The Determinants of Social Media Addiction among Nursing Students at University of Tabuk (UT): A Cross-Sectional Study

Received: 01-Aug-2024, Manuscript No. ijmrhs-24-143948; Accepted Date: Aug 22, 2024 ; Editor assigned: 03-Aug-2024, Pre QC No. ijmrhs-24-143948(PQ); Reviewed: 07-Aug-2024, QC No. ijmrhs-24-143948(Q); Revised: 10-Aug-2024, Manuscript No. ijmrhs-24-143948(R); Published: 30-Aug-2024

Introduction

Social media platforms like Instagram, Snapchat, and others have taken over an important portion of people's life in the 21^st century. The public has become so interested in social media platforms that they are now an essential part of modern communication. These communication tools promote interpersonal connections, help maintain relationships, and give people a place for self-expression. [1].

Through social media, people may stay in touch with friends they already have and make new ones regardless of where they are or how available they are [2]. Additionally, social media can be utilized as a tool for health interventions; for instance, interventions based on WhatsApp have been shown to increase physical activity among Saudi Arabian female college students [3].

Addiction is behavior defined as being excessively concerned about social media, motivated by an insatiable urge to log on to or use social media, and spending so much time and effort on social media that it interferes with other important aspects of life. However, excessive and compulsive use of social media platforms can result in addiction to them, This might lead to symptoms like anxiety and depression and impair the person's psychosocial functioning and general wellbeing. Around 4.48 billion individuals use social media worldwide, accounting for 56.8% of the world's population who are active users [4]. Social media adoption has been widely used worldwide [5]. Social media use in the Kingdom of Saudi Arabia (KSA) is growing quickly. The astounding increase in social media users from 7.6 million in 2014 to 29.5 million in 2022 attests to the fact that social media platforms are proliferating throughout the whole country [1,6]. According to this research, there's a chance that Saudi people would use social media in a detrimental way. Thus, a comprehensive investigation into social media addiction among the country's most vulnerable population’s young adults, medical students, college students, it’s desperately needed. Few research has looked on social media addiction or consequences related to it in a variety of communities, including Saudi Arabian university students [7-9]. According to a study done on Saudi Arabian female university students, social media addiction significantly positively correlates with participants' Body Mass Index (BMI), but not their body image [8]. Multiple variables were looked at in our study, including academic, psychological, and sociodemographic factors including anxiety and depression. Nursing students' academic responsibilities might result in a variety of psychological disorders. The future of health care is built on these students. However, if individuals develop a social media addiction, it can impair their capacity to learn, interfere with their ability to do everyday tasks, and negatively impact their chances of finding employment in the future especially considering how much time they spend at work.

Problem Statement

In Kingdom of Saudi Arabia (KSA), social media has become a crucial aspect of our daily lives and is used by over than 50% of the population for over three and a half hours, which is higher than the average of two and a half hours and continues to increase each year. Although there’s a negative effect to its use such as depression and anxiety [6]. Nursing students are a vital portion of the community and there's no data determines the determinants of social media addiction among nursing students at University of Tabuk (UT) in Saudi Arabia. As a nursing student at University of Tabuk (UT) in our research we determined the determinants of social media addiction among nursing students.

Aim of the Study

The present study aimed to determine the determinants of social media addiction among a sample of nursing students selected from University of Tabuk (UT) in Saudi Arabia.

Research Question

What are the associated determinants of social media addiction among nursing students from University of Tabuk (UT) in Saudi Arabia?

Variables of the Study

Independent: Sociodemographic variables such as age, and gender.

Dependent:

• Sociodemographic variables such as Grade Point Average (GPA), level of education

• Psychological variables such as depression and anxiety.

• Academic variables such as academic performance.

Research hypothesis

H0: There is no association between the frequency of social media use and the levels of social media addiction among nursing students at the University of Tabuk (UT).

H1: There is a positive association between social media addiction among nursing students at the University of Tabuk (UT) and anxiety and depression

H2: There is a negative association between social media addiction among nursing students at the University of Tabuk (UT) and academic performance (Figure 1).

