Facebook use and its effects on the life of health science students in a private medical college of Nepal

Abstract

Background
Facebook, a popular social networking site, has been used by people of different ages and professions for various purposes. Its use in the field of medical education is increasing dramatically. At the same time, the pros and cons of facebook use among the health science students has attracted the attention of educators. The data regarding its use and the effect on the life of Nepalese health science students has not yet been documented. Therefore, this study is carried out to evaluate the effect of facebook use on social interactions, behaviour, academics, and the health of students in a medical college of Nepal.

Results
A cross-sectional descriptive study conducted among medical, dental, nursing and allied health science students using self-administered questionnaire. The study showed that 98.2 % of participants were facebook users. Among 452 respondents, 224 and 228 were male and female respectively, with a mean age of 20.2 ± 1.2 years. The main reason for using facebook was to remain in contact with family and friend (32 %), while its use for the academic purpose was only 5 %. However, 80.8 % of students acknowledged ease in acquiring academic materials from others, through facebook. One-fourth of the students acknowledged that they are using facebook late at night on a regular basis, while surprisingly 4.2 % of the students admitted accessing facebook during the classroom lectures. Almost two-third of the users, further admitted that facebook has had a negative impact on their studies. Burning eyes (21 %), disturbed sleep (19 %), and headache (16 %) were the most common adverse health effects reported by the facebook users. Many students (71.4 %) tried and most of them (68.7 %) succeeded, in reducing time spent on facebook, to allow for increased time devoted to their studies.

Conclusion
The widespread use of facebook among the health science students, was found to have both positive and negative effects on their academics, social life, and health.

Full text

Jha et al. BMC Res Notes (2016) 9:378
DOI 10.1186/s13104-016-2186-0
RESEARCH ARTICLE
Facebook use andits eects onthe life
ofhealth science students ina private medical
college ofNepal
Rajesh Kumar Jha1*, Dev Kumar Shah2, Sangharshila Basnet3, Keshab Raj Paudel1, Phoolgen Sah3,
Ajit Kumar Sah1 and Kishor Adhikari4
Abstract
Background: Facebook, a popular social networking site, has been used by people of different ages and professions
for various purposes. Its use in the field of medical education is increasing dramatically. At the same time, the pros and
cons of facebook use among the health science students has attracted the attention of educators. The data regarding
its use and the effect on the life of Nepalese health science students has not yet been documented. Therefore, this
study is carried out to evaluate the effect of facebook use on social interactions, behaviour, academics, and the health
of students in a medical college of Nepal.
Results: A cross-sectional descriptive study conducted among medical, dental, nursing and allied health science
students using self-administered questionnaire. The study showed that 98.2 % of participants were facebook users.
Among 452 respondents, 224 and 228 were male and female respectively, with a mean age of 20.2 ± 1.2 years. The
main reason for using facebook was to remain in contact with family and friend (32 %), while its use for the academic
purpose was only 5 %. However, 80.8 % of students acknowledged ease in acquiring academic materials from others,
through facebook. One-fourth of the students acknowledged that they are using facebook late at night on a regular
basis, while surprisingly 4.2 % of the students admitted accessing facebook during the classroom lectures. Almost
two-third of the users, further admitted that facebook has had a negative impact on their studies. Burning eyes (21 %),
disturbed sleep (19 %), and headache (16 %) were the most common adverse health effects reported by the facebook
users. Many students (71.4 %) tried and most of them (68.7 %) succeeded, in reducing time spent on facebook, to
allow for increased time devoted to their studies.
Conclusion: The widespread use of facebook among the health science students, was found to have both positive
and negative effects on their academics, social life, and health.
Keywords: Academic, Social networking site, Family and friend, Adverse health effects
© 2016 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Background
e internet has emerged as the most effective means of
disseminating information. It is worth mentioning that
social networking platforms such as facebook, has been
in use since its beginning. Initially created for Harvard
University students in 2004, as a method of socializing,
this forum was opened for use by the general public in
2006. Facebook is now one of the best known social net-
working sites used by people of all ages and professions.
