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ORIGINAL ARTICLE
Year : 2022  |  Volume : 49  |  Issue : 2  |  Page : 133-139

A study on predictors of nomophobia among undergraduate medical students of a Tertiary Care Teaching Institute in Kolkata, West Bengal


Department of Community Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

Date of Submission19-Feb-2022
Date of Acceptance23-May-2022
Date of Web Publication23-Aug-2022

Correspondence Address:
Vineeta Shukla
Department of Community Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_36_22

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  Abstract 


Background and Objectives: Undergraduate medical students are more prone to develop stress, anxiety, and depression; and COVID-19 is an additional source of pressure for them. The present study was conducted with the objectives to estimate the proportion of nomophobia among undergraduate medical students of a tertiary care teaching institute in Kolkata and to find the factors associated with it. Materials and Methods: An observational study, cross-sectional in design, was conducted at a tertiary care teaching institute in Kolkata among 395 undergraduate medical students for a period of 8 weeks. Nomophobia Questionnaire scale was used to measure nomophobia. Data were analyzed using the SPSS software version 25.0. Multivariable multinomial logistic regression was performed to find the predictors of moderate and severe nomophobia. Results: All the medical students had some degree of nomophobia. About 26.8% of them had severe nomophobia, 61.3% had moderate nomophobia, and 11.9% had mild nomophobia. Age up to 20 years and the presence of addiction had statistically significant higher odds of severe nomophobia. Age up to 20 years, the presence of addiction, and up to 6 h' time spent per day with smart phone had significantly higher odds of moderate nomophobia. Conclusion: There was a high proportion of nomophobia among young budding doctors. Those who have already got moderate nomophobia should use smart phones more wisely and judiciously and avoid downloading addictive applications.

Keywords: Nomophobia, undergraduate medical students, mobile phone


How to cite this article:
Basu M, Shukla V, Maulik S, Kerketta P, Bysack RK. A study on predictors of nomophobia among undergraduate medical students of a Tertiary Care Teaching Institute in Kolkata, West Bengal. J Sci Soc 2022;49:133-9

How to cite this URL:
Basu M, Shukla V, Maulik S, Kerketta P, Bysack RK. A study on predictors of nomophobia among undergraduate medical students of a Tertiary Care Teaching Institute in Kolkata, West Bengal. J Sci Soc [serial online] 2022 [cited 2022 Sep 27];49:133-9. Available from: https://www.jscisociety.com/text.asp?2022/49/2/133/354270




  Introduction Top


Science and technology have changed the world. One of the greatest gifts of science to mankind for communication and access to information is mobile phone. It allows people from around the world to communicate and helps one stay connected with his loved ones. However, addictive apps are making it harder to focus on academics and professional life. Social media is making us more anxious and depressed. So much so, that life without mobile phone is unimaginable. Nomophobia or “no mobile phone phobia” is a psychological condition where people have a fear of being detached from their mobile phones.[1] The terminology has been described in the DSM-IV as a “phobia for a particular/specific thing” with symptoms such as anxiety, agitation, nervousness, and disorientation.[1] It has also been proposed to be included in the DSM-V.[2]

Undergraduate medical students are more prone to develop stress, anxiety, and depression; and COVID-19 is an additional source of pressure on them. During the pandemic, all their classes were shifted to online mode and mobile phones were the only source of contact between the faculty and students. As a result, the medical students spent more time with their mobile phones.

Several studies have been conducted in the past to assess nomophobia among medical students. Sharma et al. in a study on medical students in Indore reported that 75% of the students had nomophobia and 83% experienced panic attacks when unable to access their mobile phones.[3] There was a high proportion of nomophobia (42.6%) among medical students of a college in North Bengal as reported by Dasgupta et al.[4] However, there is a scarcity of studies from this region of the country. The present study was conducted with the objectives to estimate the proportion of nomophobia among undergraduate medical students of a tertiary care teaching institute in Kolkata and to find the factors associated with it.


  Materials and Methods Top


Study type, study design, study area, and study population

An observational study, cross-sectional in design, was conducted at a tertiary care teaching institute of Kolkata among undergraduate medical students for a period of 8 weeks (December 1, 2020–January 25, 2021). Partial offline classes (practical and tutorials) had resumed from December 1st in the institute for all semesters.

