Investigating social media statistics of usage and its determinant factors in students of Kurdistan University of Medical Sciences in 2018: A cross-sectional study.

Background and Aim: the present study was conducted to investigate social media statistics of usage and its determinant factors in students of Kurdistan University of Medical Sciences in 2018. Materials and Methods: This study is a cross-sectional-analytical study. The total of 380 students of Kurdistan University of Medical Sciences were randomly selected by Probability Proportional to Size Sampling method, from the lists of the students in each faculty. The data collection tool was a researcher-made questionnaire, organized in four sections. Data analysis was done using descriptive and inferential statistics by SPSS software version 21. Results: Based on the results of this study 373 (98.2%) of the sample students were on social media, which the most popular ones among them were Telegram (94.1%), Instagram (78.8%) and Whatsapp (61.9%), respectively. The average time spent on social media among students was reported to be 2.78 hours per day and is a signi�cant difference between age groups in terms of attitudes toward using social media (P = 0.031). Conclusion: the results of this study suggested that the majority of students use social media. Since improper use of social media can exert unfortunate effects on different aspects of life of students, and negatively in�uence their education.


Introduction
Internet is a multipurpose tool used for engaging in social communication, recovery of large amounts of information and doing leisure activities (1).Social media as a subcategory of internet, with different levels of access, is created for the purpose of interpersonal communication (2).
Statistics suggest that, the number of social media users has doubled from 2008 to 2010 (3).Facebook, Telegram and Instagram are among the most popular social media platforms (4).According to recent studies, Telegram is the most popular platform in Iran (5).In Korea 99.9% of adolescents use Internet in their daily life(6).
The internet usage among U.S. adolescents has increased from 89.4% in 2014 to 97.5% in 2016 (7).Following the same pattern, the adolescent Internet usage rate in Iran has increased from 3.8% in 2000 to more than 68.5% in 2016(8).
Excessive use of social media can lead to several undesirable effects, including: anxiety, stress and adverse effects on school performance (9).Internet addiction can also be associated with psychological problems such as depression and drug abuse, suicide and nomophobia (10,11).Reasons for such interest in using Internet is due to its easy access, widespread use, low cost, multimedia sharing feature and lack of need for special skills (12).According to several studies conducted in Iran, since students are often away from their families after admission to the University, in order to stay in touch with their friends and families, students tend to use social media which makes the effects of social media perfectly visible in this period (13).According to a study by Dastani et al. (2015) in Gonabad University of Medical Sciences, the main purpose of social media usage in students are communication with old friends, nding new friends and entertainment (14).According to a study by Pouralajel et al., The higher the use of the Internet, the lower the students' grades, and in addition, better students' grades, was associated with less social media use (10).
Considering the widespread use of social media and its associated complications, the present study aims to investigate the social media usage pattern in Kurdistan University of Medical Sciences in 2018.

Materials And Methods
Participants and Setting: The present study is a cross-sectional-analytical study, which was conducted on students of Kurdistan University of Medical Sciences in 2018.The sample was consisted of 380 students from faculties of medicine, dentistry, nursery and midwifery, paramedics and health sciences, which were randomly selected by Probability Proportional to Size Sampling method from the list of the students in each faculty.
Data Collection: The data collection tool was a questionnaire designed by researchers that was completed by each participant and then collected and analysed.The content validity of the questionnaire was evaluated through a panel of experts.Also Cronbach's alpha coe cient was used in order to obtain its reliability.To calculate the Cronbach's alpha coe cient, 30 questionnaires were completed by students who had the inclusion criteria.The value of alpha was 0.83.The questionnaire was organized in 4 sections.The rst section included demographic information, the second section included questions regarding social media membership history, the third section included the quantitative and qualitative evaluations of social media usage and the last section for students who had account in social media that included questions regarding attitude assessment.The questionnaires were distributed and were provided to the participants after obtaining their consent.
Data Analysis: In this study relationship between time spent on social media and school of study was investigated between students of medicine, dentistry, nursery and midwifery, paramedical sciences and health sciences schools.Also for investigation relationship between the most important reasons for using social media and school of study and eld of study sample was divided into medicine school students and other schools students.SPSS software version 21 was used to enter the data.Central tendency, dispersion indices and ratio were used to describe the variables using tables and graphs (frequency and percentage).One-way analysis of variance, chi square,T-test and goodness of t test of chi-square was used for analytical analysis.A signi cance level of 5% was considered.

