CORRELATION BETWEEN THE EFFECTS OF SMARTPHONE

ADDICTION AND INTERACTION ANXIETY AMONG NURSING

STUDENTS OF
JOSE RIZAL MEMORIAL STATE UNIVERSITY

A Research Presented to the

Faculty of the College of Nursing and Allied Health Sciences
JOSE RIZAL MEMORIAL STATE UNIVERSITY
The Premier University in Zamboanga del Norte
Main Campus, Dapitan City

In Partial Fulfillment
of the Requirements for the Course
Nursing Research 1

Amora, Elizabeth S.
Cagatan, Justine Malou Z.
Provido, Princess T.
Rudas, Kessa Marie E.

February 2021

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 Chapter 1

THE PROBLEM AND ITS SCOPE

Introduction

Internet addiction has become a serious behavioral health problem in Asia.

However, there are no up-to-date country comparisons. The Asian Adolescent Risk

Behavior Survey (AARBS) screens and compares the prevalence of Internet behaviors

and addiction in adolescents in six Asian countries. A total of 5,366 adolescents aged

12–18 years were recruited from six Asian countries: China, Hong Kong, Japan,

South Korea, Malaysia, and the Philippines. (Mak, K. et. al 2014). According to Mak

et.al (2014) the rapid increase in smartphone ownership around the world and

specifically in Asia is readily apparent.

The Philippines is “the fastest-growing smartphone market in Southeast Asia”

and adolescents and young adults aged 16–24 years constitute “the largest chunk” of

smartphone owners in the country. They use these devices to engage in online

activities (e.g., access SNSs, send and receive emails, chat with others, search for

information, and watch, download, and upload videos). Consequently, the Philippines

was labeled as “the social media capital in the world” which contributed to the

consistent increase of smartphone addiction prevalence among adolescents (Buctot et

al., 2018; Haug et al., 2015).

Despite the advantages and needs of smartphone, excessive use can lead to

smartphone addiction. Smartphone addiction refers to dependency, excessive and

uncontrolled use of the smartphone. The phenomenon of smartphone addiction has

been a global concern as it can contribute to poor mental health especially among

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university students. Based on previous studies, smartphone addiction has also been

categorized as behavioral addiction due to the inability of users to control their use. A

recent study of smartphone addiction’s predictive capacity for health-related quality

of life among Filipino adolescents found a high prevalence rate of smartphone

addiction (62.6%) (Buctot, Kim, & Kim, 2020).

According to Choliz (2010) the problem of using smartphones is related to

behavioral addiction due to clinical features such as psychological effects on

emotions, personality and cognitive in which the younger generation is more

vulnerable to excessive usage and dependency towards smartphones. Alavi et al.

(2010) stated that individuals suffering from behavioral addiction have symptoms

such as craving, excessive behavior, psychological and physical withdrawal

symptoms. This behavioral addiction usually feature a very strong desire that

encourages someone to do something repeatedly without the ability to control, to

reduce or to stop.

Chiu (2015) stated that smartphone addiction can cause mental health

problems such as anxiety and depression that will cause critical barriers in

relationships, activities, physical and mental well-being. The issue has reached a

significant public health concern and in 2015, World Health Organization (WHO)

issued a report on Public Health Implications of Excessive Use of the Internet,

Computers, Smartphones and Similar Electronic Devices. This report summarizes the

problems associated with excessive use of smartphone with mental health such as

anxiety, depression and stress.

In addition, recent studies have found there was a relationship between

smartphone addictions with anxiety. The higher the person addicted to smartphone,

their anxiety is higher. An addictive individual will loss of self-control, lack of desire

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and ability to communicate with others. As a result, the individual will start isolating

himself or herself and continue to depend on smartphones. Indirectly, this also causes

the individual to be worried when cannot use smartphone. (Kwon et al. 2008). Social

avoidance and social distress refer to the emotional experience that results from one’s

anticipation of others’ judgment in a social situation. After experiencing social

distress (i.e. fear of being embarrassed in front of people) individuals come to avoid

various social situations, which consequently undermine their social functioning.

Social distress increases with increasing severity of internet and gaming addictions,

and the same is true with smartphone addiction (Kim et al. 2008, Eom 2013).

According to Eom (2013), some studies on college students suggest that students use

smartphones as means to avoid situations that induce social anxiety or to gain

emotional stability through repeated usage while others suggest that smartphones are

more frequently used to search study-related information on the internet, as opposed

to engage in interactions with others.

Kim et al. (2008) stated that the social networking service (SNS) feature of

smartphones enables quick communication between people. It is a medium, as well as

a language, through which people can network and communicate. Unlike internet and

gaming addictions, smartphone addiction is more prevalent among females.

Nursing students are prospective healthcare professionals who will provide

care for people to promote physical, psychological, mental and spiritual health. For

nurses, communication competence is a tool to be used for therapeutic purposes in

nursing practice. Nurses’ therapeutic communication is significant, as it enables

interaction through an exchange of verbal and nonverbal communication for the

purpose of education, prevention, support and correction. Communication

competence varies across individuals, and experiencing anxiety and tension about

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communication may have an adverse impact on one’s interpersonal relations through

reduced confidence, impacting everything from school performance to interpersonal

relationships and therapeutic approach in college undergraduates (Park 2006).

Moreover, clinical training in healthcare institutions also induces high anxiety,

as students encounter healthcare professionals and patients from diverse backgrounds

in an unfamiliar environment. Persons who experience social distress may even

entirely avoid situations in which others may observe them, and even if they do

participate in such situations, they demonstrate defensive or avoidance behaviors to

minimize their exposure to others (Park 2006)

This study will focus on the correlation between the effects of smartphone

addiction and interaction anxiety among the nursing students of Jose Rizal Memorial

State University. If campus health providers can uncover additional factors attributed

to the bad effects of too much used of smartphones in nursing students, they will be

able to increase self-awareness of possible mental health issues and give more

comprehensive solutions for alleviating this problem.

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Theoretical Framework of the Study

This theory is anchored on the following theories: Uses and Gratifications

Theory (UGT) by Blumler (1979) and Compensatory Internet Use Theory (CIUT) by

Kardefelt-Winther, (2014).

Several theoretical frameworks have been developed that can explain how

such individual differences as psychological and psychopathological constructs

(including anxiety symptoms) may relate to the use of internet communications (such

as smartphone use, and excessive use).

Uses and Gratifications Theory (UGT) (Blumler, 1979) is a long-standing

mass communications theory (Ruggiero, 2000) pro- posing that people have diverse

needs that they wish to satisfy through the use of different types of media. UGT

proposes that motivations to use media include sociodemographic and psychological

characteristics. As a concrete example, nursing students who are lonely may turn to

social media in an attempt to satisfy their need for social connection. Furthermore, if

the lonely person is also angry and irritable, s/he may turn to Twitter to troll other

users. In relevance to this paper, UGT would propose that anxiety can drive people to

use, or overuse, internet technology such as smartphones in order to satisfy or calm

their anxiety. In fact, several papers have used UGT to conceptualize anxiety

symptoms as driving Problematic Smartphone Use (PSU) (Contractor, Weiss, &

Elhai, in press; Elhai, Levine, Dvorak, & Hall, 2017; Lee, Chang, Cheng, & Lin,

2018; van Deursen, Bolle, Hegner, & Kommers, 2015).

