ORIGINAL RESEARCH ARTICLE INTERNET ADDICTION AMONG STUDENTS OF SELECTED SCHOOLS OF POKHARA, NEPAL

Background : Internet is accessed by over billion users worldwide and continues to rise every year. A huge number of these users belong to teenagers and young adults that uses internet on daily basis for different purposes. The present study was conducted with the purpose to assess the internet addiction among adolescence. Methods: A cross-sectional study was conducted among students studying in selected schools of Pokhara, Nepal. A total 144 students were selected as sample using purposive sampling dur ing April/May 2019. Data collection was done using structured demographic proforma, Modified young 20 item internet Addiction Test. Self-administered method was used for data collection. Data were analyzed using descriptive and inferential statistics. Results: The study revealed among the 144 students mean age was 15.52 +1.17, two third 60.7% were from 16-20 years of age, 61.1 % were male, more than half 51.1% were from grade nine and starting mean age of the respondents was 11.78+2.4.Majority 85.4 % were using internet from more than one year,43.8% were spending one to two hour with internet users,65.3% of the respondents were using internet for recreation purpose, all most respondents 96.5 were using in - ternet in home,74.23% were using internet in mobile, starting mean age was 11.78+2.4.More than half 51.2% of the respondents had moderate to severe level of Internet addiction. Conclusions: Study findings shows moderate to severe level of Internet addiction. There was sig - nificant association between internet addiction and Internet using year, duration of internet use, spent with internet user and purpose of internet use.


INTRODUCTION
According to the internet society report internet user number reached to 3 billion peoples across the world. 1 The use of the internet has become an important part of adolescents' daily routines. Each day, adolescents make use of the internet for connecting and communicating with friends and family, and for academic as well as leisure activities. Researchers have agreed that internet use has brought numerous positive changes in human lives including promotion of psychological well-being. 2 Rapid expansion and proliferation of the internet has provided better opportunities for communication, information and social interaction. However, the excessive undisciplined use by some individuals has led to the emergence of the concept of internet addiction. 3. There were 10.21 million internet users in Nepal in January 2020. The number of internet users in Nepal increased by 315 thousand (+3.2%) between 2019 and 2020. Internet penetration in Nepal stood at 35% in January 2020. 4 The majority of internet users (14.2%) are 15-19-year olds. 5 A study conducted by CWIN-Nepal in which 1430 students from the inner city of Kathmandu participated, showed that out of the total respondent children 82% use internet. Among the children using internet, 74% were girls and 91% were boys. About 94.7% students from private schools and 58.3% from public schools use the internet. Of those, 59.5% spend 1-4 hours a week on the internet. 94.7% students from private schools and 58.3% from public schools use the Internet. 6 Thus this study was aimed to assess the internet addiction among adolescence and the association between demographic variables and use of internet among adolescence.

METHODS
A cross-sectional study was carried out in two selected schools of Pokhara, Nepal. Population of the study were adolescent students who were studying in grade 9 and 10. Data was collected from April 2019 to May 2019. Complete enumeration system was used so entire population was taken for sample size which included 144 students of 9 th and 10 th grade. Modified young internet Addiction Tool, 7 a 20-item questionnaire was translated and used for the study. Each answer was scored on a Likert scale from 0 to 3. Score0= Not applicable, 1=rarely, 2= occasionally, 3 = frequently. Internet addiction was categorized in four level; Normal<18.25, mild 18.25-24.5, moderate 24.6-32.0 and severe>32 in Quartile basis. Data was col lected in schools during school hours after getting data collec tion permission from the respective school principals. Eligible participants were explained about the purpose of the study and took verbal informed consent from them. Prior to data col lection, ethical approval was taken from the Institutional Ethical Committee of Manipal Teaching Hospital (MCOMS-IRC) and written informed consent was obtained from respondents 'parents. About 10% of the sample size was taken for conducting pilot study to find out the feasibility of the study, clarity of language of the tool and to finalize the plan for analysis while 10% of the sample size was taken for conducting reliability to find out the reliable of the study which was conducted in different school. Those students were similar in characteristics with actual samples of this study. The questionnaire was distributed to students in the classroom and returned back in the presence of researcher. Data entry and analysis was done using SPSS version 19. Both descriptive and inferential statistics was used for data analysis. p-value at <0.05 was considered significant. Table 1 revealed that among 144 respondents, more than half were from 16-20 years (50.7%) mean age was 15.52 +1.17, internet starting mean age was 11.78+2.4. Around 61.1 % were male, more than half (51.4%) were from grade 9, Majority (85.4 %) were using internet form more than one year, highest percentage were spending time in internet more than two hour (59.7%).   Table 2 showed almost (96.5%) of the respondents were using internet in home, highest of the respondents (74.3%) were using internet in mobile, more than half (54.2%) of the respondents were using internet during evening time.   Table 3 showed the significant association between levels of Internet addiction and Internet using year, duration of internet use, spent with internet user, objectives of internet user.

DISCUSSION
The present study revealed that more than half (51.2%) of the respondents had moderate to severe level of internet addiction whereas similar findings were reported by other study 8 in which 40.7% of the respondents reported moderate to severe addiction but in contrast to the findings of the study conducted in India 9 where 6.5% of the respondents had moderate to severe addiction. This variation may be due to study setting, tools used and Internet Addiction scoring cut-off points used in same tools in the studies.
About 60.7% were from 16-20 years of age which support the present study as two third 67.6% of internet using respondents were from 15 to 19 years of age group. This similar study showed that large proportion of the respondent 74.23% were using internet in mobile which is consistent with this study as majority 70.5% of the respondents were using mobile Phone and they are using it in the evening . 10 The respondents were using internet in mobile it may because of availability and affordability with the widespread adoption of home computers and smart phones and easy access to internet package of 3G/4G scheme on mobile phone. About 47.7% were male in this study which is consistent with the literature is the large susceptibility for males to be addicted to the Internet [11][12][13][14][15] whereas study conducted by Gupta et al contradicts the findings as female were more addicted to internet. 16 This study found respondents 52.0% use internet for more than 2 hour which is contrast with the result in turkey 17 as 63.3% was using the internet less than one hour. The present study reveals that the Purpose of internet was recreation among the respondents was 53.0 % which is consistent with study conducted by Karacic et.al. 18 The present study reveals there was no association between age, gender, grades in same way which is consistent with other studies. 19,20 However, the result constant with the findings 21 which showed significant association of internet addiction with age of the respondent.
The study was conducted among two Private schools only of Pokhara, Nepal with self-administered questionnaire. Due to this, the generalizability of this study finding to all adolescent Internet users in Nepal is a matter of concern.
CONCLUSION This study found more than half of the respondents had moderate to severe level of Internet addiction. There is association between Internet addiction and Internet using year, duration of internet use, spent with internet user. It also reveals that the place of internet use was home it is understood that though internet has become one of the most significant information resources for adolescents, unfortunately, the almost half of adolescent population has the problem of addiction.

ACKNOWLEDGEMENT
Our Special thanks to Participants of school children for cooperation during Data Collection and thanks to Ms. Manmaya Rana, MCOMS for helping in Data Collection.