Üniversite Öğrencilerinin Psikolojik Sıkıntı Düzeyleri ve Sosyal Ağlardan Sosyal Destek Beklentileri

Abstract

University Students' Levels of Psychological Distress and Expectations of Social Support From Social Networks Üniversite Öğrencilerinin Psikolojik Sıkıntı Düzeyleri ve Sosyal Ağlardan Sosyal Destek Beklentileri Nihan Altan Sarıkaya1, Büşra Sanal2 1Department of Mental Health and Psychiatric Nursing, Faculty of Health Sciences, Trakya University, Edirne/Turkey 2Department of General Surgery, Edirne Sultan 1. Murat State Hospital, Edirne/Turkey e-mail:[e-mail], [e-mail] ORCID: 0000-0002-3678-6186 ORCID: 0009-0001-3154-9640 *Sorumlu Yazar / Corresponding Author: Nihan ALTAN SARIKAYA Gönderim Tarihi / Received: Kabul Tarihi / Accepted: DOI: 10.34087/cbusbed. Öz Giriş ve Amaç: Üniversite yaşamında karşılaşılan zorluklar, bireylerin psikolojik dayanıklılığını azaltarak, çevrelerinden yardım arama davranışlarına yönlendirebilmektedir. Bu çalışmanın amacı, üniversite öğrencilerinin yaşadıkları psikolojik sıkıntı düzeyleri ile sosyal ağlardan sosyal destek beklenti düzeylerini belirlemek ve arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Bu tanımlayıcı ve ilişki arayıcı çalışmanın örneklemini bir üniversitenin sağlık bilimleri fakültesinde öğrenim gören öğrenciler (n=340) oluşturmaktadır. Veriler Katılımcı Bilgi Formu, Kessler Psikolojik Sıkıntı Ölçeği ve Sosyal Ağlardan Sosyal Destek Beklentisi Ölçeği kullanılarak toplanmıştır. Bulgular: Üniversite öğrencilerinin psikolojik sıkıntı düzeyleri 33,37±7,97, sosyal ağlardan sosyal destek beklenti düzeyleri ise 33,36±10,10 olarak bulunmuştur. Öğrencilerin psikolojik sıkıntı düzeyleri ile sosyal ağlardan sosyal destek beklenti düzeyleri arasında istatistiksel olarak anlamlı, pozitif yönlü ve düşük düzeyli bir ilişki vardır (p<0.05). Sonuç: Çalışmada, üniversite öğrencilerinin psikolojik sıkıntı düzeyleri arttıkça sosyal ağlardan sosyal destek beklentileri artmaktadır. Üniversitelerin öğrencilerine yönelik sosyal medya okuryazarlığı eğitimlerini arttırması ve stresle baş etme, psikolojik dayanıklılık ile sosyal destek konularında seminer ve psikoeğitim çalışmalarının düzenlenmesi önerilmektedir. Anahtar kelimeler: Psikolojik sıkıntı, ruhsal sıkıntı, sosyal ağ, sosyal destek, üniversite öğrencisi Abstract Aim: Difficulties encountered in university life can reduce individuals’ psychological resilience and lead them to seek help from their surroundings. The purpose of this study was to determine the psychological distress levels experienced by university students and the levels of social support expectations from social networks, and to investigate the relationship between them. Method: This descriptive and correlational study sample consisted of 340 students studying at a university's Faculty of Health Sciences (n=340). Data were collected using the Participant Information Form, Kessler Psychological Distress Scale, and Social Support Expectation in Social Networks Scale. Results: The psychological distress levels of university students were found to be 33.37±7.97, and the social support expectation levels from social networks were found to be 33.36±10.10. There was a statistically significant, positive, and low-level relationship between the psychological distress levels of students and social support expectation levels from social networks (p<0.05). Conclusion: As the psychological distress levels of university students increased, their social support expectations from social networks increased. It is recommended that university students increase their social media literacy training, organize seminars on coping with stress, psychological resilience, and reliable social support sources, and organize psychoeducation studies. Keywords: Psychological distress, mental distress, social network, social support, university student 1. Introduction University life, which coincides with the transition to adulthood and requires rapid adaptation to a new life, is considered to be a period of intense stress and psychological distress for many students. Psychological distress can be defined as a disturbing emotional state that begins with a person's perception that they cannot cope with stressors, resulting in temporary or permanent harm to themselves [1]. It is emphasized that psychological distress is more common and felt more intensely in students who start university compared to adults in the general population or individuals of the same age who do not attend university [2]. In a study conducted with university students in Norway in 2010, 2014, and 2018, it was emphasized that both the psychological distress levels of the students and the increase in psychological distress levels over the years were at a worrying level [3]. In a similar study conducted with university students in recent years, 69.5% of students experienced serious psychological distress [4]. The difficulties encountered in university life can reduce the psychological resilience of individuals and lead them to seek help from their environment [5]. In recent years, the use of social networking sites has also greatly changed the way social support is provided [6]. Social networking sites are also used today as sources of interpersonal communication and social support [7]. While social support plays a protective role in individuals' stress-coping processes, social support received through social networks has positive effects on psychological well-being [8]. Tammemi et al. [4] found that 70.6% of university students use social media platforms to cope with psychological distress. Al-Asibong et al. [9] found that psychological distress is seen at a high level among university students and that psychological distress is more common in those who use social networking sites less. Social media platforms, which are widely used, especially among young adults, are used not only for sharing information but also for regulating their psychological states [9]. This situation necessitates questioning the extent to which social networks are effective in meeting individuals’ psychological needs. In this context, research is needed to better understand the social support expectation levels of students with psychological distress from social networks. This study contributes to the literature on the social support function of social networks, especially in the digital age, to better understand the help-seeking behaviors of young adults and the impact of social media platforms on young people. In this context, this study aimed to determine and examine the relationship between the psychological distress levels experienced by university students and their expectations of social support from social networks. For this purpose, the following questions were asked: 1. What are the psychological distress levels of the university students? 2. What are the levels of students' expectations of social support from social networks? 3. Is there a relationship between the psychological distress levels of students and their expectations of social support from social networks? 2. Materials and Methods 2.1 Research Design This descriptive and correlational study was conducted among students studying at the Faculty of Health Sciences of a public university between April and June 2023. 2.2 Population and Sample The universe of the study consisted of 2295 students continuing their education at the faculty. The sample in the study was calculated using the sample calculation formula with a known universe in a single-sample design (n=Nt2pq/d2(N-1)+t2pq) [10]. According to this formula, at least 330 students should be included in the sample at a 95% confidence level, a tolerance rate not exceeding 0.05, and an 80% power. Considering that there may be data loss in the study, 340 students were included in the study. The study was conducted by 340 students. 2.3 Inclusion Criteria Students studying at the Faculty of Health Sciences were included in this study. 2.4 Exclusion Criteria Students who were unwilling to participate in the study were excluded. 