Psychometric properties of the smartphone use and distraction questionnaire in Spanish and Portuguese nursing students
-
Isabel Jesus Oliveira
,
Pedro Lopes Ferreira
,
Jagoba Zarandona
,
Paulo Manuel Azevedo
,
Itziar Hoyos Cillero
Abstract
Background & Aim: Smartphone use in nursing education offers both learning benefits and risks of distraction, influenced by cultural and institutional norms. The Nursing Students’ Smartphone Use and Distraction Questionnaire, originally developed in Spanish but never psychometrically validated, was formally validated among Spanish nursing students and simultaneously translated, culturally adapted, and validated for Portuguese nursing students.
Methods & Materials: A psychometric study was conducted among 543 Portuguese and 480 Spanish nursing students enrolled in their second year or higher. The questionnaire was translated and culturally adapted into Portuguese following International Society for Pharmacoeconomics and Outcomes Research guidelines. Psychometric evaluation included exploratory factor analysis with varimax rotation, Kaiser-Meyer-Olkin measure, Bartlett’s test of sphericity, and internal consistency analysis using Cronbach’s alpha, conducted with IBM SPSS Statistics version 29.
Results: The analysis extracted 26 items across six factors: Clinical Practice Use, Regulatory Policy, Unprofessional Personal Use, Observed Unprofessional Use, Student’s Distraction, and Ethics, explaining 57.8% of the variance in Portugal and 61.8% in Spain. Kaiser-Meyer-Olkin values were 0.747 and 0.818, with Bartlett’s test significant in both samples (p < 0.001). Cronbach’s alpha coefficients for the total scale were 0.717 (Portugal) and 0.740 (Spain), with subscale values ranging from moderate to good reliability.
Conclusion: The Smartphone Use and Distraction Questionnaire showed valid structural properties and acceptable reliability in two distinct cultural settings. Its adaptability supports use across health professions and diverse countries and cultures, informing evidence-based policies that promote professional smartphone use and reduce distraction in clinical education.
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25. Higginbottom GM, Richter MS, Mogale RS, Ortiz L, Young S, Mollel O. Identification of nursing assessment models/tools validated in clinical practice for use with diverse ethno-cultural groups: An integrative review of the literature. BMC Nursing. 2011 Aug 3;10(1):16.
26. Mokkink LB, Prinsen CA, Patrick DL, Alonso J, Bouter LM, De Vet HC, Terwee CB. COSMIN Study Design checklist for Patient-reported outcome measurement instruments. Amsterdam, The Netherlands. 2019 Jul;2019:1-32.
27. Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New-York: MacGraw-Hill; 1994.
28. Bartlett MS. A note on the multiplying factors for various χ 2 approximations. Journal of the Royal Statistical Society. Series B (Methodological). 1954 Jan 1:296-8.
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30. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. London: Routledge; 1988.
31. Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HC. Rating the methodological quality in systematic reviews of studies on measurement properties: A scoring system for the COSMIN checklist. Quality of Life Research. 2012 May;21(4):651-7.
32. Gutiérrez-Puertas V, Gutiérrez-Puertas L, Aguilera-Manrique G, Rodríguez-García MC, Márquez-Hernández VV. Nursing students’ perceptions of smartphone use in the clinical care and safety of hospitalised patients. International Journal of Environmental Research and Public Health. 2021 Feb;18(3):1307.
33. Bray L, Antoniou P, Nikolaidou M, Fides-Valero A, Roberts T, Ahonen O, Häyrinen S, Campos-Diaz E, Bamidis PD. Evaluation of the effectiveness of educational escape rooms within health professions education: A systematic review protocol. International Journal of Educational Research. 2023 Jan 1;117:102123.
2. Kiyarosta N, NAJAFI GT, Naghashzadeh F, Feizi M, Haghani S. The effect of using smartphone applications on self-care in patients with heart failure. Nursing Practice Today. 2020 Jul 22;7(4):311-21.
3. Gonçalves-Bradley DC, Maria AR, Ricci-Cabello I, Villanueva G, Fønhus MS, Glenton C, Lewin S, Henschke N, Buckley BS, Mehl GL, Tamrat T. Mobile technologies to support healthcare provider-to-healthcare provider communication and management of care. Cochrane Database of Systematic Reviews. 2020 Aug 18;8(8):CD012927.
4. Chang HY, Wu HF, Chang YC, Tseng YS, Wang YC. The effects of a virtual simulation-based, mobile technology application on nursing students’ learning achievement and cognitive load: Randomized controlled trial. International Journal of Nursing Studies. 2021 Aug 1;120:103948.
5. Gause G, Mokgaola IO, Rakhudu MA. Technology usage for teaching and learning in nursing education: An integrative review. Curationis. 2022 Jun 15;45(1):2261.
6. Lazaro GR, Duart JM. Moving learning: A systematic review of mobile learning applications for online higher education. Journal of New Approaches in Educational Research. 2023 Jul;12(2):198-224.
7. Zarandona J, Cariñanos-Ayala S, Cristóbal-Domínguez E, Martín-Bezos J, Yoldi-Mitxelena A, Cillero IH. With a smartphone in one's pocket: A descriptive cross-sectional study on smartphone use, distraction and restriction policies in nursing students. Nurse Education Today. 2019 Nov 1;82:67-73.
8. Beauregard P, Arnaert A, Ponzoni N. Nursing students' perceptions of using smartphones in the community practicum: A qualitative study. Nurse Education Today. 2017 Jun 1;53:1-6.
9. Kim JH, Park H. Effects of smartphone-based mobile learning in nursing education: A systematic review and meta-analysis. Asian Nursing Research. 2019 Feb 1;13(1):20-9.
