Health Issues with Learning to Use Smart Devices in the Digital Age: Using a Grounded Theory Approach
Abstract
:1. Introduction
2. Methods
2.1. Setting and Participants
2.2. Ethical Considerations
2.3. Data Collection
2.4. Data Analysis
3. Results
3.1. Open Coding
3.2. Axial Coding
3.2.1. Paradigm
Causal Conditions
“My eyes hurt more when I watch lectures on a smartphone because the screen is small, and the letters are small, too. […] I hold the screen as close to my eyes as possible.”
“I think my eyes hurt because I look at the smartphone screen on a shaking bus.”
“My lower back hurts when I watch lectures while sitting on a chair without a backrest.”
“When loading is slow, I get annoyed. I do something else while waiting and I’m not able to study. On such days, I cannot study the lessons.”
Context
“Regardless of whether I use the smartphone for study or not, my mom scolds me for using it all day long.”
“When I perform smart learning while wearing circle lenses, my eyes feel dry after 30 to 40 min.”
“The media and people around me say using a smartphone is bad for my health because of electromagnetic waves. Once I heard these claims, I became worried about the safety of smart devices.”
Central Phenomena
“When I listen to a lecture with my earphones on for more than an hour, my hearing feels weaker and I feel slight pain, so I take them out. I was almost hit by a motorcycle because I was listening while I was walking.”
“I just feel sleepy. […] Whenever I listen to something in a lecture that I already know, I stare blankly at the screen while thinking about something else.”
Intervening Conditions
“I searched for eye-massage method’ on the Internet.”
“I didn’t tell my mom when my eyes hurt because I did not want to hear her nagging me that I use my computer too much. When I talked to my friend, he understood, saying he experienced the same thing.”
“I think I once had a lesson about computer-use habits in health class when I was in elementary school.”
Action–Interaction Strategy
“When my eyes hurt while I work on the computer, I just take a break. Then the symptom goes away, and I don’t have to tell mom about it.”
“My mom takes my cellphone away after nine o’clock in the evening on weekdays. And my computer use is limited, meaning I can only use the computer when my parents are around.”
“I don’t think I had such a conversation with my teacher.”
Consequences
“When I swapped my cellphone for one that doesn’t have smart features, my body and mind felt better. If the time I spent on a cellphone equaled 100% when I had a smartphone, it has now been reduced to about 1%. The best thing about it is that I no longer hear mom saying I’m stuck on the phone all the time.”
“After looking at the tablet screen for a while, I get this unusual burning sensation in my eyes. When this happens, I stop looking at the computer screen and get up […] then I take a break, trying to look at something else other than the computer screen. I look at far-away buildings.”
3.2.2. Process Analysis
3.3. Selective Coding
3.3.1. Core Category: Forming of Ideal Digital Learning Habits
3.3.2. Generating Hypotheses and Theory
- -
- High dependence on smart devices and high anxiety over uncertain information;
- -
- Low dependence on smart devices and high anxiety over uncertain information;
- -
- High dependence on smart devices and low anxiety over uncertain information;
- -
- Low dependence on smart devices and low anxiety over uncertain information.
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Kim, T.; Cho, J.; Lee, B. A Study on the Development Strategy of Smart Learning for Public Education. J. Internet Comput. Serv. 2015, 16, 123–131. [Google Scholar] [CrossRef] [Green Version]
- Koper, R. Conditions for effective smart learning environments. Smart Learn. Environ. 2014, 1, 5. [Google Scholar] [CrossRef] [Green Version]
- Palau, R.; Mogas, J. Systematic literature review for a characterization of the smart learning environments. In Propuestas Multidisciplinares de Innovación e Intervención Educativa; Cruz, A.M., Aguilar, A.I., Eds.; Universidad Internacional de Valencia: Valencia, Spain, 2019; pp. 55–71. Available online: https://www.universidadviu.es/modelode-investigacion/ (accessed on 28 June 2021)ISBN 978-84-09-07242-2.
