Perceived Health Risks Associated with Smartphone Use Among Health College Students at Qassim University in Saudi Arabia

Nikolic A., Bukurov B., Kocic I., Vukovic M., Ladjevic N., Vrhovac M., Pavlović Z., Grujicic J., Kisic D., Sipetic S.

IntroductionStudies consistently link excessive smartphone use to poor sleep quality, depression, anxiety, and stress. This study specifically aimed to investigate these associations among medical students in Belgrade and Nis (Central Serbia).Materials and methodsThe cross-sectional study included a sample of 761 students, who were selected from both the Faculties of Medicine at the University of Belgrade and the University of Nis. Questionnaires, including the International Physical Activity Questionnaire – Short Form (IPAQ-SF), Smartphone Addiction Scale – Short Version (SAS-SV), the Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale – 21 items (DASS-21), were completed by the participants. Statistical analysis techniques, such as the Chi-square test, student’s t-test, and logistic regression, were employed to examine the relationship between smartphone addiction, physical activity, sleep quality, depression, anxiety, and stress.ResultsThe findings indicated a prevalence of smartphone addiction among medical students at 21.7%, with rates of 22.9% among males and 21.1% among females. Females exhibited significantly higher scores on the SAS-SV scale compared to males (p = 0.032). Univariate logistic regression analysis revealed significant associations between smartphone addiction and spending over 4 h daily on smartphones (OR = 2.39; p < 0.001), poor sleep quality (OR = 1.65; p = 0,005), as well as elevated levels of stress (OR = 1.75; p = 0.003), anxiety (OR = 2.04; p < 0.001), and depression (OR = 2.29; p < 0.001). Multivariate regression analysis identified spending more than 4 h daily on smartphones (OR = 2.39; p < 0.001) and increased levels of depression (OR = 2.51; p < 0.001) as independent significant factors associated with smartphone addiction.ConclusionThis study sheds light on the prevalence of smartphone addiction among medical students, with spending excessive time on smartphones and higher levels of depression standing out as significant factors. Future research should delve into the underlying mechanisms and causal relationships between smartphone addiction and these psychosocial factors. Understanding these connections will aid in developing effective interventions and strategies to tackle this growing public health concern.

Abo-Ali E.A., Al-Ghanmi A., Hadad H., Etaiwi J., Bhutta K., Hadad N., Almilaibary A., Ghareeb W.A., Sanad A., Zaytoun S.

Excessive smartphone use leads to several physical and psychological disorders, particularly among young adults. This study aimed to investigate the prevalence and the associated factors of problematic smartphone use (PSU) among health sciences students in Jeddah, Saudi Arabia. During the 2019 academic year, a cross-sectional analytic study randomly recruited 408 health sciences students (67.5% were females), with a mean age of 20.5 ± 1.42. Data on sociodemographic and health profiles, smartphone usage patterns, and overuse symptoms were collected for each participant. The Smartphone Addiction Scale-Short Version (SAS-SV) and Generalized Anxiety Disorder 7-item (GAD-7) scale were used to assess PSU and anxiety levels. PSU was detected in 66.9% of the study participants. The prevalence is high among both females and males (69.5 and 61.7%, respectively). PSU was found to be associated with more years of use and frequent smartphone upgrading (aOR = 2.11, 95% CI: 1.12, 3.97) and (aOR = 1.69, 95% CI: 1.08, 2.65), respectively (p = 0.021 and 0.021, respectively). Participants with moderate and severe anxiety levels were found to be more likely to have PSU (aOR = 2.22, 95% CI: 1.21, 4.05) and (aOR = 5.97, 95% CI: 2.41, 14.78), respectively. (p = 0.010 and < 0.001, respectively). PSU is an emerging problem among health sciences students in Saudi Arabia with a high prevalence in both genders. Longer years of use, more frequent smartphone upgrades, and higher anxiety levels are associated with PSU among health sciences students. Special health education and psychological support programs are recommended to guide and support future healthcare providers against the consequences of PSU.

Lee P.S., Lee C.M.

Dai C., Tai Z., Ni S.

