Electronic device use and its adversities among BPH students of Kathmandu valley

INTRODUCTION

Electronic Devices (ED) here simply means devices that are run by electricity and includes portable electronic devices (PED) like laptop, tablet, smart phones, e-games etc. and also desktop/PC. Recently the ownership, use and time-spent on electronic devices has increased dramatically among adult groups as well as adolescents as showed by different studies. These devices have many things to offer to people making it popular among all age groups. It can be used for communication, entertainment, study purpose, office work and many more. However, it has both advantages and disadvantages and one should use it smartly to make it an utility.¹

These days using electronic device has become a necessity for many people. It is also true that these devices have made life easier for many people but now as suggested by many research using these devices continuously for a long time has negative effect on both physical and mental health of people. Some of the physical symptom that develops due to continuous use of these devices includes Computer Vision Syndrome (CVS), occupational overuse syndrome, neck pain, lower back pain, headache, ear symptoms etc.² The main objective of this study was to determine the ownership, time-spent, use and dependence on electronic devices and hypothesis were set to find out their relation with different adversities like health symptoms, sleep quality and loneliness.

METHODS

Cross sectional descriptive study design was used to conduct this quantitative study among 248 BPH students of Kathmandu valley. Sample size was calculated using formula n=_Z²pq/d² and taking in consideration 0.8 prevalence of eye strain due to computer use from study “Computer Vision Syndrome Prevalence and associated factors among the medical student in Kist Medical College”. 1^st, 2^nd and 3^rd year students were included in the study and 4^th year students were excluded.

There were 16 colleges affiliated to different university in Kathmandu valley offering BPH. Through lottery method 4 colleges were selected and through disproportionate stratified sampling, 62 students were conveniently selected from each college. Semi-structured and self-administered questionnaire was used along with some standard tools like PSQI for sleep quality, UCLA for loneliness and technology dependence assessment for dependency, to collect data which was analysed using the SPSS version 21 and interpreted using frequency, percentage, chi-square test. The results of the study were then presented using tables.

Research approval was taken from IRC of Nobel College, Sinamangal and Informed consent was obtained from respondents by clarifying the purposes of the study prior to the data collection.

RESULTS

It was found that among total respondents (248), respondents 77% were female whereas remaining 23% were male. The majority of the respondents were between the age group 16-20 i.e. 57% and. The mean age was 20.7 and standard deviation was 2.044. Majority of respondents were found to be Brahmin 39% and 93% of them followed Hinduism. First year students were more i.e. 93% (Table 1).

Out of 248 respondents, majority of them i.e. 94% and 87% owned smart phone and laptop respectively. Only few respondents i.e. 10% and 6% owned non-smart phones and E-games respectively (Table 2).

Majority of respondents i.e. 68.5% and 44.4% spent more than 1 hour using ED per day for visual and interactive content respectively. While, for audio content majority of the respondents (46%) used ED for less than 30 minutes. 61% of the total respondents used ED for more than 1 hour per day (Table 3).

We found that smart phones were the most used ED by the respondents i.e. 204 (82%) and second most used ED was laptop i.e. 36 (14.5%). According to the table Electronic device were found to be mainly used for Entertainment purpose by the respondents. More than half i.e. 59.7% respondents used ED for entertainment followed by social media purpose i.e. 27.8% (Table 4).

Our study showed eye symptoms to be most common health effects among ED users where 62.5% reported mild effect while 10.9% and 2% reported moderate and severe effect respectively. After eye symptoms, headache was the second most common health effect reported and third most common health effects seen among respondents due to ED use was musculoskeletal symptoms. Ear symptoms were the least common health effects among the respondents were more than half of the respondents reported no effect. 10.5% of the respondents reported either serious health effect resulting from ED use (Table 5).

We found out that more than 53% of the respondents had poor sleep quality. We also found out that majority of the respondents used ED before bed i.e., 80%. Only 2% of the respondents never used ED before bed. However, more than half of the respondents i.e. 56% were found to have 7 or more than 7 hours of sleep (Table 6).

Among the respondents. 93.5% of the respondents were dependent on ED and 64% were lonely (Table 7).

Time spent on electronic devices for visual and interactive purpose was found to be associated with musculoskeletal symptoms (Table 8).

Electronic device use before bed was found to be associated with sleep quality of the respondents (Table 9). Age was found to be associated with dependency on electronic device with p-value 0.003 (Table 10).

DISCUSSION

We could interpret from result that 77% of the respondents were females and 57% belonged to age group 16-20. Laptops and smart phones were owned by 87% and 94% of the respondents. Smart phones were the mostly used ED and entertainment was the main purpose for which devices were used. 10.5% of the respondents showed moderate to severe health adversities in relation to ED use with eye symptoms being the most common adversity. Also musculoskeletal symptoms were found to be associated with time-spent on ED. 80% of the respondents used electronic device before bed which was associated with the sleep quality of the respondents. 93.5% of the respondents were dependent on electronic device and 64% were found to be lonely however, these two variables were not associated with one another (p-value=0.23).

