Abstract
Background: The COVID-19 pandemic brought about great transformation to medical education mode. Although mobile communication devices played a crucial role in online learning among quarantined university students, the potential smartphone addition problems, negative health behaviors, and psychological symptoms need considerable attention. This study examined the relationship of problematic smartphone use (PSU), sleep quality, and daytime fatigue among medical students.Methods: A web-based survey was conducted in six polyclinic hospitals in Beijing between February and May 2020. 1016 participants (26.01 ± 2.46 years, 65.16% female) completed self-report measurements including Short Version Smartphone Addiction Scale (SAS-SV), Athens Insomnia Scale (AIS), and Subjective Fatigue Scale (FS). Spearman correlation coefficients and multiple regression models were used to analyze the association among PSU, sleep quality, and daytime fatigue. We used structural equation modeling to test the mediating effect of sleep quality between PSU and daytime fatigue.Results: 49.70% of the participants had PSU. Significant positive correlations were found among SAS-SV, AIS, and FS scores (r = 0.35–0.61, PS < 0.001). Subjects with PSU were more likely to report sleep disturbance (β = 1.07, P < 0.001, OR = 2.91, 95%CI = 2.17–3.91), physical fatigue (β = 1.16, P < 0.001, OR = 3.18, 95%CI = 2.45–4.15), and mental fatigue (β = 0.88, P < 0.001, OR = 2.42, 95%CI = 1.86–3.14). The indirect effect of PSU on physical fatigue and mental fatigue mediated by sleep quality accounted for 50.03 and 45.43% of the total effect, respectively.Conclusions: PSU was significantly associated with sleep disturbance and fatigue among medical students during the COVID-19 pandemic. Sleep quality mediated the relationship between PSU and daytime fatigue. Our results provide valuable information for maintaining medical students' health status and constructing online education structures.
Highlights
Since December 2019, an acute respiratory infectious disease caused by a novel coronavirus (SARS-CoV-2) broke out in Wuhan, China
Many studies indicated that smartphone overuse directly impacts daytime functions and sleep quality [12,13,14], while the relationship has not been identified under the influence of the COVID-19 pandemic among medical students
65.16% were female, 61.81% were master’s students, 55.02% had a professional degree type, 77.46% majored in clinical medicine, 31.69% were first-year graduate students, and 34.55% lived in rural areas
Summary
Since December 2019, an acute respiratory infectious disease caused by a novel coronavirus (SARS-CoV-2) broke out in Wuhan, China. A recent national survey among 746, 217 Chinese college students showed that the risks of developing depression and anxiety disorders increased with the exposure time to electronic devices [10]. Another cross-sectional study showed that the level of COVID-19 related anxiety symptoms was correlated with the severity of problematic smartphone use (PSU) among Chinese adults [11]. Many studies indicated that smartphone overuse directly impacts daytime functions and sleep quality [12,13,14], while the relationship has not been identified under the influence of the COVID-19 pandemic among medical students. This study examined the relationship of problematic smartphone use (PSU), sleep quality, and daytime fatigue among medical students
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