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 A theory of excessive internet communications use that is more specific to,

and explicitly addresses, psychopathological constructs is Compensatory Internet Use

Theory (CIUT) (Kardefelt-Winther, 2014). CIUT assumes that after experiencing

stressful life events, many people attempt to reduce their resulting negative emotion

by engaging in excessive internet use (such as problematic smartphone use). Thus in

contrast to UGT, CIUT’s primary focus is on psychopathology in explaining

excessive internet communications use. People may turn to other means for

alleviating their negative emotion, whether adaptive such as exercise and social

support, or maladaptive such as promiscuous sex or substance abuse. But as discussed

above, the smartphone is constantly accessible and available on the students, and as

such may be the first and most obvious object (or process) that many people may use

to regulate or alleviate their negative emotion. CIUT fits well with negative

reinforcement models of addiction, also referred to as “self-medication” or “affect

regulation” models, emphasizing substance use as a means of alleviating negative

emotion (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004; Robinson & Berridge,

2003).

Numerous papers have used CIUT to conceptualize anxiety severity as driving

Problematic Smartphone Use (PSU). Because CIUT more prominently incorporates

psychopathology into its framework than UGT does, we believe that CIUT is more

relevant in understanding anxiety’s relationship with PSU. We should emphasize that

the theoretical models discussed above would conceptualize anxiety-related

psychopathology as driving PSU, rather than the other way around. Furthermore, this

sequence of psychopathology driving PSU is the typical type of analytic model tested

and supported in the literature (e.g., Elhai, Levine, O’Brien, & Armour, 2018b; Kim,

Seo, & David, 2015; van Deursen et al., 2015).

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 However, it is alternatively possible that excessive engagement in a

smartphone can drive anxiety symptoms. For instance, people who engage in PSU

may consequently isolate themselves, and neglect to engage in behavioral activity that

is important to psychological health (Dimidjian, Barrera, Martell, Munoz, &

Lewinsohn, 2011).

As a result of such social isolation and decreased behavioral activity, people

engaging in PSU may suffer from anxiety symptoms as a consequence. However, the

vast majority of studies examining relations between psychopathology and PSU are

cross-sectional. Only a limited number of longitudinal papers have examined the

sequence of these constructs, with some support found for bidirectional effects

between mental health problems and PSU severity.

Nonetheless, within the context of these theoretical models, we conceptualize

PSU as a means of, and consequence of, at- tempting to regulate negative emotion. In

behavioral terms, PSU would be considered a negative reinforce aimed at reducing or

preventing anxiety symptom.

Anxiety – Related Trans Problematic

Anxiety Smartphone
diagnostics factors: Increased Smartphone

Use Frequency Use

 Social Isolation

 Fear of Missing Out

 Boredom Proness

 Rumination

Fig. 1 Theoretical Model of Problematic Smartphone Use and Anxiety Symptoms

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 The schematic diagram of this study illustrates the effects of smartphone

addiction which is the independent variable and interaction anxiety. This may relate to

a negative or positive effect to the interaction anxiety among nursing students which

is identified as the dependent variable in terms of their demographic profile as to their

age, gender, year level and smartphone usage.

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 Effects on the Nursing
Students’ Interaction
Smartphone
Anxiety in terms of their
Addiction profile:
Age
Gender
Year level
Smartphone Usage

Figure 2. Schema of the Study

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Statement of the Problem

This study attempts to describe the relationship between nursing students’

smartphone addiction and interaction anxiety based on an analysis of the

characteristics of smartphone usage. The central research questions are:

1. What is the demographic profile of the respondents in terms of;

a. Age,

b. Gender;

c. Year level;

d. Smartphone usage

2. Is there a significant relationship with smartphone addiction to the nursing

students’ interaction anxiety in terms of demographic profile?

3. What are the current characteristics of smartphone usage, behavior and

smartphone addiction among nursing students?

4. Is the nursing students currently experiencing smartphone addiction?

Hypotheses:

Ho1- There is no significant relationship between the smartphone addiction

and the interaction anxiety of nursing students.

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Significance of the Study

The study desired to establish understanding towards the correlation between

the effects of smartphone addiction and interaction anxiety of nursing students,

furthermore the findings of this study will benefit the following:

Nursing Students. This study will help the nursing student to be aware of this certain

situation and in addition to their knowledge as a future health practitioner/workers, it

may also help them in influencing or sharing information towards their peers. This

study may help everyone see that their health is constantly changing because of this`

certain phenomenon.

Parents. The outcome of the study will give an additional knowledge to the parents

on what are the behaviors of their children has been displaying. It would also give

them a resolution on how to influence their children on participating in activities in

order to have a wide experience in socializing.

Clinical Instructors. Outcomes of the study will help the clinical instructors on

developing an idea or strategies that may help on preparing the teenagers/students on

their future, especially involving on reality based activities that may distract the mind

of the teenagers/students away from their smartphones.

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Administration. Particular in guidance, they can highly influence or educate the

young adults specially the nursing students of the possible outcome of using their

smartphones too much. This research will help the guidance to gain more information

as they educate the young adults.

Nursing Professionals. The information will help to enable the professionals to act

and give further information about the problem about the certain phenomenon that

would make everyone aware of the developing mental problem of too much exposure

on smartphones as it highly affects the teenagers.

Future Researchers. The findings of the study may be used as a reference data for

the future researchers in conducting a new researches as it will give them an overview

of their related study. They can also use it for learning purposes.

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Scope and Delimitation of the Study

The study focuses on the nursing students of Jose Rizal Memorial State

University. The researchers aim to highlight and understand it within the context of

this growing social concern. It is hoped that by doing so, nursing students will be

better able to understand the harms of smartphone addiction and the excessive use of

mobile phones and thereafter cultivate a consciously healthier lifestyle. The selection

of respondents is limited as its main purpose of the study is to know if there is a

relationship between the effects of smartphone addiction and interaction anxiety

among nursing students. The study covers some of the personal information of the

respondents. Every respondents are given same questionnaires to answer.

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Definition of Terms

Addiction. Is a condition where you cannot stop doing things in particular. It is a

repeated involvement of the smartphone in particular since most of the nursing

students are more active on socializing.

Anxiety. Is a characterized emotion that might be influenced by the overuse of

smartphones, feelings of tension, worried thoughts because of the negative feedback

of the social media, and physical changes like being underweight because of losing

their appetite.

Interaction Anxiety. A nursing student can be extremely concerned about other

people’s positive evaluations and are correspondingly disturbed by any negative

information about themselves which appears in a social context.

Nursing Students. The students currently enrolled in Jose Rizal Memorial State

University College of Nursing and Allied Health Sciences during the 2nd semester

AY 2020-2021.

Smartphone. It is currently a tool for communications that is widely used by all

people, especially among students.

Smartphone Addiction. The prevalence of smartphone use among students and its

association with addictive behavior. A condition that affects the daily life of users

inducing clinical characteristics such as loss of attention, tolerance, and mood

disorders.

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Smartphone Usage. The consumption of time that the nursing student spent with

their smartphones during day and night.

CHAPTER II

Review of Related Literature

This chapter presents the relevant literature and studies that the researcher

considered in strengthening the importance of the present study. It also presents the

synthesis or the art to fully understand the research for better comprehension of the

study.

Smartphone Addiction

The rapid increase in smartphone ownership around the world and specifically

in Asia is readily apparent. The Philippines is “the fastest-growing smart phone

market in Southeast Asia” and adolescents and young adults aged 16-24 years

constitute “the largest chunk” of smart phone owners in the country. Consequently,

the Philippines was labelled as “the social media capital in the world which

contributed to the increase of smart phone addiction prevalence among adolescents.

(Buctol et al,. 2018; Haug et al., 2015).