Headache, musculoskeletal, eye and ear symptoms

In this study, 74% and 75% of the respondents reported headache and eye symptoms respectively in response to ED use. A study conducted among young medical students also showed results where 16.08% complained of headache. People are spending more hours on screen these days and as shown by a study conducted in Egypt among medical students 86% complained to have more than one type of CVS. Also, in a study conducted in Nepal 89% reported eye strain and 71% complained of headache.³

A study that not just included students but also office workers found out 44.7% prevalence of musculoskeletal problems and also found out that a significant association was present among musculoskeletal problems and duration of computer use, same as shown by this study where ED use for interactive and visual purposes were found to have statistically significant association with musculoskeletal symptoms.⁴

Ownership, time-spent and purpose of electronic device use

This research showed that 100% respondents owned one or the other type of electronic devices and 94% respondents owned smart phones which is in support with the study done by Iman A. El Kiweri and Najoud A. Al Ghamdi among Saudi Female Nursing students which showed in its study that 92.4% owned electronic device and 95.9% owned mobile phones. This same study also showed that 43.3% of the Saudi Female Nursing students used computer for more than an hour per day and this study showed 61% of the BPH students spent more than an hour on Electronic device per day. ⁵

Sleep quality, dependency and loneliness

In this study 53% of the respondents were found to have poor sleep as measured by PSQI similar to another study of Saudi that showed 52% of its respondents had poor sleep quality.⁵ Late night use of electronic devices were found to have adverse effect on sleep quality and from the respondents using electronic devices from 19:00 to 24:00, 73% slept poorly as shown by a study “Quality of sleep among university students: effects of night-time computer and television” which was similar in this study as well where 80% used ED before bed which was found to have statistically significant association with the sleep quality (p=0.005).⁶ In this study, more than seven hours sleep duration was reported by 56% of the respondents while another similar study showed much higher percentage i.e. 89.5% Dependency on ED was high in this study i.e. 93.5% and not just in this study but a similar study conducted among Saudi female nursing students showed 77% dependency on electronic devices.⁵

This study has some limitations. Increased screen time and dependence on electronic devices has been found to be a risk factor for different health condition as well as disturbances to the sleep pattern. It would be good if further studies focused on whether sleep disturbances due to ED use could be a risk factor for mental health. Also, future research can be focused on mechanisms relating ED use with health effects and sleep quality to understand it better to develop evidence-based and effective intervention programs. Future research might also be directed to find out ways on how to encourage respondents from using ED mostly for Entertainment to using ED for other productive activities.

CONCLUSION

This study concluded that using electronic devices before bed time was significantly associated with the sleep quality. Not just sleep quality but excessive use of these devices for longer time had the risk of developing health effects like headache, eye, ear and musculoskeletal symptoms among the users and few of the respondents had already reported moderate to severe health effects in response to the use. Loneliness however was not found to be associated with dependence as per this study, even though the dependent and lonely respondents were high.

ACKNOWLEDGEMENTS

We would like to thank Dr. Birendra Kumar Singh for their guidance. We would like to thank Mr. Saroj Bhandari and Mr. Sampurna Kakchapati, Lecturers of Nobel College, for providing their expertise throughout this research.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee of Nobel College, Pokhara University