2.5 Data Collection Before data collection, all the students were informed of the research purpose and confidentiality. Those who agreed to participate completed the data collection forms. Each participant took 13 min to fill out the forms. 2.6 Data Collection Instruments The data of the study were obtained using the “Participant Information Form”, “Kessler Psychological Distress Scale (K10-PDS)”, and “Social Support Expectation in Social Networks Scale (SSESNS)”, which took approximately 13 minutes. 2.6.1 Participant Information Form This form included five questions about university students’ age, gender, social media usage time, purpose of using social media, and the most frequently used social media application. 2.6.2 Kessler Psychological Distress Scale (K10-PDS) The validity and reliability of the scale developed by Kessler et al. [11] in Turkey was assessed by Altun et al. [12]. The scale evaluates the level of symptoms, such as irritability, hopelessness, sadness, worthlessness, and fatigue in individuals. The scale is a five-point Likert-type scale (from 1 (never) to 5 (always)) and consists of 10 questions. The lowest score can be obtained on a scale of 10, and the highest is 50. The Cronbach’s alpha value of the scale was 0.95. The Cronbach alpha reliability coefficient in the study was found to be α=0.89. 2.6.3 Social Support Expectation in Social Networks Scale (SSESNS) The scale, the validity and reliability of which were assessed by Uzakgiden and Erozkan in 2019 [13], has a total of 14 items. The scale was scored on a four-point Likert scale (1= never, 2= rarely, 3= frequently, 4= always). The lowest score that can be obtained from the scale is 14 and the highest score is 56. Increasing scores on the scale indicate that individuals' expectations of social support from social networks increase, while decreasing scores indicate that their expectations of social support decrease. The total Cronbach alpha reliability coefficient of the scale is stated as α=0.85 (3). In this study, Cronbach’s alpha reliability coefficient was 0.94. 2.7 Variables of the Study The dependent variables were the average scores on the K10-PSD and the SSESNS. The independent variable in the study was the descriptive characteristics questionnaire ( age, sex, duration of social media use, purpose of social media use, and the most frequently used social media application). 2.8 Ethical Considerations The study was approved by the Ethics Committee of a University (TÜTF-GOBAEK 2022/441- Date 09.01.2023 and No: 01/38). Permission was obtained from the Faculty of Health Sciences of a public university. Informed consent was obtained from all the students. This study was conducted in accordance with the principles of the Declaration of Helsinki. Permissions for the use of the scale were obtained from researchers who tested the validity and reliability of the scales in Turkish. 2.9 Data Analysis The Statistical Package for Social Science for Windows 21 (SPSS 21) program was used for statistical analysis. Normal distribution of the data was evaluated using the Shapiro-Wilk test. In the data analysis, arithmetic mean, standard deviation, and median values were used for ordinal variables, and percentages and frequencies were used for nominal variables. Pearson’s correlation analysis was used to determine the relationships between ordinal variables. Statistical significance was set at p<0.05. 3. Results and Discussion 3.1 Result The average age of the students participating in the study is 20.60±1.67 (min: 18, max: 26). Of the students, 82.4% were female. When the answers given by the students to the questions about their social media usage were evaluated, it was determined that 50.6% of the students used social media for 4-6 hours, used social media mostly for communication with family, friends, and other social circles, and used the social media application Instagram the most (Table 1). Table 1: Descriptive characteristics of participants Variables Mean±SD Age 20.60±1.67 (minimum:18-maximum:26) n % Gender Female 280 82.4 Male 60 17.6 Social media usage time Less than 1 hour 9 2.6 1-3 hours 117 34.4 4-6 hours 172 50.6 7 hours and above 42 12.4 Purpose of using social media* Entertainment/games 211* 62.1 Communication with family, friends and other social circles 286 84.1 Getting news 232 68.2 Getting information 247 72.6 Personal sharing (sharing personal photos, videos, pictures, ideas) 194 57.1 Most frequently used social media application* Facebook 4 1.2 Instagram 220 64.7 Snapchat 27 7.9 Twitter 53 15.6 Youtube 76 22.4 WhatsApp 143 42.1 Tiktok 7 2.1 SD: Standart deviation; *: Since more than one marking was made, n was multiplied. The first research question was, “What are the psychological distress levels of university students?” Students had a mean K10-PSD score of 33.37±7.97. The second research question wasWhat are the students’ expectation levels of social support from social networks?”. Students had a mean SSESNS score of 33.36±10.10. Table 2 presents the results. Table 2. Participants' total K10-PSD and SSESNS score averages X±SD Scale min-max. K10-PSD Total 33.37±7.97 10-50 SSESNS Total 33.36±10.10 14-56 X: Mean; SD: Standart deviation; Min: minimum; Max: Maximum The third research question was, “Is there a relationship between students’ psychological distress levels and their social support expectation levels from social networks?”. According to the Pearson Correlation analysis in Table 3, a significant positive correlation was found between students’ K10-PSD and SSESNS total scores (r = .119, p<0.05). Table 3. The relationship between K10-PSD and SSESNS K10-PSD Total SSESNS Total r .119* p .028 r: Pearson’s correlation; p: p<0.05 3.2 Discussion This study is important in terms of revealing the relationship between the psychological distress levels of university students and their social support expectations from social networks, and in terms of better understanding the social support expectations of students with psychological distress from social networks. Three important findings were obtained in this study. The first finding was that the psychological distress levels of university students were above average, whereas the second important finding was that the social support expectations of students from social networks were below average. The third important finding was that as students' psychological distress increased, their expectations of social support from social networks also increased. Psychological distress emerges as a concept that describes students' psychological well-being. The psychological distress of university students, which is increasing daily, is an important problem that affects students. In our study, it was determined that the psychological distress levels of the students were above average. Knapstad et al. [3] highlighted the potential increase in self-reported psychological distress among Norwegian students in higher education as a concern. A study among university students in China found that at least 40.7% of students had at least one symptom of psychological distress [14]. A study conducted by Hakami [15] with undergraduate students at Jazan University reported that approximately 31% of the students were psychologically distressed. March-Amengual et al. [16] conducted a study with first-year university students in Spain and found that 27.1% of the students experienced psychological distress. A study conducted by Ramon-Arbues et al. [17] with nursing students in Northern Spain reported that symptoms of psychological distress were significantly prevalent among participants. Collin et al. [18] conducted a study in the UK in which dental students participated and found that students experienced high levels of psychological distress, stress, and burnout. Salvarani et al. [19] conducted a study with university students, 70.9% of the participants reported experiencing psychological distress. Pehlivan et al. [20] conducted a study with university students in Turkey, finding that 78.2% of