Ethical approval: This study was approved by the Ethics Committee and Research Council of Kurdistan
University of Medical Sciences.The questionnaire was distributed between students after inform them about our study goals and take the students informed consent to participate in our study.Students could refuse to answer our questionnaire.All clause of Declaration of Helsinki were done.Data was accessible only to the researchers and individual respondents.

Results
380 students were studied in terms of social media status in this cross-sectional study.168 (44.2%) of the students were male and 212 (55.8%) of them were female.Most of the participants were single (86.3%), and less than 25 years old (81.8%).373 of the sample students (98.2%) were on social media and 7 of them (1.8%) did not have any social media accounts.The three most popular social media platforms were Telegram (94.1%),Instagram (78.8%) and Whatsapp (61.9%), respectively]Table 1[.Most (83.9%) of the students who were on social media stated that they have been on social media for more than 2 years.The duration of membership in social media in female students is longer than male students.Among those who were aware of social media platforms and had membership, 294 (77.8%) became familiar through friends, 18 (4.8%) through the press, 61 (16.3%) through websites, 18 (4.8%)through television, 55 (14.7%) through university's ambience and 48 (12.9%) through factors other than the ones mentioned.The average time spent on social media among the studied population is 2.78 (±1.41) hours per day.There is a signi cant difference in time spent on social media among male and female students (p = 0.041), the average time spent online among girls is higher than boys.In other cases, there is no signi cant difference between the time spent online considering the students' school of study (P = 0.053) and Grade (P = 0.588) ]Table 2[.A total of 229 students (61.4%) of those who were on social media have stated that they do not accept friendship requests from strangers, 112 (30%) sometimes accept and 32 (8.6%) accept strangers' requests.348 (93.8%) of the students stated that their parents were aware of their membership in social media.164 (44.1%) of the students stated that their face to face communication has decreased due to social media.Also 321 (86.5%) of the students agreed to the importance of social media.A signi cant relationship was observed between school of study and information acquisition, entertainment.[Table 3].According to the results of one-way analysis of variance test, it can be concluded that there is no signi cant difference between the attitudes of students with different levels of education (P = 0.413).Also, there is no signi cant difference between different elds of study in terms of attitudes toward using social media (P = 0.176), but there is a signi cant difference between age groups in terms of attitudes toward using social media (P = 0.031).Of the 373 students who had accounts in the social media, 372 students responded to the attitude questionnaire, the evaluation of which 75% of students 75% of students said that if they had free time, they would spend their time in social media, which was very different from those who disagreed with this attitude.
76.9% of students said visiting social media is part of their schedule.72.8% of students believed that on social media, users are less likely to declare their personality and identity correctly and more likely to use nicknames and characters; Because they do not have the necessary con dence in this environment to tell the truth (P < 0.001) ]Table 4 placed at the end of the document [.The results also showed that female students use social media more than male students, while studies by  (31).It seems that restrictions on social, cultural, sports and other activities for girls, as well as special cultural circumstances in some areas and climates are the most important factors encouraging girls to spend more time on social media.
The results showed that 72.8% of students do not fully trust the media to express the truth, while Forqani and Mohajeri in a study conducted in 2018 on the level the students trust social media in Tehran, The level of trust was a bit more than medium (32).

Conclusion
The results of the present study showed that 98% of students are on social media, and the average time spent on social media was 2.78.Given that social media has become an integral part of human life and students spend a lot of time on it, it is worthwhile to create a culture of proper use of social media.Students' use of social media should be in line with scienti c attitude and educational purpose.Families and academic o cials need to use appropriate educational programs and proper management to provide a suitable environment for students to use social media properly. Declarations

Table 1 .
Frequency of membership in social media, personal account and total time spent on social media in participants.

Table 2 .
The relationship between time spent on social media and sex, school of study and grade

Table 3 .
Relationship between the most important reasons for using social media and school of

Table 4
(29)haya27)nd guragain, Dashti et al., As well as Anand et al., Showed that boys use social media more than girls(22, 26,27)Also Adiele and Olatokun's study on adults showed that the severity of Internet addiction in men is 3 to 1 compared to women (28).The study of Ghamari et al., on medical students in Arak considers being to be one of the risk factors for Internet addiction(29).Alamgir Khan et al., considers the amount of social media usage to be equal in both sexes (30) And Ahmer and Tanzil's study on Karachi medical students estimated that girls use social media more than boys, which is consistent with our study