The World Health Organization (WHO) is currently undertaking a health risk

assessment of radiofrequency electromagnetic fields, to be published as a monograph

in the Environmental Health Criteria Series. However, in addition to physiological

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aspects of the exposure, there is a growing research literature that takes a

psychological or behavioral perspective on potential health effects of smart phone use.

Traditionally, addiction has been defined using a psychological model based

on material rather than behavioral patterns, such as substance abuse and drug

dependence. As society has continued to develop and research into addiction has

evolved, researchers have found that some people also overindulge in particular

activities. Based on this, a scientific researcher proposed the concept of Behavioral

Addiction, that is, individuals may not be experiencing any direct biological effect, as

they would from drug ingestion, but nevertheless experience excessive psychological

and behavioral dependence on certain things or activities, as we see in gambling

addiction, wealth addiction, pornography addiction and Internet addiction (Goldberg,

1990).

Smartphone is currently a tool for communications that is widely used by all

people, especially among high school students. Excessive use of smartphone can lead

to smartphone addiction. Someone who has a smartphone addiction have anti-social

behavior towards his environment. The smartphone is described as a mobile phone

that executes most of the tasks of a processor. It usually has a touch screen, access to

Internet, and an effective working system that is proficient of proceeding downloaded

applications. A Smartphone is a term for differentiating cell phones, with improved

characteristics from fundamental phones‘ characteristics. The term ―Smartphone

originally emerged in 1997, when Ericsson explained its GS 88 ―Penelope

idea/notion as a smartphone. Smartphones have progressively been turned out to be

the most important/key segment of our lives because of their several advantages, for

example, comfortability to access news, data and evidence, an easy social

connectivity, work station applications, comfort, easy to move, small size, and so on.

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Furthermore, now a days, smartphones are working very crucially and significantly in

the health care departments, as health care professionals and patients both pursue to

encourage effective health or health care facilities for the patients. However, in recent

modern years, the negative consequences of smartphone usage have also been raised.

Smartphone addiction is a significant public health concern with a significant

impact on the mental and behavioral status of its users. Previous evidence has linked

smartphone addiction to impaired behavioral attitude, low school/work performance,

impaired social interaction and relationship difficulties. Physically, the overuse of

smartphones was linked to higher risks of musculoskeletal pain, headache, blurred

vision and hearing impairment. (Soni et al., 2017).

Several studies have focused on smartphone addiction. Thompson (2017)

states that smartphone addiction, also colloquially called nomophobia, of their life

through their device, using it to socialize, work, access entertainment and any of the

other functions and subsequent addiction, has led to some concern regarding what the

consequences might be. In order to be categorized as an addiction, usage of

smartphones needs to.

Smartphone addiction is considered as the inability to control the smartphone

use despite negative effects on users. The use of a smartphone not only produces

pleasure and reduces feelings of pain and stress but also leads to failure to control the

extent of use despite significant harmful consequences in financial, physical,

psychological, and social aspects of life (Shaffer, 1996; Van Deursen et al., 2015;

Young, 1999).

Addiction to media has been characterized as excessive or poorly controlled

preoccupations, and compulsive needs or behaviors that lead to impairment. A study

reported that media addicts could not manage real-life. The people using the Internet

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longer had poor social support and higher levels of loneliness. Children using the cell

phone displayed more behavioral problems such as nervousness, temperament, mental

distraction, and indolence, and these problems worsened if the children began using a

cell phone at an early age (Divan et al., 2012).

A general point of concurrence in studies on smartphones is the prevalence of

smartphone use among younger people and its association with addictive behavior. As

smartphone use is more prevalent among younger people, they are generally more

exposed to the negative effects of excessive use, and smartphone addiction is seen as

a particularly high risk factor for younger people (Kim et al., 2014).

Smartphone addiction is defined as a condition that affects the daily life of

users, inducing clinical characteristics such as loss of attention, tolerance, and control;

mood disorders; and withdrawal symptoms (Lee, Chang, Lin, & Cheng, 2014).

According to Manzoor, A. et al (2020) Smartphone addiction has been

founded upon the description of Internet addiction, smartphone addiction has been

described as the excessive use of smartphones to such a degree/level, that it interrupts

the routine life of a user. Furthermore, an excessive use of mobile phone may bring

about mental or behavioral issues. It may result in behavioral issues, affect or delay

school or routine work performance, lessen or diminish real-life social

communication, negligence in personal life, mental preoccupation, and mood adapting

experiences and can cause relationship disorders as well.

Gender, specifically, being male, is a risk factor for pathological Internet use.

Results from multivariate logistic regression analyses have suggested 50 percent

increased odds for males to be addicted to the Internet (odds ratio (OR)  =  1.5, 95%

confidence interval (CI)  =  1.1, 2.2) as compared with females (Lam et al., 2009).

Women use the Internet mostly for social purposes and males do so for downloading

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programs, getting information, and for visiting pornographic sites (Tsitsika et al.,

2009; Ybarra and Mitchell, 2005).

In contrast to Internet addiction, studies on smartphone addiction reported that

females were more dependent on smartphones than males were (Billieux et al., 2008).

Females are more likely to be involved with their mobile than males are (Walsh et al.,

2011), owing to the differences in the purpose of use of mobile phones. Males are

more likely to use their phones for functional purposes, such as work-related use,

whereas females primarily use their phones to keep in contact with valued people

(Lemish and Cohen, 2005; Rees and Noyes, 2007). Thus, it seems that males and

females have different smartphone use patterns.

The smartphone usage rate was 62% that was discovered to be the highest

among the age group of 25- 34, all around the world. Worldwide, 50% and 43% of

Android and Apple devices users were younger than 34 years of age. Among them,

47% of Smartphone users are female while 53% are male. Recently, Indian

adolescents have been operating/running Smartphone's market place in India. The

percentage of 16-18 years of adolescents using Smartphone increased from 5% -25%

in 2012 to early 2014. In 2013, ―51 million‖ Smartphone users were discovered in

Urban India and the percentage was increased to 90% in the year of 2013 than 2012.

Manzoor et al. (2020)

In a meta-analysis study on Indian adolescents, smartphone addiction

prevalence was reported to vary between 39% and 44%, with this addiction

potentially associated with psychologically negative health outcomes (Davey &

Davey, 2014). Smartphone addiction has reportedly reached a prevalence of 11.4%

among younger people in South Korea, with 2.2% facing smartphone-addiction-

related difficulties in their daily lives (Kim et al., 2014). In a report published in the

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United States, 15% of 18- to 29-year-olds were identified as heavily addicted to

smartphones (Smith, 2017a), with 92% of the current younger generation owning

smartphones (Smith, 2017b). According to the results of the 2015 Household

Information Technologies Use Survey by the Turkish Institute of Statistics, the rate of

mobile phone use in Turkey is 96.9% (Turkish Statistical Institute, 2017).

Although smartphones have transformed lives in positive ways, such as

increased productivity and social networking, there is growing evidence indicating

that people overuse their phones in ways that interfere with their daily lives and

mental health. Various terms have been used to describe different patterns of

smartphone overuse, such as “smartphone addiction”, “problematic smartphone use”,

and “excessive smartphone use”. This study will refer to this phenomenon as

smartphone addiction. Smartphone addiction has rapidly grown to become a major

social and health problem, particularly among adolescents and young people. A recent

systematic review examined the prevalence of problematic smartphone use, including

smartphone addiction, and found a prevalence between 10% and 30%, with a median

of 23.3%.In Asia, the geographic region of this study, the prevalence of smartphone

addiction and other types of smartphone overuse among adolescents and young

people varied across studies and countries. For example, studies have documented

prevalence ranging from 13.5% to 36% in South Korea, 4.05% to 29.8% in China

15.5% to 82% in India and 62.6% in Filipino adolescents. In Japan and Thailand, the

focus of the current research, very few studies have reported on the prevalence of

smartphone addiction. One Thai study found that 45.8% of students aged 18–24 years

in Chiang Mai had excessive smartphone use , while in Japan, Tateno and colleagues

documented a smartphone addiction prevalence of 22.8% among males and 28%

among female college students (mean age 19 years ±1.3). In Western countries, the

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prevalence of smartphone addiction and/or other problematic smartphone use ranged

from 16.9% to 43.3%. Tangmunkongvorakul, et al. (2006).

