الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 129 |  |  |
| | | from | 129 | | |
Abstract
Internet addiction (IA) always refers to the inability of individuals to control their Internet use, resulting in marked distress and/or functional impairment in psychological, physical and social daily life activities. It shares characteristics of substance dependency which include preoccupation with internet use, inability to control online use, withdrawal symptoms, use the internet as a way to escape from problems. The negative consequences of IA on physical health include musculoskeletal disorders, poor diet quality and Sleep disturbance. Regarding social health, IA reduces face-to-face communication and the quality of social relations. Moreover, psychological effects of the internet addiction include increasing anger, irritability, nervousness and mood change. The pediatric nurse has an essential and vital role in developing effective preventative intervention programs to increase awareness of the relation between health status and IA and its consequences on adolescents’ health as well as promoting internet addicts’ health by providing appropriate intervention.
The aim of the present study was to assess the relation between health status and internet addiction among adolescents.
The current study was conducted at outpatient clinics (Dental clinics), at Damanhour Medical National Institute. Outpatient clinics working hours were from 8:30 am - 1:30 pm daily. Simple random sample of 200 adolescents, their ages ranged from 13-18 years old and attending the previously mentioned settings were selected randomly to constitute the study.
Three tools were used to collect the necessary data. The first tool was Socio-Demographic characteristics of Adolescents and their Pattern of Internet Usage Interview Questionnaire Sheet which developed by the researcher after reviewing the relevant and recent literature. This tool was used to assess Socio-demographic characteristics of adolescents and their pattern of internet usage. It included two parts; Part I involved Socio- Demographic characteristics of Adolescents, while part II contained to Pattern of Internet Usage. Whereas, the second tool included Internet Addiction Test which was developed originally by Kimberly Young (1996) and modified by the same researcher (2011) to assess degree of internet addiction. While, Tool III contained Assessment of Internet Addiction Consequences on the Health Status among Adolescents Interview Questionnaire Sheet that was developed by the researcher after reviewing the relevant and recent literature. It consisted of three parts. Part I included Physical Health Status, while Part II contained Social Health Status as well as Part III which involved Psychological Health Status.
Responses to questions of tool II which included Internet Addiction Test measured on a six-point Likert scale that ranges from 0 to 5 as follows: 0 = (does not apply), 1 = (Rarely), 2 = (Occasionally), 3 = (Frequently), 4 = (Often), 5 = (Always). The total score of the scale ranges from (0-100 point); from 0 - 30 pointed to normal internet users, while from 31 - 49 indicated mild degree of internet addiction or an average on-line user and from 50 -79 meant moderate degree of internet addiction or the user is experiencing occasional or frequent problems as well as 80 - 100 represented severe degree of internet addiction or the Internet usage is causing significant problems in the user’s life. The research tool III ’’Assessment of Internet Addiction Consequences on the Health Status among Adolescents’’ was tested for its content validity by a jury of five experts in the pediatric nursing field of the study and the necessary modifications was done accordingly. The reliability of the tool III was done by measuring the internal consistency of its items using Cronbach Coefficient Alpha Test. The tool III was reliable for adolescents as r = 0.742.
A pilot study was carried out by the researcher on 10% of the study subjects (20 adolescents) attending the previously mentioned setting to test feasibility of the research and ascertain the clarity and applicability of the tools. There are no modifications.
Those 20 adolescents were excluded from the study. Every adolescent was interviewed individually at the specified waiting area by the researcher in the morning when attending the outpatient clinics. Data was collected over the period of five months starting from the beginning of August to the end of December 2018.
The main results of the current study revealed the following:
Forty five percent of adolescents used internet for more than 5 years.
Two-thirds of adolescents (63.8%) reported the mobile phone and tablet as the most commonly used device.
“Home” is the most frequent place for internet access as reported by 70.4% of the adolescents.
