Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
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Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

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Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2021 | Month : July | Volume : 15 | Issue : 7 | Page : VC06 - VC10 Full Version

Development and Validation of the Smartphone Addiction Scale for Children- Parent Version (SASC-P)


Published: July 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/48398.15098
Gopi Rajendhiran, Vikhram Ramasubramanian, P Bijulakshmi, S Mathumathi, M Kannan

1. Consultant Psychologist, Department of Psychology, Ahana Hospitals, Madurai, Tamil Nadu, India. 2. Consultant Psychiatrist, Department of Psychiatry, Ahana Hospitals, M.S.Chellamuthu Trust and Research Institute, Madurai, Tamil Nadu, India. 3. Consultant Psychologist, Department of Psychology, Ahana Hospitals, Madurai, Tamil Nadu, India. 4. Consultant Psychiatrist, Department of Psychiatry, Ahana Hospitals, Madurai, Tamil Nadu, India. 5. Director, Department of Research, M.S.Chellamuthu Trust and Research Institute, Madurai, Tamil Nadu, India.

Correspondence Address :
Dr. P Bijulakshmi,
Consultant Psychologist, Department of Psychology, Ahana Hospitals, No-11,
Subburam Street, Gandhinagar, Madurai-625020, Tamil Nadu, India.
E-mail: bijuparthiban26@gmail.com

Abstract

Introduction: The use of smartphone among children and adolescents has been increasing steadily over the past decade and is becoming a cause of concern for parents and healthcare professionals alike. Excessive use of smartphone could make a child vulnerable to develop addictive behaviour leading to decrease in academic performance and impairments in social and personal environment. Early identification is key to addressing this issue and although there are scales to measure smartphone addiction in adults, there are no scales to measure smartphone use in children objectively.

Aim: To construct a smartphone addiction scale for children that can be administered to parents.

Materials and Methods: A set of statements were created to assess smartphone addiction in children. Initially, 43 statements were selected after identifying its content validity and face validity and the scale was administered to parents of children in the age group of 3-17 years after obtaining informed consent from the parents. The construct validity was examined by the exploratory factor analysis. The screen plot of ordered eigen values of a correlation matrix was used to decide the appropriate number of factors extracted. A factor loading of >0.30 was used to determine the items for each factor. Intra-class correlations were calculated for the test-retest reliability, and Cronbach's alpha was calculated for the internal consistency. The final questionnaire contained 24 statements across six subdomains of smartphone addiction and it was administered to a small sample group of 65 parents of children aged 3-17 years and the data was used to test for reliability and validity of the scale.

Results: Alpha correlation for the Smartphone Addiction Scale for Children-Parent (SASC-P) ranged from 0.670 to 0.823. The intrinsic validity for the domains was calculated using Cronbach’s alpha and it ranged from 0.819 to 0.907 for the domains and was 0.972 for the whole questionnaire. Thus the scale was found to be reliable and valid for use in children and adolescents.

Conclusion: The SASC-P has good reliability and validity and can be used to measure smartphone use in children and adolescent.

Keywords

Environment, Measure, Questionnaire, Reliability

The advent of the smartphone has made technology easily accessible, bringing the world into our palms. Smartphones with their innumerable features and usage among children and adolescents as a recreational and educational purpose has increased which has both benefits and adverse effects. Despite warnings given by child health specialists about the adverse effects, the prevalence of smartphone usage among children and adolescents is increasing alarmingly. Though there has been necessity of smartphone use for various activities, excessive use of smartphone particularly for recreational activities can lead to addiction as shown in various studies among young people across the globe (1),(2),(3).

A study in Australia (4) in 2008, had shown that young people are more attached to their phones and warned of addictive behaviours linked to mobile usage. This has proven to be true with another online study showing that young people are more vulnerable to develop smartphone addiction (5) due to increased usage, lack of self-regulation and presence of social stress.

Griffiths M operationally defined ‘technological addictions as a behavioural addiction that involves human-machine interaction and is non chemical in nature’ (6). Gaming disorder is the only disorder included as behavioural addiction in the fifth edition of the Diagnostic and Statistical Manual of Disorders (DSM-5) (7) and in the International Classification of Disorders, 11th edition (ICD 11) (8) by the World Health Organisation (WHO). With the easy accessibility of smartphone (9),(10),(11), addiction to it has become a rising problem in recent years demanding attention and the need for evaluation (12).

