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J Res Dev Nurs Midw 2023, 20(1): 1-3 |
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mancheri H, sabzi Z, royani Z, talebi Z, sadeghian S. Effects of Cyberspace Addiction on Academic Performance of Nursing and Midwifery Students of Golestan University of Medical Sciences, Iran. J Res Dev Nurs Midw 2023; 20 (1) :1-3
URL: http://nmj.goums.ac.ir/article-1-1452-en.html
URL: http://nmj.goums.ac.ir/article-1-1452-en.html
1- Nursing Research Center, Golestan University of Medical Scienses, Gorgan, Iran.
2- Nursing Research Center, Golestan University of Medical Scienses, Gorgan, Iran ,dr.sabzi@goums.ac.ir
3- Paramedical School, Golestan University of Medical Sciences, Gorgan, Iran
4- Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
5- Faculty of Humanities, Department of Psychology, Gorgan Branch, Islamic Azad University, Golestan Iran.
2- Nursing Research Center, Golestan University of Medical Scienses, Gorgan, Iran ,
3- Paramedical School, Golestan University of Medical Sciences, Gorgan, Iran
4- Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
5- Faculty of Humanities, Department of Psychology, Gorgan Branch, Islamic Azad University, Golestan Iran.
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Introduction
The use of the internet has increased rapidly in general society. It is estimated that there are more than 600 million internet users worldwide (1). In recent years, internet use by medical students has been growing worldwide. Mobile phones and smartphones are even used for educational and entertainment purposes (2, 3). Pathological use of the internet or internet addiction is a common problem among teenagers and university students (1).
In a study in Iran, 47.7% of paramedical students had internet dependence, and 38.6% of the users reported internet chat as the most important reason for using the internet (4). In another study on 360 students of medicine, paramedicine, dentistry, pharmacy, nursing, midwifery, and health, the average rate of addiction to social networks was 50.83%, and 70.60% of the students had moderate addiction to the internet (5).
The excessive use of the Internet can have negative consequences as several studies have shown that dependence on smartphones is associated with loneliness and lower academic achievement (6, 7). In addition, other studies also showed that excessive use of the internet by students leads to anxiety, depression, mood swings, restlessness, obsessive thoughts, fantasy, social isolation, and academic and educational performance decline (1, 8). In a study by Parizad et al. in Urmia, Iran, the feeling of loneliness and academic performance score of students was in the average range. Moreover, the smartphone addiction score had a direct relationship with the feeling of loneliness and an inverse relationship with academic performance (9).
In Malaysia, a study reported an inverse significant relationship between the use of smartphones and the academic performance of undergraduate students (10). However, D'Souza et al. (2020) reported no significant relationship between mobile phones and students' academic performance (11). In another study, 48% of nursing students were addicted to the internet, which can have very bad consequences on the nursing processes as well as the safety and well-being of patients (12). On the other hand, the use of smartphones in the workplace, especially in healthcare settings that require high concentration, causes medical errors and exposes patients to serious risks. Therefore, the use of smartphones in the nursing work environment should be minimized (13).
Considering the adverse effects of internet addiction on students and their academic performance, the present study was conducted to investigate the relationship of internet and cell phone addiction with the academic performance of nursing and midwifery students of Golestan University of Medical Sciences, Gorgan, Iran.