the students experienced stress. When the results of studies conducted with students studying in various fields and at all levels of education were evaluated, it was observed that a significant portion of university students experienced high levels of psychological distress, and these results were similar to those of our study. Social support is a protective factor for individuals in coping with life difficulties. The expectation of social support on social networks is that when an individual experiences intense emotions and shares the situation or emotions they experience on social networking sites, they expect interest, sincere, and friendly approaches from people and hope that they are not alone and that an environment of support and trust will be created through social networks [13]. Yılmaz [21] stated that communication established on social networks is perceived as social support by young people. In the research conducted by Balcı and Kaya [22], it was emphasized that social networks have an important position in increasing emotional support. The same study stated that young people seek more emotional support on social networks and use social media for this purpose [22]. In our study, it was determined that students' social support expectations from social networks were below average, and that the most common purpose of using social networks was communication with the environment. In his thesis study, Üstündağ [23] stated that social media is a communication tool for adolescents and concluded that there is a significant and positive relationship between adolescents' social support perception levels and their social network usage purposes. In the research conducted by Ürkmez and Eskicumalı [24], it was stated that social networks are used for information sharing and socialization purposes. In the research conducted by Karadaş et al. [25] with university students, it was reported that the participants used social networks to follow the agenda, share, and as a means of entertainment and communication. The results obtained in the literature review revealed the support expectations of today's young people from social networks. As a result of our study, it was determined that as students' psychological distress increases, their expectations of social support from social media also increase. Clark et al. [8] emphasized in their research that the positive use of social networks supports the increase in connections for social support. Consequently, it was stated that the needs of users to belong and be accepted were met [8]. Balcı and Kaya [22] described social media as a tool used by the young segment of society when they feel sad and lonely or want to escape their problems. Shiraly et al. [26] concluded in their research that students with high levels of psychological distress spend more time on social media. Similarly, Sampasa-Kanyiga and Lewis [27] determined in their research that students with poor mental health use social networking sites more. In the research conducted by Lin et al. [28], it was stated that the rate of problematic social media use of students with low levels of psychological distress is also low. Lake Yimer [29] concluded in his research with university students that students who use social media more often have lower levels of psychological well-being. Sun [30] emphasized in his research that people who experience psychological problems such as anxiety and loneliness can use social networks as a coping mechanism by receiving social support from social networks. Pop et al. [31] reported in their research with young social network users that people who spend more time on social networks have higher loneliness and depression scores. Similarly, Karakuş and Tarhan [32] observed that lonely people spend more time on social media. The results obtained in line with our study and the literature suggest that young adults see social networks as a place where they can get support when they feel lonely, stressed, and sad, and use them for this purpose. The fact that the study was conducted only with students studying at the Faculty of Health Sciences of a state university and that the data were based on subjective statements prevents the generalization of the study results. It is recommended that future studies be conducted with larger samples, and that students' perceived experiences of social support from social networks be examined in more depth using qualitative methods. 4. Conclusion Our study found that university students’ psychological distress was higher than moderate and their expectations of social support from social networks were lower than moderate. Another important finding of our study is that as students’ psychological distress increases, their expectations of social support from social media also increase. Considering these findings, awareness of psychological distress experienced by university students should be increased, and the accessibility of psychological counseling and guidance services at universities should be increased. Students’ expectations of social support from social networks increase in the face of psychological distress. In this context, it is important to increase social media literacy training for university students and organize seminars and psychoeducation studies on coping with stress, psychological resilience, and reliable social support sources. 5. Acknowledgements We thank all students who participated in the research. 6. Referanslar 1. Ridner, S.H. Psychological distress: concept analysis. Journal of advanced nursing, 2004;45(5):536-545. 2. Sharp, J., Theiler, S. A review of psychological distress among university students: Pervasiveness, implications and potential points of intervention. International Journal for the Advancement of Counselling, 2018;40:193-212. 3. Knapstad, M., Sivertsen, B., et al. Trends in self-reported psychological distress among college and university students from 2010 to 2018. Psychological medicine, 2021;51(3):470-478. 4. Al-Tammemi, A.B., Akour, A., et al. Is it just about physical health? An online cross-sectional study exploring the psychological distress among university students in Jordan in the midst of COVID-19 pandemic. Frontiers in Psychology, 2020;11:562213. 5. Wadman, R., Webster, L.A.D., et al. Help-seeking and psychological distress in university students: Findings from a cross-sectional online survey in the UK. European Psychiatry, 2017;41:184-185. 6. McCloskey, W., Iwanicki, S., et al. Are Facebook “friends” helpful? Development of a Facebook-based measure of social support and examination of relationships among depression, quality of life, and social support. Cyberpsychology, Behavior, and Social Networking, 2015;18(9):499-505. 7. Gilmour, J., Machin, T., et al. Facebook-based social support and health: A systematic review. Psychology of popular media, 2020; 9(3):328. 8. Clark, J.L., Algoe, S.B., et al. Social Network Sites and Well-Being: The Role of Social Connection. Current Directions in Psychological Science. 2018, 27(1): 32-37. https://doi.org/10.1177/0963721417730833 9. Al-Asibong, U., Okafor, C. J., et al. Psychological distress and social media usage: A survey among undergraduates of a university in Calabar, Nigeria. Nigerian Postgraduate Medical Journal, 2020;27(2):115. 10. Yıldız, S. Sosyal bilimlerde örnekleme sorunu: Nicel ve nitel paradigmalardan örnekleme kuramina bütüncül bir bakiş. Kesit Akademi Dergisi, 2017;(11):421-442. 11. Kessler, R. C., Andrews, G., et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological medicine, 2002;32(6):959-976. 12. Altun, Y., Özen, M., et al. Psikolojik Sıkıntı Ölçeğinin Türkçe uyarlaması: Geçerlilik ve güvenilirlik çalışması. Anatolian Journal of Psychiatry, 2019; 20. 13. Uzakgiden, A.M. Erözkan, A. Sosyal ağlarda sosyal destek beklentisi: Ölçek geliştirme, güvenirlik ve geçerlik çalışması. Ege Bilimsel Araştırmalar Dergisi, 2019;2(1):20-33. 14. Tang, F., Byrne, M., et al. Psychological distress and risk for suicidal behavior among university students in contemporary China. Journal of affective disorders, 2018;228:101-108. 