Background: Problematic smartphone use is widespread, and college-age youth faces an especially high risk of its associated consequences. While a promising body of research has emerged in recent years in this area, the domination of quantitative inquiries can be fruitfully and conceptually complemented by perspectives informed through qualitative research. Toward that end, this study aimed to interrogate the myriad behavioral, attitudinal, and psychological tendencies as a side effect of college students’ engagement with the smartphone in their everyday lived experience through in-depth interviews.Methods: We recruited 70 participants from seven college campuses hailing from different geographic regions in China, and conducted semi-structured in-depth virtual interviews via WeChat in November and December 2020. Subjective experiences, personal narratives and individual perceptions in the context of routine interaction with the smartphone were thematically analyzed through a reiterative process in an effort to detect prevailing threads and recurring subthemes.Results: The smartphone has established a pervasive presence in college students’ everyday life. Time-based use characteristics generated a typology of four distinct user groups: hypo-connected antagonists, balanced majority, hyper-connected enthusiasts, and indulgent zealots. Habitual usage falls on predictable patterns matched onto temporal, locale-based and contextual cues and triggers. Students’ dependency relationships with the smartphone have both functional and emotional dimensions, as prominently manifested in occasions of detachment from the device. Self-regulatory effort in monitoring and limiting use is significantly impacted by mental focus and personal goal setting. Perspectives from our qualitative data suggest the need for taking into account a variety of contextual cues and situational factors in dissecting psychological and emotional outcomes of smartphone use and abuse.

Saadeh H., Al Fayez R.Q., Al Refaei A., Shewaikani N., Khawaldah H., Abu-Shanab S., Al-Hussaini M.

To reduce the spread of COVID-19, Jordan enforced 10 weeks of home quarantine in the spring of 2020. A cross-sectional study was designed to assess this extended quarantine's effect on smartphone addiction levels among undergraduates. A random sample of 6,157 undergraduates completed an online questionnaire (mean age 19.79 ± 1.67 years; males 28.7%). The questionnaire contains different sections to collect socio-demographic, socio-economic, academic, quarantine-related information, and smartphone usage. The smartphone addiction scale-short version was used to assess the degree of addiction during the quarantine. The mean addiction score across the whole sample was 35.66 ± 12.08, while the prevalence of addiction among participants was 62.4% (63.5% in males and 61.9% in females). The majority of the participants (85%) reported that their smartphone usage during the quarantine increased or greatly increased (27.6 and 57.2%, respectively), with some 42% using their smartphones for more than 6 h a day. Nevertheless, three-quarters of the students wished to reduce their smartphone usage. Several demographic and quarantine factors have been assessed, and students' gender, the field of study, parental education, household income in addition to the location of quarantine (urban, rural) and the house specifications (apartment, independent house, with/without a garden) showed statistically significant associations with smartphone addiction during the quarantine. Female students, students studying scientific- and medical-related majors compared to those studying humanity majors, those with higher incomes, those who had been quarantined in an apartment without a garden, and those who lived in urban areas showed significantly higher addiction scores.

Wacks Y., Weinstein A.M.

Background and Aims: This present paper will review the existing evidence on the effects of excessive smartphone use on physical and mental health.Results: Comorbidity with depression, anxiety, OCD, ADHD and alcohol use disorder. Excessive smartphone use is associated with difficulties in cognitive-emotion regulation, impulsivity, impaired cognitive function, addiction to social networking, shyness and low self-esteem. Medical problems include sleep problems, reduced physical fitness, unhealthy eating habits, pain and migraines, reduced cognitive control and changes in the brain's gray matter volume.In Conclusion: Excessive smartphone use is associated with psychiatric, cognitive, emotional, medical and brain changes that should be considered by health and education professionals.

Busch P.A., McCarthy S.

This article provides a systematic review of existing research on problematic smartphone use (PSU) to guide other researchers in search of relevant studies, and to propose areas for future research. In total, 293 studies were analyzed leading to the development of an overview model in the field of PSU, presenting findings on demographic factors, explanations for smartphone use and why this use becomes problematic, consequences of PSU, and how such use can be corrected. In addition, we considered in which contexts, with which methods, and with which theoretical lenses this stream of research has been studied to date. Smartphone use is most often explained by the smartphone design, and users' emotional health and their ability to control smartphone use. Our review suggests that people who are young, female, and highly educated are more prone to PSU. Emotional health issues are the most frequently identified consequence of PSU. Strategies for correcting PSU fall into three categories: information-enhancing, capacity-enhancing, and behavior reinforcement strategies. The studies on PSU are most often conducted using quantitative surveys with university and college participants considering their personal smartphone use. Whereas a variety of theoretical frameworks have been adopted to investigate PSU, they are often related to identifying factors explaining use and problematic use, and more seldom to analyze the findings. A future research agenda for PSU is proposed consisting of seven key research questions which can be investigated by researchers going forward.

Wang J., Li M., Zhu D., Cao Y.

