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Table of Contents
ORIGINAL ARTICLE
Year : 2020  |  Volume : 3  |  Issue : 2  |  Page : 101-106

Arabic validation of problematic use of mobile phone scale among university students in Saudi Arabia


1 Department of Psychiatry; SABIC Psychological Health Research and Applications Chair, King Saud University, Riyadh, Saudi Arabia
2 Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia
3 Department of Mental Health, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
4 Psychiatry Unit, Royal Hospital - Sultanate of Oman, Muscat, Sultanate of Oman
5 Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Date of Submission07-Mar-2019
Date of Decision26-May-2019
Date of Acceptance25-Nov-2019
Date of Web Publication02-Apr-2020

Correspondence Address:
Hatem Alshahwan
Department of Psychiatry, #55, King Saud University, P.O. Box: 7805, Riyadh 11472
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JNSM.JNSM_9_19

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  Abstract 


Objectives: Smart phone addiction is rampant worldwide, especially among young adults; hence, its quantification using a reliable and valid instrument is essential. The problematic use of mobile phones (PUMP) scale, designed with 20 items, is a validated tool to assess smart phone addiction based on DSM-5 criteria. This study aims to test the reliability and construct validity of the Arabic version of the PUMP scale among a sample of university students in Saudi Arabia. Methods: This study was conducted among 2367 students of King Saud University, Riyadh, Saudi Arabia. An Arabic version of the PUMP scale was developed; then, its reliability and validity were assessed. The internal consistency of the PUMP scale was assessed using Cronbach's alpha, and its construct validity was assessed by factor analysis. Results: The internal consistency values of the 20 items ranged between 0.904 and 0.912, which are highly statistically significant. The average value of the internal consistency is 0.911 (95% CI: 0.905 to 0.916). The factor analysis provides the 3 factors that can be labelled as Factor1: “use of cell phone longer than intended and activities reduced“, Factor2: “dependence and craving” and Factor3: “use despite failure of obligations, social and physical problems“. Conclusions: The study concludes that the PUMP scale used to quantify smart phone addiction was proven to be reliable and valid in the Arabic language in Saudi population. Future studies are recommended in other parts of Arabic speaking societies to confirm the reliability and construct validity of the Arabic PUMP scale.

Keywords: Addiction, Problematic use of mobile phones scale, smartphones, techno-disorders, PUMP scale


How to cite this article:
Alshahwan H, Alosaimi FD, Alyahya H, Mahyijari NA, Shaik SA. Arabic validation of problematic use of mobile phone scale among university students in Saudi Arabia. J Nat Sci Med 2020;3:101-6

How to cite this URL:
Alshahwan H, Alosaimi FD, Alyahya H, Mahyijari NA, Shaik SA. Arabic validation of problematic use of mobile phone scale among university students in Saudi Arabia. J Nat Sci Med [serial online] 2020 [cited 2020 Jun 5];3:101-6. Available from: http://www.jnsmonline.org/text.asp?2020/3/2/101/278240




  Introduction Top


Smartphones are popular technological devices, capable of processing more information than other mobile devices that are used merely for communication, including specific applications such as the 4G internet, multimedia, and navigation.[1] At the time of this study, there were approximately 1.5 billion smartphone users in the global population, with a forecast for that number to exceed 5 billion by 2019. In Saudi Arabia, the commercial success of smartphones such as iPhones and Android devices is due to their functionality and potential capabilities. Moreover, smartphones are gaining importance in health care and attracting the attention of researchers and developers of health care-related applications.[2] Smartphones are also defined as specialized mobile phones consisting of additional computing capabilities and are positioning to be the principal platforms for the next generation of improvements in clinical practice.[3],[4] The initial difference between basic mobile telephones and smartphones is that smartphones offer easy access to the Internet and various applications can be downloaded onto smartphones.[5] In professional health care, the role of smartphones is becoming robust and effective by providing access to tailored information to aid in decision-making in nearly all medical specialties.[6]

Griffiths et al. distinguished between addiction to the Internet and specific online activity.[7] Walsh describes the positive use of mobile devices, allowing interaction between a learner and a tutor to support quick, easy, and continuous communication.[8] Earlier studies from Saudi medical students confirm the association between physical and cognitive activities using mobile phones.[9],[10],[11],[12] Another study by Jamal et al. showed a negative association in female medical students.[13] Global smartphone usage has developed into uncontrolled addictive actions. Problematic use of mobile phones (PUMP) is a phenomenon related to maladaptive mobile phone usage, which could present a pattern of dependency with negative consequences. Smartphone usage is excessive during daily activities while ignoring the consequences of such usage. This results in users being unable to maintain concentration on tasks or interpersonal relationships due to their need to constantly check smartphone notifications. Researchers and clinicians have researched the addictive symptomatology of PUMP.[14] Yen et al. established that obtaining at least four of the seven symptoms facilitated the detection of PUMP (e.g., withdrawal, tolerance, and use for a longer period than intended).[15] Nevertheless, Billieux et al. highlighted that although withdrawal seems to be one of the main symptoms reported in epidemiological studies,[16] research was based on community samples rather than clinical samples.[17] The addiction to smartphone usage among students is rampant; hence, its quantification is essential. To measure the addictive phenomenon, the PUMP scale was validated and used in studies in other regions. Therefore, an Arabic version of the PUMP scale could be an ideal option to be used in Saudi Arabia. This study aims to test the reliability and construct validity of the Arabic version of the PUMP scale among the students of King Saud University.


