Indian Journal of Public Health

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 61  |  Issue : 3  |  Page : 199--204

Nomophobic behaviors among smartphone using medical and engineering students in two colleges of West Bengal


Pallabi Dasgupta1, Sharmistha Bhattacherjee2, Samir Dasgupta3, Jayanta Kumar Roy2, Abhijit Mukherjee2, Romy Biswas4,  
1 Medical Officer (Specialist), Department of Community Medicine, Malda Medical College, Siliguri, West Bengal, India
2 Assistant Professor, Department of Community Medicine, North Bengal Medical College and Hospital, Siliguri, West Bengal, India
3 Professor, Department of Community Medicine, North Bengal Medical College and Hospital, Siliguri, West Bengal, India
4 Associate Professor, Department of Community Medicine, North Bengal Medical College and Hospital, Siliguri, West Bengal, India

Correspondence Address:
Sharmistha Bhattacherjee
Department of Community Medicine, North Bengal Medical College and Hospital, Siliguri - 734 012, West Bengal
India

Abstract

Background: Growing smartphone usage among global and Indian college students has resulted in considerable issues of “nomophobia” (NMP) or feelings of discomfort or anxiety experienced by individuals whenever unable to use their smartphones. This significantly impacts their health, work, and study. Objective: The objective of this study is to find out the prevalence of NMP among smartphone using medical and engineering undergraduates of West Bengal and to compare the nomophobic behaviors, its predictors, and smartphone usage among them. Methods: A cross-sectional study was conducted among 303 medical and 305 engineering undergraduates in West Bengal using a validated NMP questionnaire consisting of four factors. Comparison of means of individual questions and factor scores was done. Nomophobic clusters among the two groups were identified using two-stage cluster analysis. Binary logistic regression was used for comparison of predictors of NMP. Results: Engineering students showed a higher proportion of nomophobics (44.6%) than medical students (42.6%). Significant higher means was observed among engineering students for the factor “giving upconvenience” and individual variables like “scared due to running out of battery,” “nervous due to disconnection from online identity,” “uncomfortable when unable stay up-to-date with social media” and “anxious when unable to check E-mails.” A Higher proportion of nomophobics among both groups were females, those owning smartphone beyond 2 years, having monthly mobile bill above Rs. 200 and spending over 4 h daily on smartphone. Conclusion: NMP has emerged as a significant cause of concern among both the groups. Standardized measures for identification and appropriate psychobehavioral therapy for those seeking help might alleviate the problem.



How to cite this article:
Dasgupta P, Bhattacherjee S, Dasgupta S, Roy JK, Mukherjee A, Biswas R. Nomophobic behaviors among smartphone using medical and engineering students in two colleges of West Bengal.Indian J Public Health 2017;61:199-204


How to cite this URL:
Dasgupta P, Bhattacherjee S, Dasgupta S, Roy JK, Mukherjee A, Biswas R. Nomophobic behaviors among smartphone using medical and engineering students in two colleges of West Bengal. Indian J Public Health [serial online] 2017 [cited 2019 Jun 26 ];61:199-204
Available from: http://www.ijph.in/text.asp?2017/61/3/199/214819


Full Text

 Introduction



With significant technological improvements and decreasing cost of smartphones, mobile dependence [1],[2] worldwide is rising.[1],[2],[3] A billion smartphones were in use globally in third quarter of 2012.[4] In urban India, there were around “51 million” smartphone users in 2013; increase over 90% since 2012.[5] Addiction to smartphones is now a well-known phenomenon. A new disorder termed nomophobia (NMP)[6] (a portmanteau for “no mobile phone” and phobia) or mobile phone addiction [7],[8],[9],[10],[11] has garnered attention from researchers.[6],[12],[13] NMP is a disorder of contemporary digital and virtual society and refers to discomfort, anxiety, nervousness, or anguish caused by being out of contact with a mobile phone.[14] It has been proposed to be included in the new Diagnostic and Statistical Manual of Mental Disorders V.[14]