15. Hakami, R. M. Prevalence of psychological distress among undergraduate students at Jazan University: A cross-sectional study. Saudi journal of medicine & medical sciences, 2018;6(2):82-88. 16. March-Amengual, J.M, Cambra Badii, I., et al. Psychological Distress, Burnout, and Academic Performance in First Year College Students. Int J Environ Res Public Health, 2022;9(6):3356. doi: 10.3390/ijerph19063356. 17. Ramón-Arbués, E., Granada-López, J.M., et al. Psychological distress in nursing students: relationship with screen time, diet and physical activity. Rev Lat Am Enfermagem, 2023;21;31:e3959. doi: 10.1590/1518-8345.6746.3959. 18. Collin, V., O'Selmo, E., et al. Stress, psychological distress, burnout and perfectionism in UK dental students. Br Dent J, 2020;229(9):605-614. doi: 10.1038/s41415-020-2281-2284. 19. Salvarani, V., Ardenghi, S., et al. Predictors of psychological distress amongst nursing students: A multicenter cross-sectional study. Nurse Educ Pract, 2020;44:102758. doi: 10.1016/j.nepr.2020.102758. 20. Pehlivan, Ş,. Tokur Kesgi, N.M., et al. Psychological distress and mental health literacy in university students. Perspect Psychiatr Care, 2021;57(3):1433-1441. doi: 10.1111/ppc.12709. 21. Yılmaz, E.A. Üniversite öğrencilerinin pandemi döneminde sosyal medya kullanımları ve algıladıkları sosyal destek arasındaki ilişki: Konya İli Örneği. Akademi Sosyal Bilimler Dergisi, 2022;9(26):171-189. 22. Balcı, Ş., Kaya, E. Sosyal medyada algılanan sosyal desteğin, yaşam doyumu üzerindeki etkinliği: Üniversite gençliği araştırması. Akdeniz Üniversitesi İletişim Fakültesi Dergisi, 2021;(36):47-71. 23. Üstündağ, A. Ergenlerin sosyal medya kullanım amaçları ile sosyal destek algıları arasındaki ilişkinin incelenmesi. Uludağ Üniversitesi Fen-Edebiyat Fakültesi Sosyal Bilimler Dergisi, 2022;23(42):169-190. 24. Ürkmez, S., Eskicumalı, A. Kullanımlar ve doyumlar teorisi çerçevesinde covid-19 pandemi sürecinde bireylerin sosyal medya kullanım motivasyonları: Instagram örneği. Sosyal, Beşerî ve İdari Bilimler Dergisi, 2021;4(2):111-129. 25. Karadaş, M.M., Koç, G., et al. Öğrenci hemşirelerin sosyal medya kullanımı, kullanım amaçları ve etik boyutu. Gazi Sağlık Bilimleri Dergisi, 2021;6(1):11-21. 26. Shiraly, R., Roshanfekr, A., et al. Psychological distress, social media use, and academic performance of medical students: the mediating role of coping style. BMC Med Educ, 2024;13;24(1):999. doi: 10.1186/s12909-024-05988-w. 27. Sampasa-Kanyinga, H., Lewis, R.F. Frequent use of social networking sites ıs associated with poor psychological functioning among children and adolescents. Cyberpsychol Behav Soc Netw., 2015;18(7):380-5. doi: 10.1089/cyber.2015.0055. 28. Lin, C.Y., Namdar, P., et al. Mediated roles of generalized trust and perceived social support in the effects of problematic social media use on mental health: A cross-sectional study. Health Expect,, 2021;24(1):165-173. doi: 10.1111/hex.13169. 29. Lake Yimer, B. Social media usage, psychosocial wellbeing and academic performance. Community Health Equity Res Policy, 2023;43(4):399-404. doi: 10.1177/0272684X211033482. 18. 30. Sun, L. Social media usage and students' social anxiety, loneliness and well-being: does digital mindfulness-based intervention effectively work? BMC Psychol., 2023;31:11(1):362. doi: 10.1186/s40359-023-01398-7. 31. Pop, L.M., Iorga, M., et al. Body-Esteem, self-esteem and loneliness among social media young users. Int J Environ Res Public Health, 2022;21:19(9):5064. doi: 10.3390/ijerph19095064. 32. Karakuş, M., Tarhan, A. Yükseköğretim öğrencilerinin sosyal medya kullanımları ve yalnızlık düzeyleri arasındaki ilişki. İletişim ve Toplum Araştırmaları Dergisi, 2023;3(2):209-232. http://edergi.cbu.edu.tr/ojs/index.php/cbusbed isimli yazarın CBU-SBED başlıklı eseri bu Creative Commons Alıntı-Gayriticari4.0 Uluslararası Lisansı ile lisanslanmıştır.

Keywords

• Psikolojik sıkıntı
• ruhsal sıkıntı
• sosyal ağ
• sosyal destek
• üniversite öğrencisi

University Students' Levels of Psychological Distress and Expectations of Social Support From Social Networks

Abstract

University Students' Levels of Psychological Distress and Expectations of Social Support From Social Networks Üniversite Öğrencilerinin Psikolojik Sıkıntı Düzeyleri ve Sosyal Ağlardan Sosyal Destek Beklentileri Nihan Altan Sarıkaya1, Büşra Sanal2 1Department of Mental Health and Psychiatric Nursing, Faculty of Health Sciences, Trakya University, Edirne/Turkey 2Department of General Surgery, Edirne Sultan 1. Murat State Hospital, Edirne/Turkey e-mail:[e-mail], [e-mail] ORCID: 0000-0002-3678-6186 ORCID: 0009-0001-3154-9640 *Sorumlu Yazar / Corresponding Author: Nihan ALTAN SARIKAYA Gönderim Tarihi / Received: Kabul Tarihi / Accepted: DOI: 10.34087/cbusbed. Öz Aim: Difficulties encountered in university life can reduce individuals’ psychological resilience and lead them to seek help from their surroundings. The purpose of this study was to determine the psychological distress levels experienced by university students and the levels of social support expectations from social networks, and to investigate the relationship between them. Method: This descriptive and correlational study sample consisted of 340 students studying at a university's Faculty of Health Sciences (n=340). Data were collected using the Participant Information Form, Kessler Psychological Distress Scale, and Social Support Expectation in Social Networks Scale. Results: The psychological distress levels of university students were found to be 33.37±7.97, and the social support expectation levels from social networks were found to be 33.36±10.10. There was a statistically significant, positive, and low-level relationship between the psychological distress levels of students and social support expectation levels from social networks (p<0.05). Conclusion: As the psychological distress levels of university students increased, their social support expectations from social networks increased. It is recommended that universities increase social media literacy training for students and organize seminars and psychoeducational programs focusing on stress coping strategies, psychological resilience and social support. Anahtar kelimeler: Psikolojik sıkıntı, ruhsal sıkıntı, sosyal ağ, sosyal destek, üniversite öğrencisi Abstract Aim: Difficulties encountered in university life can reduce individuals’ psychological resilience and lead them to seek help from their surroundings. The purpose of this study was to determine the psychological distress levels experienced by university students and the levels of social support expectations from social networks, and to investigate the relationship between them. Method: This descriptive and correlational study sample consisted of 340 students studying at a university's Faculty of Health Sciences (n=340). Data were collected using the Participant Information Form, Kessler Psychological Distress Scale, and Social Support Expectation in Social Networks Scale. Results: The psychological distress levels of university students were found to be 33.37±7.97, and the social support expectation levels from social networks were found to be 33.36±10.10. There was a statistically significant, positive, and low-level relationship between the psychological distress levels of students and social support expectation levels from social networks (p<0.05). Conclusion: As the psychological distress levels of university students increased, their social support expectations from social networks increased. It is recommended that university students increase their social media literacy training, organize seminars on coping with stress, psychological resilience, and reliable social support sources, and organize psychoeducation studies. Keywords: Psychological distress, mental distress, social network, social support, university student 1. Introduction University life, which coincides with the transition to adulthood and requires rapid adaptation