Development, design and pilot evaluation of a nurse practitioner led outpatient post-diagnostic clinic for people with dementia and their care partners: a brief report.

The rapid proliferation of smartphones has profoundly transformed daily life, particularly among university students, for whom smartphones have become indispensable tools for communication, learning, and social interaction (; ). Smartphone addiction and problematic smartphone use are related, but conceptually distinct: problematic smartphone use is a broader term referring to maladaptive or uncontrolled smartphone engagement, whereas smartphone addiction denotes a more specific addiction-like pattern involving impaired control, salience, withdrawal-like discomfort, tolerance-like escalation, and functional interference. This distinction is considered further in the literature review. Recent evidence indicates that smartphone addiction is common among Chinese university students. For example, a meta-analysis of 67 Chinese studies involving 129,996 college students estimated a pooled prevalence of 28.49%, with reported rates ranging from 4.05 to 83.60% across studies (). A study of Chinese medical college students also reported a prevalence of 49.5% (). These findings suggest that addiction-like smartphone use is not a marginal phenomenon but a substantial concern in Chinese higher education. A growing body of evidence further indicates that smartphone addiction is associated with adverse psychological outcomes, including anxiety, depression, stress, and overall mental health symptoms (; ; ). University students represent a particularly vulnerable population for elevated addiction-like smartphone use because they experience academic pressure, developmental transitions, and increased autonomy in technology use (). Empirical studies have repeatedly shown that individuals with higher levels of smartphone addiction scores tend to report greater psychological difficulties, including depression, anxiety, and emotional exhaustion (; ; ). Conceptually, addiction-like smartphone use may be interpreted as a chronic digital stress context because excessive or uncontrolled smartphone engagement can expose students to persistent cognitive, emotional, and behavioral demands rather than to a single acute stress event. Constant connectivity may be associated with attentional fragmentation and perceived obligation to remain available; information overload may be associated with cognitive strain; sleep disruption may reduce recovery capacity; and repeated social comparison or fear of missing out may co-occur with negative affect. These processes may accumulate across daily academic and interpersonal contexts and may therefore be statistically linked to stress-related arousal and mental health symptoms (; ). However, existing studies have largely focused on direct associations between smartphone addiction scores and mental health symptoms, offering limited insight into the emotional coping correlates that may be involved in this relationship. Identifying such associations is valuable for advancing theory and informing future longitudinal and intervention research.