It is accessible through computer, laptop, and small port-
able devices (tablets and cellular phones). Facebook easily
allows its users to set up and maintain personal ‘profile’
pages for the purpose of connecting, interacting, and
sharing personal views and content with other individu-
als, groups and communities online [1–3]. On average,
there were 1.01 billion daily active users globally by Sep-
tember 2015 [4]. e use of social networking websites by
those in the field of medical education has significantly
Open Access
BMC Research Notes
*Correspondence: rkjhadr@gmail.com; rkjhadr@yahoo.com
1 Department of Pharmacology, Chitwan Medical College Teaching
Hospital, Bharatpur, Nepal
Full list of author information is available at the end of the article
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

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Jha et al. BMC Res Notes (2016) 9:378
increased and attracted substantial interest among edu-
cators and institutions [5]. A recent study in the United
States showed that up to 96% of medical students regu-
larly use facebook. Facebook can be useful for students’
social life as well as their academic pursuits [6].
Facebook use by students has specific pros and cons.
Particularly, the excessive use of online social media may
contribute to misuse, dependence, and addictive behav-
iours [7]. Some studies have reviewed the impact of
online social media use on mental health. ese effects
include changes in self-esteem [8], sleep disorders, and
high percentage of depression among students [9]. How-
ever, these students were unaware of such adverse effects
[10]. With the increased accessibility and availability of
the internet, use of social media is on the rise in Nepal.
Currently there are approximately 4.4 million facebook
users [11]. To best of our knowledge, there is insufficient
data regarding the use and effect of facebook on health
science students in Nepal. We have hypothesized that
the use of facebook may have a negative impact on the
life of health science students. is study was performed
to evaluate the effects of facebook on social interaction,
behaviour, academics, and the health of students at Chit-
wan Medical College, Nepal.
Methods
A cross-sectional study was conducted in Chitwan Medi-
cal College, Bharatpur, Nepal from September to Octo-
ber, 2015. e participants were medical, dental, nursing,
and allied health science undergraduate students who
consented to participate in the study. A self-administered
questionnaire was distributed to total of 476 participants
(all of the available students in basic science courses).
Exclusion criteria included those who had incompletely
completed the questionnaire, did not have facebook
account, or had a facebook account in the past but had
closed it, students complaining of illness, and anyone
taking any medication. A pre-study questionnaire was
given to ten students, who were not included in the study.
Instruments
e questionnaire contained four different sections. e
first section of the questionnaire included demographic
characteristics such as age, gender and course of study.
e second section contained six questions about the
purpose and pattern of facebook use such as place, time,
duration and type of device used. e third section con-
tained three questions regarding the academic use of
facebook to include its impact on study, accessibility of
relevant materials, and the extent of help received in
acquiring academic materials from others who are using
facebook. Lastly, the fourth section contained seven
questions regarding the social, psychological, and health
impacts of facebook users. ese included any complaint
from family and friends of the students regarding exces-
sive time spent on social media, whether or not facebook
was a source of inspiration or motivation, or if the users
developed any physical symptoms such as headache, eye
irritation, or other symptoms following its use. e last
section of the questionnaire also included a question
about whether or not the student had tried to reduce the
amount of time spent on facebook use and why.
Statistical analysis
All the data was entered in Epidata 3.1, exported and
analyzed through Statistical Package of Social Sciences
(SPSS) (version 20). e descriptive statistical analysis
of data was performed to determine the mean, standard
deviation, frequency, and percentage.
Results
Four hundred sixty-five out of 476 students returned
the questionnaire (response rate—97.7%). Five students
incompletely completed the questionnaire and 8 stu-
dents were not having a current facebook account. Based
on our exclusion criteria, those 13 questionnaires were
rejected and the remaining 452 completed questionnaires
by facebook users, were subjected to analysis.
