Risk factors for internet addiction among Croatian university students during the COVID-19 pandemic

Abstract Background Following the increased internet use due to the COVID-19 pandemic there have been concerns regarding an elevated risk of developing internet addiction (IA). University students are especially prone to develop IA and risk factors for its development in this population during pandemics are not fully investigated nor understood. This study aimed to identify possible risk factors of IA in the studied population during the ongoing pandemic and to compare it with risk factors in pre-pandemic time. Methods In April 2016 and April 2022 a validated, anonymous questionnaire that contained questions regarding demographic data, as well as Young's Internet Addiction Test, was self-administered to a cross-faculty representative student sample of the University of Osijek, Croatia. Results The study included 1602 university students median age of 21 years (interquartile range 20-22), 34.5% males, and 65.5% females. There was no statistically significant difference in the median age between the two student samples (p = 0.234). The main reason for internet use (social networking and entertainment and online gaming) was considered the significant risk factor for IA in a studied population in pre-pandemic time (the year 2016) and pandemic time (the year 2022) (p < 0.001). In pre-pandemic time the IA was more frequent in males (p = 0.046) while the difference in IA prevalence between sexes did not exist during pandemics (p = 0.160). During pandemics, the students who did not work during their study had higher proportions of IA (p = 0.021) while there was no difference in IA prevalence among students regarding their working status during the study in pre-pandemic time (p = 0.251). Conclusions During the COVID-19 pandemic working status of students has been recognized as the new risk factor for IA in the Croatian university students population. Further studies are needed to identify other possible risk factors for IA in the studied population during pandemics. Key messages The COVID-19 pandemic has changed the set of risk factors for IA among Croatian university students. Better understanding of risk factors for IA among university students during the COVID-19 pandemic will enable the development of successful preventive programs for this behavioral addiction.


Background:
Following the increased internet use due to the COVID-19 pandemic there have been concerns regarding an elevated risk of developing internet addiction (IA). University students are especially prone to develop IA and risk factors for its development in this population during pandemics are not fully investigated nor understood. This study aimed to identify possible risk factors of IA in the studied population during the ongoing pandemic and to compare it with risk factors in prepandemic time.

Methods:
In April 2016 and April 2022 a validated, anonymous questionnaire that contained questions regarding demographic data, as well as Young's Internet Addiction Test, was selfadministered to a cross-faculty representative student sample of the University of Osijek, Croatia.

Results:
The study included 1602 university students median age of 21 years (interquartile range 20-22), 34.5% males, and 65.5% females. There was no statistically significant difference in the median age between the two student samples (p = 0.234). The main reason for internet use (social networking and entertainment and online gaming) was considered the significant risk factor for IA in a studied population in pre-pandemic time (the year 2016) and pandemic time (the year 2022) (p < 0.001). In pre-pandemic time the IA was more frequent in males (p = 0.046) while the difference in IA prevalence between sexes did not exist during pandemics (p = 0.160). During pandemics, the students who did not work during their study had higher proportions of IA (p = 0.021) while there was no difference in IA prevalence among students regarding their working status during the study in pre-pandemic time (p = 0.251).

Conclusions:
During the COVID-19 pandemic working status of students has been recognized as the new risk factor for IA in the Croatian university students population. Further studies are needed to identify other possible risk factors for IA in the studied population during pandemics. Key messages: The COVID-19 pandemic has changed the set of risk factors for IA among Croatian university students. Better understanding of risk factors for IA among university students during the COVID-19 pandemic will enable the development of successful preventive programs for this behavioral addiction.

Background:
Evaluation of preoperative anxiety and health literacy is important for healthcare professionals to understand the needs and expectations of patients and provide them with the necessary support. The study aimed to evaluate the preoperative anxiety levels of patients who applied to the anesthesia outpatient clinic and its relationship with health literacy.

Methods:
A cross-sectional study was conducted on patients who applied to the anesthesia outpatient clinic of Eskişehir Osmangazi University Medical Faculty Hospital in March 2022. The questionnaire form, which was prepared by making use of the literature, was filled in by face-to-face interview method after obtaining the participants' verbal consent. The 6 item Amsterdam Preoperative Anxiety and Information Scale (APAIS) in which the scores that can be taken range from 6 to 30 and higher score means higher anxiety was used to assess the level of anxiety, and the 16 item European Health Literacy Scale Short Form was used to assess health literacy. Descriptive statistics, Chi-Square test and Logistic Regression analysis were used to analyze the data.

Results:
In the study group, 197 (50.3%) were female. Their ages ranged from 18 to 86, with a mean of 45.7 AE 17.2 years. The median (min-max) APAIS score was 15 (6-30). There was a moderate negative correlation between the scores obtained from the APAIS and the European Health Literacy Scale Short Form (r = -0.50, p < 0.01). According to the logistic regression analysis, preoperative anxiety was found to be 1.53 (%95 CI; 1.01-2.30) times higher in women, 3.49 (%95 CI; 1.23-9.94) times higher in those with low family income, and 1.61 (%95 CI; 1.07-2.42) times higher in those with type A personality.

Conclusions:
More than half of the patients had preoperative anxiety. The level of preoperative anxiety decreased as the health literacy level increased.
Key messages: Necessary support should be given for the preoperative anxiety of the patients. Public health policies should be developed in order to increase health literacy.