REFERENCES

1. 1. Hysing M, Pallesen S, Stormark KM, Jakobsen R, Lundervold AJ, Sivertsen B. Sleep and use of electronic devices in adolescence: results from a large population-based study. BMJ open. 2015;5(1):e006748.
2. 2. Sen A, Richardson S. A study of computer-related upper limb discomfort and computer vision syndrome. J Human Ergol. 2007;36(2):45-50.
3. 3. Basnet A, Basnet P, Karki P, Shrestha S. Computer vision syndrome prevalence and associated factors among the medical student in Kist Medical College. Nepal Medi J. 2018;1(1):29-31.
4. 4. Borhany T, Shahid E, Siddique WA, Ali H. Musculoskeletal problems in frequent computer and internet users. J Family Medi Prim Care. 2018;7(2):337.
5. 5. El Kiweri IA, Al Ghamdi NA. Electronic devices: Content use and health effects in Saudi female nursing students. Int J Nurs Heal Sci. 2015;2(3):21-7.
6. 6. Mesquita G, Reimão R. Quality of sleep among university students: effects of nighttime computer and television use. Arq Neuro-psiq. 2010;68:720-5.
7. 7. Iqbal M, El-Massry A, Elagouz M, Elzembely H. Computer vision syndrome survey among the medical students in Sohag University Hospital, Egypt. Ophthal Res: Inte J. 2018;8(1):1-8.
8. 8. Yan Z, Hu L, Chen H, Lu F. Computer Vision Syndrome: A widely spreading but largely unknown epidemic among computer users. Computers in Human Behavior. 2008;24(5):2026-42.
9. 9. Niemz K, Griffiths M, Banyard P. Prevalence of pathological Internet use among university students and correlations with self-esteem, the General Health Questionnaire (GHQ), and disinhibition. Cyberpsychol Behavior. 2005;8(6):562-70.
10. 10. Xavier MKA, Pitangui ACR, Silva GRR, Oliveira VMAd, Beltrão NB, Araújo RCD. Prevalence of headache in adolescents and association with use of computer and videogames. Ciencia Saude Coletiva. 2015;20(11):3477-86.
11. 11. Demirci K, Akgönül M, Akpinar A. Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students. J Behav Addict. 2015;4(2):85-92.
12. 12. Chelala DC. Reducing the health risks of electronic devices. 2015. Available at: https://www.japantimes.co.jp/opinion/2015/07/13/commentary/world-commentary/reducing-the-health-risks-of-electronic-devices/. Accessed 22 December 2023.
13. 13. Gupta N, Garg S, Arora K. Pattern of mobile phone usage and its effects on psychological health, sleep, and academic performance in students of a medical university. Nat J Physiol Pharm Pharmacol. 2016;6(2):132.
14. 14. Szeto DG. PolyU expert studies the health effects of using portable electronic devices, 2013. Available at: https://www.polyu.edu.hk/archive/en/media-releases/index_id_2595.html. Accessed 22 December 2023.
15. 15. Muduli J. Addiction to technological gadgets and its impact on health and lifestyle: a study on college students, 2014. Available at: http://ethesis.nitrkl.ac.in/5544/1/e-thesis_19.pdf. Accessed 22 December 2023.
16. 16. Kim J, LaRose R, Peng W. Loneliness as the cause and the effect of problematic Internet use: The relationship between Internet use and psychological well-being. Cyber Psychol Behavior. 2009;12(4):451-5.
17. 17. Kawabe K, Horiuchi F, Ochi M, Oka Y, Ueno Si. Internet addiction: Prevalence and relation with mental states in adolescents. Psych Clin Neurosci. 2016;70(9):405-12.
18. 18. Telecom N. Smart phone penetration in Nepal and its impact, 2017. Available at: https://www.nepalitelecom.com/2018/03/smartphone-penetration-nepal-and-the-impact.html. Accessed 22 December 2023.
19. 19. Tucker F. Developing Autonomy and Transitional Paternalism. Bioethics. 2016;30(9):759-66.
20. 20. Berolo S, Wells RP, Amick III BC. Musculoskeletal symptoms among mobile hand-held device users and their relationship to device use: a preliminary study in a Canadian university population. Applied Ergon. 2011;42(2):371-8.
21. 21. Rosenfield M. Computer vision syndrome: a review of ocular causes and potential treatments. Ophthalm Physiol Optics. 2011;31(5):502-15.
22. 22. Khan M. Adverse effects of excessive mobile phone use. Int J Occupat Medi Environm Heal. 2008;21(4):289-93.
23. 23. Korpinen L, Pääkkönen R, Gobba F. Self-reported neck symptoms and use of personal computers, laptops and cell phones among Finns aged 18–65. Ergonom. 2013;56(7):1134-46.
24. 24. Logaraj M, Madhupriya V, Hegde S. Computer vision syndrome and associated factors among medical and engineering students in Chennai. Ann Medi Heal Sci Res. 2014;4(2):179-85.
25. 25. Lorusso A, Bruno S, L'Abbate N. Musculoskeletal disorders among university student computer users. La Medicina Del Lavoro. 2009;100(1):29-34.
26. 26. Mesquita G, Reimão R. Nightly use of computer by adolescents: its effect on quality of sleep. Arq Neuro-psiqu. 2007;65(2B):428-32.
27. 27. Kim J-H. Psychological issues and problematic use of smartphone: ADHD's moderating role in the associations among loneliness, need for social assurance, need for immediate connection, and problematic use of smartphone. Computers Human Behavior. 2018;80:390-8.
28. 28. Thomée S, Härenstam A, Hagberg M. Computer use and stress, sleep disturbances, and symptoms of depression among young adults-a prospective cohort study. BMC Psych. 2012;12(1):176.
29. 29. Nikhita CS, Jadhav PR, Ajinkya SA. Prevalence of mobile phone dependence in secondary school adolescents. JCDR. 2015;9(11):VC06.
30. 30. Fossum IN, Nordnes LT, Storemark SS, Bjorvatn B, Pallesen S. The association between use of electronic media in bed before going to sleep and insomnia symptoms, daytime sleepiness, morningness, and chronotype. Behav Sleep Medi. 2014;12(5):343-57.