The majority of the adolescents (87%) used the internet daily and the highest percentage of them (85%) used internet at night.
More than half of adolescents (50.5%) were classified as moderate internet addicts, while of them (45%) were diagnosed as mild internet addicts and only minor percentage (4.5%) were reported as sever internet addicts.
More than three- quarters of the adolescents (77.5%) sit at close distance from mobile and computer screen.
The majority of the adolescents (82%) often complained from tired and red eye, while of them (79%, 72%) had (back pain and neck and shoulder pain) respectively.
The majority of the adolescents (83.5%) were sometimes eating food while using the internet.
Nearly three-quarters of the adolescents (73%) were sometimes cancelling or skipping basic meals, whereas nearly equal percent of them were sometimes eating junk food while using the internet.
About half of the adolescents (51%) had the computer inside their bedrooms.
Two- thirds of the adolescents (67%) reported that their sleep duration was affected by internet usage.
Half of the adolescents (50.5%) sometimes complained of nightmares during sleeping, while more than half of them (54.5%) sometimes complained of insomnia during sleep.
Half of the adolescents (50.5%) sometimes participated in social activities, while one-fifth of them (20.5%) never participate.
Sixty two point five percent of adolescents reported that their families sometimes complained about their duration of using internet.
Sixty-eight percent of adolescents preferred the internet as a method of communication with their friends.
Half of the adolescents (50%) sometimes were defending the internet usage.
Nearly half of the adolescents (48.5%) sometimes had sadness feeling when being offline.
More than half of adolescents (55%) needed to increase time of using the internet.
Half of adolescents (50%) had bad mood during attempts to reduce the internet usage.
These results show statistical significance difference between frequency of internet use and degree of internet addiction (P= 0.004**).
These findings show statistical significance difference between daily internet usage in hours and degree of internet addiction (p= 0.021*).
There were statistically significant difference between the predominant time of internet use and degree of internet addiction (P= 0.015*).
There are positive correlations between daily internet usage in hours and (wrist and arm pain, numbness and tingling in the hand fingers, and migraine) with statistically significant differences (P=0.000**, 0.006** and 0.007** respectively) orderly.
A statistically significant difference was found between number of sleeping hours at night and daily internet usage (P= 0.001**).
Positive correlation was apparent between daily internet usage and sleeping hours during day (P= 0.004**).
Statistically significant differences were found between daily internet usage in hours and nightmares, unable to wake up early (p=0.002** and 0.036* respectively) orderly.
Degree of internet addiction was strongly correlated with use of internet as a way to escape the reality with statistically significant difference (P= 0.003*).
Degree of internet addiction was positively associated with comfort sensation when using the Internet continuously (p= 0.009**).
Degree of internet addiction is associated significantly with thinking about the internet (p= 0.047*).
Aggressive behavior was positively correlated with internet addiction (p= 0.000**).
There was statistically significant difference found between degree of internet addiction and the desire to increase the number of hours using the internet (p= 0.000**).
There was positive correlation between daily internet usage in hours daily and number of online friends with statistically significant difference (p= 0.000**).
Daily internet usage in hours is linked positively with number of hours to communicate with online friends daily (p= 0.000**).
According to the findings of the present study, the following recommendations are suggested:
• Develop community awareness programs about ”safe Internet use” through mass media and schools to minimize harms of internet addiction among the adolescents. Moreover, allocation social and physical facilities of sports and recreational activities in the community which are considering alternatives of internet use to invite adolescents in their leisure time.
• Developing, planning and Implementation of different workshops for adolescents about physical, psychological and social risks of excessive internet use.
• Enhance awareness among family to set home computer in a public area such as living room to enable parents’ supervision of internet use.
• Standardized age appropriate health education programs should be provided for toddlers and preschool students to prepare and educate them about safety use of the internet creatively and purposefully.
• The school nurse should coordinate health programs to educate adolescents about accurate health information and prevention of the adverse effects of internet use.