10. Ramjan LM, Salamonson Y, Batt S, Kong A, McGrath B, Richards G, Roach D, Wall P, Crawford R. The negative impact of smartphone usage on nursing students: An integrative literature review. Nurse Education Today. 2021 Jul 1;102:104909.
11. Negarandeh R, Malek M, Molaee S, Mohammadnejad E, Aazami S. Use of Personal Cell Phones by Nurses is Barrier to Effective Nursing Care in Hospitals: A Qualitative Research. Hospital Topics. 2025 Oct 2;103(4):231-7.
12. Nittas V, Daniore P, Chavez SJ, Wray TB. Challenges in implementing cultural adaptations of digital health interventions. Communications Medicine. 2024 Jan 5;4(1):7.
13. McFarland MR, Wehbe-Alamah HB. Leininger’s theory of culture care diversity and universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing. 2019 Nov;30(6):540-57.
14. Böttger T, Poschik M, Zierer K. Does the brain drain effect really exist? A meta-analysis. Behavioral Sciences. 2023 Sep 11;13(9):751.
15. Mendoza JS, Pody BC, Lee S, Kim M, McDonough IM. The effect of cellphones on attention and learning: The influences of time, distraction, and nomophobia. Computers in Human Behavior. 2018 Sep 1;86:52-60.
16. Bonafide CP, Miller JM, Localio AR, Khan A, Dziorny AC, Mai M, Stemler S, Chen W, Holmes JH, Nadkarni VM, Keren R. Association between mobile telephone interruptions and medication administration errors in a pediatric intensive care unit. JAMA Pediatrics. 2020 Feb 1;174(2):162-9.
17. McBride DL, LeVasseur SA. Personal communication device use by nurses providing in-patient care: Survey of prevalence, patterns, and distraction potential. JMIR Human Factors. 2017 Apr 13;4(2):e5110.
18. Throuvala MA, Pontes HM, Tsaousis I, Griffiths MD, Rennoldson M, Kuss DJ. Exploring the dimensions of smartphone distraction: Development, validation, measurement invariance, and latent mean differences of the smartphone distraction scale (SDS). Frontiers in Psychiatry. 2021 Mar 8;12:642634.
19. Aguilera-Manrique G, Márquez-Hernández VV, Alcaraz-Córdoba T, Granados-Gámez G, Gutiérrez-Puertas V, Gutiérrez-Puertas L. The relationship between nomophobia and the distraction associated with smartphone use among nursing students in their clinical practicum. PloS One. 2018 Aug 27;13(8):e0202953.
20. Lee S, Kim HJ, Choi HG, Yoo YS. Smartphone Addiction and Interpersonal Competence of Nursing Students. Iranian Journal of Public Health. 2018 Mar;47(3):342–9.
21. Cho S, Lee E. Distraction by smartphone use during clinical practice and opinions about smartphone restriction policies: A cross-sectional descriptive study of nursing students. Nurse Education Today. 2016 May 1;40:128-33.
22. Silva AO, Pinto CM, Vieira RM. Mobile devices for developing nursing students’ professional skills: Scoping review. Revista Latino-Americana de Enfermagem. 2024 Sep 23;32:e4371.
23. Osorio-Molina C, Martos-Cabrera MB, Membrive-Jiménez MJ, Vargas-Roman K, Suleiman-Martos N, Ortega-Campos E, Gómez-Urquiza JL. Smartphone addiction, risk factors and its adverse effects in nursing students: A systematic review and meta-analysis. Nurse Education Today. 2021 Mar 1;98:104741.
24. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value in Health. 2005 Mar 1;8(2):94-104.
25. Higginbottom GM, Richter MS, Mogale RS, Ortiz L, Young S, Mollel O. Identification of nursing assessment models/tools validated in clinical practice for use with diverse ethno-cultural groups: An integrative review of the literature. BMC Nursing. 2011 Aug 3;10(1):16.
26. Mokkink LB, Prinsen CA, Patrick DL, Alonso J, Bouter LM, De Vet HC, Terwee CB. COSMIN Study Design checklist for Patient-reported outcome measurement instruments. Amsterdam, The Netherlands. 2019 Jul;2019:1-32.
27. Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New-York: MacGraw-Hill; 1994.
28. Bartlett MS. A note on the multiplying factors for various χ 2 approximations. Journal of the Royal Statistical Society. Series B (Methodological). 1954 Jan 1:296-8.
29. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. Journal of Clinical Epidemiology. 2010 Jul 1;63(7):737-45.
30. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. London: Routledge; 1988.
31. Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HC. Rating the methodological quality in systematic reviews of studies on measurement properties: A scoring system for the COSMIN checklist. Quality of Life Research. 2012 May;21(4):651-7.
32. Gutiérrez-Puertas V, Gutiérrez-Puertas L, Aguilera-Manrique G, Rodríguez-García MC, Márquez-Hernández VV. Nursing students’ perceptions of smartphone use in the clinical care and safety of hospitalised patients. International Journal of Environmental Research and Public Health. 2021 Feb;18(3):1307.
33. Bray L, Antoniou P, Nikolaidou M, Fides-Valero A, Roberts T, Ahonen O, Häyrinen S, Campos-Diaz E, Bamidis PD. Evaluation of the effectiveness of educational escape rooms within health professions education: A systematic review protocol. International Journal of Educational Research. 2023 Jan 1;117:102123.
| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| nursing students smartphone distraction psychometrics | ||
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How to Cite
1.
Oliveira I, Ferreira P, Zarandona J, Azevedo P, Cillero I. Psychometric properties of the smartphone use and distraction questionnaire in Spanish and Portuguese nursing students. Nurs. pract. today. 2025;:X-X.