BackgroundSmartphone overuse has been cited as a potentially modifiable risk factor that can result in visual impairment. However, reported associations between smartphone overuse and visual impairment have been inconsistent.ObjectiveThe aim of this systematic review was to determine the association between smartphone overuse and visual impairment, including myopia, blurred vision, and poor vision, in children and young adults.MethodsWe conducted a systematic search in the Cochrane Library, PubMed, EMBASE, Web of Science Core Collection, and ScienceDirect databases since the beginning of the databases up to June 2020. Fourteen eligible studies (10 cross-sectional studies and 4 controlled trials) were identified, which included a total of 27,110 subjects with a mean age ranging from 9.5 to 26.0 years. We used a random-effects model for meta-analysis of the 10 cross-sectional studies (26,962 subjects) and a fixed-effects model for meta-analysis of the 4 controlled trials (148 subjects) to combine odds ratios (ORs) and effect sizes (ES). The I2 statistic was used to assess heterogeneity.ResultsA pooled OR of 1.05 (95% CI 0.98-1.13, P=.16) was obtained from the cross-sectional studies, suggesting that smartphone overuse is not significantly associated with myopia, poor vision, or blurred vision; however, these visual impairments together were more apparent in children (OR 1.06, 95% CI 0.99-1.14, P=.09) than in young adults (OR 0.91, 95% CI 0.57-1.46,P=.71). For the 4 controlled trials, the smartphone overuse groups showed worse visual function scores compared with the reduced-use groups. The pooled ES was 0.76 (95% CI 0.53-0.99), which was statistically significant (P<.001).ConclusionsLonger smartphone use may increase the likelihood of ocular symptoms, including myopia, asthenopia, and ocular surface disease, especially in children. Thus, regulating use time and restricting the prolonged use of smartphones may prevent ocular and visual symptoms. Further research on the patterns of use, with longer follow up on the longitudinal associations, will help to inform detailed guidelines and recommendations for smartphone use in children and young adults.

AlBoali R., Alkhateeb A., Alharbi W., Saleh O.

Harris B., Regan T., Schueler J., Fields S.A.

The popularity of smartphones is undeniable in nearly all facets of society. Despite the many benefits attributed to the technology, concern has grown over the potential for smartphone use to be addictive in nature. Due to the growing concerns surrounding the recognized and unrecognized implications of smartphone use, great efforts have been made through research to evaluate, label and identify problematic smartphone use mostly through the development and administration of scales assessing the behavior. This study examines 84 existing validated scales that have been developed over the past 13 years to measure, identify or characterize smartphone addiction or problematic smartphone use by evaluating their theoretical foundations and their psychometric properties. Our review determined that, despite an abundance of self-report scales examining the construct, many published scales lack sufficient internal consistency and test-retest reliability. Additionally, there is a lack of research supporting the theoretical foundation of many of the scales evaluated. Future research is needed to better characterize problematic smartphone use so that assessment tools can be more efficiently developed to evaluate the behavior in order to avoid the excessive publication of seemingly redundant assessment tools.

Sohn S.Y., Rees P., Wildridge B., Kalk N.J., Carter B.

Abstract Background Over the past decade, smartphone use has become widespread amongst today’s children and young people (CYP) which parallels increases in poor mental health in this group. Simultaneously, media concern abounds about the existence of ‘smartphone addiction’ or problematic smartphone use. There has been much recent research concerning the prevalence of problematic smartphone use is in children and young people who use smartphones, and how this syndrome relates to mental health outcomes, but this has not been synthesized and critically evaluated. Aims To conduct a systematic review and meta-analysis to examine the prevalence of PSU and quantify the association with mental health harms. Methods A search strategy using Medical Subject Headings was developed and adapted for eight databases between January 1, 1st 2011 to October 15th 2017. No language restriction was applied. Of 924 studies identified, 41 were included in this review, three of which were cohort studies and 38 were cross sectional studies. The mental health outcomes were self-reported: depression; anxiety; stress; poor sleep quality; and decreased educational attainment, which were synthesized according to an a priori protocol. Results The studies included 41,871 CYP, and 55% were female. The median prevalence of PSU amongst CYP was 23.3% (14.0–31.2%). PSU was associated with an increased odds of depression (OR = 3.17;95%CI 2.30–4.37;I2 = 78%); increased anxiety (OR = 3.05 95%CI 2.64–3.53;I2 = 0%); higher perceived stress (OR = 1.86;95%CI 1.24–2.77;I2 = 65%); and poorer sleep quality (OR = 2.60; 95%CI; 1.39–4.85, I2 = 78%). Conclusions PSU was reported in approximately one in every four CYP and accompanied by an increased odds of poorer mental health. PSU is an evolving public health concern that requires greater study to determine the boundary between helpful and harmful technology use. Policy guidance is needed to outline harm reduction strategies.