to a new life, is considered to be a period of intense stress and psychological distress for many students. Psychological distress can be defined as a disturbing emotional state that begins with a person's perception that they cannot cope with stressors, resulting in temporary or permanent harm to themselves [1]. It is emphasized that psychological distress is more common and felt more intensely in students who start university compared to adults in the general population or individuals of the same age who do not attend university [2]. In a study conducted with university students in Norway in 2010, 2014, and 2018, it was emphasized that both the psychological distress levels of the students and the increase in psychological distress levels over the years were at a worrying level [3]. In a similar study conducted with university students in recent years, 69.5% of students experienced serious psychological distress [4]. The difficulties encountered in university life can reduce the psychological resilience of individuals and lead them to seek help from their environment [5]. In recent years, the use of social networking sites has also greatly changed the way social support is provided [6]. Social networking sites are also used today as sources of interpersonal communication and social support [7]. While social support plays a protective role in individuals' stress-coping processes, social support received through social networks has positive effects on psychological well-being [8]. Tammemi et al. [4] found that 70.6% of university students use social media platforms to cope with psychological distress. Al-Asibong et al. [9] found that psychological distress is seen at a high level among university students and that psychological distress is more common in those who use social networking sites less. Social media platforms, which are widely used, especially among young adults, are used not only for sharing information but also for regulating their psychological states [9]. This situation necessitates questioning the extent to which social networks are effective in meeting individuals’ psychological needs. In this context, research is needed to better understand the social support expectation levels of students with psychological distress from social networks. This study contributes to the literature on the social support function of social networks, especially in the digital age, to better understand the help-seeking behaviors of young adults and the impact of social media platforms on young people. In this context, this study aimed to determine and examine the relationship between the psychological distress levels experienced by university students and their expectations of social support from social networks. For this purpose, the following questions were asked: 1. What are the psychological distress levels of the university students? 2. What are the levels of students' expectations of social support from social networks? 3. Is there a relationship between the psychological distress levels of students and their expectations of social support from social networks? 2. Materials and Methods 2.1 Research Design This descriptive and correlational study was conducted among students studying at the Faculty of Health Sciences of a public university between April and June 2023. 2.2 Population and Sample The universe of the study consisted of 2295 students continuing their education at the faculty. The sample in the study was calculated using the sample calculation formula with a known universe in a single-sample design (n=Nt2pq/d2(N-1)+t2pq) [10]. According to this formula, at least 330 students should be included in the sample at a 95% confidence level, a tolerance rate not exceeding 0.05, and an 80% power. Considering that there may be data loss in the study, 340 students were included in the study. The study was conducted by 340 students. 2.3 Inclusion Criteria Students studying at the Faculty of Health Sciences were included in this study. 2.4 Exclusion Criteria Students who were unwilling to participate in the study were excluded. 2.5 Data Collection Before data collection, all the students were informed of the research purpose and confidentiality. Those who agreed to participate completed the data collection forms. Each participant took 13 min to fill out the forms. 2.6 Data Collection Instruments The data of the study were obtained using the “Participant Information Form”, “Kessler Psychological Distress Scale (K10-PDS)”, and “Social Support Expectation in Social Networks Scale (SSESNS)”, which took approximately 13 minutes. 2.6.1 Participant Information Form This form included five questions about university students’ age, gender, social media usage time, purpose of using social media, and the most frequently used social media application. 2.6.2 Kessler Psychological Distress Scale (K10-PDS) The validity and reliability of the scale developed by Kessler et al. [11] in Turkey was assessed by Altun et al. [12]. The scale evaluates the level of symptoms, such as irritability, hopelessness, sadness, worthlessness, and fatigue in individuals. The scale is a five-point Likert-type scale (from 1 (never) to 5 (always)) and consists of 10 questions. The lowest score can be obtained on a scale of 10, and the highest is 50. The Cronbach’s alpha value of the scale was 0.95. The Cronbach alpha reliability coefficient in the study was found to be α=0.89. 2.6.3 Social Support Expectation in Social Networks Scale (SSESNS) The scale, the validity and reliability of which were assessed by Uzakgiden and Erozkan in 2019 [13], has a total of 14 items. The scale was scored on a four-point Likert scale (1= never, 2= rarely, 3= frequently, 4= always). The lowest score that can be obtained from the scale is 14 and the highest score is 56. Increasing scores on the scale indicate that individuals' expectations of social support from social networks increase, while decreasing scores indicate that their expectations of social support decrease. The total Cronbach alpha reliability coefficient of the scale is stated as α=0.85 (3). In this study, Cronbach’s alpha reliability coefficient was 0.94. 2.7 Variables of the Study The dependent variables were the average scores on the K10-PSD and the SSESNS. The independent variable in the study was the descriptive characteristics questionnaire ( age, sex, duration of social media use, purpose of social media use, and the most frequently used social media application). 2.8 Ethical Considerations The study was approved by the Ethics Committee of a University (TÜTF-GOBAEK 2022/441- Date 09.01.2023 and No: 01/38). Permission was obtained from the Faculty of Health Sciences of a public university. Informed consent was obtained from all the students. This study was conducted in accordance with the principles of the Declaration of Helsinki. Permissions for the use of the scale were obtained from researchers who tested the validity and reliability of the scales in Turkish. 2.9 Data Analysis The Statistical Package for Social Science for Windows 21 (SPSS 21) program was used for statistical analysis. Normal distribution of the data was evaluated using the Shapiro-Wilk test. In the data analysis, arithmetic mean, standard deviation, and median values were used for ordinal variables, and percentages and frequencies were used for nominal variables. Pearson’s correlation analysis was used to determine the relationships between ordinal variables. Statistical significance was set at p<0.05. 