A study in the United Kingdom [15] among mobile users in 2008 revealed that 53% of users suffered from NMP. Cheever et al.[16] have shown that problems associated with mobile phone use are common among youth, who were early adopters of mobile technologies. Sharma et al.[17] reported that 75% of the participant medical students had NMP and 83% experienced panic attacks when unable to access their mobiles. Similar studies among medical students have been conducted in Indore [18] and Bengaluru.[19]

A majority of college and university students from varied socioeconomic background in India are touched by the effects of widely available smartphones. Medical and engineering students, considered cream among other general students, have more or less similar acumen. Due to difference in nature of their study, we can expect differences in their smartphone usage and hence nomophobic behaviors. The medical syllabus is usually vaster while engineering syllabus is more technology oriented. Little published research is there comparing nomophobic behavior among these students in this part of India.

The present study was done with the objectives of finding out the prevalence of NMP among smartphone using medical and engineering undergraduates of West Bengal and to compare the nomophobic behaviors, its predictors, and smartphone usage among them.

 Materials and Methods



An observational, cross-sectional study was conducted from November to December 2015 in North Bengal Medical College (NBMC) and Jalpaiguri Government Engineering College (JGEC)[20] of West Bengal.

NBMC, located in Siliguri, Darjeeling [21] is the largest government healthcare facility in North Bengal region serving as a tertiary referral institute and provides graduation and postgraduation courses. JGEC [20] is a premier government technical institute situated at the outskirts of Jalpaiguri, divisional headquarter of seven districts of Bengal. The college offers bachelor's degrees in six branches and master's degrees in two branches of engineering.

Study participants were undergraduate students. They were selected by systematic random sampling from total number of enrolled students in each college to get two independent samples. Unwilling students and those not owning smartphone were excluded from the study.

Owing to scarcity of comparative studies showing NMP among medical and engineering undergraduates, a pilot study was conducted among a convenient sample of thirty students in each college to obtain the lowest mean and standard deviation among the four factors of NMP for each group of students. Adequate sample size in each group was calculated to be 306, considering a 95% confidence level, power 80%, mean difference 0.36, standard deviation as 1.24 and 1.21 in two groups, design effect of 1.5, and 10% nonresponse error.

A self-reported English questionnaire comprising background characteristics of participants, smartphone usage, and nomophobia questionnaire (NMP-Q)[3] was used. The NMP-Q is a validated questionnaire, specifically developed by Yildirim and Correia [3] in 2015, to measure the nomophobic behaviors of college students. It consists of twenty items addressing four factors of NMP: (1) Not being able to communicate, (2) losing connectedness, (3) not being able to access information, and (4) giving up convenience. All items are rated using 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree).[3]

Data were collected following approval by the Institutional Ethics Committee. Permission from respective college authorities and student committees were obtained. The students were approached personally with the help of student unions, class representatives, hostel superintendents, and monitors. Written informed consent was taken from each participant after explaining the nature and purpose of study. The participants were asked to fill up the questionnaire at their earliest convenient time and encouraged to submit completed questionnaires. Subsequent queries regarding the questionnaire were clarified by the researchers over the telephone. The filled up questionnaires were collected by the researchers at a prespecified time from the participants at their respective colleges. During collection, the questionnaires were cross-checked for completeness.

Statistical analysis

The average scores of items loading to factors of NMP-Q were computed to construct factor scores for each student. The responses were summarized with means and standard deviations to explore their nomophobic behaviors. Comparison of means of individual questions as well as factor scores was done between medical and engineering students using t-test.

A two-stage cluster analysis was performed among the two samples independently to identify groups of medical and engineering students who were homogenous within themselves, but heterogeneous with each other, regarding their nomophobic behaviors. The presence of outliers, collinearity among variables, and adequacy of sample size was examined. Preliminary analyses showed that there was no violation of assumptions which might cause a poor representation of the clusters. Using log-likelihood distance measure, a two-cluster solution was retained. Individual items of NMP-Q were used in cluster analysis. Cluster of students with higher mean scores was labeled as “nomophobic” and other as “non-nomophobic.”

