Dependence of Teenage and Adult Population over the Smartphone and Internet Services In a Tertiary Care Hospital

Background: Today digital devices and internet has become an integral part of our life. The information is available at the swipe of the finger. The vast spectrums of services are now offered by digital devices and internet such as communication, banking, education, shopping etc. People are now becoming more and more dependent on digital devices and internet which are used as transactive memory. Aims and Objectives: 1. To study the dependence of subjects on digital devices 2. To compare these effects across different variables. Material and Methods: A cross sectional study was carried out in a tertiary health care hospital. The sample frame consisted of a) Medical students as teenagers and b) staff of a tertiary health care centre as adult population. All study participants were permanent residents of the semi-urban area. Final sample size consisted of 245 medical students and 245 staff members of a tertiary health care centre. Results: Students use more internet and are more comfortable with digital devices than adults. Almost 75% of study participants prefer internet for seeking information while 60 % of participants were of the opinion that digital devices are extension of brain capacity. Conclusions: Both teenager and adult population are dependent on digital devices and internet, but the dependency of teenagers is much more than that of the adults

users. The Internet and Internet-enabled devices have transformed our everyday lives and relationships. We entrust them with our precious personal information including contacts and images and rely on them to connect us to a vast repository of knowledge, anytime, anywhere. Digital devices along with internet are now being used as a transactive memory system and this use is changing the way people encounter and treat information Transactive memory system is a means by which people may store information externally to be retrieved at a later time. This system allows people to recall where information is located, rather than to commit memory all the information itself. According to Kaspersky Labs, 44% people admit that their smartphones have everything they need to recall and serves as their memory. This study is an attempt to study the different usage patterns of people with regards to digital devices and how it is affecting their lives.

Objectives
1. To study the dependence of study population on internet and digital devices 2. To compare the dependence oninternet and digital devices among different variables

MATERIAL AND METHODS
A cross sectional study was carried out in a tertiary care hospital in the months of June and July 2017. The sample frame consisted of a) Medical students as teenagers and b) staff of a tertiary health care centre as adult population. All study participants were permanent residents of the semi-urban area.
Study population consisted of teenagers and general adult population from a semi-urban setup who were Smartphone and internet users for a minimum period of 1 year. People with personal/genetic memory impairment issues were not included.

Sample size
Findings of previous study report that 44% people accept that their smartphones serve as a part of their memory. Considering this data with type I error (α) = 0.05 and type II error (β) = 0.1, estimated sample size was 489. It was rounded to 490. Thus final sample size consisted of 245 medical students and 245 staff members of a tertiary health care centre.
A pre structured and pre tested questionnaire was used for data collection. The questionnaire consisted of questions related to the social variables and use of internet and Smartphone by the respondents. Approval of Institutional Ethical Committee was obtained. There was no conflict of interest. The data were tabulated and analyzed using Epi Info and MS Excel. The study report has been approved by ICMR New Delhi.

RESULTS AND DISCUSSION
The study population consisted of 245 medical students and 245 staff members of a tertiary health care centre. Amongst 245 students, there were 108 male (44.08%) and 137 (55.91%) were female students. Amongst 245 staff members there were 135 (55.10%) males and 110 (44.89%) were females. Following tables and graphs show the usage patterns of Smartphone and internet among the study population.

Figure1: Time spent on internet in a day by the study population
χ2=127.47, DF =2, P < 0.05 Figure 1 demonstrates time spent by the participants on internet every day. The time was measured in hours. It was observed that majority of students use internet for more than three hours in a day. Where as majority of staff use internet for less than two hours in a day. It was observed that there was statistically significant difference between the two variables.
Similar findings are reported in the study carried out by Friede E. T. in 2013 where they found that young adults spent more time on internet than the older adults.
A study carried out by Chak Katherine et al mentions that full-time students are more likely to be addicted to the Internet, because of free and unlimited access and flexible time schedules.
It shows that both adult and young participants are internet friendly, however young adults aremore dependent on internet than the adult population. Comfort level while using digital devices was found out among the study participants and the results are depicted in Table 1

Time spent on internet in a day by study population
Staff Students

Dependence of Teenage and Adult Population over the Smartphone and Internet Services In a Tertiary Care Hospital
Similar findings were observed in a study conducted by Friede E. T. in 2013 in which they observed that young adults were found relatively more comfortable in daily computer use than older adults.
In another study published by Pew Research Centre in April 2014, only 18% of adults were found comfortable learning to use a new technology device such as smartphone or tablet of their own. The lower percentage of comfort level was observed in this study as compared to our study. It may be attributed to higher age group of adults.  Table 2 reveals the information seeking behaviour of the study participants. Information seeking behavior through internet was more among most of study participants i.e. in 74.69% of total study population, though it was much more in students. It was also observed that consulting a friend as well as referral of a book was minimal in students.
When Chi square test was applied, a significant association was observed between these variables. As reported in previous studies carried out by kaspersky lab, it was seen that 50% of study population across USA and 36% of study population in Europe preferred internet for seeking information.
Use of digital devices for saving of essential data by the participants and their opinion regarding digital devices as extension to brain capacity were also studied .Results are shown in Table 3 and 4.   Table 3 reveals the practice of saving essential dada in digital devices by the participants.
Overall 264 (53.87%) participants save essential data in digital devices. It was relatively more in students than adults. However the difference was not statistically significant after applying Z test. Table 4 shows the response of participants to question whether digital devices are extension to their brain capacity. Overall 296(60.40%) respondents gave affirmative response. It was more in students than adults. There was no statistically significant difference between the variables.
In a study conducted by kasperskyLab, 44% Americans agreed that their smartphones had everything they needed to recall. In our study, 53.87% respondents agreed to similar question. According to Table 4 majority (60.40%) respondents were of the opinion that digital devices are extension to their brain capacity. Similar results are observed in a study conducted by Kaspersky lab in 2015 where almost 80% of the European consumers surveyed admitted that they use the internet as an extension of their brain. It can be said that digital devices or internet are becoming an important form of external memory or transactive memory which is stored outside an individual's brain memory. Probable Reaction of the respondents was studied if they lose all the data from the phone. The findings are shown in Fig 2.

Figure 2 : Reaction of participants when all data from mobile phone is lost.
χ2 = 106.50, DF = 2, P < 0.05. The study participants were questioned for their reaction if they lose their data in the phone. The emotional impact of loosing data was studied and found to be tremendous. It was observed that the most common reaction among the students was sadness and panicky while calmness was more reported by majority of the adults. When χ2 test was applied to above data, it was highly significant.
The results of study conducted by Kaspersky labs regarding reaction of individuals when all data from mobile phone is lost, are comparable with our study. This means that the emotional