Abolfotouh M.A., BaniMustafa A., Salam M., Al-Assiri M., Aldebasi B., Bushnak I.

In Saudi Arabia, healthcare industry is undergoing major expansions to meet the demand of rapidly growing healthcare needs. The aims of this study were; (1) to assess the pattern of smartphone use in healthcare facilities, and (2) to determine perception towards its use among healthcare workers. A cross-sectional survey of 351 healthcare workers (HCWs) at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia was conducted, from October to November 2016, using a previously validated perception domain to measure perception towards usefulness (5 statements) and practicality (5 statements) of smartphones in clinical settings. Pattern of use of smartphones and health-related applications in healthcare facilities was also investigated. Logestic regression models were applied to identify the predictors of smartphone use and installation of health-related applications for use in healthcare facilities. Significance was considered at p-value of < 0.05. Utilization rate of smartphone was 42.3%, and only 6.1% of all healthcare providers reported always using applications in their practice. Reasons for use were: as a source of drug information (69.8%), for disease diagnosis (56.4%), to access medical websites (42.5%), to review guidelines and protocols related to healthcare (34.1%), for procedure documentation (23.5%), and as a source of patients education materials (22.3%). Perceptions of HCWs towards smartphone use was less than satisfactory (Overall percentage mean score = 60.4 ± 18.7), with only 11.6% reporting positive perception. After adjusting for possible confounders, the total perception mean score was a significant predictor of both smartphone use (β = 0.033, p < 0.001) and medical applications installation (β = 0.033, p < 0.001). Installation of medical applications was also predicted by being a physician (β = 0.008, p = 0.024). Smartphone utilization in healthcare facilities by HCWs in Saudi Arabia is low. This could be attributed to their less than satisfactory level of perception towards its use. Smartphone use and installation of medical applications for use in health facilities were predicted by perceived usefulness and practicality of its use. Intervention from higher health authorities is necessary to enforce the importance of smartphone use in clinical practice. Conduction of further studies on the impact of smart phone use on the healthcare quality in Saudi Arabia is recommended.

Jilisha G., Venkatachalam J., Menon V., Olickal J.J.

As more people are utilizing smartphones, nomophobia is also on the rise. Several Indian studies have revealed nomophobia among young adults. The severity of nomophobia and related behaviors is underrated and often go unnoticed in India.The sociodemographic characteristics, smartphone usage pattern, and perceived ill-health related to smartphone usage of the participants were obtained using a semistructured questionnaire. Twenty-item Nomophobia questionnaire was used to assess nomophobia. In-depth interviews were conducted among students with moderate and severe nomophobia scores.Among the 774 participants, 23.5% had severe nomophobia scores. Older age, male gender, duration and frequency of smartphone usage, use for social networking, checking without reason, and checking smartphone after waking up in the morning were significantly associated with nomophobia. The in-depth interview showed attributes of addiction among the students, like dependency and compulsive behavior. Students also experienced anxiety and frustration when they had to part with their smartphones.A sizable minority of the students had signs of severe nomophobia, distinct patterns of usage, and misperceptions regarding health and their usage pattern.

Demir Y.P., Sümer M.M.

Penglee N., Christiana R.W., Battista R.A., Rosenberg E.

Smartphone use among college students is prevalent across the world. Recently, research has begun to investigate the relationship between smartphone use and physical activity. This study examined the amount of time spent using a smartphone and the physical activity (PA) levels among college students majoring in health science-related disciplines in the United States (US) and Thailand. Using convenience sampling, college students in the US (n = 242) and Thailand (n = 194) completed an online survey, in Fall 2016, assessing smartphone usage and PA. Data were analyzed using chi-square tests and two-way ANOVA (p < 0.05). US students reported more days per week ( U = 15,150.0 , p = 0.00 , r = 0.33 ) and greater duration of PA ( U = 11,234.0 , p = 0.00 , r = 0.33 ) than Thai students while Thai students used smartphones more per day than US students ( U = 13,137.5 , p = 0.00 , r = 0.40 ). No difference existed for years of smartphone use ( U = 22,207.0 , p = 0.27 ). Greater smartphone use per day inversely related to days per week of engaging in PA among Thai students ( X 2 ( 3 ) = 10.55 , p = 0.01 , ε 2 = 0.06 ), but not among US students ( X 2 ( 3 ) = 2.39 , p = 0.50 ). The high smartphone use among college students, especially in Thailand, may be a barrier to PA as well as a strategy for PA promotion in higher education settings. Research should examine the best techniques for smartphone application development to promote PA in college settings.