Recently, a growing body of published literature raises concerns about the

overuse of smartphones by students. Smartphone addiction is defined as a statistically

significant distribution in routine daily‐life practices due to the overuse of

smartphones (Soni, Upadhya, & Jain, 2017).

Interaction Anxiety

It is crucial to note this decline in face-to-face interactions. This decline is a

severe issue because of the impact that social interactions play on humans’ lives.

Social interactions can cause a number of changes in our day to day lives. They can

cause our day to be extremely happy or be horrible. Social interactions play a major

role on the overall experiences people have in their lifetime (Verga & Kotz, 2017).

Social interactions begin their foundational importance at an early age,

research suggest at 6 months infants begin to be impacted by social interactions.

Social interactions can occur as an infant in the form of parents making faces to an

infant, parents using different tones to convey attitude, or using different facial

expressions to convey attitude/meaning (Hakuno, Omori, Yamamoto, & Minagawa,

2017).

Currently in today’s society, children are being exposed to technology at

increasingly earlier years, this exposure can have numerous harmful effects on the

child. According to research done by Dale Hay (2017), children who are less

knowledgeable on how to make friends are more likely to have less friends. This may

seem like a no brainer statement, obviously children that are more knowledgeable on

how to make friends will have more friends. However, the presence of technology too

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early in a child’s life can prevent them from learning the important skills necessary to

make friends later in their lives.

Social interactions do not only impact the amount of friends we have, they

also correlate with our overall psychological well-being. “In a survey of research on

suicide and attempted suicide, Stengel (1971) concluded that ’social isolation’ is the

common denominator of a number of factors correlated with a high suicide rate”.

The Uses and Gratification theory states that individuals seek out specific

media to fulfill specific needs. The various needs of college students in their

development process are the internal driving forces of their smartphone-related

behavior. When certain conditions arise, the use of mobile phones is required to meet

or partially meet developmental needs. From low to high, the classic Maslow

hierarchy of needs theory divided individual needs into physiological needs, safety

needs, love and belonging, esteem, and self-actualization.

From the point of view of individual needs satisfaction, Suler (1999) points

out that Internet addiction is not only a special channel for an individual’s

unconscious needs, but also notes a pathological satisfaction is obtained when the

demand is suppressed, neglected, or transferred.

Media system dependency theory (Ball-Rokeach & Defleur, 1976) states that

the more a person depends on media to meet needs, the more important media will be

in a person’s life, and therefore the greater effect media will have on a person. If the

individual must rely on audience media to accomplish a certain need and purpose, the

audience media is particularly important to that individual. The audience’s

dependence on the media is interactive but not equal. Against the background of

digital streaming media integration, “mobile phones are more popular than computers,

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more interactive than newspapers, and more portable than TVs”. As such, Internet

addiction must increasingly be understood in dialogue with smartphone addiction.

Rapee and Heimberg (1997) argue that individuals suffer from social anxiety

because they believe that the people around them will, as an “audience”, positively or

negatively evaluate them. Such individuals are extremely concerned about other

people’s positive evaluations and are correspondingly disturbed by any negative

information about themselves which appears in a social context. At the same time,

self-interested people have a relatively high level of social anxiety, and as a measure

of the surrounding people's own self-esteem, once they fail to meet the requirements,

they will think that others will make a negative evaluation. This fear, caused by self-

perception deviation, is thus a subjective cause of social anxiety.

The basic assumption of the self-regulation model is that people monitor their

own behavior and compare their behavior with established standards. Once they

perceive a gap between the two, they will adjust their behavior to bring it closer to the

standard. The self-evaluation system decides whether more effort is needed to reduce

the gap between behavior and standards.

According to Carve and Scheier (1981), if individuals are very confident in

their ability to meet standards, they will continue to push toward them. However,

when they doubt their ability, they experience negative emotions and self-deprecating

thoughts, which can lead to evasive behavior. Carver and Scheier explained that such

behavior may be a blatant evasion, such as leaving a social occasion, but it may also

take certain psychological forms, such as generating ideas that are unrelated to the

task. Smartphones offer a near-ubiquitous tool with which people can evade stressful

tasks, awkward social situation and so on.

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 The theory of interpersonal relationships holds that the interpersonal cycle of

individual interpersonal patterns can lead to social anxiety. The socially anxious

person often adopts some maladaptive behaviors, such as non-verbal gestures that

rarely involve eye-contact, self-exposure, or affinity. If they do have short

conversations with others, they often blush or exhibit other symptoms of anxiety.

These maladaptive behaviors are unlikely to trigger positive responses from the other

people present. This has a compounding effect, with social anxiety sufferers

becoming ever more concerned about negative reactions as they enter future scenarios

involving interpersonal communication, thus entrenching their maladaptive behaviors

and symptoms in a vicious circle. Initially, researchers thought that this was due to a

defect in individual social skills which then led to the maladaptive behavior patterns.

However, later researchers found that maladaptive behavior patterns were actually

dependent on the perceived social risk factors in a given scenario. (Segrin, 2001).

The overuse of the smartphone causes health problems, but the deprivation of

a smartphone can also cause health problems. For instance, smartphone addicts were

reported to feel distressed when deprived of their smartphone for some time, and

adolescents exhibited anxiety, depression, anger, and sleep disturbances when their

smartphones were switched off. (Assabawy, 2006; Torrecillas, 2007).

Heavy smartphone use can often be symptomatic of other underlying

problems, such as stress, anxiety, depression, or loneliness. At the same time, it can

also exacerbate these problems. If you use your smartphone as a “security blanket” to

relieve feelings of anxiety, loneliness, or awkwardness in social situations, for

example, you’ll succeed only in cutting yourself off further from people around you.

Staring at your phone will deny you the face-to-face interactions that can help to

meaningfully connect you to others, alleviate anxiety, and boost your mood. In other

25
words, the remedy you’re choosing for your anxiety (engaging with your

smartphone), is actually making your anxiety worse. (Robinson L. et al)

Smartphone addictive people tend to feel depressed and isolated without their

smartphones; besides, they can experience other symptoms of addiction such as

preoccupation, tolerance, lack of control, withdrawal, mood modification, conflict,

lies, excessive use and loss of interest. Depression and low self‐esteem are general

reflections of psychological well‐being, which are believed to be highly correlated

with smartphone addiction (Alhassan et al., 2018).

Broadly, smartphone addiction is one form of behavioural addiction. Many

central components of addiction have been established by behavioural addictions,

including salience, mood change, preoccupation, tolerance, lack of control,

withdrawal symptoms, lies, excessive use and loss of interest, interpersonal and

intrapersonal conflict and relapse. Behavioural addiction can be considered similar to

substance addiction and many aspects such as functional impairment and tremendous

difficulties in withdrawal (Mitchell & Hussain, 2018).