  Materials and Methods Top


This university-based, cross-sectional study was initiated between September 2014 and December 2015 among the university students of King Saud University (KSU), Riyadh, the capital city of Saudi Arabia. Both genders participated, our target was to enroll 10,000 students, but we enrolled only 2367 students, which is approximately 24%. The PUMP scale questionnaire is designed with twenty items to assess mobile usage based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. This original English version was first translated into Arabic language by two linguistics specialists who were fluent in both Arabic and English. Then, it was back-translated into English by another linguistics specialist. The final Arabic version of the PUMP scale was obtained by comparing the translated and back-translated versions with the original scale, and the differences were discussed and resolved. The content validity of the Arabic PUMP scale was carried out by experts in the areas of addiction, technology, and psychiatry to ensure the applicability and relevance of the twenty items. A pilot study was carried out with a sample of twenty college students, and the test–retest reliability was assessed by repeating the pilot study on the same sample after 2 weeks. A total of 258 students were required from each college of KSU, with the assumptions of a minimum correlation of 0.20 among the scores of the PUMP and the scores of the consequences of using smartphones, with a 0.05 level of significance and a power of 90%. A total of 2500 students from different colleges of KSU constituted the effective sample size of this study.

Statistical analysis

The data were analyzed using SPSS version 21.0 statistical software for Windows (IBM Inc., Chicago IL, USA). Descriptive statistics (mean, standard deviation [SD], frequencies, and percentages) were used to describe the quantitative and categorical variables. The internal consistency of the PUMP scale was assessed using Cronbach's alpha; convergent validity was evaluated using Pearson's correlation coefficient among the items. Construct validity of the PUMP scale was determined by means of factor analysis, in which the correlation matrix, Kaiser–Meyer–Olkin (KMO) measurement of sampling adequacy, and Bartlett's test of sphericity were used to assess the factorability of the twenty items. The factor structure was examined by using principal component method. Proportion of variance was estimated through initial Eigen values explained by each of the factors. The Varimax rotation was used to obtain the rotated factors.


  Results Top


From the targeted 10,000 study participants, 2367 (24%) responded to our study. More than 50% were in the age group between 20 and 24 years and 43.6% were males. The majority were Saudi nationals (92.7%).

Reliability

The 20-item instrument used to assess the problematic use of smartphones was applied among the 2367 study participants. The mean (SD) of the responses to these twenty items ranged between a minimum of 2.35 (1.19) for the item “I have gotten into trouble at work or school because of my cellphone use” and a maximum of 4.13 (1.02) for the item, “I have used my cellphone when I knew I should be sleeping.” Reliability refers to the ability of an instrument (questionnaire) to consistently measure an attribute and how well the items fit together conceptually. One of the commonly used estimators of reliability is internal consistency reliability. The internal consistency reliability of the twenty items was assessed by calculating Cronbach's α. The values ranged between 0.904 and 0.912 (for all the twenty items), that is α value if the item was deleted, which are highly statistically significant. The average value of internal consistency was 0.911 (95% confidence interval: 0.905–0.916) as shown in [Table 1].
Table 1: Problematic use of mobile phone scale item analysis to assess internal consistency

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Validity

Construct validity refers to the degree to which the items of an instrument relate to the relevant theoretical construct. Construct validity is a quantitative value rather than a qualitative distinction between valid and invalid. It refers to the degree to which the intended independent variable (construct) is related to the proxy independent variable (indicator variable). When an indicator consists of multiple items, factor analysis will be used to determine construct validity. The correlation among the twenty items of the instrument showed highly significant statistical correlation, as shown in [Table 2]. The determinant of the correlation matrix was 0.0001, which is greater than the necessary value of 0.00001; hence, multicollinearity is not a problem. That is, not only all items in the PUMP scale correlate fairly well, but also none of the correlations are particularly large; hence, there is no need to consider eliminating any item.
Table 2: Correlation between the items of the problematic use of mobile phone scale