Methods
This cross-sectional study with a descriptive-analytical approach was performed on 302 nursing and midwifery students of the Golestan University of Medical Sciences, Gorgan, Iran. The study population was selected by convenience sampling method. Inclusion criteria were being a second-semester and higher nursing or midwifery student at a BSc, MSc, or PhD level and not having a history of mental disorders. Students with incomplete questionnaires were excluded from the study. Based on the sample size formula and considering a 50% prevalence rate of cyberspace addiction (13, 14), an error of 5%, and a 25% dropout rate, the sample size was determined to be 400. Data were collected using a demographic information questionnaire, the internet addiction test (IAT) questionnaire, and a cell phone addiction questionnaire. The demographic information questionnaire investigated age, gender, education level, marital status, dormitory life, etc. The IAT questionnaire was prepared by Kimberly Young in 1998. This questionnaire is composed of 20 multiple-choice items (ranging from none to always) that are scored on a 5-point Likert scale. The total score varies from 0 to 100. Based on the total score, individuals’ addiction is divided into four levels, namely, a normal user (score: <20), mild addiction (score: 20-49), moderate addiction (score: 50-79), and severe addiction (score: 80 to 100). This questionnaire is one of the most valid criteria for measuring internet addiction. The validity and reliability of the questionnaire were confirmed in Iran by Alavi et al. (2010) (15).
The cell phone addiction questionnaire was first introduced by Hyun Young Koo in 2009. This questionnaire is composed of 20 questions about cell phone addiction, each of which has four options: very much, much, little, and very little. According to the scores, subjects are categorized as cell phone addicts (score: ≥70), heavy cell phone users (score: 63-70), and moderate cell phone users (score: <63). This tool was previously used in Iran by Kia and Talebi, and its reliability was calculated using Cronbach's alpha coefficient (α=0.092) (16). The student’s grade-point average was used to evaluate academic performance.
Data were collected online (questionnaire design on the press-line platform). First, the sampling frame was determined, then the number of nursing and midwifery students was determined based on the sample size. The link to the questionnaires was sent to the WhatsApp group of different academic levels through the education department so that the students who wanted to participate in this research could complete the questionnaires online. The ethical principles including confidentiality and protection of the personal information of the participants were observed in the research. This study was approved by the Research Ethics Committee of Golestan University of Medical Sciences (Ethical code: GOUMS.REC1395.256).
Data were analyzed with descriptive and inferential statistics using SPSS (version 23). The normality of the variables was assessed using the Shapiro-Wilk test. Due to the non-normal distribution of the data, the Kruskal-Wallis and Mann-Whitney non-parametric tests were used. The statistical significance level was considered at 0.05.
Results
In this study, 302 nursing and midwifery students were enrolled, most of whom were female (n=214, 70.9%) and single (n=259, 87.5%). Of 302 students, 234 (78.8%) were studying nursing and 170 (56.3%) lived in the dormitory Table1.
The average overall score of internet addiction was 44.61±12.77, which is at a mild level. The average overall score of cell phone addiction was 51.46±14.59, which is at a moderate level Table 2. There was an inverse relationship between internet and cell phone addiction and the academic performance of the students, but this relationship was not statistically significant (P>0.05) Table 3.
There was no statistically significant difference in the average score of internet addiction between students with different education levels (P=0.440). The average score of internet addiction in dormitory students was significantly higher than that in non-dormitory students (P=0.038).
The average score of cell phone addiction was significantly higher in single students (P=0.011). Also, there was no significant relationship between internet addiction and the age of the students (P=0.365, r=-0.05). However, there was a significant inverse relationship between cell phone addiction and age (P=0.011, r=-0.14).
Discussion
This study showed that the rate of internet addiction in nursing and midwifery students is at a mild level, which is consistent with the results of a study by Namiranian et al. (17). However, Karimi Johani et al. reported moderate use of the internet in Paramedical students of Urmia University, Iran (4).
This contradiction may be related to the difference in the study population. In the mentioned study, paramedical students were studied using the IAT, while in our study, nursing and midwifery students were enrolled.
In our study, the level of cell phone addiction was at a moderate level, which is in line with the findings of a previous study by Mamashli et al. (18). This might be due to the lack of suitable recreational and sports facilities for the younger population, especially students, as well as the easy access to cell phones as a mean of entertainment. Parizad et al. reported moderate to a high level of cell phone addiction among students of Uremia University of Medical Sciences (9). It should be noted that cultural differences and the level of internet access among students could affect the level of cell phone addiction.