Through exploratory factor analysis by Lin YH et al., demonstrated that smartphone addiction has several similar aspects to DSM-5 substance-related disorders including the following four main factors: compulsive behaviour, functional impairment, withdrawal, and tolerance (13). Lin YH et al., proposed six behavioural symptoms and 4 functional impairments with the exclusion criteria for the diagnosis of smartphone addiction (14), while Peckel L proposed that smartphone addiction leads to problematic behaviours and psychological problems with symptoms of craving, dependency, decreased academic performance, impulsivity, impairment in social relationships, irritability, stress, and mood changes associated with decline in smartphone use among others (15).

Utilising these criteria for the diagnosis of smartphone addiction, few scales have been validated to assess the presence of smartphone addition among young people and very few of these have been modified for use in children like the smartphone addiction scale for use in adolescents (16), and the Smartphone Addiction Inventory (SPAI) (13) among others (17),(18). All these scales are self-administered and hence only evaluate the presence of addiction behaviour as perceived by the children. They fail to account for the fact that children might not have an objective evaluation of their behaviours especially if functional impairments as mentioned by Lin YH et al., have to be evaluated (14). Hence, the authors felt the need to construct a scale that can be given to parents to evaluate smartphone usage in the children.

The aim of this study was to construct and validate a self-administered smartphone addiction scale for children for use in parents.

Material and Methods

The Institutional Ethics Committee, at Ahana hospitals in Madurai, approved the study (Reference no. 09/2018) and the research was conducted from January 2019 to March 2019. Simple random sampling was done. Parents who had children in the age group of 3-17 years were invited to participate in the study through social media and through known contacts. The age group was selected because this is the typical school years in the life of the child, when parents can observe their children’s behaviours.

Inclusion criteria: Parents who had children between the age groups of 3 to 17 years, of both gender and who were well versed in English language were included.

Exclusion criteria: Parents who had children with pre-existing psychiatric problems and who were differently abled were excluded from the study.

Construction of the Smartphone Addiction Scale for Children-Parent Version (SASC-P)

Six domains of smartphone addiction were proposed based on previous studies detailing the diagnostic criteria for smartphone addiction (14),(15),(19). The six domains were:

• Smartphone dependency
• Psychological ill health
• Physical ill health
• Lack of academic performance
• Social relationship
• Family relationship

Items were formed based on these dimensions and 54 statements were formed. The statements were designed as a 5-point Likert response scale (with scores 4- strongly agree, 3-agree, 2-neutral, 1-disagree and 0-strongly disagree). The content validity was examined by an expert panel of 4 psychiatrists and 4 psychologists. Based on their feedback, some statements in the questionnaire were reworded and 11 statements were excluded. The resulting questionnaire contained 43 statements. A focus group was identified to establish face validity and feedback from the focus group was used to amend the statements.

The questionnaire was administered to a representative sample of 397 parents. Parents completed the questionnaire after signing an informed consent form to participate in the study. Trained psychologists were present with the parent while they completed the questionnaire. Total 389 participants completed the questionnaire and their responses were taken for the initial analysis. The smartphone addiction scale was reduced to 24 item scale and was administered to 65 participants who were not part of the previous sample to test for validity and reliability.

Statistical Analysis

Data analysis was done using the Statistical Package for Social Services (SPSS) software, (IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp). The construct validity was examined by the exploratory factor analysis using a principle component factoring estimation method and oblique promax rotation. The screen plot of ordered eigen values of a correlation matrix was used to decide the appropriate number of factors extracted. A factor loading of >0.30 was used to determine the items for each factor. Intra-class correlations were calculated for the test-retest reliability, and Cronbach’s alpha was calculated for the internal consistency.

Results

The total scores of SASC-P ranged from 0 to 96 (mean=67.1).The internal consistency of the statements was calculated as described in (Table/Fig 1), by calculating the item discriminating values of the statements based on the responses obtained from the sample. The statements with values lesser than two were excluded and a total of 24 statements were chosen as the final statements for use in the scale (Table/Fig 2).

The proposed 24 item questionnaire with four items for each of the six domains is shown in (Table/Fig 3), (Table/Fig 4).

