Nomophobia causes disorders in individuals’ emotions, thoughts, behaviors, and attitudes. Nomophobia levels in individuals are affected by numerous factors (
1,
13,
16,
17). This study was conducted to reveal the nomophobia levels of nursing students and the relationship between nomophobia and personality traits. Although there were no non-nomophobic students in this study, it was shown that 31.1%, 52.6%, and 16.3% of the students had mild, moderate, and severe levels of nomophobia, respectively. The total nomophobia mean score was also observed to be 74.17 ± 25.53 (
Tables 1 and
2). In line with the results of the current study, the nomophobia levels of the university students (
11,
12,
18) and nursing and medical faculty students were observed to be moderate and high in the literature (
1,
19,
22,
23).
Nomophobia, which is common, especially among the young population, causes distraction in nursing students due to the misuse of smartphones in clinical practice, the decrease in the quality of care given to patients, the risk to patient safety, and the decrease in students’ academic performance and decision-making skills (
1,
22,
39). In addition, it has been reported that nursing students are unaware that smartphone use causes distraction. On the contrary, they believe they need their phones more to obtain information and ask for support in the clinic and feel safe when they have their phones with them (
40). This might lead to increasing phone usage, becoming more dependent on phones day by day, and encountering many problems (
30). For this reason, it is believed that nomophobia levels of nursing students are significant for the institution, the patient, and the student. Including the topic of behavioral addictions in nursing curricula and organizing activities aimed at preventing technology addiction can be effective in reducing nomophobia levels. In addition, it will be important for nurses, who show a holistic approach with their protective, preventive, therapeutic, and rehabilitative roles, to direct nursing students to health-promoting behaviors, such as healthy eating, doing sports, and regular sleep, in order to reduce their nomophobia levels.
Nomophobia is affected by numerous factors. In the current study, it was observed that the variables with a significant difference between the nomophobia total score and subdimension score averages had a small effect size. Even if the effect size was at a low level, it was noticed that the variables did not cause a random difference. According to the results of the
t-test in independent groups analysis, the total nomophobia mean score was higher in students who play games and shop on the phone (
Table 5).
| Variables | No. (%) | Not Being Able to Have Access to Information | Giving Up Convenience | Not Being Able to Communicate | Loss of Connectedness | Total Nomophobia | Openness to Experience | Agreeableness | Emotional Stability | Conscientiousness | Extroversion |
|---|
| Data on Smartphone Usage Area |
| Social media | | | | | | | | | | | |
| Yes | 332 (78.3) | 16.83 ± 6.18 | 18.49 ± 7.66 | 25.67 ± 9.28 | 14.26 ± 8.14 | 75.26 ± 26.29 | 9.88 ± 2.33 | 8.92 ± 2.34 | 8.56 ± 2.85 | 10.59 ± 2.68 | 9.42 ± 3.10 |
| No | 92 (21.7) | 16.40 ± 5.47 | 16.56 ± 6.73 | 23.67 ± 9.08 | 13.60 ± 7.14 | 70.25 ± 22.28 | 9.84 ± 2.18 | 8.52 ± 2.89 | 8.98 ± 2.71 | 10.94 ± 2.55 | 9.05 ± 2.78 |
| Test value; significance level | | t = 0.60; P = 0.516 | t = 2.19; P = 0.029 | t = 1.83; P = 0.067 | t = 0.70; P = 0.481 | t = 1.67; P = 0.095 | t = 0.13; P = 0.889 | t = 1.46; P = 0.144 | t = -1.26; P = 0.208 | t = -1.12; P = 0.261 | t = 1.02; P = 0.306 |
| Effect size | | 0.185 | 0.267 | 0.217 | 0.086 | 0.205 | 0.017 | 0.152 | 0.151 | 0.133 | 0.125 |
| Playing games | | | | | | | | | | | |
| Yes | 166 (39.2) | 16.99 ± 5.95 | 19.50 ± 7.17 | 26.22 ± 9.04 | 14.50 ± 8.34 | 77.65 ± 25.86 | 9.90 ± 2.62 | 9.10 ± 2.50 | 8.04 ± 2.95 | 10.48 ± 2.80 | 9.16 ± 3.17 |
| No | 258 (60.8) | 16.57 ± 6.09 | 17.15 ± 7.58 | 24.60 ± 9.36 | 13.38 ± 7.02 | 71.94 ± 25.12 | 9.85 ± 2.06 | 8.66 ± 2.20 | 9.05 ± 2.67 | 10.79 ± 2.56 | 9.45 ± 2.95 |
| Test value; Significance level | | t = 0.69; P = 0.489 | t = 3.16; P = 0.002 | t = 1.77; P = 0.77 | t = 1.67; P = 0.095 | t = 2.25; P = 0.025 | t = 0.22; P = 0.826 | t = 1.87; P = 0.062 | t = -3.62; P < 0.001 | t = -1.16; P = 0.244 | t = -0.973; P = 0.331 |
| Effect size | 0.069 | 0.318 | 0.176 | 0.145 | 0.223 | 0.021 | 0.186 | 0.358 | 0.115 | 0.094 | |
| Shopping | | | | | | | | | | | |
| Yes | 280 (66.0) | 16.99 ± 6.10 | 18.62 ± 7.54 | 26.04 ± 9.32 | 14.92 ± 8.37 | 76.17 ± 26.39 | 9.94 ± 2.38 | 8.91 ± 2.37 | 8.52 ± 2.90 | 10.71 ± 2.61 | 9.42 ± 3.01 | |
| No | 144 (34.0) | 16.25 ± 5.90 | 17.00 ± 7.32 | 23.60 ± 8.97 | 13.60 ± 7.60 | 70.30 ± 23.39 | 9.75 ± 2.12 | 8.68 ± 2.25 | 8.93 ± 2.65 | 10.58 ± 2.73 | 9.17 ± 3.03 | |
| Test value; Significance level | | t = 1.20; P = 0.231 | t = 2.12; P = 0.034 | t = 2.50; P = 0.012 | t = 1.38; P = 0.167 | t = 2.25; P = 0.025 | t = 0.81; P = 0.414 | t = 0.99; P = 0.323 | t = -1.41; P = 0.158 | t = 0.48; P = 0.632 | t = 0.817; P = 0.414 | |
| Effect size | | 0.123 | 0.218 | 0.266 | 0.165 | 0.223 | 0.084 | 0.099 | 0.014 | 0.048 | 0.082 | |
a t: t-test in independent groups; P < 0.05; Effect size: Cohen’s d.