In line with previous studies (18), we found no significant relationship between internet addiction and the academic performance of nursing and midwifery students. Unlike the past, when the internet was considered a main cause of decline in the academic performance of students, today, the internet plays an opposite role in the lives of students and teenagers. Nevertheless, a study by Hassanzadeh et al. demonstrated a significant relationship between internet addiction and decline in academic performance (19). The reason for this discrepancy is the difference in the study population and the socio-cultural background of the subjects.
In the present study, there was no significant relationship between cell phone addiction and the academic performance of nursing and midwifery students. which is consistent with the results of a study by Desuza et al. (11). However, some studies reported a significant negative correlation between dependence on cell phones and academic achievement (9, 20).
We found that cell phone addiction was significantly higher among single students, which is similar to the findings of the study by Manacle et al. (18). Indeed, single students have more spare time and opportunity to use cell phones compared to their married counterparts.
We observed no significant association between internet addiction and education level. Similarly, Mohammadbeigi, et al. also reported that internet addiction is not related to education level (21). However, a study by Behbodhi et al. showed that internet addiction is significantly correlated with education level (22).
The average score of internet addiction was significantly higher in dormitory students than in non-dormitory students. This is inconsistent with the findings of a previous study in Iran that showed that the average score of internet addiction is lower in dormitory students than in students living in rented houses (23). This might be because of students’ access to the internet and the lack of parental supervision in the dormitory environment.
In our study, there was a significant inverse relationship between cell phone addiction and age. Mansourian et al. also reported that younger students were more dependent on cell phones (24). Therefore, younger students should be prioritized when tailoring strategies to target the problem of cell phone addiction.
Conclusion
Our results indicate that there is internet and cell phone addiction among nursing and midwifery students. Therefore, authorities of the university must address this issue by holding educational workshops and increasing awareness regarding the appropriate use of the internet and cell phones. It is suggested to investigate the relationship between cyberspace addiction and the mental health of students and teenagers in future studies.
Acknowledgement
The authors would like to express their gratitude to the Vice-Chancellor of Research and Technology of Golestan University of Medical Sciences for supporting this study. The nursing and midwifery students of Golestan University of Medical Sciences are also acknowledged for their cooperation and participation in this study.
Funding source
The authors received no financial support for the research, authorship, and/or publication of this article.
Ethical statement
The ethical principles including confidentiality and protection of the personal information of the participants were observed in the research. This study was approved by the Research Ethics Committee of Golestan University of Medical Sciences (Ethical code: GOUMS.REC1395.256).
Conflict of interest
The authors declare that there is no conflict of interest.
Author contributions
All authors contributed equally to the methodology, data analysis, writing, and revising of the manuscript.
The use of the internet has increased rapidly in general society. It is estimated that there are more than 600 million internet users worldwide (1). In recent years, internet use by medical students has been growing worldwide. Mobile phones and smartphones are even used for educational and entertainment purposes (2, 3). Pathological use of the internet or internet addiction is a common problem among teenagers and university students (1).
In a study in Iran, 47.7% of paramedical students had internet dependence, and 38.6% of the users reported internet chat as the most important reason for using the internet (4). In another study on 360 students of medicine, paramedicine, dentistry, pharmacy, nursing, midwifery, and health, the average rate of addiction to social networks was 50.83%, and 70.60% of the students had moderate addiction to the internet (5).
The excessive use of the Internet can have negative consequences as several studies have shown that dependence on smartphones is associated with loneliness and lower academic achievement (6, 7). In addition, other studies also showed that excessive use of the internet by students leads to anxiety, depression, mood swings, restlessness, obsessive thoughts, fantasy, social isolation, and academic and educational performance decline (1, 8). In a study by Parizad et al. in Urmia, Iran, the feeling of loneliness and academic performance score of students was in the average range. Moreover, the smartphone addiction score had a direct relationship with the feeling of loneliness and an inverse relationship with academic performance (9).