Reliability and Validity Testing

The 24-item questionnaire was administered to a small sample population consisting of 65 parents and the scores were used to calculate the reliability and validity of the final questionnaire. The overall sampling adequacy of the 24-item scale was tested using Kaiser-Meyer-Olkin, and a high value of 0.945 was reported. The internal consistency of the questionnaire was established by calculating the correlations between the items and the domains, the items and the whole questionnaire and between the domains. Alpha correlation for the items in the domains ranged from 0.670 to 0.823, significant at p-value <0.001. The intrinsic validity for the domains was calculated using Cronbach’s alpha and it ranged from 0.819 to 0.907 for the domains and was 0.972 for the whole questionnaire. The reliability coefficient for the whole questionnaire was 0.945, significant at p-value <0.001. The coefficients were significant indicating that the scale was reliable as shown in (Table/Fig 5).

The reliability of the questionnaire was further tested using the test-retest method by re-administrating the questionnaire to the same sample consisting of 65 parents after an interval of 2 weeks. The scores were used to find the correlation between the domains using the pearson’s moment correlation. The correlation coefficient was found to be within 0.678 to 0.845 for the various domains and the correlation coefficient was 0.955 for the whole questionnaire, significant at p-value <0.001. The Cronbach’s alpha for the entire questionnaire was 0.972 indicating that the questionnaire was reliable and valid for use.

Discussion

The Smartphone Addiction Scale for Children-Parent (SASC-P) has been proven to be reliable and valid tool for measuring smartphone use and addiction in children and adolescents. It measures smartphone usage levels based on symptoms of addictive behaviour (15) namely lack of control, craving and irritability when denied use as described by the statements assessing dependency in this scale like “my child becomes impatient when not having smartphone” and “I find it difficult to control my child’s smartphone use”. The functional impairments are assessed in 5 domains (family, social, physical, psychological and academic areas) as described by Lin YH et al., by statements such as “my child is facing unnecessary fear and tension due to use of smart phone”, “my child is having adjustment problems with siblings due to use of smartphone” and “my child is having frequent headaches due to use of smartphone” (14).

The subscales have high internal consistency and the entire scale has high reliability as shown by the test-retest reliability scores. The items in the subscale are reflective of the domains specified and help in measuring smartphone addiction, and the domains that are most impacted by the increased use of smartphone. Males are more likely to become addictive to games while females are more likely to become addictive to different social media platforms (20), but addictive use has always been shown to affect a child’s physical, social and psychological health and has a negative impact on academic life of the child (21). The statement in the present scale “my child is missing necessary work due to use of smartphone” has the highest factor loading indicating that parents are worried about their children missing out of necessary academic work due to use of smartphone. This is in accordance with another study conducted in 2014, involving parents perception of the children’s smartphone use (22), which indicated that parents were more worried about decline in academic performance due to smartphone use.

Most smartphone addiction scales are meant as self-assessment tools (23), constructed for use in young adults (24) and then modified for use in adolescents (16); implying that responses to the items could be biased due to various reasons. Children and adolescents tend to become very attached to their smartphone and they may not be aware of their addiction (25). But parents are able to ascertain the symptoms of additive behaviour (26) and hence become worried about their children (27). The smartphone addiction has been found to impact the childrens’ psychological (21), academic (28) and social life. Hence, this questionnaire has been designed to be self-administered scale for use with parents. Early detection of smartphone addiction can help in formulating plans to help deal with the issue and therapy could be targeted to address specific impairments as identified in the scale.

This scale can objectively measure smartphone use in children and adolescents and specifically addresses symptoms of dependency and functionally impairments that clearly fulfils diagnostic criteria for smartphone addiction.

Limitation(s)

The authors acknowledge that this scale was for use, with parents who have a good knowledge of the English language. The scale need to be translated in local languages for easy administration and assessment. It may need explanation/helpful intervention of researcher to make the participants understand the exact meaning of each question.

Conclusion

This study has proven that the SACS-P was a reliable and valid tool to measure smartphone use in children and adolescents.

References

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DOI and Others

10.7860/JCDR/2021/48398.15098

Date of Submission: Jan 05, 2021
Date of Peer Review: Apr 21, 2021
Date of Acceptance: May 26, 2021
Date of Publishing: Jul 01, 2021

Author declaration:
• Financial or Other Competing Interests: This study was financially supported by Ahana Hospitals, Madurai
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 30, 2021
• Manual Googling: May 25, 2021
• iThenticate Software: Jun 10, 2021 (9%)

Etymology: Author Origin

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