Figure 1. The conceptual framework

Literature Review

As social media becomes increasingly important in students' lives, students may be at greater risk for social media addiction. Based on the findings of a study conducted by King Khalid University (KKU), it was aimed to investigate the prevalence and determinants of social media addiction among medical students in Saudi Arabia. The data were collected from 326 students via questionnaires. The findings revealed a negative association between students' academic performance and social media addiction scores. Additionally, students with symptoms of depression exhibited higher scores on the Bergen Social Media Addiction Scale (BSMAS) compared to their counterparts. Furthermore, in another article, it was reported that more than half of the students were classified as social media users, while fewer reported severe addiction. Moreover, students use social media channels like WhatsApp group to share their lecture content in the form of PDFs. Another study was conducted aimed to assess the prevalence and level of social media addiction among nursing students in the Faculty of Nursing, Cairo University [10]. The data were collected from 340 students via a demographic background information sheet and the Social Networking Addiction Scale (SNAdds-6S). Found that social media addiction negatively affects a student's life in which students face family problems and lose social communication, and was prevalent among all students, but at different levels. Severe addiction was found in only 6.76% of students, while more than half of the students (60.59%) were classified as moderate users, and one-third (32.65%) were classified as controlled users.

Moreover, investigated the relationship between social media addiction and academic performance of Iranian medical science students: a cross-sectional study. The data were collected from 360 students were enrolled by stratified random sampling via questionnaires and found a negative and significant relationship between social media and academic performance [11]. There were also negative and significant relationships between all subscales of social media participation and Grade Point Average (GPA). Research has also been done that looks at relationship between social media use and depression among college students in the US, studied the time the student spends on social media and its behaviours. The data were collected from 727 students via questionnaires. Consistently showed higher correlations 40% between loneliness, neuroticism, self-esteem, social media addiction, social media comparison and depression in college students [12].

Investigated the relationship between social media addiction and depression: a quantitative study among university students in Khost, Afghanistan [13]. The data were collected from 384 students via questionnaires that social media was positively associated with depression among college students in Khost Province, Afghanistan. Furthermore, examined social media sites and their effects on college students Anxiety Levels among University Students [14].

The data were collected from 361 university students via questionnaires and self-reported items. Found that there was a significant positive correlation between addiction to social networks and anxiety. It is concluded that the harmlessness of social networks and their inappropriate use can lead to behavioural addiction [14].

Overall, this study supports the findings of this study that social media is a common problem among college students and can negatively impact academic performance and mental health. However, they offer an alternative explanation for the relationship between social media and mental health problems.

Methodology

Type and Location of Study

We used an online questionnaire, to assess the determinants of social media addiction.

Participants Selection

Through the nursing club and student groups on social media platforms including Facebook, Instagram, Twitter, and WhatsApp, nursing students enrolled in the 2023–2024 academic year who had access to the internet were invited to participate in the study. The inclusion criteria were:

• Undergraduate students

• Active social media users for at least one year

The exclusion criteria were:

• Graduate students

• Non-users, occasional users, and active users on social media for less than one year

Sample: The study sample included male and female nursing student in academic year (first - second - third - fourth) at the University of Tabuk (UT) in Saudi Arabia.

Sample type: A convenience sample was used to collect data from undergraduate nursing students at University of Tabuk (UT) in Saudi Arabia.

Sample size: Because our sample is restricted to University of Tabuk nursing students, we decided to use the Cochrane equation for small groups of known size with population correction to calculate the sample size, Population Size 435

Data collection tool: During the review of the literature, it was found that a similar study had used a specific tool to collect data on a particular aspect of the research question. While the tool was appropriate for their study's objectives, it was decided that certain modifications were necessary to better suit the needs of the proposed study. The modifications made to the tool were guided by the study's research question, intended to address specific gaps in the literature, and tailored to the study's population and setting. The process of modifying the tool involved a rigorous review of the original tool, a thorough assessment of its relevance to the proposed study's objectives, and a thorough evaluation of its validity and reliability.

Research instrument: There were six sections and a total of 41 variables in the study questionnaire

• Sociodemographic and behavioural information (variable=04).

• Apps-related information (variable=06).

• Social media addiction (variable=06) [15].

• Assessment of Academic performance (variable=08) [16].

• Assessment of anxiety symptoms (variable=07) [17].

• Assessment of Major Depressive Inventory (MDI) (variable = 10) [18].

The research team created the questions to gather data on behavior and sociodemographic from the standpoint of the nation. Four validated tools, including the Major (ICD-10) Depression Inventory, the Generalized Anxiety Disorder (GAD-7) scale, the Bergen Social Media Addiction Scale (BSMAS), and the Academic Performance Scale (APS-8), these methods were used to evaluate social media addiction, anxiety symptoms, depression symptoms, and academic performance scale. Approximately no more than 8-10 minutes were needed to complete the study questionnaire.