Inclusion and exclusion criteria

All students from 1st year to final year were included in the study. Students who did not respond after three attempts and who did not give informed electronic consent to participate in the study were excluded from the study.

Sample size

Taking proportion (p) of vaccine acceptance from a study[4] in another medical college of West Bengal by Dasgupta et al. as 0.42, Type I error α = 0.05, confidence interval 95% with Zα=1.96 and absolute precision d = 5%, the sample size was calculated using Cochran's formula:



=375

Applying finite population correction, i.e., multiplying with = 0.68 (where N = finite population size = 701, n = 375) sample size = 375 × 0.68 = 255

After multiplying with 1.5 as the design effect for stratified random sampling, the minimum sample size was calculated to be 383. Adding 20% as nonresponse, the final sample size was 460. As it was an online survey, we took 20% as nonresponse during sample size calculation.

Sampling technique

The study participants were selected using stratified random sampling technique [Figure 1].
Figure 1: Process of sampling technique (n = 395)

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Study tool

The study tool was a structured questionnaire comprising the following parts: (a) sociodemographic and background characteristics, (b) mobile phone use, and (c) Nomophobia Questionnaire (NMP-Q).

The NMP-Q is a 20-item validated scale developed by Yildirim and Correia specifically to measure nomophobia among undergraduate college-going students.[5] The scale focuses on the four main domains of nomophobia, that is, unable to communicable, losing connection, not being able to access information, and giving up convenience. All 20 items are rated using a seven-point Likert scale, with 1 being “strongly disagree” and 7 being “strongly agree” only at the extremes. Score ranges from 20 to 140 with higher scores corresponding to greater nomophobia severity.

Study variables

The study variables were broadly dependent variables and independent variables:

  1. Dependent variable: nomophobia
  2. Independent variables: sociodemographic and background characteristics and mobile phone usage-related variables.


Study technique and data collection

The questionnaire was administered to the students as an online survey (Google Forms). The first page was designed for consent. If any participant selected “no” as option, the form would not proceed further. All questions under NMP-Q section were made compulsory to mark, ensuring no items were left unattempted.

Data analysis

Out of 460 forms that were sent, a total of 395 responses were received. Thus, there was a nonresponse of 14.1%. Data were tabulated in Microsoft Excel 2019 (Microsoft Corp, Redmond, WA, USA) and then imported to Statistical Package for the Social Sciences (SPSS for Windows, version 25.0, SPSS Inc., Chicago, USA) for interpretation and analysis.

Total scores were calculated by summing up responses to each item, resulting in a score ranging from 20 to 140. Nomophobia was categorized as follows: score 20: nomophobia absent, 21–59: mild nomophobia, 60–99: moderate nomophobia, and 100–140: severe nomophobia.

Descriptive statistics were used to summarize the data. Bivariate analysis was performed to ascertain the association between the dependent and the independent variables. All independent variables having P < 0.20 were considered biologically plausible to be included in the multivariable multinomial logistic regression model where a P < 0.05 was considered statistically significant.

Ethical consideration

Institutional Ethics Committee permission was obtained before the start of the study (Institute name/IEC/2020/666 dated October 14, 2020). Informed electronic consent was obtained from each participant, and all ethical principles were strictly adhered to throughout the course of the study.


  Results Top


About 32.4% of the students belonged to 2nd year, 30.1% were 1st year, 22.3% were in their final year, and 15.2% belonged to 3rd year. About 57.5% of the study population were above 20 years of age. The mean age was 21.04 ± 1.51 years. Nearly 60% were males. A little over half (55.2%) were residing in a hostel with their friends. About 73.7% of the study population belonged to the upper class as per the Modified BG Prasad Scale 2020[6] and 9.4% were addicted to smoking and drinking alcohol [Table 1].
Table 1: Sociodemographic profile of the study population (n=395)

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The distribution of the study population according to mobile phone usage is shown in [Table 2]. A little over 35% reported that they started using smart phones before turning 16 and nearly 40% of them spent more than 6 h daily with their phones. About 26.3% had three or more social media accounts and 40.3% reported spending above 200 rupees monthly on recharge. Nearly half of them perceived that smart phone usage was affecting their academic performance.
Table 2: Distribution of the study population according to mobile phone usage (n=395)