In Malaysia, a study reported an inverse significant relationship between the use of smartphones and the academic performance of undergraduate students (10). However, D'Souza et al. (2020) reported no significant relationship between mobile phones and students' academic performance (11). In another study, 48% of nursing students were addicted to the internet, which can have very bad consequences on the nursing processes as well as the safety and well-being of patients (12). On the other hand, the use of smartphones in the workplace, especially in healthcare settings that require high concentration, causes medical errors and exposes patients to serious risks. Therefore, the use of smartphones in the nursing work environment should be minimized (13).
Considering the adverse effects of internet addiction on students and their academic performance, the present study was conducted to investigate the relationship of internet and cell phone addiction with the academic performance of nursing and midwifery students of Golestan University of Medical Sciences, Gorgan, Iran.
Methods
This cross-sectional study with a descriptive-analytical approach was performed on 302 nursing and midwifery students of the Golestan University of Medical Sciences, Gorgan, Iran. The study population was selected by convenience sampling method. Inclusion criteria were being a second-semester and higher nursing or midwifery student at a BSc, MSc, or PhD level and not having a history of mental disorders. Students with incomplete questionnaires were excluded from the study. Based on the sample size formula and considering a 50% prevalence rate of cyberspace addiction (13, 14), an error of 5%, and a 25% dropout rate, the sample size was determined to be 400. Data were collected using a demographic information questionnaire, the internet addiction test (IAT) questionnaire, and a cell phone addiction questionnaire. The demographic information questionnaire investigated age, gender, education level, marital status, dormitory life, etc. The IAT questionnaire was prepared by Kimberly Young in 1998. This questionnaire is composed of 20 multiple-choice items (ranging from none to always) that are scored on a 5-point Likert scale. The total score varies from 0 to 100. Based on the total score, individuals’ addiction is divided into four levels, namely, a normal user (score: <20), mild addiction (score: 20-49), moderate addiction (score: 50-79), and severe addiction (score: 80 to 100). This questionnaire is one of the most valid criteria for measuring internet addiction. The validity and reliability of the questionnaire were confirmed in Iran by Alavi et al. (2010) (15).
The cell phone addiction questionnaire was first introduced by Hyun Young Koo in 2009. This questionnaire is composed of 20 questions about cell phone addiction, each of which has four options: very much, much, little, and very little. According to the scores, subjects are categorized as cell phone addicts (score: ≥70), heavy cell phone users (score: 63-70), and moderate cell phone users (score: <63). This tool was previously used in Iran by Kia and Talebi, and its reliability was calculated using Cronbach's alpha coefficient (α=0.092) (16). The student’s grade-point average was used to evaluate academic performance.
Data were collected online (questionnaire design on the press-line platform). First, the sampling frame was determined, then the number of nursing and midwifery students was determined based on the sample size. The link to the questionnaires was sent to the WhatsApp group of different academic levels through the education department so that the students who wanted to participate in this research could complete the questionnaires online. The ethical principles including confidentiality and protection of the personal information of the participants were observed in the research. This study was approved by the Research Ethics Committee of Golestan University of Medical Sciences (Ethical code: GOUMS.REC1395.256).
Data were analyzed with descriptive and inferential statistics using SPSS (version 23). The normality of the variables was assessed using the Shapiro-Wilk test. Due to the non-normal distribution of the data, the Kruskal-Wallis and Mann-Whitney non-parametric tests were used. The statistical significance level was considered at 0.05.
Results
In this study, 302 nursing and midwifery students were enrolled, most of whom were female (n=214, 70.9%) and single (n=259, 87.5%). Of 302 students, 234 (78.8%) were studying nursing and 170 (56.3%) lived in the dormitory Table1.
The average overall score of internet addiction was 44.61±12.77, which is at a mild level. The average overall score of cell phone addiction was 51.46±14.59, which is at a moderate level Table 2. There was an inverse relationship between internet and cell phone addiction and the academic performance of the students, but this relationship was not statistically significant (P>0.05) Table 3.