Pilot study: A pilot study was conducted on 25 (16.67 %) of students to ensure the clarity, objectivity and comprehensiveness of the tool, and to estimate the time needed to fill in the tools. These students were excluded from the total number of the main study sample. No required modifications were performed on the tools final version.

Statistical analysis: The Statistical Package for Social Sciences (SPSS) was used to do statistical analysis on data that had been entered into an Excel sheet. To investigate the relationship between social media addiction and its determinants, inferential statistics were employed.

Ethical consideration: Participants' consent was obtained before filling the questionnaire, which was filled anonymously. Sensitive personal data was not handled. Permission from the ethical committee of University of Tabuk (UT) was obtained prior to conducting the study. Permission from the authors of the instrument to be used in the current study was obtained. The benefit of participating in this study determined the determinants of social media addiction among nursing students at the University of Tabuk (UT) in Saudi Arabia.

Result

The sample is diverse, with participants evenly distributed across different age groups and genders (Table 1).

Willingness to cooperate with research: 83.7% of respondents are willing to cooperate, while 16.3% are not (Figure 2).

Figure 2: Percent and are you willing to cooperate with our research

Gender: 61.4% of the sample population identifies as Female, while 38.6% identify as Male (Figure 3).

Figure 3: Percent and gender

Age

• The largest age group is 22 years-23 years old, comprising 34.2% of the sample.

• The second largest group is 20 years-21 years old, accounting for 30.7%.

• Most respondents are between 18 years and 24 years old, with a few under 18 (3.0%) and some 24 years old or above (8.9%) (Figure 4).

Figure 4: Percent and age

Level of Education

• The largest group of students are in their fourth year, making up 37.1%.

• The second largest group is second-year students at 24.8%.

• First-year and third-year students represent 17.3% and 20.8% respectively (Figure 5).

Figure 5: Percent and level of education

Grade Point Average (GPA)

• The majority of respondents (45.0%) have a GPA of more than 4.5.

• 35.6% have a GPA between 4 and 4.5.

• The lowest percentage falls in the 2.5-3 GPA range, at only 0.5% (Figure 6).

Figure 6: Percent and grade point average

Hypothesis

There is no association between the frequency of social media use and the levels of social media addiction among nursing students at University of Tabuk (UT) (Table 2).

The data from table 2 illustrates the relationship between the presence of different social media apps on smartphones and the levels of social media addiction among respondents.

Throughout the different social media platforms, there seems to be a consistent pattern where a higher proportion of users fall into the medium and Sever addiction categories compared to the low addiction category. This suggests a potential link between the presence of these apps and increased susceptibility to addiction.

Among the surveyed apps, Telegram stands out with a notably lower percentage of users categorized as strongly addicted, compared to other platforms. This could imply that Telegram might have different features or usage patterns that make it less addictive for some users.

Interestingly, there is a category labeled "others" which comprises less popular or niche social media apps. Users of these apps appear to have a higher proportion of Sever addiction compared to the medium and low addiction categories. This finding might suggest that users of less mainstream social media platforms might be more prone to stronger addictive behaviors (Table 3).

The data presented in table 3 reveals a concerning trend regarding social media addiction among nursing students at the University of Tabuk (UT). It appears that there is a positive correlation between the frequency of social media use and the levels of addiction, as evidenced by the varying percentages across different social media platforms.

Among the surveyed apps, TikTok seems to have the highest prevalence of addiction, with 25.8% of users falling into the severe addiction category. This is followed closely by Instagram, Snapchat, and WhatsApp, all of which exhibit substantial percentages of users experiencing medium to severe addiction levels. Interestingly, Telegram stands out as having a lower overall prevalence of addiction compared to other platforms, with only 12.3% falling into the severe addiction category. This could suggest that certain platforms may have different psychological impacts or addictive qualities compared to others (Table 4).

Table 4 sheds light on the association between individuals' purposes for using social media and the levels of social media addiction.

It is clear that there is a consistent level of moderate to severe levels across all categories of social media use; This shows the relationship between social media use and addictive behavior. Interestingly, the intended use of social media in education and learning shows a relatively high percentage of people in the medium and severe categories. This research may show that social media can be a useful tool for education but can also reveal the effects of addictive behavior among users who engage in such activities.