Binary logistic regression was used for comparison of predictors of NMP among two groups of students. Dependent variables were “nomophobic” or “non-nomophobic,” dichotomous in nature, where “nomophobic” = 1; “non-nomophobic” = 0. Background predictors were age, gender, current place of stay, year in study. Smartphone ownership/usage related predictors were duration of smartphone ownership, price of latest smartphone, having mobile internet, average monthly mobile bill including internet usage, number of newer apps installed in the previous month, and ownership of other gadgets. IBM Statistical Package for the Social Sciences (SPSS, Armonk, NY: IBM Corp) version 20 was used in all the analysis. P < 0.05 was considered statistically significant.

 Results



Three hundred and six selected students were approached in each college. Three medical students and one engineering student were unwilling - so excluded from the study. A total of 303 medical and 305 engineering students completed the questionnaire. There were no incomplete forms.

Mean age of medical students (21.33 ± 2.36) was higher than that of engineering students (19.44 ± 1.44). Among medical students, 194 (64%) were male, 289 (95.4%) stayed in hostel. Among engineering students, 253 (83%) were male, 259 (84.9%) stayed in hostel. Majority studied in 3rd year or above (173 [57.1%]) among medical students and 1st/2nd year (227 [74.4%]) among engineering students [Table 1]. Number of medical students owning more than one smartphones were 85 (28.1%), and engineering students were 54 (17.7%). The proportion of engineering students checking their mobile frequently, i.e. every 5 min to every hour (235 [77%]) were slightly more than medical students (222 [73.3%]). In addition, mean number of times checking the phone daily were more in engineering students [Table 2].{Table 1}{Table 2}

Comparing factors of nomophobia

Considering four factors of NMP, engineering students showed higher mean scores in all except factor-1 “not being able to communicate.” Significant higher means were observed among engineering students for factor-4 “giving up convenience.” The overall highest mean was observed among both groups relating to the factor of “not being able to access information.”

Significant higher means were found in engineering students regarding Q5 (scared due to running out of battery), Q16 (nervous due to disconnection from online identity), and highly significant (P< 0.001) in case of Q17 (uncomfortable because could not stay up-to-date with social media), and Q19 (anxious because could not check E-mail) [Table 3].{Table 3}

Cluster analysis among medical and engineering students

Engineering students showed a slightly higher proportion of NMP (136 [44.6%]) than medical students (129 (42.6)). Most important predictor for both the clusters were Q15, i.e. “anxious because connection to family/friends would be broken” and the variables mainly related to “not being able to access information” (item 14 >12 >13 >10 for engineering; item13 >10 >11 >12 >for medical). The quality of clusters was fair (average silhouette = 0.03).

Predictors of nomophobia

Aged below 21 years (adjusted odds ratio [AOR] = 1.321 [0.637–2.740]), staying in hostel, greater duration of smartphone ownership, higher price of latest smartphone, monthly mobile bill over Rs. 200, not owning any other gadgets (AOR = 1.064 [0.645–1.756]), spending over 4 h with smartphone had higher odds of having NMP among medical students. Among medical college students, females, and those studying in 3rd year and above were significantly associated with NMP.

In case of engineering students, age below 21 years (AOR = 1.188 [0.563,2.507]), females, being in 1st and 2nd year (AOR = 1.242 [0.584, 2.640]), staying in home or other places (AOR = 1.287 [0.634, 2.611]), owning smartphone more than 2 years, lesser price of smartphone (AOR = 1.290 [0.733, 2.270]), having mobile internet data, greater monthly mobile bill, not owning any other gadgets (AOR = 1.127 [0.664–1.914]) had higher likelihood of NMP. Spending over 4 h daily using smartphone had a significant effect on nomophobic behavior [Table 1].