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The mean nomophobia score was 85.8 ± 22.7 with a range of 111 (29,140). All the study participants had some degree of nomophobia. About 26.8% of the study population had severe nomophobia, 61.3% had moderate nomophobia, and 11.9% had mild nomophobia [Figure 2]. The distribution of the study population according to their responses to NMP-Q is shown as median (interquartile range) in [Table 3]. The distribution of nomophobia scores across categories of MBBS batches as shown in [Figure 3] was not found to be statistically significant.
Figure 2: Pie diagram showing distribution of the study population according to nomophobia (n = 395)

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Figure 3: Box plot showing distribution of the study population according to Nomophobia Questionnaire score (n = 395)

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Table 3: Distribution of the study population according to their responses to Nomophobia Questionnaire (n=395)

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The predictors of moderate and severe nomophobia are shown in [Table 4]. Age up to 20 years (Adjusted odds ratio [aOR] 4.20 [1.86–9.49]) and the presence of addiction (aOR 9.17 [1.11–25.40]) had statistically significant higher odds of severe nomophobia. Age up to 20 years (aOR 3.43 [1.63–7.24]), the presence of addiction (aOR 8.87 [1.14–18.99]), and up to 6 hours' time spent per day (aOR 1.99 [1.03–3.85]) with smart phone had significantly higher odds of moderate nomophobia. Socioeconomic class upper (aOR 0.11 [0.02–0.56]) and upper middle (aOR 0.12 [0.06–0.77]) had lower odds of severe nomophobia which was statistically significant.
Table 4: Predictors of nomophobia: Multivariable multinomial logistic regression (n=395)

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  Discussion Top


The present study revealed a high proportion of moderate nomophobia (61.3%) which was similar to a study by Sethia et al. in Gandhi Medical College, Bhopal (61.5%).[7] This was greater than the findings by Chethana et al. in a study in Coastal Karnataka (53.5%), Prasad et al. in her study among dental students in Uttar Pradesh (24.12%), Ramudu et al. in Madhya Pradesh (22.3%), and Dixit et al. in MGM Medical College, Indore (18.5%).[8],[9],[10],[11] Studies by Sharma et al. in Indore and Kubrusly in Brazil revealed that 73% and 64.5% of the study participants had nomophobia, respectively.[3],[12]

The high proportion of nomophobia found in the current study could be attributed to the fact that more than half (55.5%) of the study participants were residing in a hostel. They were staying away from their family members and might have been homesick. The on-going COVID-19 pandemic was an additional source of fear, anxiety, and loneliness for them. Moreover, as partial online classes were going on, students had to keep checking their phones from time to time for updates in the academic groups. Thus, they had to become more and more dependent on mobile phones.

About 49% of the medical students in the present study reported that using mobile phones is affecting their academic performance. This proportion was higher than the finding by Prasad et al. where about 40% of students perceived their academic performance to be poorer due to spending of more time on phone.[9] Similar finding was corroborated by Aman et al. in Pakistan, Baghianimoghadam et al. in Iran, and Krithika and Vasantha.[13],[14],[15] However, this was in contrast to study conducted by Ezemenaka which revealed no significant association between academic performance and using smart phones.[16]

The present study found that the proportion of nomophobia was highest in second professional students which corroborated with Prasad et al. who reported preclinical students had highest proportion of nomophobia.[9] This was in contrast to the findings of Ramudu et al. and Dixit et al., who reported that nomophobia was maximum among interns and 3rd-year students, respectively.[10],[11]

There was no gender-based difference in nomophobia observed in this study. However, the prevalence of nomophobia was higher among females compared to males as found by Prasad et al.(20.68%) which was also statistically significant.[9] Ibraheem et al. in their study in Iraq also found that nomophobia was higher among females (79%) than males (58%).[17]

This study shows that nearly 13% of students strongly agreed that running out of battery in smart phone would scare them. About one-fourth of the study participants strongly agreed to the statement that if they did not have data signal or could not connect to Wi-Fi, then they would constantly check to see if they could connect to a signal. This shows that our budding doctors have become totally dependent on mobile phones which are affecting their mental health.

Strengths of the study

First, we used NMP-Q scale to measure nomophobia which has been validated in college students. Although many research works have been conducted on mobile phone addictive disorders all across the globe, there is a limited number of studies from West Bengal, India. Furthermore, we had a large sample size and followed a stratified random sampling technique.

