European Journal of Investigation in Health, Psychology and Education · 4 authors, 2 centres
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This cross-sectional study of 486 nursing students in Spain found that 60.4% spend 20+ hours per week online and 96% search for health information on the internet at least annually. While 82.1% make health decisions based on online information, only 31.1% feel confident about the information they find, highlighting a gap between internet reliance and critical appraisal skills among future healthcare professionals.
**Background:** The use of the internet and information technologies has become indispensable for young university students, offering ease and speed in searching for information and enabling health-related decision-making. Internet addiction, first described by Dr. Kimberly Young in 1996, manifests as a disturbance of control over use with cognitive, behavioral, and physiological symptoms. Health risk factors associated with internet abuse—including depression, anxiety, insomnia, and vision problems—have been rising. Nursing students, as future health agents, need to understand how people use online information for health decisions to provide appropriate care. This study aimed to analyze internet and social network use in relation to health and decision-making processes among nursing students.
**Methods:** A cross-sectional survey was conducted during the first quarter of 2022 among first- through fourth-year nursing students at Gimbernat University School of Barcelona, Spain. A total of 486 students participated voluntarily (406 women, 83.5%; 79 men, 16.3%; 1 non-binary person, 0.2%). The mean age was 22.2 years. Most respondents were first-year (36.4%) or second-year (31.5%) students. Data were collected via a self-administered 39-item structured questionnaire adapted from a Kaiser Family Foundation study, completed online through Google platform. Variables included sociodemographics, perceived health, frequency and conditions of internet/social network use, motives for health information seeking, and satisfaction with information found. Statistical analysis was performed using R Project software with descriptive analysis (frequencies, percentages) and correlation analysis (contingency coefficients). The study was approved by the Institutional Management of Gimbernat University Schools (February 2022) and conducted in accordance with the Declaration of Helsinki.
**Key Results:** Internet abuse (defined as ≥20 hours/week) was found in 60.4% of students, with minimal gender difference (60.7% of women vs. 59.5% of men). For social networks, 43.6% spent more than 20 hours/week, with a difference between women (42.4%) and men (35.5%). Regarding messaging, 42.4% of women were online more than 20 hours/week and 7.9% more than 40 hours/week, compared to 35.5% and 5.1% of men, respectively. Of all students, 96% searched for health information on the internet at least once a year: 42.2% searched monthly, 28.6% weekly, 25.5% a few times a year, and 3.3% daily. Only 0.4% never searched for health information online. A total of 82.1% reported making health decisions using internet information, and 62.3% resolved their doubts based on this information. However, only 31.1% felt confident about the information they found, while 37.7% were unsure how to use it. Regarding self-perceived health, 74.2% rated their health as good or very good (8.8% very good, 65.4% good), 23.5% as fair, and 2.3% as poor. Correlation analysis showed positive associations between age and internet use (contingency coefficient 0.50) and social network use (Phi 0.66). A positive correlation (0.37) was found between using internet/social media information and making health decisions. From a gender and age perspective, the correlation for making health decisions using internet information was 0.20 and 0.52, respectively.
**Clinical Implications:** The high proportion of nursing students (60.4%) exceeding 20 hours/week online and the finding that 82.1% make health decisions based on internet information—yet only 31.1% feel confident about that information—reveal a critical gap in digital health literacy among future healthcare professionals. As 96% of students use the internet for health information, but many lack confidence in evaluating sources, there is an urgent need to integrate digital literacy training into nursing curricula. Teaching students to critically appraise online health information could optimize their use of resources and improve their ability to guide patients. Nurses, as key health education professionals, can become strategic players in public health by promoting proper internet use and helping other generations navigate health information online. The study's limitations include its cross-sectional design (precluding causal inference), potential under-representation of some groups, and limited generalizability due to its single-region focus in Spain.