Smartphone Addiction Effect on Vision Syndrome and Fatigue for Students Colleges at Mosul City Universities, Iraq

The terms smartphone, smartphone and cell phone were used twenty years ago interchangeably but had significant implicit differences in function [1] are a lot as all of the benefits are in there [2], also has paralleled with an increase in apprehension about the harms of smartphone use [3]. Smartphone addiction (MPC) is a trending topic in contemporary society, with a rising literature body suggesting multiple health and wellness consequences [4] such as physical and mental health problems such as hand diseases, eyesight problems, headaches, fatigue and cognitive impairment [5]. In light of the potential influence of MPA and its consequences, a systematic investigation is required to inform the development of interventions that promote usage [6]. Different researchers have approached health-related issues from different perspectives. For instance, some have focused solely on health disorders such as eye illnesses [7], while others have studied the impacts on health more generally, including mental health and physical health [8]. Problems with smartphone addiction (MPA) have also been associated with hand-related issues like wrist and finger pain [9]. In addition to eye problems such as tired eyes and vision that is hazy [10]. Furthermore, more smartphone use has been associated with an increase in tiredness and a decrease in mental performance, which requires more investigation [11]. Although the phone devices have aided communication in various ways, the excessive and irresponsible use of these devices is predicted to induce fatigue, as well as various other issues in the academic, physical and social aspect [12,13]. For students, smartphones and the internet constitute important technological developments that make accessing information easier across a wide range of activities [14]. This may lead to an increase in usage that can become excessive and may be associated with disruptions in sleep patterns, fatigue, headaches and eyestrain [15] Given the large number of students or young people, the vastly increased internet and smartphone use in recent years suggests that more study on their potentially ill effects is needed [16]. Excessive internet use had a profound correlation with problems like difficulties waking up from sleep and dozing off during lectures, adversely affecting academic and health outcomes [17]. Another study mentioned students of universities in Mosul have complaints of persistent fatigue (21.3%), which is often related to academic stress, poor lifestyle choices and suboptimal sleep [18].

Study Design

A cross-sectional approach was used in this study to assess smartphone addiction affected Mosul university students' vision syndrome and fatigue. A study period from 2024 to 2025.

Sample and Data Collection

A purposive sampling technique was used to select participants. A sample consists of 1700 students from universities in Mosul. Specifically, samples were collected from eight colleges at the University of Mosul, including Dentistry, Nursing, Agriculture, Engineering, Administration, Economics, Education and Law. The data for the current study were collected in November 2024 and continued until January 2025. This sample was selected according to some criteria, which were divided into two criteria, the inclusion criteria: the study focused solely on students in the third and fourth stages of public universities. While, exclusion criteria exclude private institutions to ensure consistency in sample characteristics and the first and second stages from public universities.

Tool of the Study

Data were collected using a structured questionnaire that taken from different literature and tested for validity and reliability, The Content validation of the questionnaires was done by eleven experts working on different sites (community health nursing, psychological and mental health nursing, adult health nursing, applied English, statistics) and followed up with evaluation by expert reviewers or committees to facilitate the validation of the content. Cronbach's alpha, a measure of the survey's internal consistency, was used to assess reliability. The dependability was found to be acceptable with an alpha of 0.85. They agreed to use them after amending, while reliability was tested through pilot study take an about 50 sample from 15th to 30th October 2024. The questionnaire included sections divided on:

• Demographics: age, sex, field of study, how many hours used phone for study
• Smartphone addiction: Assessed using the smartphone addiction Scale Short version (SAS - SV) consist from 33 question [19]
• Fatigue: Assessed with the Fatigue Severity Scale (FSS) [20]
• Vision Syndrome: Evaluated based on symptoms such as eye strain, dryness and headaches [21]

Data Collection and Analysis

Data collection was entered into Microsoft Excel and coded. The first: included a measure of smartphone addiction, represented by thirty-three questions and the second was a measure of seeing tired, which was divided into two parts (Fatigue Rating Scale & Reactions to smartphone-induced vision syndrome) and included nineteen questions, according to five- point (Likert scale) scale used to code the answers: the coding was (1) for very simple, (2) for simple, (3) for normal, (4) for severe and then (5) for very intense. Export these data into SPSS (Statistical Package for the Social Sciences) version 29 in 2022 (frequency, percentage, ANOVA, regression and diagram explain the effect of smartphone addiction on fatigue and vision syndrome).