Furthermore, the purpose of downloading songs, photos, and videos appears to have a particularly high percentage of users categorized as severely addicted. This finding underscores the potential role of content consumption in driving addictive behaviors on social media platforms (Table 5).

Table 5 presents data on the association between the device used to access social media and the levels of social media addiction. Interestingly, regardless of the device used, there is a consistent distribution of individuals across the low, medium, and severe addiction categories. This suggests that the type of device does not significantly influence the likelihood of experiencing social media addiction.

Both smartphones and iPads show similar percentages of users falling into the medium and severe addiction categories, with slight variations in the proportions across the different levels of addiction.

These findings suggest that social media addiction is not inherently tied to a specific device but rather is influenced by other factors such as usage patterns, content consumption, and individual predispositions.

While smartphones are traditionally associated with higher levels of accessibility and usage convenience for social media platforms, iPads, with their larger screens, may offer a different user experience. However, despite these differences in user interface and mobility, the levels of social media addiction appear comparable across both devices.

There is a positive association between social media addiction among nursing students at University of Tabuk (UT) and anxiety and depression (Table 6).

The data presented in table 6 indicates a correlation between social media addiction among nursing students at the University of Tabuk (UT) and anxiety and depressive.

Firstly, there is a positive relationship between social media and anxiety symptoms among nursing students, as indicated by the Pearson correlation coefficient of 0.289 with a p-value of .000. This suggests that as social media addiction levels increase, so do levels of anxiety among the students. This study highlights the potential impact of social media use on mental health, particularly in terms of increasing feelings of anxiety.

On the other hand, there is a weaker and non-significant correlation between social media addiction and depressive symptoms, with a Pearson correlation coefficient of -0.102 and a p-value of 0.150. While the correlation is negative, it shows that depression symptoms tend to decrease slightly as social media levels increase; this relationship is not statistically significant at the 0.01 level.

There is a negative association between social media addiction among nursing students at University of Tabuk (UT) and academic performance (Table 7).

The data provided in table 7 reveals that there is a significant but negative correlation between social media addiction among nursing students at the University of Tabuk (UT) and their academic performance.

The Pearson correlation coefficient of -.190** indicates that as levels of social media addiction increase, academic performance tends to decrease slightly among the nursing students. This negative correlation suggests that there is some association between higher levels of social media addiction and lower academic achievement. The strength of the correlation (- 0.190) is relatively modest. This means that while there is a connection between social media and academic performance, other factors may also play a role in students' academic outcomes.

Discussion

The findings suggest a relationship between the presence of these apps and an increased susceptibility to addiction. This conclusion is consistent with Nicosia's (2023) research, which found that frequent usage of social media can lead to addictive behaviors due to reasons such as social validation, fear of missing out, and the quick gratification offered by these platforms. Compared to other platforms, Telegram stands out for having a noticeably smaller percentage of users classified as severely hooked. This observation raises the potential that Telegram has unique features or usage patterns that help some users who struggle with addiction. Examining further what makes Telegram different from other social media platforms could yield important information about how to build features into platforms that encourage better usage practices.

With 25.8% of its users classified as severely addicted, TikTok is the social media site with the highest frequency of addiction among those surveyed. This discovery is alarming and calls for more research into the special qualities or dynamics of TikTok's content that can encourage viewers to engage in addictive behaviors. Furthermore, considerable proportions of users on Instagram, Snapchat, and WhatsApp report having medium-to-severe addictions, suggesting that these platforms may provide serious risk of social media addiction for nursing students. These results were consistent with the Chao et al., (2023) investigation. The goal of utilizing social media for learning and education reveals that a comparatively larger proportion of people fit into the categories of medium and severe addiction. Even though social media can be a useful tool for education, this study draws attention to the possible disadvantages that come with using these platforms for excessively for educational purposes. It suggests that social media use, even when it seems advantageous, might lead to addictive habits among users.