Demographics
e number of male and female participants were 224
(49.6%) and 228 (50.4%) respectively. eir ages ranged
from 17 to 25years with a mean age of 20.2±1.2years.
e participants from the Bachelor of Medicine and
Bachelor of Surgery (MBBS) 1st year, MBBS 2nd year,
Bachelor of Dental Surgery (BDS) 1st year, BDS 2nd
year, Bachelor of Nursing and Allied courses (Bachelor of
Pharmacy-B Pharm and Bachelor in Medical Laboratory
Technology-BMLT) were 31.9, 27.9, 8.6, 8.6, 12.8 and
10.2% respectively.
Reasons andpattern offacebook usage
e students were found to be using facebook mainly to
remain in contact with their family and friends (32%), to
get news updates (26%) and to spend leisure time (24%)
(Fig.1). However, only a few students (5%) admitted to
using facebook for academic purpose. Table1 describes
the pattern of facebook usage. A majority of students
(84.1%) accessed facebook on a daily basis while 44.9%
of them spent less than 1h daily on facebook. One-fourth
of the students accepted indulging in facebook until
late night frequently, while 61.5% admitted to doing so
occasionally. e use of mobile devices was more com-
mon (76.5%) among the participants than desktop/lap-
top for facebook use. A majority of students (54.6 %)
usually accessed facebook while at their hostel. Among
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Jha et al. BMC Res Notes (2016) 9:378
the majority of participants (52.7%) the bedroom at the
student’s home was the favorite place to access face-
book, while 29.4% of students used the library at college
for surfing facebook. Interestingly, 4.2% of the students
admitted to accessing facebook during lecture sessions,
while most of the participants (51.5%) also accessed face-
book in other locations (like playground, corridor etc.)
which were not mentioned in the list of locations in the
questionnaire (Figs.2, 3).
Academic usage offacebook andits impact onstudy
A limited number of students (10.8 %) admitted to
receiving relevant information for their studies directly
from facebook. Conversely, 80.8% of students acknowl-
edged receiving academic materials from other students
via facebook (Table2). However, 67.5% of participants
noted that the facebook had a negative effect on their
studies (Fig.4).
Social, psychological andhealth eect offacebook
A majority of the students (66.4 %) socialized more
actively in real life situation than in facebook (Table3).
Some students (17.5 %) indicated that facebook was a
source of inspiration and motivation for them. e study
also revealed that 86.7 % of users indicated that they
were annoyed when anyone disturbed them during face-
book use. Among the respondents, 13.5% reported that
their friends and family frequently complained about the
amount of time spent on facebook while 24.3% of partic-
ipants in the study admitted that they found it difficult to
not log onto facebook during the course of an entire day.
Most of the students (76.8%) believed that facebook had
negatively affected their health and behaviour (Fig. 5).
Fig. 1 Reasons for using facebook by the participants (N = 452)
Table 1 Pattern offacebook usage amongparticipants
N=452 (percentage)
Do you use facebook daily?
Yes 380 (84.1 %)
No 72 (15.9 %)
How many hours do you use facebook in a usual day? (h)
Less than 1 203 (44.9 %)
1–2 157 (34.7 %)
2–3 53 (11.7 %)
More than 3 39 (8.6 %)
How often do you use facebook late night (after 10.00 p.m.)?
Never 61 (13.5 %)
Sometimes 278 (61.5 %)
Most of the times 113 (25.0 %)
In a usual day, where do you use facebook mostly?
Home 172 (38.1 %)
Hostel 247 (54.6 %)
College 22 (4.9 %)
Cafeteria 11 (2.4 %)
What do you commonly use to access facebook?
Desktop/laptop 106 (23.5 %)
Portable devices (E.g. mobile) 346 (76.5 %)
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Jha et al. BMC Res Notes (2016) 9:378
e adverse health effects experienced by the participants
were burning eyes (21 %), followed by disturbed sleep
(19%), headache (16%), and others (Table4). A major-
ity (71.4%) of the students admitted to making efforts to
reduce their duration of facebook use and to instead use
the time for the academic and creative purposes (16.2%)
(Table 3). Among these participants, 68.7 % were suc-
cessful at reducing the amount of facebook use to pursue
their academic goals.