The major question is how do we get to know we are addicted to our cell

phone? When a person uses his/her cell phone most of the time, unable to cut back on

cell phone usage, using cell phones as a solution to boredom, feeling anxiety or

depression when your phone is out of your range, losing your relationships. Research

says “when cell phone use becomes an addiction, the behavior becomes stressful”.

Salvatore Insiga, a neurosurgeon at Northwell Health's Neuroscience Institute in

Manhasset, New York, considered that nonetheless that there is no solid proof

between cell phone radiation and tumor risk but the possibility still exists.

Adolescents are at high risk of being smartphone addicts. (Cha and Seo, 2018).

26
 Excessive use of smartphone paired with negative attitude and feeling of

anxiety and dependency on gadgets may increase the risk of anxiety and depression

(Rosen et al., 2013).

Another research was conducted on mobile phone usage in adolescents. They

recruited 439 students, aged 12-17 from Central Switzerland as their sample and

distributed a questionnaire among their parents first, then to the children (the

procedure was repeated a year later on the same sample). It was concluded that

mobile phone usage during night hours was common among youngsters and reported

that poor perceived health was shown due to staying up all night. No recordable

association was found between memory performance and mobile phones (Schoeni et

al., 2015).

Boumosleh & Jaalouk (2017) investigated whether anxiety and depression

independently contributed to smartphone addiction. Their sample was 668 random

Lebanese undergraduate students. Their cross-sectional study proposed that

depression and anxiety were also a positive predictor of smartphone addiction. They

also revealed that with depression scores were a more powerful predictor as compared

to anxiety.

A study of Brian (2013) subjected “Two days without phone” and revealed

that Kenny didn't want to lose his cell ever but Franchesca was happy to not have her

cell phone and she decided to give up her phone. Researchers found an intensive

increase of cell phone usage among teenagers and the symptoms of depression,

suicide risk factors and suicide rate in the year 2012.

Negi and Godiyal (2016) observed HNBUG-SRT college students while

walking around the campus, along with a questionnaire and found 64 % of students

used mobile phones in the campus. A randomized sample of 100 students was

27
collected. The survey showed that there were negative psychological effects of

smartphone usage on the young generation. They felt depressed and anxious while

using cell phones. On the other hand, some youngsters showed relax behavior even

without having a cell phone. A study investigated the addiction to the internet and

personality traits and found that loyalty, emotional stability, and extroversion were the

major predictors of internet addiction

Thomée et al. (2011) purposed that high frequency of cell phone use had a risk

of mental health outcomes when they had a 1-year followed-up for young students

aged 20-24. They concluded that high cell phone usage was associated with sleep

deprivation and symptoms of depression for both men and women.

An online study on Malaysian population stated that heavy mobile phone

usage may lead to physiological and psychological complications when a study was

conducted on 409 respondents. A descriptive research suggested that internet

addiction is similar to drug addiction except behavioral addiction (internet addiction)

doesn't involve a substance. In addition, the physical symptoms are absent in

behavioral addiction, but if internet addiction continues, it will undergo the same

results as alcohol addiction (Alavi et al., 2012).

Cha and Seo (2018) aimed to examine the predictive factors of smartphone

addiction in middle school students in South Korea. Two groups were chosen, one

risk group and another normal group. The two groups expressed significantly different

results. The predictive factors for smart phone addiction were social networking and

awareness of game overuse. A researcher revealed that teenagers who spend more

hours on their gadgets are highly likely more at risk of suicide.

Research has shown that smartphone addiction, in the form of long-term,

intensive use of the technology, can lead to physical symptoms, such as dizziness,

28
nausea, vomiting, and even sleep problems. It has been reported that radiation from

mobile phones can also impair human function, affect the expression of human cells,

thereby destroying protein molecules and protein immunity of other systems. Nylund

and Leszczynski (2006)

According to Young (1998), he believes that any behavior defined as addiction

must satisfy six principles: saliency, mood change, tolerance, withdrawal symptoms,

conflict and relapse. Corresponding to the diagnostic criteria with regard to

smartphone addiction, numerous researchers have developed corresponding

measurement tools.

Other research has shown that people with smartphone addiction are less

healthy than those who are not mobile phone addicts. Some scholars have found that

suicidal moods are related to the use of mobile phones at night. Sanchez-Martinez and

Otero (2009) surveyed more than 1,000 high school students in Spain and found that

students who overused their smartphones showed higher rates of depression, social

isolation and frustration. (Oshima, Nishida, Shimodera, Tochigi, Ando, Yamasaki,

Sasaki, 2012)

Young college students represent a group that is particularly affected by

smartphone use. Smartphone dependence not only affects their physical health, in the

form of neck, shoulder and back pain, as well as hearing and visual problems but it

also leads to many psychological problems, such as when the phones are used as a

means of distraction from work and thereby ultimately reduce the efficiency of their

learning (Leung, 2008).

The problematic use of mobile phone can negatively affect the quality of

sleep; quality of life; educational self-concept; academic engagement; the motivation

for advancement; academic performance; mental health; social interactions; and

29
feeling of loneliness; and also can increase academic burnout, aggression, anxiety,

and depression. (Griffiths, 1995).

The negative effects of smartphone overuse on physical health include cancer;

brain tumor; nervous disturbances; weakening of the immune system; problems with

the eardrum; pain in the wrist, neck, and joints; fatigue; and sleep disorders. (Alasdair

and Philips, 2017; Richard, 2001).

Excessive smartphone use at night could keep one awake till late, thus

impairing sleep and influencing stress and depression. The data was formulated by the

use of Fear of Missing Out (FOMO) scale. Screen time and Internet usage were

found to affect sleep and SNS addicts were reported to show poorer sleep quality than

non-SNS addicts did. (Wolniczak et al., 2013).

Based on Internet Related Addictive Behavior Inventory, Brenner (1997)

reported some daily-life disturbances such as less sleeping time, less time

management, missing meal and other symptoms. Several factors identified of internet

addiction, such as impatience, withdrawal, compulsive use, and interpersonal

problem. In recent years, the extant research has been shifted from internet addition to

mobile phone addiction. Researcher of mobile phone addiction uses internet addiction

measures in designing mobile phone addiction instrument. (Ko et al., 2006)

In a 2015 study, also published in Computers in Human Behavior, that

examined 318 graduate students at the University of Illinois, researchers found that

people who already experience depression and anxiety often turn to their phones or

other “information and communication technologies” (ICTs) as a tool for avoidance

coping—temporarily distracting themselves from negative feelings. Over a long

period of time, this can make a person more vulnerable to mental health problems.

But if you’re thinking of how often you check Twitter to make it through a morning

30
commute, don’t panic: Using the phone or other technology is only maladaptive over

the long run “when users are attempting to escape negative feelings, thoughts, or

experiences and thereby recruit the ICTs as a kind of therapeutic tool,” they clarify.

Present – day adolescence spend a lot of their time on their smart phones.

They use them to play games, watch videos, browse the internet, and check the

notification from social networking sites (SNSs). As a result smart phones users find

it difficult to refrain from using their smart phones. Further, when they are away from

their smart phones, they experience anxiety. This phenomenon is called nomophobia

(NO Mobile Phone phobia), and it refers to anxiety that is experienced when one loses

or is away from his/her smartphones and the fear that result from being unable to use

one’s smartphone. (Bian & Leung 2015., Emanuel et el., 2015., SecurEvoy, 2012;

Yildirim, 2014).

