Effect of Structured Teaching Programs (STP) on Knowledge Regarding the Impact of Internet Addiction (IA) among Adolescents of Selected Nursing College, Mangalore

Introduction

Internet is reshaping or redefining majority of conventional communication mediums, including telephone, music, cinema, and television. Through instant messaging, various Internet forums, and social networking, the Internet has permitted or expedited new types of human connection. Internet sales have soared for both large retailers and independent makers and merchants.¹

India has billions of residents but only 52 million of them use Internet regularly. In all, 71 million people used the Internet in 2009, of which 52 million were "active" users who did so at least once each month. The Internet is becoming increasingly addictive for young people in India; 72% of them use it often.²

Internet is a virtual informational treasure trove. On the Internet, people may acquire information regarding nearly every subject they can think of. Students and young children are among the most frequent Internet researchers.¹

Modern-day addictions include Internet addiction disorder (IAD). Similar to those who are addicted to alcohol, gambling, drugs, shopping, and other compulsive habits, those with IAD may display symptoms, experience setbacks, and face repercussions. Regrettably, this addiction is negatively influencing every area of the lives of millions of teenagers and their families. The main impacted areas include relationships, job, family, and school.³

More than 30% of parents surveyed do not talk to their children about the downsides of using the Internet, despite the potential negative impact it can have on teens using the Internet.⁴

Internet addiction disorder is getting a lot of attention as the Internet becomes more and more a part of our lives. Internet addicts can withdraw from social and interpersonal relationships. Family relationships, academic and professional performance may deteriorate. Several withdrawal symptoms, including nervousness, restlessness, and aggression, and an addiction syndrome, including the presence of withdrawal symptoms, increased tolerance, and loss of control, have been identified. High rates of comorbid psychiatric disorders have also been reported, particularly depressive symptoms and social impairment.¹

The investigator in this study intended to assess the knowledge of adolescents on the impact of Internet addiction and determine the effectiveness of structured teaching programs in improving the knowledge regarding Internet addiction.

Objectives of the study

• To determine the levels of knowledge among nursing students regarding the impact of Internet addiction as measured by a structured knowledge questionnaire.
• To evaluate the effectiveness of structured teaching program on the level of knowledge among nursing students regarding the impact of Internet addiction.
• To find the association between pre-test knowledge scores and selected demographic variables.

Material and Methods

A quantitative research approach with one group pretest and post-test design was adopted to achieve the objectives of the study. A stratified random sampling technique was used to draw a sample of 60 adolescents studying at selected nursing college who fulfilled the inclusion criteria. Each batch of BSc Nursing (1st to 3rd year) was considered as strata and 20 students from each batch were recruited randomly using lottery method. The roll numbers of the students were written on the slips and after preparing all the slips, they were folded in similar manner to hide the material written on the slips. In the presence of a co-supervisor, the folded slips were put in the container. Investigator shuffled the container and then picked the slip and then again the container was shuffled before picking the next slip till the desired students from the class were selected without replacing the slips.

A structured knowledge questionnaire was used to assess the levels of knowledge on the impact of Internet addiction. Thereafter, a structured teaching programme (STP) for around 20 minutes was conducted for the adolescents using a PowerPoint presentation followed by a discussion. Post-test was taken after one week of the structured teaching program.

Ethical clearance was obtained from the ethics committee of the institution followed by permission to conduct the study from the management of the nursing college. Informed consent was obtained from all the participants of the study. Anonymity and confidentiality of the information were maintained during and after data collection.

Analysis and interpretation of data were done according to the study by using descriptive and inferential statistics.

Results

Majority of the adolescents (45.5%) belonged to the age group of 18-20 years and were females (59.10%). Majority of the participant’s parents worked in the private sector (38.6%) and 69% had an income of above Rs 30,000/- per month. The majority belonged to nuclear families (56.7%). Smartphones were accessed by all the participants and majority (58%) spent around 3-5 hours on the Internet per day. Study (50%) and entertainment (44%) were the main reasons for using the Internet on a daily basis. Most of them (77%) have heard about Internet addiction.

In terms of knowledge on Internet addiction, the mean ± SD of pre-test scores was 12.96 ± 2.81 and the median was 13.0, whereas, the mean ± SD post-test score after the structured teaching program (STP) was 23.21 ± 2.30 with a median of 24.0. Furthermore, pre-test and posttest knowledge scores on Internet addiction is depicted in Table 1.