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The KMO and Bartlett's tests measure the sampling adequacy, which should be >0.5 for a satisfactory factor analysis to proceed. The data reported KMO measure of 0.936 and demonstrated that the Bartlett's test of sphericity was statistically significant (P< 0.0001); this indicates that the correlation matrix is not an identity matrix. The communality values show the amount of the variance in the variables accounted for by the extracted factors. In this study, 53.2% of the variance in Item 1, “When I decrease the amount of time spent using my cellphone, I feel less satisfied,” is accounted for, whereas 47.7%% of the variance in Item 20, I have continued to use my cellphone even when someone asked me to stop,” is accounted for. From the analysis of the factor extraction along with their Eigen values, the percent of variance attributable to each factor, and the cumulative variance of the factors, it was observed that the first factor accounts for 37.73% of the variance, the second factor accounts for 7.57% of the variance, and the third factor accounts for 7.15% of the variance. The scree plot is a graph of the Eigen values against all the factors. The graph is useful for determining the number of factors to retain. The point of interest is where the curve starts to flatten, which occurs between factors 4 and 5. In addition, note that factor 4 has an Eigen value of <1, so only three factors have been retained [Figure 1].
Figure 1: Scree plot of Eigen values for extraction of factors

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[Table 3] shows the loadings of the twenty items of problematic use of smartphones on the three extracted factors. The higher the absolute value of the loading, the more the factor contributes to the variable. The loading indicates that all the three factors contributed to each of the items. The three factors can be labeled as factor 1: “use of cellphone longer time than intended and activities reduced“, factor 2: “dependence and craving,” and factor 3: “use despite failure of obligations and social and physical problems.“
Table 3: Rotated factors related to the misuse of cellphones by factor analysis

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  Discussion Top


The purpose of this study was to assess the reliability and construct validity of the Arabic version of a validated self-reporting measurement instrument using the PUMP scale. The results indicate that the correlation matrix is not an identity matrix, the KMO measure was 0.936, and the Bartlett's test of sphericity was statistically significantly associated (P< 0.0001). The factor analysis of the twenty items of the PUMP scale provides a three-factor structure rather than a single-factor structure. The three factors include use of cellphone longer than intended and activities reduced; dependence and craving; and use despite failure of obligations and social and physical problems. It displayed convergent validity when compared to an existing measure of cellular phone dependency items measuring the frequency and intensity of cellular phone use behaviors and self-reported feelings of “addiction” to mobile phones. These data provide preliminary support for the use of the PUMP scale in research examining problematic mobile phone usage in English-speaking samples.[18] Usually, scientists are interested in the validity of scales for the prediction of specific, often behavioral criteria, such as job performance, health behavior, educational achievement, or marital adjustment. We investigated differential validity because it allowed us to use criteria that were comparable across a range of scales. With that design, we were able to isolate the different forms of reliability in the predictor scales' contribution to validity; we found that only retest reliability was relevant to differential validity.[19] Studies by Payne et al. confirm that 84% of the medical students' smart mobile/devices were used for their educational purposes.[20] In literature, we found few similar studies, and this is the initial study implemented in a Saudi population of university students. In our earlier study, we concluded that university students at their current level of smartphone usage are at risk of addiction to smartphone use, which is associated with negative effects on sleep, energy level, eating habits, weight changes, exercise, and academic performance.[10] There have been several studies performed on medical students that describe their usage of smartphones for medical education purposes. Questionnaires are a desirable tool to assess and measure the usage of smartphones because they are relatively inexpensive and easy to administer to large groups. However, a questionnaire must be shown to be valid and reliable before it can be used. Hence, our PUMP questionnaire-based study was designed to record the validity and reliability of such results. The recent remarkable increase in the adoption of smartphones enables not only easy communication but also the possibility of utilizing devices in diverse settings, including health care. While the majority of medical students own smartphones, use medical applications at least once a day, and agree that having a smartphone has a positive effect on their education, it has been suggested that medical students have conflicting negative perceptions of smartphone utilization in a hospital setting. One of the most common recurring negative themes that surfaced in a survey of medical students in the United Kingdom was the fear of appearing disinterested in patient care while using mobile applications.[5],[21] The strength of our current study is that it was carried out only on Saudi students rather than a mixed Arab population due to the relatively low number of students of other nationalities in the university in which the study was conducted. A current limitation of this study was recruiting students from a single university rather than multiple institutions; another limitation was the lack of a standard (gold standard) measure of smartphone addiction against which to base the estimates of prevalence in the current sample.[10]


  Conclusion Top


From our results, we conclude that this study has established the addictive behaviors of smartphone use among some students of one of the universities in Saudi Arabia and that the PUMP scale is both reliable and valid in the Arabic language in a Saudi population. It is recommended that future studies implement a similar study in other parts of Arabic-speaking societies to confirm the reliability and construct validity of the Arabic PUMP scale.

Acknowledgments

The authors acknowledge the support they received from the SABIC Psychological Health Research and Applications Chair, Deanship of Scientific Research, KSU, Riyadh, Saudi Arabia.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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