Cell phones, and smartphones in particular, have an undeniably addictive

quality, earning an entry in the Diagnostic and Statistical Manual of Mental Disorders

(DSM) 5th edition. A review of literature on cell phone addiction, published in

Frontiers in Psychiatry, describes cell phone and technology addiction manifesting in

one or more of the following ways: choosing to use your device even in "dangerous or

prohibited contexts;" losing interest in other activities; feeling irritable or uneasy if

separated from your phone; or feeling anxiety or loneliness when he or she is unable

to send or receive an immediate message. The researchers also found that adolescents

and women may be more susceptible to this behavioral addiction. (Lemola et al.,

2015).

Wanag et al. (2012) examined the internet usage patterns and lifestyle of

junior and senior high school and university students and found that there was a

significant grade difference. Similarly, Pan, Chiu, and Lin (2019) found that mobile

31
game addiction is more prevalent among junior high school students than among

senior high school students. Senior high school students obtained significantly higher

scores on the not being able to communicate, positive life perspective, interpersonal

relationship, and stress management subscales than junior high school students, who

in turn obtained significantly higher scores on the health responsibility subscale. This

findings suggests that juniors are more responsible about their health than seniors.

However, seniors are more likely to feel anxious about not being able to communicate

using their smartphones, be optimistic about life, have better social relationships and

handle stress better than juniors.

Research about overuse, excessive, dependent, addictive, problematic, or

pathological mobile phone use has emerged in parallel with the increased mobile

phone usage. The constructs are commonly referred to as behavioral addictions and

are likened with other non-substance addictions such as gambling addiction. As such,

it seems to be a case of impaired ability to regulate one’s mobile phone use and can be

associated with general symptoms of dependency, such as tolerance, withdrawal,

escape, craving, using the mobile phone even when it is unsafe or prohibited, or

functional consequences, such as financial or relational problems . Yet another

construct is “ringxiety”, or “phantom ringing”, which refers to perceiving that the

phone rings even when it does not. Excessive or problematic mobile phone use is

usually associated with a high quantity of mobile phone use, while a high quantity of

use does not necessarily imply problematic use. (Philippine Journal of Nursing, 2013)

It is confirmed that adolescent's mental health and physical health is associated

with cell phone addiction. But we cannot say it with 100 % accuracy that mobile

phone is the only cause of poor mental or physiological health issues in adolescents.

Reviewed articles of this study showed dual results. The result comes in two different

32
schools of thoughts. One opinion emphasizes that cell phone addiction and

psychological health has direct relation. Cell phone usage badly affects mental health

of adolescents and they look anxious, depressed and angry or sometimes commit

suicide. The suicidal rate is increasing in this era. Some studies also showed a positive

relation of cell phone addiction and physiological health.

The other school of thought reveals an indirect relation between cell phone

usage and psychological health. They say adolescents use cell phones at night, which

leads to insomnia. And insomnia ultimately results in depression, anxiety, and

depression. Cell phone addiction has no direct relation to mental health. After

reviewing these results, it is concluded that there is a relationship between cell phone

addiction and adolescent's mental or physical health whether they have direct or

indirect relation. We cannot neglect the relation and its adverse effects on adolescents.

It is suggested that more studies should be done in this regard to clarify their nature of

relations.

Synthesis and Gap

The previous literatures and studies mentioned was the common topic if there

is a relationship between smartphone use and interaction anxiety. As stated,

smartphone use may interfere with self-esteem because of social anxiety. The

proximity of the mobile device can be a tempting distraction, leading to multitasking

or task-switching. Literatures and studies provides facts that greater encourage the

researchers to help the society resolve one of the most unrecognized but slowly

growing issue of the country. All literature and studies reviewed had significant

similarities with the study since mostly we discuss related concepts as evidently

presented in the latter portion.

33
 CHAPTER III

Research Methodology

This chapter presents the methodology of the study. It includes the discussion

of the methods used, research environment, research respondents, research

instruments, validation, scoring procedure and statistical treatment.

Method Used

The researcher chose to follow quantitative descriptive correlational design.

This method of research is designed to gather information about present and existing

condition, or what is about a certain phenomenon. This method involved the

collection, organization, presentation or tabulation, analysis and interpretation of the

34
condition that exist. It will determine the correlation between the effects of

smartphone addiction and interaction anxiety among nursing students.

Research Environment

This study will be conducted through online survey with the use of social

media platforms such as; Messenger and Google Form. The respondents of this study

will be selected in every year level of the College of Nursing and Allied Health

Services of Jose Rizal Memorial State University Main Campus- Dapitan City.

According to the study of Smith most likely young adults are the participants

of this problem since they exceed the use of their smartphones, they spent a lot of

time browsing down social medias, playing games, reading comics, etc., they

unusually couldn’t meet their allotted time of sleep. This problem grows bigger since

smartphones are developing annually and it calls out the attention of the new

generation.

As the researchers, the first goal in conducting this research was to protect all

the individuals that will be involved, given the fact that Coronavirus Disease (CoVid-

19) is still prevalent throughout this study and by that he or she will strictly observe

certain health guidelines and protocols to avoid any inconvenience that might happen.

Respondents of the Study

The respondents of the study are Bachelor of Science in Nursing students from

the College of Nursing and Allied Health Sciences of Jose Rizal Memorial State

University, Main Campus. A stratified random sampling technique will be

employed to gather the necessary sample for this study. Given the low attrition rate of

the Bachelor of Science in Nursing program per observation, the current student

35
population will be used to compute the sample for this proposal. However, for better

accuracy, the exact population of Bachelor of Science in Nursing students for the

second semester of AY 2020-2021 will be utilized once available. Hence, out the 619

Bachelor of Science in Nursing students enrolled in the college in the first semester of

AY 2020-2021, a random sample of 243 students was computed using Slovin’s

formula with 0.05 margin of error. The data-gathering shall be done online via

Messenger or Google forms due to the restriction of face-to-face interaction. Thus,

physical data-gathering is impossible to do this time. The researchers identified the

respondents by contacting for approval involvement and then send out their

questionnaires through Messenger or Google forms.

Table 1. Research Respondents Distribution

Level Population Percentage Sample respondents

BSN 1 187 30.21% 73
BSN 2 207 33.44% 81
BSN 3 195 31.50% 77
BSN 4 30 4.85% 12
TOTAL 619 100.00% 243

Research Instruments

The researchers will be utilizing an adopted standardized questionnaire. It is

composed of the following parts: in Part I is the Demographic profile of the

respondents in terms name (optional), age and gender; year level and smartphone

usage. Part II, is a questionnaire of Smartphone Addiction and Part III is a

questionnaire of Social Anxiety.

36
Respondents use a Likert scale ranging from one (Strongly Disagree) to five (Strongly

Agree). The scoring of this questionnaire is as follows; Strongly Disagree = 1.00 –

1.49, Disagree= 11.50 – 2.49, Undecided= 2.50 – 3.49, Agree= 3.50-4.49 and

Strongly Agree 4.50 – 5.00. Prior to the preparation of the instrument, the researcher

endeavored to read several references like books, magazines, journals and make use

of the internet materials

Scoring Procedures

To determine the response of the respondents on the relationship between smartphone

addiction and interaction anxiety, the 5-point adjectival equivalent was used.

Numerical scale Continuum Adjective equivalent Abbreviation

5 4.50 – 5.00 Strongly Agree SA
4 3.50 – 4.49 Agree A
3 2.50 – 3.49 Undecided U
2 1.50 – 2.49 Disagree D

1 1.00 – 1.49 Strongly Disagree SD

Validation of Instrument

Prior to the collection of data the researchers will submit a draft questionnaire

to the adviser for feedback and suggestions. After being reviewed by the adviser, it

will be then handed over to three authorities on the subject, then to the members of

the panel of examiners for approval, before being released. When all the suggestions

are going to be integrated and the researchers’ study will be accepted for the

dissemination of the questionnaire, the instrument will be reproduced.