Discussion
is study demonstrated the widespread use of facebook
among 98.2% of the health science students in a medical
college of Nepal. is was found to be similar in compari-
son, to studies conducted in different countries [12–14]
on the same subject. In addition to ease of connecting
with friends or family, facebook’s news updates in a vari-
ety of different categories (sports, politics, education,
health etc.) encourages its users to spend even more of
their leisure time on the site. e increasing availabil-
ity of Wi-Fi (wireless fidelity), portable devices, and the
popularity of facebook itself, might have also contrib-
uted to facebook use among this population. Accord-
ing to Hew KF [2], facebook has very little educational
value and the participants mainly used facebook to keep
in contact with the known individuals which were found
to be concurring with this study. Moreover, this study
also demonstrated that only 5 % of participants used
facebook for academic purpose, while other studies con-
ducted by Raacke etal. [15] and Gray etal. [13] reported
academic use to be higher (10.9 and 25.5% respectively).
is difference could be due to academic culture and var-
ied institutional policies on the use of internet in these
institutions. While one-fourth of users in this study were
found to be accessing facebook during leisure time, when
accessed regularly, there is potential risk for developing
addictive behaviours, through the development of poor
self-discipline and task avoidance [16].
A majority of the students accessed facebook on daily
basis, in higher numbers than similar past studies [13,
Fig. 2 Common places in home used to surf facebook (N = 435)
Fig. 3 Common sites in college used to surf facebook (N = 431)
Table 2 Eect offacebook use onthe study
N=452 (percentage)
How much of the relevant information for your study is accessible
through Facebook?
Quite a lot 49 (10.8 %)
Somewhat 322 (71.2 %)
Not at all 81 (17.9 %)
To what extent do you get help in academics from others using face-
book?
Quite a lot 70 (15.5 %)
Somewhat 295 (65.3 %)
Not at all 87 (19.2 %)
Does facebook have negative effects on your study?
Quite a lot 84 (18.6 %)
Somewhat 221 (48.9 %)
Not at all 147 (32.5 %)
Fig. 4 Overall negative effects of facebook on studies
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Jha et al. BMC Res Notes (2016) 9:378
17]. Most of the students spent time on facebook on aver-
age, less than 1–2h daily, which was consistent with the
findings reported by others [18, 19]. A majority of partic-
ipants in this study admitted that they were on facebook
until late at night (61.5%). A similar finding was obtained
by Farooqi etal. among the students of Dow University
in Pakistan [20]. Young KS found that the university stu-
dents’ sleep patterns were disrupted due to facebook use
late at night, leading to fatigue and impaired academic
performance [21]. is study also supported the findings
of previous studies [6, 17] that the majority of students
accessed facebook using mobile devices. is particular
method of accessing facebook could be due to increased
availability of internet access and newer versions of oper-
ating systems on mobile devices that support facebook
use.
Similar to the previous studies [2, 6, 22], a small num-
ber of students reported that relevant academic informa-
tion was accessible through the facebook. e majority
of the participants felt that they could acquire academic
assistance from other facebook users to some degree,
which was higher than a previous study conducted
by Gafni and Deri [6]. Facebook allows for rapid, easy
access, and immediate interaction among students and
their teachers. is use of facebook can facilitate rapid
consultation and dissemination of lecture notes, prior
exam information, and other information, much more
quickly than using traditional methods of learning. As a
result, facebook has been found to be effective in obtain-
ing information quickly from others, saving time, and
money [6]. However, Hew [2] reviewed that only a min-
imal number of facebook users actually asked for assis-
tance from facebook friends, while most of the students
preferred discussing their personal life over their studies.
erefore, spending time on facebook may significantly
compromise a student’s academic success. In this study,
Table 3 Eect of facebook use on personal, familial
andsocial life
N=452 (percentage)
Are you more socially active on facebook than in real life?
More active on facebook 39 (8.6 %)
More active in real 300 (66.4 %)
Equally active on both 113 (25.0 %)
Do you think facebook is a source of inspiration and motivation for
you?
Quite a lot 79 (17.5 %)
Somewhat 271 (60.0 %)
Not at all 102 (22.5 %)
Do you get irritated when anyone disturbs you while using facebook?