Limitations of the study

The present study was conducted only in one medical college in Kolkata, so the findings cannot be generalized to other colleges in West Bengal. Academic performance was assessed based on the self-perception of the students. Furthermore, the study only focused on the prevalence and predictors of nomophobia and not on the suggested treatment options for the same.


  Conclusion and Recommendations Top


There was a high proportion of nomophobia among medical students. Predictors of nomophobia were younger age, time spent with mobile phones, and the presence of other addictions. Excessive use of smart phones is affecting the mental health of young budding doctors. The use of smart phones should be discouraged wherever possible such as during college hours. Medical students who have already got moderate nomophobia should use smart phones more wisely and judiciously and avoid downloading addictive applications. Parents should also observe and monitor the use of smart phones by their children.

Way forward

Further studies are needed to be conducted with a shift of focus from predictors to treatment options, especially among the general public to address this growing problem.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Bhattacharya S, Bashar MA, Srivastava A, Singh A. NOMOPHOBIA: NO MObile PHone PhoBIA. J Family Med Prim Care 2019;8:1297-300.  Back to cited text no. 1
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Bragazzi NL, Del Puente G. A proposal for including nomophobia in the new DSM-V. Psychol Res Behav Manag 2014;7:155-60.  Back to cited text no. 2
    
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Sharma N, Sharma P, Sharma N. Rising concern of nomophobia amongst Indian medical students. Int J Res Med Sci 2015;3:705-7.  Back to cited text no. 3
    
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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.  Back to cited text no. 4
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Yildirim C, Correia AP. Exploring the dimensions of nomophobia: Development and validation of a self-reported questionnaire. Comput Hum Behav 2015;49:130-7.  Back to cited text no. 5
    
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Debnath DJ, Kakkar R. Modified BG Prasad socio-economic classification, updated-2020. Indian J Community Health 2020;32:124-5.  Back to cited text no. 6
    
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Sethia S, Melwani V, Melwani S, Priya A, Gupta M, Khan A. A study to assess the degree of nomophobia among the undergraduate students of a medical college in Bhopal. Int J Community Med Public Health 2018;5:2442-5.  Back to cited text no. 7
    
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Chethana K, Nelliyanil M, Anil M. Prevalence of nomophobia and its association with loneliness, self happiness and self esteem among Undergraduate medical students of a medical college in Coastal Karnataka. Indian J Public Health Res Dev 2020;11:523-9.  Back to cited text no. 8
    
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Prasad M, Patthi B, Singla A, Gupta R, Saha S, Kumar JK, et al. Nomophobia: A cross-sectional study to assess mobile phone usage among dental students. J Clin Diagn Res 2017;11:ZC34-9.  Back to cited text no. 9
    
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Ramudu RV, Raj R, Purushothaman M, Reddy KG, Ramana PV. A study of assessment of mobile phone dependence among medical students in tertiary care teaching hospital. Indo Am J Pharm Res 2015;5:2583-7.  Back to cited text no. 10
    
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Dixit S, Shukla H, Bhagwat A, Bindal A, Goyal A, Zaidi AK, et al. A study to evaluate mobile phone dependence among students of a medical college and associated hospital of central India. Indian J Community Med 2010;35:339-41.  Back to cited text no. 11
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Kubrusly M. Nomophobia among medical students and its association with depression, anxiety, stress and academic performance. Rev Bras Educ Med 2021;45:e162.  Back to cited text no. 12
    
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Aman T, Shah N, Hussain A, Khan A, Asif S, Qazi A. Effects of mobile phone use on the social and academic performance of students of a public sector medical college in Khyber Pakhtunkhwa Pakistan. Khyber J Med Sci 2015;8:99-103.  Back to cited text no. 13
    
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Baghianimoghadam MH, Shahbazi H, Masoodi Boroojeni D, Baghianimoghadam B. Attitude and usage of mobile phone among students in Yazd University of Medical Science. Iran Red Crescent Med J 2013;15:752-4.  Back to cited text no. 14
    
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Krithika M, Vasantha S. The mobile phone usage among teens and young adults impact of invading technology. Int J Innov Res Sci Eng Technol 2013;2:7259-65.  Back to cited text no. 15
    
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Ezemenaka E. The usage and impact of Internet enabled phones on academic concentration among students of tertiary institutions: A study at the University of Ibadan, Nigeria. Int J Educ Dev Using Inf Commun Technol 2013;9:162-73.  Back to cited text no. 16
    
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    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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