The instrument will be introduced to the adviser for corrections, after which

the experts on the subjects will be asked to give their opinion on its validity. Some

37
elements have been updated on the recommendations of the adviser. The final copy of

the instrument was administered after approval of the elements by the expert.

Data Gathering Procedure

After the chosen instrument will be validated, the researchers will provide a

request letter to the College Nursing and Allied Health Sciences Dean for the

approval in gathering the data for our respondents will be the Nursing students. In

administering the questionnaire through the use of social media platform, we will give

the respondents 24 hours to answer so that they will not feel any time pressure and

they can answer it in their free time. After data gathering, the researchers will collect

the data and will be tallying the scores to apply the possible treatment to be used with

the study.

Statistical Treatment of Data

As soon as the researchers gathered the data, they will be compiled, sorted,

organized and tabulated. They were subject to statistical treatment in order to answer

the questions proposed in the study. The following statistical tools will be used:

Percentage is to be used to determine the proportion of each given data by

using the formula.

%=(F/N) X 100

Where:

%= Percentage

F= No. of respondents

38
 N= total number of cases

Percentage and frequency count will be used to determine the profile of the

respondents.

The Likert Scale will be used to gauge the perception of the respondents

towards the Smartphone addiction and Interaction anxiety.

Cronbach's alpha is a measure to be used to assess the reliability, or internal

consistency, of a set of scale or questionnaire.

The Weighted Arithmetic Mean will be employed to determine the level of

Smartphone addiction and Interaction anxiety of the respondents.

Spearman Rank-Order Correlation Coefficient. It will be used in testing

significant relationship between Smartphone addiction and level of Interaction anxiety

among respondents.

Ethical Consideration

The letter of Informed Consent follows a detailed explanation of procedures,

description of risks, benefits reasonably to be expected, an offer of inquiry regarding

the procedures, and an instruction that the person is free to withdraw at any point in

the study. At the beginning of the study, a caution message will be presented to the

participant indicating that if they feel any stress, the study is to be discontinued. All

respondents will be over 18 years of age, and all are students of Jose Rizal Memorial

State University. Meeting these criteria qualified them as participants in this study.

The data collected will be anonymous (no identifying information is included) with no

attempt to identify it to a particular participant of the study. Results of the study will

39
 be available to the participants in the study. The data will be maintained on personal,

secured computer with no identification to a specific participant of the study. Only the

researcher will have access to the data.

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Appendix A

REPUBLIC OF THE PHILIPPINES

JOSE RIZAL MEMORIAL STATE UNIVERSITY
The Premier University in Zamboanga del Norte
GOV. GUADING ADAZA ST., STA. CRUZ, DAPITAN CITY, ZAMBOANGA DEL NORTE

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

February 2021

Ma’am:

The undersigned are currently conducting a study on “CORRELATION

BETWEEN THE EFFECTS OF SMARTPHONE ADDICTION AND
INTERACTION ANXIETY AMONG NURSING STUDENTS OF JOSE RIZAL
MEMORIAL STATE UNIVERSITY, MAIN CAMPUS” in partial fulfillment of
the requirements in Nursing NCM 111 (Nursing Research I).

45
In line with this, the undersigned would like to request permission from your good
office to allow him to field out the questionnaire and gather pertinent data for the
purpose. The data that will be gathered from the questionnaire is of great contribution
to the success of this endeavor. Further, the undersigned greatly assures that the data
gathered shall be treated with utmost confidentiality and shall be for the purpose of
this research only.

With high hopes that this request be given a positive at your end.

Very truly yours,

ELIZABETH S. AMORA
JUSTINE MALOU Z. CAGATAN
PRINCESS T. PROVIDO
KESSA MARIE E. RUDAS
The Researchers

GRACE R. ABAD, RN, LPT, MAN

Dean, College of Nursing and Allied Health Sciences
Main Campus, Dapitan City

Appendix B

REPUBLIC OF THE PHILIPPINES

JOSE RIZAL MEMORIAL STATE UNIVERSITY
The Premier University in Zamboanga del Norte
GOV. GUADING ADAZA ST., STA. CRUZ, DAPITAN CITY, ZAMBOANGA DEL NORTE

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

February 2021

Dear Respondents,

The undersigned are currently conducting a study on “CORRELATION

BETWEEN THE EFFECTS OF SMARTPHONE ADDICTION AND
INTERACTION ANXIETY AMONG NURSING STUDENTS OF JOSE RIZAL
MEMORIAL STATE UNIVERSITY, MAIN CAMPUS” in partial fulfillment of
the requirements in Nursing NCM 111 (Nursing Research I).

46
Please do the activities given and answer the questionnaires religiously. Your
cooperation is highly appreciated for it greatly contributes to the validity of the study
and response will be kept confidential.

Thank you very much and may God bless you always.

Respectfully yours,
ELIZABETH S. AMORA
JUSTINE MALOU Z. CAGATAN
PRINCESS T. PROVIDO
KESSA MARIE E. RUDAS
The Researchers

Appendix C
REPUBLIC OF THE PHILIPPINES
JOSE RIZAL MEMORIAL STATE UNIVERSITY
The Premier University in Zamboanga del Norte
GOV. GUADING ADAZA ST., STA. CRUZ, DAPITAN CITY, ZAMBOANGA DEL NORTE

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

CORRELATION BETWEEN THE EFFECTS OF SMARTPHONE

ADDICTION AND INTERACTION ANXIETY AMONG NURSING
STUDENTS OF
JOSE RIZAL MEMORIAL STATE UNIVERSITY
QUESTIONNAIRE

PART I: DEMOGRAPHIC PROFILE OF THE RESPONDENTS

Name: (Optional) _____________________________
Age: ( ) 17-19 ( ) 20-22 ( ) 23 above
Gender: ( ) Male ( ) Female ( ) LGBTQIA
Year Level: ( ) 1st Year ( ) 2nd Year ( ) 3rd Year ( ) 4th Year

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 1. How long have you been using your smartphone phone?
( ) <2 years ( ) 2—4 years ( ) >4 years
2. How long do you use your smartphone per day?
( ) <3 hours ( ) 3—7 hours ( ) >7 hours
3. How much do you spend on smartphone services per month?
( ) <100 ( ) 200-400 ( )>400
4. The primary motivation for using a smartphone is for (Single selection)
( ) Interpersonal need ( ) Killing Time
( ) Amusing and Entertaining ( ) Studying or working need

PART II: SMARTPHONE ADDICTION

Direction: Put a check mark (/) on the column that corresponds to your answer. The
scaling below will guide you in answering this questionnaire.
5 - Strongly Agree 4 – Agree 3 - Undecided 2 – Disagree 1 –
Strongly Disagree

ITEMS 5 4 3 2 1
1. Missing planned work due to smartphone use.
2. Having a hard time concentrating in class, while doing
assignments, or while working due to smartphone use.
3. Experiencing lightheadedness or blurred vision due to excessive
smartphone use.
4. Feeling pain in the wrists or at the back of the neck while using a
smartphone.
5. Feeling tired and lacking adequate sleep due to excessive
smartphone use.
6. Feeling calm or cozy while using a smartphone.

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7. Feeling pleasant or excited while using a smartphone.