Using social media, playing games, shopping, having access to information, and communicating are reported as the most common reasons for nursing students to use smartphones (
23). The constant use of smartphone applications and activities that cause one to spend much time on the phone, such as playing games and shopping, increases phone addiction. As in other behavioral addictions, tolerance develops for the situation that causes addiction (
15,
27). The development of tolerance is the continuation of the behavior due to the loss of control over the behavior, as in substance addiction. In behavioral addictions, although it is aimed to avoid addictive behaviors or to have them at a moderate level, longer uncontrolled permanent behavior experiences occur with loss of control (
41-
43). This, in turn, causes problems in interpersonal relationships and social life (
41,
42), sleep disorders, stress, anxiety, a decline in academic performance, and nomophobia (
27). The present study also suggests that playing games and shopping with a smartphone increase the level of nomophobia due to the development of tolerance. Moreover, individuals checking their mobile phones for 15 minutes or more frequently and spending a long time on the phone have a high level of nomophobia (
44). It can be said that the time spent on the phone poses a risk for nomophobia.
Placing a device in the center of life affects human relationships and social life. Individuals with different personalities have different smartphone usage habits, which affect their life choices (
15,
29,
35,
45). According to Pearson correlation analysis, a weak negative connection was shown between emotional stability and conscientiousness personality traits and nomophobia total score (
Table 3). Nursing students with mild nomophobia were observed to have higher emotional stability and conscientiousness personality traits’ scores than students with moderate and severe nomophobia. In addition, a weak link was observed between the traits of extroversion, agreeableness, and discipline with the nomophobia levels of nurses and a strong relationship between neuroticism and nomophobia levels (
35). Nomophobia level is reported to be high in reward addiction (
15), neuroticism (
46), and low agreeableness (
42) dimensions of personality trait models; nevertheless, the level of nomophobia is low in the cooperation dimension (
15) of the personality trait models.
There is a positive correlation between the nomophobic status of university students with their extraversion, compliance, responsibility, and openness to development personality scores and a negative relationship between emotional balance personality scores (
47). Individuals with low emotional balance personality traits give extreme emotional reactions in stressful environments. They may prefer to stay away from people to stay away from stressful environments. For this reason, they might prefer to use mobile phones and spend more time on them instead of face-to-face contact. There is a negative correlation between nomophobia and basic psychological needs. There is also a negative correlation between the personality trait open to experience and the subdimensions of giving up comfort and loss of connection of nomophobia. This result is compatible with the results in the literature (
46). The fact that those who would not like to experience new experiences use their mobile phones more instead of preferring social environments has an impact on this result.
It is argued that personality traits known to be effective in the initiation and maintenance of behaviors also affect nomophobia levels, and positive personality traits, such as emotional stability and conscientiousness, play a role in controlling behaviors. For this reason, it is important for psychiatric nurses to evaluate the personality traits that are effective on nomophobia, which is known as the common disease of the digital age, and to take appropriate initiatives to cope with it. Psychiatric nurses need planning, implementation, and evaluation skills to reduce the cognitive and behavioral addiction levels of nursing students.
5.1. Conclusions and Recommendations
The current study showed that most of the students had a moderate level of nomophobia, and the purpose of using the mobile phone and the students’ personality traits were related to students’ nomophobia levels. It is suggested to perform further studies to evaluate the effect of nomophobia on nursing students in terms of students themselves and clinics to introduce smartphone usage regulations in clinics, determine the effects of these regulations on nurses and students both in the educational environment and in clinics, and plan nomophobia prevention or treatment initiatives in accordance with the personality characteristics of individuals.