0.001, Cohen's d = 0.433), and sleep efficiency (p = 0.021, Cohen's d = 0.673).

CONCLUSIONS

These findings suggest that the two-week sunrise alarm clock protocol with electronic device removal was effective in improving sleep quality and reducing burnout scores, and perceived stress. However, additional research comparing this intervention to a proper control group is needed to draw meaningful conclusions about the effectiveness of this intervention.

Sleep Quality as a Mediator in the Relationship Between Perceived Stress and Job Burnout Among Chinese Nurses: A Structural Equation Modeling Analysis

Background: Job burnout has become an increasing prevailing phenomenon among nurses in both developed and developing countries. There is a paucity of research exploring the relationship between perceived stress (i.e., the level of one's perception or appraisal of stress rather than objective stressful events) and job burnout and no existing literature examining the mediating role of sleep quality in the relationship between these two constructs. The objective of the study was to examine if sleep quality mediates the relationship between perceived stress and job burnout. Methods: Cross-sectional data were collected from a total of 1,013 nurses working in six public tertiary hospitals in China. The self-administered questionnaire included demographic information, the Maslach Burnout Inventory-General Scale, the Pittsburgh Sleep Quality Index and the Perceived Stress Scale. Hierarchical multiple regression (HMR) analyses were performed to examine the contribution of each covariate to the prediction of job burnout. Structural equation modeling (SEM) was employed to test whether the proposed relationships between variables involved existed. Results: Both perceived stress and poor sleep quality exhibited strong positive associations with job burnout among Chinese nurses. The SEM analysis confirmed the direct pathway from perceived stress to burnout and the indirect pathway mediated by sleep quality. The direct effect of perceived stress on job burnout was found to be statistically significant and positive (β = 0.69, p < 0.05). There existed statistically significant effects of sleep quality on both perceived stress (β = 0.48) and job burnout (β = 0.29). The path coefficients of perceived stress on job burnout were significantly reduced (β = 0.56) when sleep quality was modeled as a mediator. The bias-corrected and accelerated bootstrap test revealed that sleep quality had a significant mediating effect on the relationship between perceived stress and job burnout (a ^* b = 0.139, BCa 95%, CI: 0.110~0.174). Conclusion: Perceived stress might exert significant effects on burnout both directly and indirectly through the mediating role of sleep quality. Efforts to reduce burnout among nurses in clinical settings may benefit from interventions for coping with perceived stress and practices for promoting healthy sleep.