Quite a lot 155 (34.3 %)
Somewhat 237 (52.4 %)
Not at all 60 (13.3 %)
How often do your friends and family complain you about the time
period you spend on facebook?
Quite a lot 61 (13.5 %)
Somewhat 214 (47.3 %)
Not at all 177 (39.2 %)
Do you feel difficult to spend your day if you can’t log into facebook for
an entire day?
Quite a lot 110 (24.3 %)
Somewhat 40 (8.8 %)
Not at all 302 (66.8 %)
Did you ever try to reduce time on facebook?
No, I didn’t 129 (28.5 %)
Yes, I tried but couldn’t succeed 101 (22.3 %)
Yes, I tried and succeed 222 (49.1 %)
For what reason you have tried to reduce time on facebook? (N = 323)
To use my time in academic 204 (45.1 %)
To save my time for creative work 73 (16.2 %)
To improve my relation 9 (2.0 %)
Others 37 (8.2 %)
76.80%
23.20%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
Yes No
Fig. 5 Overall negative effect of facebook on health and behaviour
Table 4 Adverse health eects onfacebook users
Adverse eects N=452 (percentage)
Burning eyes 95 (21.0 %)
Disturbed sleep 86 (19.0 %)
Headache 73 (16.2 %)
Neck pain 33 (7.3 %)
Back pain 22 (4.9 %)
Reduced appetite 4 (0.9 %)
Others 34 (7.5 %)
None 105 (23.2 %)
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67.5 % of the users admitted that facebook negatively
affected their studies, which was higher than the finding
of a previous study by Farooqi etal. [20].
e data from previous studies clearly indicated that
the excessive use of social media, compromises actual
live social interaction and academic accomplishments. It
may also be associated with relationship problems, per-
sonal loneliness, and depression [23, 24]. We found that
very small population (8.6%) spent more time on face-
book than live interactions with others, unlike the result
obtained by the previous study [20]. However, 17.4 %
of participants indicated that facebook was a source of
inspiration and motivation for them. is is consist-
ent with the findings of Farooqi etal. who observed that
many students admitted that excessive facebook use had
ruined their social life, causing them to spend less time
with their loved ones [20]. Moreover, the researchers at
the University of Southern California reported that an
increasing number of people, admitted to spending less
time with their family members as result of excessive use
of the internet, including social networking sites [25].
Young people have an increased tendency to develop
additive behaviour with facebook use. However, they are
usually unaware of this additive behaviour [20]. In this
study, one-fourth of the users found it difficult to spend
an entire day without accessing facebook. Half of them
complained of feeling irritated when they were disturbed
while using facebook, which was consistent with the find-
ings of previous studies [17, 20]. More than half of the
participants received complaints from their family or
friends about the amount of time they spent on facebook.
As these are some of the key components in determining
the facebook addiction according to ‘Bergen Facebook
Addiction Scale (BFAS)’ [26], this supports the theory
that these participants possibly have some degree of
facebook addiction. Sharifah etal. identified the negative
behavioural consequences of social networking as: hyper-
activity, attention deficit, depression, and multi-tasking
mania [27]. us, proper education regarding the use of
social media is needed.
As with any other technology facebook is not unique
for eliciting both positive and negative effects on its
users. Previous studies have shown adverse effects simi-
lar to computer use, such as: headache, backache, weight
change, and eye problems [17, 28]. Of those reported
by the users in this study, burning eyes, disturbed sleep,
and headache were the most common reported adverse
health effects. On the other hand, 23.2% of participants
denied experiencing any adverse effects. Sierra et al.
stated that both quantity and quality of sleep might
strongly influence mood [29] and subjective well-being,
which in turn could impact the academic performance
[21, 30] of the students who use facebook late at night
and do not allow for sufficient sleep. Al-Dubai etal. had
clearly indicated a significant association between face-
book use, its adverse health effects, and unhealthy behav-
ior. ey have recommended that higher educational
institutions should create awareness and safer practices
for their students. Additionally, they have advocated
regular health screening of students to avoid the possible
health consequences due to facebook use [31].
