# Assessment Tools and Psychosocial Consequences of Smartphone Addiction in Nursing Students: A Systematic Review and Meta-Analysis

## TL;DR

Nursing students with high smartphone addiction face stress, poor sleep, and worse academic performance, according to a systematic review and meta-analysis.

## Contribution

This study systematically reviews and meta-analyzes smartphone addiction in nursing students, identifying assessment tools and psychosocial correlates.

## Key findings

- Pooled mean smartphone addiction score was 29.5 out of 60 with very high heterogeneity.
- Higher addiction scores correlated with stress, anxiety, sleep issues, and poor academic performance.
- Cross-sectional study design and high heterogeneity limit interpretation of results.

## Abstract

Background/Objectives: Problematic smartphone use is common among nursing students and has been linked to academic and psychosocial difficulties. This PROSPERO-registered systematic review (CRD42024559668) identified the instruments used to assess smartphone addiction in nursing students and, secondarily, pooled typical addiction levels using the Smartphone Addiction Scale–Short Version (SAS-SV; 10–60) and examined psychosocial correlates. Methods: Following PRISMA 2020, we searched PubMed, Scopus, Web of Science, CINAHL and ScienceDirect from 1 January 2014 to 9 May 2024. Eligible studies assessed problematic smartphone use in undergraduate nursing students with validated instruments, while development-only studies and pandemic-specific contexts were excluded. Methodological quality was appraised using the JBI checklist, and a random-effects meta-analysis was performed to estimate pooled scores and explore cross-study variability. Results: Fifty-three studies met inclusion; eleven contributed to the SAS-SV meta-analysis (N = 5586). The pooled mean score was 29.5 (95% CI 27.7–31.3), with very high heterogeneity (I2 = 98%). Sensitivity analyses yielded similar results, and no publication bias was detected. Across studies, higher smartphone addiction was correlated with elevated stress and anxiety, sleep disturbance, and poorer academic and clinical performance. Conclusions: Nursing students’ SAS-SV scores cluster around ~29/60, with substantial between-study variability. Higher addiction scores were consistently associated with stress, anxiety, poor sleep, and reduced academic and clinical performance. However, interpretation is limited by the cross-sectional nature of the included studies and the very high heterogeneity observed. Standardising measurement is essential, but equally important is developing targeted educational interventions to foster healthier smartphone habits in nursing education. These results may guide nursing educators and institutions to design programs that foster healthier digital habits and support students’ academic and clinical performance.