There was no statistically significant difference in the average score of internet addiction between students with different education levels (P=0.440). The average score of internet addiction in dormitory students was significantly higher than that in non-dormitory students (P=0.038).
The average score of cell phone addiction was significantly higher in single students (P=0.011). Also, there was no significant relationship between internet addiction and the age of the students (P=0.365, r=-0.05). However, there was a significant inverse relationship between cell phone addiction and age (P=0.011, r=-0.14).
Discussion
This study showed that the rate of internet addiction in nursing and midwifery students is at a mild level, which is consistent with the results of a study by Namiranian et al. (17). However, Karimi Johani et al. reported moderate use of the internet in Paramedical students of Urmia University, Iran (4).
This contradiction may be related to the difference in the study population. In the mentioned study, paramedical students were studied using the IAT, while in our study, nursing and midwifery students were enrolled.
In our study, the level of cell phone addiction was at a moderate level, which is in line with the findings of a previous study by Mamashli et al. (18). This might be due to the lack of suitable recreational and sports facilities for the younger population, especially students, as well as the easy access to cell phones as a mean of entertainment. Parizad et al. reported moderate to a high level of cell phone addiction among students of Uremia University of Medical Sciences (9). It should be noted that cultural differences and the level of internet access among students could affect the level of cell phone addiction.
In line with previous studies (18), we found no significant relationship between internet addiction and the academic performance of nursing and midwifery students. Unlike the past, when the internet was considered a main cause of decline in the academic performance of students, today, the internet plays an opposite role in the lives of students and teenagers. Nevertheless, a study by Hassanzadeh et al. demonstrated a significant relationship between internet addiction and decline in academic performance (19). The reason for this discrepancy is the difference in the study population and the socio-cultural background of the subjects.
In the present study, there was no significant relationship between cell phone addiction and the academic performance of nursing and midwifery students. which is consistent with the results of a study by Desuza et al. (11). However, some studies reported a significant negative correlation between dependence on cell phones and academic achievement (9, 20).
We found that cell phone addiction was significantly higher among single students, which is similar to the findings of the study by Manacle et al. (18). Indeed, single students have more spare time and opportunity to use cell phones compared to their married counterparts.
We observed no significant association between internet addiction and education level. Similarly, Mohammadbeigi, et al. also reported that internet addiction is not related to education level (21). However, a study by Behbodhi et al. showed that internet addiction is significantly correlated with education level (22).
The average score of internet addiction was significantly higher in dormitory students than in non-dormitory students. This is inconsistent with the findings of a previous study in Iran that showed that the average score of internet addiction is lower in dormitory students than in students living in rented houses (23). This might be because of students’ access to the internet and the lack of parental supervision in the dormitory environment.
In our study, there was a significant inverse relationship between cell phone addiction and age. Mansourian et al. also reported that younger students were more dependent on cell phones (24). Therefore, younger students should be prioritized when tailoring strategies to target the problem of cell phone addiction.
Conclusion
Our results indicate that there is internet and cell phone addiction among nursing and midwifery students. Therefore, authorities of the university must address this issue by holding educational workshops and increasing awareness regarding the appropriate use of the internet and cell phones. It is suggested to investigate the relationship between cyberspace addiction and the mental health of students and teenagers in future studies.
Acknowledgement
The authors would like to express their gratitude to the Vice-Chancellor of Research and Technology of Golestan University of Medical Sciences for supporting this study. The nursing and midwifery students of Golestan University of Medical Sciences are also acknowledged for their cooperation and participation in this study.
Funding source
The authors received no financial support for the research, authorship, and/or publication of this article.
Ethical statement
The ethical principles including confidentiality and protection of the personal information of the participants were observed in the research. This study was approved by the Research Ethics Committee of Golestan University of Medical Sciences (Ethical code: GOUMS.REC1395.256).
Conflict of interest
The authors declare that there is no conflict of interest.
Author contributions
All authors contributed equally to the methodology, data analysis, writing, and revising of the manuscript.
Type of study: Review Article |
Subject:
Nutrition
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