8. Feeling confident while using a smartphone.

9. Being able to get rid of stress with a smartphone.

10. There is nothing more fun to do than using my smartphone.

11. My life would be empty without my smartphone.

12. Feeling most liberal while using a smartphone.

13. Using a smartphone is the most fun thing to do.

14. Won’t be able to stand not having a smartphone.

15. Feeling impatient and fretful when I am not holding my

smartphone.
16. Having my smartphone in my mind even when I am not using it.

17. I will never give up using my smartphone even when my daily

life is already greatly affected by it.

18. Getting irritated when bothered while using my smartphone.

19. Bringing my smartphone to the toilet even when I am in a hurry

to get there.

20. Feeling great meeting more people via smartphone use.

21. Feeling that my relationships with my smartphone buddies are

more intimate than my relationships with my real-life friends.

22. Not being able to use my smartphone would be as painful as

losing a friend.

23. Feeling that my smartphone buddies understand me better than

my real-life friends.

24. Constantly checking my smartphone so as not to miss

conversations between other people on Twitter or Facebook.

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25. Checking SNS (Social Networking Service) sites like Twitter or
Facebook right after waking up.

26. Preferring talking with my smartphone buddies to hanging out

with my real-life friends or with the other members of my family

27. Preferring searching from my smartphone to asking other people

28. My fully charged battery does not last for one whole day.

29. Using my smartphone longer than I had intended.

30. Feeling the urge to use my smartphone again right after I stopped
using it.

31. Having tried time and again to shorten my smartphone use time,
but failing all the time.

32. Always thinking that I should shorten my smartphone use time.

33. The people around me tell me that I use my smartphone too

much.

Source:
Kwon, M. et al. (2013). The Smartphone Addiction Scale: Development and
Validation of a Short Version for Adolescents.
https://www.researchgate.net/publication/259589326_The_Smartphone_Addic
tion_Scale_Development_and_Validation_of_a_Short_Version_for_Adolesce
nt

PART III: INTERACTION ANXIETY

50
 Direction: Put a check mark (/) on the column that corresponds to your answer. The

scaling below will guide you in answering this questionnaire.

5 - Strongly Agree 4 – Agree 3 - Undecided 2 – Disagree 1 –

Strongly Disagree

ITEMS 5 4 3 2 1
1. Using a telephone in public.
2. Participating in a small group activity.
3. Eating in public.
4. Drinking with others.
5. Talking to someone in authority.
6. Acting, performing, or speaking in front of an audience.

7. Going to a party.

8. Working while being observed.

9. Working while being observed.

10. Calling someone you don't know very well.

11. Talking face to face with someone you don't know very well.

12. Meeting strangers.

13. Urinating in a public bathroom.

14. Entering a room when others are already seated.

15. Being the center of attention.

16. Speaking up at a meeting.

17. Taking a test of your ability, skill, or knowledge.

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18. Expressing disagreement or disapproval to someone you don't
know very well.

19. Looking someone who you don't know very well straight in the
eyes.

20. Giving a prepared oral talk to a group.

21. Trying to make someone's acquaintance for the purpose of a

romantic/sexual relationship.
22. Returning goods to a store for a refund.

23. Giving a party.

24. Resisting a high pressure sales person.

Source:

Liebowitz, M. (2016) Liebowitz Social Anxiety Scale.

https://nationalsocialanxietycenter.com/liebowitz-sa-scale/

CURRICULUM VITAE

ELIZABETH S. AMORA
Antonino, Labason, Zamboanga Del Norte
09353961853/bethyamora@gmail.com

PERSONAL INFORMATION:

Age: 21
Birthdate: February 24, 1999
Birthplace: Antonino, Labason, Zamboanga del Norte
Civil Status: Single
Citizenship: Filipino
Religion: Roman Catholic
Mother’s Name: Elisa S. Amora Father’s Name: Arnold A. Amora S.R

52
EDUCATIONAL BACKGROUND:

COLLEGE: Jose Rizal Memorial State University

Bachelor of Science in Nursing
Dapitan City, Zamboanga del Norte
2018-present

SENIOR HIGH: St. Mary's College of Labason

Science Technology Engineering and
Mathematics
Labason, Zamboanga del Norte
2016-2018

JUNIOR HIGH: St. Mary's College of Labason

Labason, Zamboanga del Norte
2012-2016

ELEMENTARY: Labason Central School

Labason, Zamboanga del Norte
2016-2012

CURRICULUM VITAE

JUSTINE MALOU Z. CAGATAN

Polo, Dapitan City, Zamboanga Del Norte
09070186253/jazzyswizzle18@gmail.com

PERSONAL INFORMATION:

Age: 20
Birthdate: March 21, 2000
Birthplace: Dapitan City, Zamboanga del Norte
Civil Status: Single
Citizenship: Filipino
Religion: Roman Catholic
Mother’s Name: Mary Ann Z. Cagatan Father’s Name: Cerilo O.
Cagatan

53
EDUCATIONAL BACKGROUND:

COLLEGE: Jose Rizal Memorial State University

Bachelor of Science in Nursing
Dapitan City, Zamboanga del Norte
2018-present

SENIOR HIGH: Jose Rizal Memorial State University

Technology and Livelihood Services
(Caregiving)
Dapitan City, Zamboanga del Norte
2016-2018

JUNIOR HIGH: Rizal Memorial Institute of Dapitan City Inc.

Potol, Dapitan City, Zamboanga del Norte
2012-2016

ELEMENTARY: Banbanan Elementary School

Banbanan, Dapitan City, Zamboanga del Norte
2016-2012

CURRICULUM VITAE

PRINCESS T. PROVIDO
El Paraiso La Libertad, Zamboanga Del Norte
09505245060/princessprovido111@gmail.com

PERSONAL INFORMATION:

Age: 21
Birthdate: March 26, 1999
Birth Place: Dapitan City, Zamboanga del Norte
Civil Status: Single
Citizenship: Filipino
Religion: Roman Catholic
Mother’s Name: Almira T. Provido Father’s Name: Arnold T.
Provido

54
EDUCATIONAL BACKGROUND:
COLLEGE: Jose Rizal Memorial State University
Bachelor of Science in Nursing
Dapitan City, Zamboanga del Norte
2018-present

SENIOR HIGH: Jose Rizal Memorial State University

Humanities and Social Sciences
Dapitan City, Zamboanga del Norte
2016-2018

JUNIOR HIGH: La Libertad, National High School

La Libertad, Zamboanga del Norte
2012-2016

ELEMENTARY: El Paraiso Elementary School

La Libertad El Paraiso, Zamboanga del Norte
2016-2012

CURRICULUM VITAE
KESSA MARIE E.RUDAS
021, Leonor Rivera St. Sta Cruz, Dapitan City,
Zamboanga Del Norte
09105881930/rudaskessamarie@gmail.com

PERSONAL INFORMATION:

Age: 21
Birthdate: September 9, 1999
Birth Place: Dapitan City, Zamboanga del Norte
Civil Status: Single
Citizenship: Filipino
Religion: Roman Catholic

55
Mother’s Name: Lani E.Rudas Father’s Name: Rodolfo Rudas
Jr.

EDUCATIONAL BACKGROUND:
COLLEGE: Jose Rizal Memorial State University
Bachelor of Science in Nursing
Dapitan City, Zamboanga del Norte
2018-present

SENIOR HIGH: Jose Rizal Memorial State University

Technology and Livelihood Services
(Caregiving)
Dapitan City, Zamboanga del Norte
2016-2018

JUNIOR HIGH: Rizal Memorial Institute of Dapitan City Inc.

Potol, Dapitan City, Zamboanga del Norte
2012-2016

ELEMENTARY: Dapitan City Central School

Dapitan City, Zamboanga del Norte
2016-2012

56