- Chun, S. Korea’s Smart Education Initiative and its pedagogical implications. CNU J. Educ. Stud. 2013, 34, 1–16. [Google Scholar] [CrossRef]
- Sharonova, S.; Avdeeva, E. Dialogue between smart education and classical education. Lang. Dialogue 2021, 11, 151–170. [Google Scholar] [CrossRef]
- Giovanelli, A.; Ozer, E.M.; Dahl, R.E. Leveraging Technology to Improve Health in Adolescence: A Developmental Science Perspective. J. Adolesc. Health 2020, 67, S7–S13. [Google Scholar] [CrossRef]
- Hillmayr, D.; Ziernwald, L.; Reinhold, F.; Hofer, S.I.; Reiss, K.M. The potential of digital tools to enhance mathematics and science learning in secondary schools: A context-specific meta-analysis. Comput. Educ. 2020, 153. [Google Scholar] [CrossRef]
- Drossel, K.; Eickelmann, B.; Vennemann, M. Schools overcoming the digital divide: In depth analyses towards organizational resilience in the computer and information literacy domain. Large-Scale Assess. Educ. 2020. [Google Scholar] [CrossRef]
- Jang, D.H.; Yi, P.; Shin, I.S. Examining the Effectiveness of Digital Textbook use on Students’ Learning Outcomes in South Korea: A Meta-analysis. Asia-Pac. Educ. Res. 2016, 25, 57–68. [Google Scholar] [CrossRef]
- Car, L.; Kyaw, B.; Dunleavy, G.; Smart, N.; Semwal, M.; Rotgans, J.; Low-Beer, N.; Campbell, J. Digital Problem-Based Learning in Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J. Med. Internet Res. 2019, 21, 1439–4456. [Google Scholar] [CrossRef] [Green Version]
- Lee, J.; Lee, Y.; Kim, M.H. Perceptions of Teachers and Students towards Educational Application of SNS and its Educational Effects in Middle School Class. Turk. Online J. Educ. Technol. 2015, 14, 124–134. [Google Scholar]
- Morgado, J.C.; Lencastre, J.A.; Freires, T.; Bento, M. Smart Education as empowerment: Outlining Veteran Teachers’ Training to Pro-mote Digital Migration. Technol. Knowl. Learn. 2021. [Google Scholar] [CrossRef]
- Dennen, V.P.; Choi, H.; Word, K. Social media, teenagers, and the school context: A scoping review of research in education and related fields. Educ. Technol. Res. Dev. 2020, 68, 1635–1658. [Google Scholar] [CrossRef]
- Canto-Sancho, N.; Sanxhez-Brau, M.; Ivorra-Soler, B.; Segui-Crespo, M. Computer vision syndrome prevalence according to individual and video display terminal exposure characteristics in Spanish university students. Int. J. Clin. Pract. 2020, 75, e13681. [Google Scholar] [CrossRef]
- Seomun, G.; Lee, J.-A.; Kim, E.-Y.; Im, M.; Kim, M.; Park, S.-A.; Lee, Y. Health Effects of Digital Textbooks on School-Age Children A Grounded Theory Approach. West. J. Nurs. Res. 2013, 35, 1184–1204. [Google Scholar] [CrossRef]
- Ahn, S. Effect of Internet Addiction by Using Digital Textbook in Teenager. J. Korean Assoc. Inf. Educ. 2015, 19, 253–260. [Google Scholar] [CrossRef]
- Kown, M.; Nam, G.; Seo, B. A Survey on Internet Addiction 2015. [National Information Society Agency]. Available online: http://www.nia.or.kr/ (accessed on 28 June 2021).