In terms of association, no significant association was found between knowledge on Internet addiction and selected baseline variables.

Discussion

Electronics are an integral part of the lives of young people in the 21st century. Internet is widely recognized as one of the world's largest technology platforms. It is a resource for knowledge, entertainment, branding, commerce, education, and more. But over the last few years, Internet has changed the way we live, work, and communicate. Adolescents are creative with new technologies, and this creativity can create resistance from parents, teachers, and health care providers. The present study discussed the knowledge of adolescents regarding the impact of Internet addiction and the effectiveness of structured teaching programs (STP) in improving their knowledge.

In the present study, 45.5% of adolescents belonged to the age group of 18-20 years and 59.10% were females. Around 38.6% parents of the adolescents worked in the private sector and 69% had a total income of above Rs 30,000/- per month and 6.7% belonged to nuclear families. It was noticed that 100% had access to smartphones and 58% spent around 3-5 hours on the Internet per day. In terms of usage, 50% used the Internet for study purposes, and 44% used it for entertainment purposes. About 77% heard about Internet addiction.

A similar study conducted in Pune in 2022 showed that 66.7% of the adolescents were in the age group of 19- 21 years and 61.7% were females. Around 88.3% were from the middle class, 46.7% lived in joint families, 15% of them were from single parent families. Among the participants, 70% were college students, 15% were graduates, 96.7% of adolescents had a smartphone, 45% had one social media account and 10% of them had more than three social media accounts.⁵ Another study conducted in Nepal in 2021 showed divergent results. All the adolescents belonged to the age group of 18- 19 years, 58% were males, 50% lived in joint families, 58% used their mobile for two hours or more for using Facebook.⁶

In terms of knowledge on Internet addiction, the mean ± SD of the pre-test scores was 12.96 ± 2.81 and the median was 13.0, whereas, the post-test mean ± SD score after the STP was 23.21± 2.30 with a median of 24.0.

This study findings are supported by a study conducted in Nepal in 2021, which showed that during the pre-test, the subjects had inadequate knowledge with a mean of 40.5 and standard deviation of 5.4, whereas in the posttest, there was a significant gain in knowledge with a mean knowledge score of 76.9 and a standard deviation of ^7.6

Another study conducted in Pune in 2022 showed that during the pre-test, 8.3% of the students had poor knowledge (score 0-6), 41.7% of them had average knowledge (score 7-13) and 50% had good knowledge (score 14-20) regarding social media addiction. In the post-test, 11.7% demonstrated average knowledge (score 7-13) and 88.3% showed good knowledge (score 14-20) regarding social media addiction. This indicates that the knowledge among students improved remarkably after a structured teaching program regarding social media addiction among students.⁵

In this study, no significant association was found between knowledge on Internet addiction and selected baseline variables. A study conducted in Pune in 2022 reported a significant association of the demographic variables such as gender, socio-economic status, and number of social media accounts with the knowledge among students regarding social media addiction.⁵

A significant association was found between sociodemographic variables such as age, type of family, number of siblings, educational status of the father, educational status of the mother, time spent on mobile per day using Facebook, leisure time activities, and heard about Facebook addiction at 0.05 levels of significance. In a study conducted in Meerut in 2022, each variable such as age, gender, educational status, family type, and family income showed no statistically significant association with the post-test knowledge scores at the level p< 0.05.⁷

Raising awareness about the harmful effects of adolescents' internet viewing habits is the primary responsibility of caregivers working in communities, rehabilitation centers, and the workplace. Through role-plays, motivational interviews, and a structured curriculum, the harmful effects of prolonged screen time should be taught so as to create awareness and reduce excessive use of screen devices. Awareness programs should be planned by governing authorities for implementation in various health system settings.

The present study was limited to a group of adolescents in a selected nursing college. Therefore, studies could be conducted involving large sample sizes with different demographic variables and studies can also be conducted to assess the harmful effects of Internet and coping strategies.

Conclusion

On the basis of the findings of current study, it can be concluded that adolescents have Internet addiction issues, and health education to adolescents about the psychosocial impact of Internet addiction would help to promote healthy habits towards usage of the Internet and social media.

Conflict of Interest

Nil