Smartphone usage

Median number of calls, messages, and E-mails sent or received is almost similar into two groups [Table 2]. Majority of students in both groups used their smartphones for talking and texting (medical - 89.1%; engineering - 92.5%) followed by gaming, music or for killing time (medical - 86.8%; engineering - 90.2%) and checking mail or social media (medical - 81.2%; engineering - 84.6%). A majority of both medical and engineering students use their smartphones when alone/in the restroom (medical - 95.7%; engineering - 92.5%), or while waiting for something or walking (medical - 69.6%; engineering - 70.5%) [Table 4].{Table 4}

 Discussion



NMP is a relatively newer concept. NMP has different characteristics such as spending considerable time on mobiles, having more than one devices, always carrying a charger, feeling anxious at the thought of losing handset or when it is not available nearby, or during lack of network coverage. Nomophobics tend to keep their phone always switched on,[18] sleep with mobiles with a habit to look at the screen frequently to the point of hearing “false mobile sounds” or ringxiety.[14],[22],[23]

A wide variety of prevalence of nomophobics has been revealed among students in India ranging from 18.5% among medical students in Indore by Dixit et al.[18] 75% by Sharma et al.[17] This might be due to different tools used or lack of standardized measures to assess nomophobics.

Yildirim et al.[24] in Turkey found students having greater fear of “not being able to access information.” Probably due to higher smartphone usage of engineering students with respect to social media, E-mails, etc., they showed greater fear of “giving up convenience.”

The previous findings by Yildirim et al.,[24] Sharma et al.[17] support the present findings of females having higher proportion of NMP. Deursen et al.[25] found males experiencing less social stress and using smartphones less for social purposes. Bianchi and Phillips [26] suggested that females use mobile for social reasons while males for technology and work. Hence, women have higher chance of developing more addictive smartphone behavior. Male students in both the colleges here tend to spend more time in outdoor activities.

Dixit et al.[18] found nomophobics were maximum from third professional MBBS students similar to present finding. However, junior engineering students showed higher odds of NMP probably due to higher proportion of nomophobics staying in hostel and utilizing smartphone in talking or texting family. Another reason might be overall higher representation of 1st/2nd year engineering students.

Higher age negatively affects social stress and social usage and increases self-regulation.[25] Ample evidence for the effect of age on problematic mobile phone use behaviors, with younger individuals being more likely to exhibit such behaviors, have been generated by previous studies globally.[27],[28],[29],[30],[31]

Dixit et al.[18] and Pavithra et al.[19] found no significant association of mobile phone dependence (MPD) with place of stay. Yildirim et al.[24] in their study found duration of smartphone ownership was positively related to of NMP. Pavithra et al.[19] in Bengaluru study, Sahin et al.[32] in Pakistan also showed higher daily usage of mobiles related to NMP and mobile phone addiction. Availability of newer smartphones with multitasking features has led to increased time spending with smartphones. A study by Nikhita et al.[2] among secondary school adolescents shows participants with MPD were significantly associated with increasing amount of time spent on mobile and more than 3 years of use.

Those who did not own other gadgets were more likely to use their smartphones for diverse purposes such as taking photos or recording videos, checking lecture notes, blogging, reading e-books, and even preparing project proposals as revealed by few. Availability of mobile internet plan did not significantly affect NMP since students could avail shared Wi-Fi connection at their college.

Texting and calling were reported the major use of smartphone in studies by Pavithra et al.,[19] Sahin et al.,[32] etc., The pattern of usage such as frequency of checking, average number of times of checking mobiles was in similar lines of the previous studies in India.[2],[18],[19],[33]

 Conclusion



NMP has emerged as a noteworthy problem among both the groups despite slightly higher proportion of nomophobics among engineering students. The present study, however, did not assess socioeconomic status, pocket money of students, which might influence nomophobic behaviors. Multicenter studies among diverse students would bring out a clearer picture.

Smartphones as a self-learning tool providing sleek connectivity are essential. Their benefits lead to overuse resulting in addiction or NMP. Increased awareness generation is needed among the youth regarding NMP. Standardized measures for identification and appropriate psychobehavioral therapy for those seeking help might alleviate the problem.

Acknowledgment

The authors acknowledge the support received from the Principal, North Bengal Medical College and Hospital and the Principal, Jalpaiguri Government Engineering College of West Bengal, India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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