3. Results and Discussion 3.1 Result The average age of the students participating in the study is 20.60±1.67 (min: 18, max: 26). Of the students, 82.4% were female. When the answers given by the students to the questions about their social media usage were evaluated, it was determined that 50.6% of the students used social media for 4-6 hours, used social media mostly for communication with family, friends, and other social circles, and used the social media application Instagram the most (Table 1). Table 1: Descriptive characteristics of participants Variables Mean±SD Age 20.60±1.67 (minimum:18-maximum:26) n % Gender Female 280 82.4 Male 60 17.6 Social media usage time Less than 1 hour 9 2.6 1-3 hours 117 34.4 4-6 hours 172 50.6 7 hours and above 42 12.4 Purpose of using social media* Entertainment/games 211* 62.1 Communication with family, friends and other social circles 286 84.1 Getting news 232 68.2 Getting information 247 72.6 Personal sharing (sharing personal photos, videos, pictures, ideas) 194 57.1 Most frequently used social media application* Facebook 4 1.2 Instagram 220 64.7 Snapchat 27 7.9 Twitter 53 15.6 Youtube 76 22.4 WhatsApp 143 42.1 Tiktok 7 2.1 SD: Standart deviation; *: Since more than one marking was made, n was multiplied. The first research question was, “What are the psychological distress levels of university students?” Students had a mean K10-PSD score of 33.37±7.97. The second research question wasWhat are the students’ expectation levels of social support from social networks?”. Students had a mean SSESNS score of 33.36±10.10. Table 2 presents the results. Table 2. Participants' total K10-PSD and SSESNS score averages X±SD Scale min-max. K10-PSD Total 33.37±7.97 10-50 SSESNS Total 33.36±10.10 14-56 X: Mean; SD: Standart deviation; Min: minimum; Max: Maximum The third research question was, “Is there a relationship between students’ psychological distress levels and their social support expectation levels from social networks?”. According to the Pearson Correlation analysis in Table 3, a significant positive correlation was found between students’ K10-PSD and SSESNS total scores (r = .119, p<0.05). Table 3. The relationship between K10-PSD and SSESNS K10-PSD Total SSESNS Total r .119* p .028 r: Pearson’s correlation; p: p<0.05 3.2 Discussion This study is important in terms of revealing the relationship between the psychological distress levels of university students and their social support expectations from social networks, and in terms of better understanding the social support expectations of students with psychological distress from social networks. Three important findings were obtained in this study. The first finding was that the psychological distress levels of university students were above average, whereas the second important finding was that the social support expectations of students from social networks were below average. The third important finding was that as students' psychological distress increased, their expectations of social support from social networks also increased. Psychological distress emerges as a concept that describes students' psychological well-being. The psychological distress of university students, which is increasing daily, is an important problem that affects students. In our study, it was determined that the psychological distress levels of the students were above average. Knapstad et al. [3] highlighted the potential increase in self-reported psychological distress among Norwegian students in higher education as a concern. A study among university students in China found that at least 40.7% of students had at least one symptom of psychological distress [14]. A study conducted by Hakami [15] with undergraduate students at Jazan University reported that approximately 31% of the students were psychologically distressed. March-Amengual et al. [16] conducted a study with first-year university students in Spain and found that 27.1% of the students experienced psychological distress. A study conducted by Ramon-Arbues et al. [17] with nursing students in Northern Spain reported that symptoms of psychological distress were significantly prevalent among participants. Collin et al. [18] conducted a study in the UK in which dental students participated and found that students experienced high levels of psychological distress, stress, and burnout. Salvarani et al. [19] conducted a study with university students, 70.9% of the participants reported experiencing psychological distress. Pehlivan et al. [20] conducted a study with university students in Turkey, finding that 78.2% of the students experienced stress. When the results of studies conducted with students studying in various fields and at all levels of education were evaluated, it was observed that a significant portion of university students experienced high levels of psychological distress, and these results were similar to those of our study. Social support is a protective factor for individuals in coping with life difficulties. The expectation of social support on social networks is that when an individual experiences intense emotions and shares the situation or emotions they experience on social networking sites, they expect interest, sincere, and friendly approaches from people and hope that they are not alone and that an environment of support and trust will be created through social networks [13]. Yılmaz [21] stated that communication established on social networks is perceived as social support by young people. In the research conducted by Balcı and Kaya [22], it was emphasized that social networks have an important position in increasing emotional support. The same study stated that young people seek more emotional support on social networks and use social media for this purpose [22]. In our study, it was determined that students' social support expectations from social networks were below average, and that the most common purpose of using social networks was communication with the environment. In his thesis study, Üstündağ [23] stated that social media is a communication tool for adolescents and concluded that there is a significant and positive relationship between adolescents' social support perception levels and their social network usage purposes. In the research conducted by Ürkmez and Eskicumalı [24], it was stated that social networks are used for information sharing and socialization purposes. In the research conducted by Karadaş et al. [25] with university students, it was reported that the participants used social networks to follow the agenda, share, and as a means of entertainment and communication. The results obtained in the literature review revealed the support expectations of today's young people from social networks. As a result of our study, it was determined that as students' psychological distress increases, their expectations of social support from social media also increase. Clark et al. [8] emphasized in their research that the positive use of social networks supports the increase in connections for social support. Consequently, it was stated that the needs of users to belong and be accepted were met [8]. Balcı and Kaya [22] described social media as a tool used by the young segment of society when they feel sad and lonely or want to escape their problems. Shiraly et al. [26] concluded in their research that students with high levels of psychological distress spend more time on social media. Similarly, Sampasa-Kanyiga and Lewis [27] determined in their research that students with poor mental health use social networking sites more. In the research conducted by Lin et al. [28], it was stated that the rate of problematic social media use of students with low levels of psychological distress is also low. Lake Yimer [29] concluded in his research with university students that students who use social media more often have lower levels of psychological well-being. Sun [30] emphasized in his research that people who experience psychological problems such as anxiety and loneliness can use social networks as a coping mechanism by receiving social support from social networks. Pop et al. [31] reported in their research with young social network users that people who spend more time on social networks have higher loneliness and depression scores. Similarly, Karakuş and Tarhan [32] observed that lonely people spend more time on social media. The results obtained in line with our study and the literature suggest that young adults see social networks as a place where they can get support when they feel lonely, stressed, and sad, and use them for this purpose. The fact that the study was conducted only with students studying at the Faculty of Health Sciences of a state university and that the data were based on subjective statements prevents the generalization of the study results. It is recommended that future studies be conducted with larger samples, and that students' perceived experiences of social support from social networks be examined in more depth using qualitative methods. 