This outcome was consistent with Saini and Mir (2023). Traditional learning methods have been altered by the use of social media in education, which presents both benefits and challenges. In order to fully utilize social media, educators must find a balance between maximizing its positive effects on learning outcomes and minimizing any negative consequences it may have on students' wellbeing and academic standing. Similar percentages of users on smartphones and iPads fall into the categories of medium and severe addiction, with very minor differences in the percentages across the various stages of addiction. The levels of social media addiction seem to be similar for both smartphones and iPads, despite smartphones being historically linked to higher levels of accessibility and usage ease for social media platforms and iPads providing a different user experience with their larger screens. This implies that variables other than the gadget itself, such people's underlying motives and how they use social media, are more important in influencing addictive behaviors. While there is a weaker and nonsignificant correlation with depression symptoms, there is a strong positive correlation between social media addiction and anxiety symptoms. These results highlight the significance of treating social media addiction as a possible risk factor for anxiety symptoms in nursing students and the necessity of additional study to more clearly define its relationship to signs of depression. This association could have multiple clarifications. Social media platforms often facilitate comparisons with others, leading to feelings of inadequacy or anxiety about one's own life and accomplishments. The relationship might have multiple explanations: Social media sites frequently make it easier to compare one's life to others, which can cause worry or feelings of inadequacy about one's own achievements. Overuse of social media can exacerbate anxiety about being left out or falling short of peers by feeding a worry of missing out on social events, experiences, or opportunities. Constantly being exposed to carefully chosen and frequently idealized depictions of other people's lives on social media can put pressure on one to live up to expectations or norms, which can increase worry about one's accomplishments, looks, or social standing.

Overuse of social media can interfere with in-person social interactions and relationships, which can result in feelings of loneliness or isolation, which are recognized anxiety risk factors. This outcome was consistent with Overuse of social media, particularly in young people, has been associated with more severe feelings of anxiety [19]. Time spent on social media is positively correlated with anxiety levels among university students. Furthermore, anxiety in high school and university students is linked to Facebook addiction. Understanding this relationship might help nursing students make more informed decisions about how to responsibly utilize social media while still achieving academic success. It emphasizes how crucial it is to support digital literacy, good technology usage practices, and study skills and time management resources [20-23].

Recommendations

• Develop and implement educational programs aimed at raising awareness about the risks and consequences of social media addiction among nursing students. These programs can include workshops, seminars, and informational sessions to provide students with information on healthy digital habits and strategies for managing social media use effectively.

• Integrate digital literacy education into the nursing curriculum to equip students with the skills and knowledge necessary to navigate social media responsibly. This includes teaching critical thinking skills to evaluate online information, promoting privacy and security awareness, and fostering a reflective approach to social media use.

• Establish counseling and support services specifically tailored to address social media addiction and its associated psychological effects among nursing students. These services can offer individual counseling, group therapy, and peer support networks to help students cope with stress, anxiety, and other mental health challenges related to social media use.

• Encourage students to adopt healthy digital habits by setting boundaries around social media use, practicing mindfulness, and prioritizing offline activities and relationships. Emphasize the importance of balance and moderation in using social media and provide resources and tools to help students manage their online presence effectively.

• Collaborate with social media platforms to promote responsible usage and implement features that support users in managing their time and reducing addictive behaviors. Encourage platforms to provide tools for monitoring and controlling usage, promoting positive content, and fostering a supportive online community

• Provide academic support services to help students improve their time management skills, study habits, and academic performance. Offer tutoring, study groups, and academic advising to assist students in achieving their academic goals while balancing their social media use.

• Conduct further research to explore the long-term effects of social media addiction on nursing students' mental health, academic performance, and professional development. Investigate the efficacy of intervention strategies and identify additional factors influencing social media addiction among this population.

Conclusion

In conclusion, our cross-sectional study illuminates the complex nature of social media addiction in the context of higher education by examining the factors that contribute to it among University of Tabuk (UT) nursing students. Several important discoveries have been revealed by examining a variety of aspects, such as social media usage habits, reasons, devices used, and their relationships with academic performance and psychological well-being. First of all, a considerable fraction of nursing students fall into the medium to severe addiction categories on various social media platforms, indicating the high levels of social media addiction among this population. This emphasizes how critical it is to identify and treat social media addiction as a real problem that has an impact on nursing students' wellbeing. Our findings also demonstrate the intricate relationship that exists between psychological variables and social media addiction. particularly anxiety symptoms, emphasizing the need for targeted interventions to support mental health among nursing students. Additionally, while there is evidence of a negative correlation between social media addiction and academic performance, the magnitude of this effect is relatively modest, suggesting that other factors may also influence academic outcomes. Furthermore, our study reveals interesting insights into the role of specific social media platforms, purposes for usage, and devices used in contributing to social media addiction among nursing students. Understanding these determinants can inform strategies for promoting healthier digital habits and mitigating the risks associated with excessive social media use.

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