- Leem, J.; Sung, E. Teachers’ beliefs and technology acceptance concerning smart mobile devices for SMART education in South Korea. Br. J. Educ. Technol. 2019, 50, 601–613. [Google Scholar] [CrossRef]
- Bae, J.; Cho, E.; Cho, Y.; Kim, K. A study on parents’ observation of adolescent children’s smartphone use problem and their parenting experiences. J. Fam. Relat. 2015, 20, 143–164. [Google Scholar]
- Lee, J.; Chung, H.; Moon, J.; Yoo, Y.R. Exploring Preservice Teachers’ Acceptance of Smart Learning Emerging Issues in Smart Learning; Springer: Berlin/Heidelberg, Germany, 2015; pp. 175–181. [Google Scholar] [CrossRef] [Green Version]
- Lee, S.; Kwon, M. A Study on the Awareness of Elementary School Teachers and Students About the Smart Education and Its Improvement Plan. J. Commun. Sci. 2014, 14, 258–294. [Google Scholar] [CrossRef]
- Sung, E. The Influence of Smart Media Literacy’s Factors on Subject Attitude and Achievement: Focusing on Middle School Students’ Gender Differences. J. Educ. Technol. 2014, 30, 621–650. [Google Scholar]
- Agha, N.I.; ZaaZa, A. The Effects of Digital Technology Usage on Children’s Development and Health. World Fam. Med. 2021, 19, 54–60. [Google Scholar] [CrossRef]
- Mehra, D.; Galor, A. Digital Screen Use and Dry Eye: A Review. Asia-Pac. J. Ophthalmol. 2020, 9, 491–497. [Google Scholar] [CrossRef]
- Sanchez-Valerio, M.D.; Mohamed-Noriega, K.; Zamora-Ginez, I.; Duarte, B.G.B.; Vallejo-Ruiz, V. Dry Eye Dis-ease Association with Computer Exposure Time Among Subjects with Computer Vision Syndrome. Clin. Ophthalmol. 2020, 14, 4311–4317. [Google Scholar] [CrossRef] [PubMed]
- Mazloumi, A.; Pourbabaki, R.; Samiei, S. Studying factors influencing eye indicators of computer users: A systematic review. J. Health Saf. At. Work 2019, 9, 231. [Google Scholar]
- Seomun, G.; Pyun, S.B.; Lee, J.A.; Kim, E.J.; Noh, W. A comparison of carpal tunnel syndrome between digital and paper textbook users in elementary schools. Work-A J. Prev. Assess. Rehabil. 2016, 53, 909–915. [Google Scholar] [CrossRef] [PubMed]
- Ryoo, S.; Cheung, C. International students’ perceptions of safety level and safe-ty education needs in Korea. Int. J. Disaster Risk Reduct. 2021, 102068. [Google Scholar] [CrossRef]
- Corbin, J.; Strauss, A. Basics of Qualitative Research; Sage: London, UK, 2008. [Google Scholar] [CrossRef]
- Qualitative Research: Grounded Theory. Available online: https://guides.temple.edu/groundedtheory (accessed on 28 June 2021).
- Kay, R.; Benzimra, D.; Li, J. Exploring factors that influence technology-based distractions in bring your own device classrooms. J. Educ. Comput. Res. 2017, 55, 974–995. [Google Scholar] [CrossRef]
- Yadegaripour, M.; Hadadnezhad, M.; Abbasi, A.; Eftekhari, F.; Samani, A. The Effect of Adjusting Screen Height and Keyboard Placement on Neck and Back Discomfort, Posture, and Muscle Activities during Laptop Work. Int. J. Hum. Comput. Interact. 2020, 37, 459–469. [Google Scholar] [CrossRef]
- Hwang, S.H.; Kang, J.S. Grounded Theoretical Analysis on Children’s Smartphone Using Experience: Focusing on Smartphone Using Experi-ence and Overcome Strategy. Educ. Cult. Res. 2014, 20, 111–134. [Google Scholar] [CrossRef]
- Keating, G.M. Diquafosol ophthalmic solution 3%: A review of its use in dry eye. Drugs 2015, 75, 911–922. [Google Scholar] [CrossRef]
- Ciccarelli, M.; Fraser, K.; Vaz, S. Allied health management of technology-related musculoskeletal complaints among children and ad- olescents. Aust. Ouccupational Ther. J. 2016, 63, 399–407. [Google Scholar] [CrossRef]
- Rhee, J.; Lee, D.; Lim, H.; Park, M.; Shu, M.; Lee, J.; Hong, Y.; Oh, S. Hearing loss in Korean adolescents: The prevalence thereof and its as-sociation with leisure noise exposure. PLoS ONE 2019, 14, e0209254. [Google Scholar] [CrossRef] [Green Version]
- Kim, D.M.; Lee, C.H. Phenomenological Approach of Overindulgence Smartphones Experience in Elementary Student. J. Korean Pract. Arts Educ. 2015, 28, 65–90. [Google Scholar]
- Lee, K.-M. Analysis of Textbook Related to Safety Education in Elementary School. J. Sport Leis. Stud. 2015, 61, 25–36. [Google Scholar] [CrossRef]
- The KOREA Transport Institue. How safe passage in the environment, including bicycles. Mon. KOTI Mag. Transport. 2013, 12, 30–35. [Google Scholar]
- Song, Y.; Byun, H.A. Grounded theory approach on teachers’ digital textbook experience. Educ. Technol. 2012, 28, 231–262. [Google Scholar] [CrossRef]
Stage | Interview Topic | Sample Questions |
---|---|---|
Introductory questions | Use experience and frequency | Have you ever used a computer or a smartphone for learning? If so, how many times a week do you use it? |