4. Conclusion Our study found that university students’ psychological distress was higher than moderate and their expectations of social support from social networks were lower than moderate. Another important finding of our study is that as students’ psychological distress increases, their expectations of social support from social media also increase. Considering these findings, awareness of psychological distress experienced by university students should be increased, and the accessibility of psychological counseling and guidance services at universities should be increased. Students’ expectations of social support from social networks increase in the face of psychological distress. In this context, it is important to increase social media literacy training for university students and organize seminars and psychoeducation studies on coping with stress, psychological resilience, and reliable social support sources. 5. Acknowledgements We thank all students who participated in the research. 6. Referanslar 1. Ridner, S.H. Psychological distress: concept analysis. Journal of advanced nursing, 2004;45(5):536-545. 2. Sharp, J., Theiler, S. A review of psychological distress among university students: Pervasiveness, implications and potential points of intervention. International Journal for the Advancement of Counselling, 2018;40:193-212. 3. Knapstad, M., Sivertsen, B., et al. Trends in self-reported psychological distress among college and university students from 2010 to 2018. Psychological medicine, 2021;51(3):470-478. 4. Al-Tammemi, A.B., Akour, A., et al. Is it just about physical health? An online cross-sectional study exploring the psychological distress among university students in Jordan in the midst of COVID-19 pandemic. Frontiers in Psychology, 2020;11:562213. 5. Wadman, R., Webster, L.A.D., et al. Help-seeking and psychological distress in university students: Findings from a cross-sectional online survey in the UK. European Psychiatry, 2017;41:184-185. 6. McCloskey, W., Iwanicki, S., et al. Are Facebook “friends” helpful? Development of a Facebook-based measure of social support and examination of relationships among depression, quality of life, and social support. Cyberpsychology, Behavior, and Social Networking, 2015;18(9):499-505. 7. Gilmour, J., Machin, T., et al. Facebook-based social support and health: A systematic review. Psychology of popular media, 2020; 9(3):328. 8. Clark, J.L., Algoe, S.B., et al. Social Network Sites and Well-Being: The Role of Social Connection. Current Directions in Psychological Science. 2018, 27(1): 32-37. https://doi.org/10.1177/0963721417730833 9. Al-Asibong, U., Okafor, C. J., et al. Psychological distress and social media usage: A survey among undergraduates of a university in Calabar, Nigeria. Nigerian Postgraduate Medical Journal, 2020;27(2):115. 10. Yıldız, S. Sosyal bilimlerde örnekleme sorunu: Nicel ve nitel paradigmalardan örnekleme kuramina bütüncül bir bakiş. Kesit Akademi Dergisi, 2017;(11):421-442. 11. Kessler, R. C., Andrews, G., et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological medicine, 2002;32(6):959-976. 12. Altun, Y., Özen, M., et al. Psikolojik Sıkıntı Ölçeğinin Türkçe uyarlaması: Geçerlilik ve güvenilirlik çalışması. Anatolian Journal of Psychiatry, 2019; 20. 13. Uzakgiden, A.M. Erözkan, A. Sosyal ağlarda sosyal destek beklentisi: Ölçek geliştirme, güvenirlik ve geçerlik çalışması. Ege Bilimsel Araştırmalar Dergisi, 2019;2(1):20-33. 14. Tang, F., Byrne, M., et al. Psychological distress and risk for suicidal behavior among university students in contemporary China. Journal of affective disorders, 2018;228:101-108. 15. Hakami, R. M. Prevalence of psychological distress among undergraduate students at Jazan University: A cross-sectional study. Saudi journal of medicine & medical sciences, 2018;6(2):82-88. 16. March-Amengual, J.M, Cambra Badii, I., et al. Psychological Distress, Burnout, and Academic Performance in First Year College Students. Int J Environ Res Public Health, 2022;9(6):3356. doi: 10.3390/ijerph19063356. 17. Ramón-Arbués, E., Granada-López, J.M., et al. Psychological distress in nursing students: relationship with screen time, diet and physical activity. Rev Lat Am Enfermagem, 2023;21;31:e3959. doi: 10.1590/1518-8345.6746.3959. 18. Collin, V., O'Selmo, E., et al. Stress, psychological distress, burnout and perfectionism in UK dental students. Br Dent J, 2020;229(9):605-614. doi: 10.1038/s41415-020-2281-2284. 19. Salvarani, V., Ardenghi, S., et al. Predictors of psychological distress amongst nursing students: A multicenter cross-sectional study. Nurse Educ Pract, 2020;44:102758. doi: 10.1016/j.nepr.2020.102758. 20. Pehlivan, Ş,. Tokur Kesgi, N.M., et al. Psychological distress and mental health literacy in university students. Perspect Psychiatr Care, 2021;57(3):1433-1441. doi: 10.1111/ppc.12709. 21. Yılmaz, E.A. Üniversite öğrencilerinin pandemi döneminde sosyal medya kullanımları ve algıladıkları sosyal destek arasındaki ilişki: Konya İli Örneği. Akademi Sosyal Bilimler Dergisi, 2022;9(26):171-189. 22. Balcı, Ş., Kaya, E. Sosyal medyada algılanan sosyal desteğin, yaşam doyumu üzerindeki etkinliği: Üniversite gençliği araştırması. Akdeniz Üniversitesi İletişim Fakültesi Dergisi, 2021;(36):47-71. 23. Üstündağ, A. Ergenlerin sosyal medya kullanım amaçları ile sosyal destek algıları arasındaki ilişkinin incelenmesi. Uludağ Üniversitesi Fen-Edebiyat Fakültesi Sosyal Bilimler Dergisi, 2022;23(42):169-190. 24. Ürkmez, S., Eskicumalı, A. Kullanımlar ve doyumlar teorisi çerçevesinde covid-19 pandemi sürecinde bireylerin sosyal medya kullanım motivasyonları: Instagram örneği. Sosyal, Beşerî ve İdari Bilimler Dergisi, 2021;4(2):111-129. 25. Karadaş, M.M., Koç, G., et al. Öğrenci hemşirelerin sosyal medya kullanımı, kullanım amaçları ve etik boyutu. Gazi Sağlık Bilimleri Dergisi, 2021;6(1):11-21. 26. Shiraly, R., Roshanfekr, A., et al. Psychological distress, social media use, and academic performance of medical students: the mediating role of coping style. BMC Med Educ, 2024;13;24(1):999. doi: 10.1186/s12909-024-05988-w. 27. Sampasa-Kanyinga, H., Lewis, R.F. Frequent use of social networking sites ıs associated with poor psychological functioning among children and adolescents. Cyberpsychol Behav Soc Netw., 2015;18(7):380-5. doi: 10.1089/cyber.2015.0055. 28. Lin, C.Y., Namdar, P., et al. Mediated roles of generalized trust and perceived social support in the effects of problematic social media use on mental health: A cross-sectional study. Health Expect,, 2021;24(1):165-173. doi: 10.1111/hex.13169. 29. Lake Yimer, B. Social media usage, psychosocial wellbeing and academic performance. Community Health Equity Res Policy, 2023;43(4):399-404. doi: 10.1177/0272684X211033482. 18. 30. Sun, L. Social media usage and students' social anxiety, loneliness and well-being: does digital mindfulness-based intervention effectively work? BMC Psychol., 2023;31:11(1):362. doi: 10.1186/s40359-023-01398-7. 31. Pop, L.M., Iorga, M., et al. Body-Esteem, self-esteem and loneliness among social media young users. Int J Environ Res Public Health, 2022;21:19(9):5064. doi: 10.3390/ijerph19095064. 32. Karakuş, M., Tarhan, A. Yükseköğretim öğrencilerinin sosyal medya kullanımları ve yalnızlık düzeyleri arasındaki ilişki. İletişim ve Toplum Araştırmaları Dergisi, 2023;3(2):209-232. http://edergi.cbu.edu.tr/ojs/index.php/cbusbed isimli yazarın CBU-SBED başlıklı eseri bu Creative Commons Alıntı-Gayriticari4.0 Uluslararası Lisansı ile lisanslanmıştır.