Table 1 illustrates the current demographic profile of 1,700 students. The age category of 21-23 years has the highest 54.9%, with males at 53.5% more than females and the live urban. Most students (54.5%) in the fourth year. Estimating Study Hours on Phone was (83.4%) spend 1-5 hours daily.

Table 1: Distribution of the demographic information for students (n=1700)

Table 2 represents the levels of smartphone addiction among university students in Mosul. The level ranged from moderate 48.4% to severe 37.8%.

Table 2: Represented the smartphone addiction, vision syndrome and fatigue among students (n= 1700)

Figure 1 depicts probability level = 0.000, Chi-Square = 19.734 e1, e2, e3 = Unobserved, exogenous variables, A1 = Fatigue, B = Smartphone Addiction, A2 = vision syndrome, C = Seeing tired (fatigue + vision syndrome).

Figure 1: Show the effect of smartphone with fatigue and vision syndrome

Table 3 and Figure 2 display a highly significant relationship of smartphone with fatigue and vision  syndrome.

Figure 2: Percentage of smartphone addiction related to vision syndrome and fatigue

Table 3: The effect of smartphone addiction on fatigue and vision syndrome in direct and indirect among students in Mosul government universities

*Correlation is significant at the 0.01 level (2-tailed)

These results indicated that Smartphone addiction, vision disorder and fatigue, are crucially interdependent among the university students in Mosul. The responses of male students revealed a stupendous addiction to the smartphone, where 40.4% had moderate problems with their vision syndrome. Such correlation coefficient gaps display a strong relationship between Smartphone addiction to fatigue (p ≤ 0.01) and vision syndrome (p ≤ 0.01). These findings are consistent with other research that indicates excessive use of smartphones results in digital eye strain, musculoskeletal pain and psychological fatigue [5,10]. This study’s findings alongside global studies show that students from Mosul universities are affected by Smartphone addiction comparably as other students from different parts of the world [8] conducted a study in Saudi Arabia that demonstrated the connection between Smartphone addiction and declines in academic performance, mental health problems and physical exhaustion. Moreover, [11] claimed that students’ over-reliance on digital devices adversely affects their cognitive abilities which corroborates our finding of increased fatigue and low attention levels among individuals addicted to smartphones. The alarming tendency we found was having over 83.4 % of students utilizing their smartphones for 1 to 5 hours every single day. This sharp increase in usage is strikingly similar to the [12] study which suggested the possibility of Smartphone addiction among university students suffering from oxidative stress and neurodegeneration. Our finding on vision syndrome and cell phone addiction strongly correlates to what [7] reported: prolonged periods of eye contact with screens lead to a variety of complications including blurred vision and general eye discomfort. This study uniquely interjects a regional angle to previously conducted studies with Mosul students, who are often subjected to specific demographic and academic stressors. Smartphone addiction in the western world usually gets blamed on social media or video games - whereas, the students from our region use smartphones extensively for academic purposes, which also has negative health consequences. Mukhlif and Younis (2022) investigated the problem of internet addiction and fatigue among university students in Mosul. Their investigation revealed that 68.2% of students reported experiencing moderate fatigue and 12.2% reported severe fatigue, all predominantly attributed to overuse of the internet, thus illustrating the reality of fatigue [22].

The study highlights the great importance of Smartphone addiction regarding fatigue and vision syndrome in Mosul, university students in particular. The results substantiate that the problematic use of smartphones is associated with both physical and cognitive health problems, which strengthens the global concern of health risks of digital dependency.

Recommendation

The problem requires immediate interventions in the form of awareness campaigns to promote healthier smartphone behaviours among students through the universities organizing workshops or seminars aimed at reducing smartphone usage and digital eye strain and fatigue among students and other learners. Students should be encouraged to observe the 20-20-20 rule to reduce vision problems look away from the computer every 20 minutes for 20 seconds at a distance of 20 feet. More longitudinal studies need to be done on the impact of smartphone addiction and long-term health and academic performance impacts across various cultures and societal settings. Also, vision screening and fatigue measures are set for students who report health problems.

Acknowledgement

The authors express their gratitude to the students who participate in the study for their continued support and the facilitation of the research findings. Also, thanks for University of Mosul, Nineveh, Al-Hamdainya, Talafer and Northern Technology University has given help.

Ethical Statement

In accordance with Administrative Order No. (54) dated October 28, 2024, the Scientific and Ethical Committee for Postgraduate Studies at the College of Nursing/University of Mosul obtained initial approval. The College Committee for Medical Research Ethics then provided approval letters and the five public Mosul universities also provided their approval.

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