Transition questions | Attitude about usage | Do you think learning from smart devices is more useful than learning from books? Or do you think it is disturbing? |
Key questions | Status issues with using smart devices | Have you ever experienced any kind of health-related inconvenience or concern over the past year while using smart devices for learning? |
Coping with health problems | If so, how did you deal with it? How did you deal with any inconvenience or problems with your smart device while or after you used it? | |
Factors affecting health problems and results after coping | In what circumstances do you feel the discomfort or feeling is getting worse? How do you think it will help you when it comes to dealing with an uncomfortable situation? | |
Health support system | Who did you ask for help when you felt uncomfortable? What kind of help did they offer you? | |
Final questions | Summary and additional comments | Is the content summary to this point appropriate? |
We have been talking about the health problems of smart learning so far. Do you have anything else that you want to add? |
Paradigm | Categories | Subcategories | Concepts | |
---|---|---|---|---|
Causal conditions | Unsafe smart learning behavior | Learning without a break for a long time | Watching lectures for longer than 2 h on a regular basis | |
Danger when using a smartphone while walking | Danger (standing on bus, subway, etc.) when watching lectures on smartphone non-stop while walking | |||
Unhealthy habits and posture when using a smartphone | Due to small letters on smartphones, the distance between one’s eyes and the device is closer than the distance when reading a textbook Posture affected when laying down a smartphone to watch in a lying position | |||
Inefficient smart learning environment | Inefficient use of support devices | Engaging in smart learning when sitting on a chair without a backrest or a monitor stand | ||
Smart device malfunction occurred | If the computer breaks down while working, it is very irritating and can affect one’s concentration | |||
Context | High dependency on smart devices | Use of smart devices indiscriminately for long periods of time for purposes other than learning | Greatly increased non-learning activities (Internet browsing, SNS, etc.) Too much dependency on SNS; indiscriminate use when parents are not present | |
Unhealthy lifestyle (daily) | Wearing circle lenses for aesthetics, using earphones for long periods of time | Wearing circle lenses causes dry eye syndrome Reduced hearing due to extended earphone use | ||
Anxiety due to uncertain information | Vague anxiety due to unconfirmed information | Fear of negative effects of electromagnetic waves on brain development and health | ||
Central phenomena | Experience with health problems | Experience of physical health problems | Eye symptoms | As the eyes become easily tired, vision will degrade, eyes will feel heavy, stuffy, dry, and irritated |
Musculoskeletal symptoms | Discomfort and pain in neck, shoulders, back, and wrists | |||
Hearing symptoms | Feeling of deafness is uncomfortable; hearing loss | |||
Systemic symptoms | Feeling sleepy, blurry, tired, and dizzy at the same time | |||
Experience of psychosocial health problems | Passive attitude | Not trying to understand the content after engaging in smart learning but studying in a passive posture and blankly learning the content due to a lack of interest | ||
Decreased concentration | When studying with digital tools, cannot resist the temptation to consume entertainment (SNS, Internet surfing, games, etc.), unlike with normal textbooks, so concentration is always poor | |||
Intervening situations | Student’s coping competence | Searching for health knowledge with digital information | Searching the Internet for similar answers, searching for ways to reduce problems and get similar information about others’ experiences, and figuring out how to respond with their own strategies | |
Trying to maintain a positive attitude while using smart learning | Raising interest in smart learning through curiosity and satisfaction with various types of information, convenience, etc.; being able to learn on mobile device | |||
Ability to handle health problems and ask for help | To properly deal with health problems, regular rest and exercise are needed, along with asking for help immediately whenever any symptom of discomfort appears | |||
Family’s copingpattern | Friendly support | Parents approve the use of smart devices only for learning purposes, and in exchange they will make time to listen to their children’s situations seriously; they will try to decide how to prevent problems if they have trouble together as a family | ||