Keywords

• Psikolojik sıkıntı
• ruhsal sıkıntı
• sosyal ağ
• sosyal destek
• üniversite öğrencisi

References

1. Al-Asibong, U., Okafor, C. J., et al. (2020). Psychological distress and social media usage: A survey among undergraduates of a university in Calabar, Nigeria. Nigerian Postgraduate Medical Journal, 27(2):115.
2. Al-Tammemi, A.B., Akour, A., et al. (2020). Is it just about physical health? An online cross-sectional study exploring the psychological distress among university students in Jordan in the midst of COVID-19 pandemic. Frontiers in Psychology,11:562213.
3. Altun, Y., Özen, M., et al. Psikolojik Sıkıntı Ölçeğinin Türkçe uyarlaması: Geçerlilik ve güvenilirlik çalışması. (2019). Anatolian Journal of Psychiatry,20.
4. Balcı, Ş., Kaya, E. (2021). Sosyal medyada algılanan sosyal desteğin, yaşam doyumu üzerindeki etkinliği: Üniversite gençliği araştırması. Akdeniz Üniversitesi İletişim Fakültesi Dergisi, (36):47-71.
5. Clark, J.L., Algoe, S.B., et al. (2018). Social Network Sites and Well-Being: The Role of Social Connection. Current Directions in Psychological Science, 27(1): 32-37. https://doi.org/10.1177/0963721417730833
6. Collin, V., O'Selmo, E., et al. (2020). Stress, psychological distress, burnout and perfectionism in UK dental students. Br Dent J, 2020;229(9):605-614. doi: 10.1038/s41415-020-2281-2284.
7. Gilmour, J., Machin, T., et al. (2020). Facebook-based social support and health: A systematic review. Psychology of popular media, 9(3):328.
8. Hakami, R. M. (2018). Prevalence of psychological distress among undergraduate students at Jazan University: A cross-sectional study. Saudi journal of medicine & medical sciences,6(2):82-88.

9. Karadaş, M.M., Koç, G., et al. (2021). Öğrenci hemşirelerin sosyal medya kullanımı, kullanım amaçları ve etik boyutu. Gazi Sağlık Bilimleri Dergisi,6(1):11-21.
10. Karakuş, M., Tarhan, A. (2023). Yükseköğretim öğrencilerinin sosyal medya kullanımları ve yalnızlık düzeyleri arasındaki ilişki. İletişim ve Toplum Araştırmaları Dergisi,3(2):209-232.
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14. Lin, C.Y., Namdar, P., et al. (2021). Mediated roles of generalized trust and perceived social support in the effects of problematic social media use on mental health: A cross-sectional study. Health Expect, 24(1):165-173. doi: 10.1111/hex.13169.
15. March-Amengual, J.M, Cambra Badii, I., et al. (2022). Psychological Distress, Burnout, and Academic Performance in First Year College Students. Int J Environ Res Public Health,9(6):3356. doi: 10.3390/ijerph19063356.
16. McCloskey, W., Iwanicki, S., et al. (2015). Are Facebook “friends” helpful? Development of a Facebook-based measure of social support and examination of relationships among depression, quality of life, and social support. Cyberpsychology, Behavior, and Social Networking,18(9):499-505.
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18. Pop, L.M., Iorga, M., et al. (2022). Body-Esteem, self-esteem and loneliness among social media young users. Int J Environ Res Public Health,21:19(9):5064. doi: 10.3390/ijerph19095064.
19. Ramón-Arbués, E., Granada-López, J.M., et al. (2023). Psychological distress in nursing students: relationship with screen time, diet and physical activity. Rev Lat Am Enfermagem,21;31:e3959. doi: 10.1590/1518-8345.6746.3959.
20. Ridner, S.H. (2004). Psychological distress: concept analysis. Journal of Advanced Nursing,45(5):536-545. Salvarani, V., Ardenghi, S., et al. (2020). Predictors of psychological distress amongst nursing students: A multicenter cross-sectional study. Nurse Educ Pract,44:102758. doi: 10.1016/j.nepr.2020.102758.
21. Sampasa-Kanyinga, H., Lewis, R.F. (2015). Frequent use of social networking sites ıs associated with poor psychological functioning among children and adolescents. Cyberpsychol Behav Soc Netw.,18(7):380-5. doi: 10.1089/cyber.2015.0055.
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25. Shiraly, R., Roshanfekr, A., et al. (2024). Psychological distress, social media use, and academic performance of medical students: the mediating role of coping style. BMC Med Educ, 13;24(1):999. doi: 10.1186/s12909-024-05988-w.
26. Sun, L. (2023). Social media usage and students' social anxiety, loneliness and well-being: does digital mindfulness-based intervention effectively work? BMC Psychol.,31:11(1):362. doi: 10.1186/s40359-023-01398-7.
27. Tang, F., Byrne, M., et al. (2018). Psychological distress and risk for suicidal behavior among university students in contemporary China. Journal of affective disorders,228:101-108.
28. Uzakgiden, A.M. Erözkan, A. (2019). Sosyal ağlarda sosyal destek beklentisi: Ölçek geliştirme, güvenirlik ve geçerlik çalışması. Ege Bilimsel Araştırmalar Dergisi,2(1):20-33.
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