Although a majority of students (71.5%) claimed that
they tried to reduce their time spent on facebook, one-
fourth of them were not successful indicating additive
behavior, consistent with the result found by Farooqi
etal. [20]. It is worth mentioning that the students were
willing to invest more of their time on their studies rather
than on facebook. Further studies in a large population
may reveal the factors associated with positive and nega-
tive impacts of facebook use among the health science
students.
Since information technology is rapidly evolving, pop-
ular social networks like facebook, could be used by the
educational institutions for academic purposes, such as
uploading data and sharing educational materials. It is
likely that more students will use social sites like face-
book in future, as more attractive features are offered
to their users. is will undoubtedly affect the students’
learning process and have an impact on their health and
personal life. erefore, new approaches and tools need
to be developed for evaluating the facebook use and its
consequences among students.
Conclusions
Excessive use of facebook, a popular social network
site, has important positive and negative effects on the
academics, social interactions, and health of the health
science students in this study. With limited academic
benefits, excessive use of facebook may actually increase
the risk of facebook additive behavior, resulting in less
time spent on academics. It is important to involve the
parents of students, educational institutions, and the
facebook authority, to collaborate on how to encourage
students to limit social media usage and bring awareness
to the consequences of excessive use, especially among
the student population.
Limitations ofthe study
Since this is a cross-sectional study conducted in a single
medical school in Nepal, this study might not be repre-
sentative of all health science students. We believe that
similar studies are important in exploring and under-
standing the practices of facebook and other social media
use along with its consequences. e results of this study
revealed that the health problems were prevalent in face-
book users. However, the specific cause and effects could
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Jha et al. BMC Res Notes (2016) 9:378
be better established through further studies. Future
research could be designed to explore the effects of
excessive use of different social media among students in
different academic programs.
Abbreviations
SPSS: statistical package for the social sciences; MBBS: Bachelor of Medicine
and Bachelor of Surgery; BDS: Bachelor of Dental Surgery; B Pharm: Bachelor
of Pharmacy; BMLT: Bachelor in Medical Laboratory Technology.
Authors’ contributions
RKJ conceived, designed and proposed the research idea, supervised the
data collection, analyzed the data, and drafted the manuscript. DKS designed
the methodology, analyzed the data, and prepared the initial version of the
manuscript. KRP, SB, and PS collected the data, contributed to data analysis,
and critically revised the manuscript. AKS and KA contributed to data analysis,
drafting and critical revision of the manuscript. All authors read and approved
the final manuscript.
Author details
1 Department of Pharmacology, Chitwan Medical College Teaching Hospital,
Bharatpur, Nepal. 2 Department of Physiology, Chitwan Medical College Teach-
ing Hospital, Bharatpur, Nepal. 3 School of Pharmacy, Chitwan Medical College
Teaching Hospital, Bharatpur, Nepal. 4 School of Public Health and Community
Medicine, Chitwan Medical College, Bharatpur, Chitwan, Nepal.
Acknowledgments
We would like to thank Chitwan Medical College, Bharatpur, Nepal for provid-
ing the necessary information and permission to conduct the study. We wish
to acknowledge the help extended by Elizabeth M. Lykins (PA-C, MPAS Santa
Cruz, California) in editing the language of manuscript and Mr. Gobind Prasad
Dhungana (Chitwan Medical College, Bharatpur, Nepal) for his constant sup-
port in statistical analysis. We would also like to thank all the students who
participated and offered their time for this study.
Competing interests
The authors declare that they have no competing interests.
Availability of data and materials
The data supporting our findings can be made available on requests from the
corresponding author.
Ethics approval and consent to participate
The study was ethically approved by Chitwan Medical College-Institutional
Review Committee. The purpose of the study was explained to the partici-
pants and their informed verbal consent was taken before conducting the
study.
Funding
The authors have not received any fund or benefits from the institution or
elsewhere to conduct this study.
Received: 27 February 2016 Accepted: 26 July 2016
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