Opposition | Forcing students to reduce their use of smart devices by endlessly talking negatively about them | |||
School (friend, teacher) support system | Sharing empathy for uncomfortable situations with friends | Sharing sympathy about an uncomfortable situation, and consoling each other when experiencing difficult feelings | ||
Teachers convey and support relevant information | School provides videos on ways to manage health problems During class, teacher will explain the causes of health problems from the use of smart devices Students can learn from compulsory education provided by schools to deal with health problems when they appear Students can practice with their teachers how to prevent health problems at school | |||
Action–interaction strategies | Student’s self-led coping | Does not express discomfort to anyone | Students do not express feelings of discomfort to parents, siblings, friends, or teachers, or ask people around them for advice or help on ways to reduce such feelings | |
Endures every uncomfortable feeling unconditionally | Students ignore feelings of discomfort and endure them alone, thinking they will be fine if they take a short break, but when it is too hard to bear, they stop learning | |||
Takes a rest when feeling uncomfortable | When feeling uncomfortable (eye fatigue, low back pain, numbness, etc.), student immediately takes a break | |||
Practices action and response methods to mitigate discomfort | Students try to repeat basic exercises they already know (stretching, changing posture, blinking their eyes, etc.), smart devices will also allow them to rest their eyes for a short time; if they have eye drops, they can put them in for hydration | |||
Telling parents about feelings of discomfort and trying to improve the problem | Expressing discomfort to family (especially the mother) based on the environment and try to follow the family’s guidance | |||
Coping through mutual contracts between students and parents | Setting rules for using smart devices between parents and students | Discussing use of smart device, setting up and following rules (use time, work, circumstances, etc.) with parents, and remembering to follow the rules as promised | ||
Using materials with parents to help prevent health problems | When using a computer at home, parents prevent back pain by using a chair with a backrest and props to adjust monitor height to eye level | |||
Passive sharing and intervention between students and teachers | Passive health problems arise between teachers and students | Without informing teachers about students’ health problems, opportunities for counseling on smart learning and health problems are not available, but teachers still will not do anything to prevent them | ||
Teachers cannot actively intervene | There are no exact guidelines on adverse effects when using smart devices, not all teachers are accustomed to using them, and not many teachers are aware of the side effects of using smart devices at school | |||
Consequences | Forming diverse digital habits | Ambivalent use of smart devices | Students cannot resist playing with their smart devices when their parents are absent or on holidays; most of them turn off the lights and sneak it in their beds and play non-stop | |
Some students try to overcome the temptation to use their phones too much and exercise self-control by replacing their smartphone with a 2G phone that only allows conversation and text messaging | ||||
Differences in ability to control health problems | Health issues due to smart learning are a necessary evil, so students should be patient and stop using smart devices temporarily to address their health problems | |||
Active students monitor their own health problems and attempt to properly deal with them and try to prevent them |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Chung, M.-S.; Seomun, G. Health Issues with Learning to Use Smart Devices in the Digital Age: Using a Grounded Theory Approach. Int. J. Environ. Res. Public Health 2021, 18, 7062. https://doi.org/10.3390/ijerph18137062
Chung M-S, Seomun G. Health Issues with Learning to Use Smart Devices in the Digital Age: Using a Grounded Theory Approach. International Journal of Environmental Research and Public Health. 2021; 18(13):7062. https://doi.org/10.3390/ijerph18137062
Chicago/Turabian StyleChung, Myung-Sill, and GyeongAe Seomun. 2021. "Health Issues with Learning to Use Smart Devices in the Digital Age: Using a Grounded Theory Approach" International Journal of Environmental Research and Public Health 18, no. 13: 7062. https://doi.org/10.3390/ijerph18137062