Smartphone Dependence in the Hospital Ward: Nurses’ Nomophobia Tested Against Job Performance

Nomophobia—the colloquial shorthand for “no-mobile-phone phobia”—has become one of the most discussed psychological phenomena of the smartphone era, describing the anxiety and discomfort people experience when they cannot access their mobile devices. For most professions, a wandering attention toward a glowing screen is a productivity problem. For nurses, whose work involves medication administration, vital-sign monitoring, and rapid clinical judgment, the stakes of divided attention are considerably higher. A new cross-sectional study published in BMC Nursing by Feyzanur Ersoy of Biruni University’s Faculty of Medicine Hospital and Anita Karaca of Biruni University’s Department of Nursing set out to quantify whether nomophobic tendencies actually translate into measurable declines in nurses’ self-reported job performance—and the answer, perhaps surprisingly, is more nuanced than the popular narrative suggests.

The research team recruited 111 nurses working at a university hospital in Türkiye, a sample drawn from a workforce that is simultaneously among the most demanding in healthcare and among the most digitally connected. Ethical approval was obtained from the Ethics Committee of Biruni University under decision number 2023/85-60, and the study was conducted in accordance with institutional and national ethical guidelines as well as the 1964 Declaration of Helsinki and its later amendments. Every participant provided informed consent before data collection began, and the authors declared no competing interests and no external funding for the work.

Methodologically, the study rested on two well-established psychometric instruments. The first was the Nomophobia Questionnaire, or NMP-Q, a 20-item scale that yields scores reflecting the severity of nomophobic symptoms across dimensions such as fear of losing communication, loss of connectedness, lack of access to information, and giving up convenience. The second was the Individual Work Performance Questionnaire, the IWPQ, which measures perceived job performance across task performance, contextual performance, and counterproductive behavior. Participants also completed a nurse information form capturing demographic details and patterns of smartphone use, including daily screen time, phone use during working hours, and whether they personally considered their smartphone use excessive.

The headline numbers from the survey are striking in their own right. The mean NMP-Q score among the 111 nurses was 73.37 with a standard deviation of 27.25, indicating a substantial degree of nomophobic tendency in this population. The mean IWPQ total score was 3.86 with a standard deviation of 0.69, a figure that sits toward the favorable end of the performance scale. In other words, these were nurses who reported meaningful smartphone dependence but who nonetheless rated their own work functioning as generally solid—a discrepancy that immediately hints at the complexity the statistical analysis would go on to reveal.

The primary analysis examined the Pearson correlation between total NMP-Q and IWPQ scores, reported with a 95 percent confidence interval. The result was a correlation coefficient of −0.098, with a confidence interval spanning −0.279 to 0.090 and a p-value of 0.305. Because the interval crosses zero, the study could not confirm a statistically significant association between nomophobia and perceived job performance. A supplementary Spearman rank correlation, which is robust to outliers and non-normal distributions, produced a nearly identical estimate of −0.105 with a p-value of 0.274, reinforcing the same conclusion. The negative sign of both coefficients is directionally consistent with the hypothesis that higher nomophobia accompanies lower performance, but the magnitude is small and the uncertainty around it is wide.

The authors were careful to characterize what this null result actually means, and their framing is a lesson in statistical humility. The estimated association, they write, is compatible with both no association at all and a small-to-moderate negative association. With 111 participants, the study simply lacks the statistical power to distinguish between those possibilities. This is a common and underappreciated feature of correlation studies: a wide confidence interval does not prove that no relationship exists, it proves only that the data cannot yet pin one down. For hospital administrators tempted to conclude that smartphone anxiety is irrelevant to nursing performance, the honest reading is that the question remains open, pending larger samples.

Where the study did find robust signals was in its exploratory analyses of smartphone behavior, and here the statistical rigor is notable. The researchers applied false-discovery-rate, or FDR, correction to their secondary comparisons—a procedure that adjusts p-values to limit the number of false positives that inevitably arise when many tests are run simultaneously. After this correction, NMP-Q scores differed significantly according to daily smartphone use (q = 0.003), smartphone use during work (q = 0.011), and perceived excessive smartphone use (q = 0.003). Intriguingly, none of the comparisons involving IWPQ total scores survived the FDR correction, meaning that smartphone habits predicted nomophobia levels but not, in this dataset, perceived performance.

The adjusted analysis drove the point home with a multivariable linear regression using heteroskedasticity-consistent HC3 standard errors, a technique that guards against distorted confidence intervals when the variability of outcomes differs across groups. In this model, nurses who reported more than seven hours of daily smartphone use had NMP-Q scores 21.36 points higher than those reporting one to three hours per day, with a 95 percent confidence interval of 5.52 to 37.20 and a p-value of 0.008. That is a substantial effect—roughly three-quarters of a standard deviation of the nomophobia scale—suggesting that heavy daily screen time and nomophobic symptoms travel together in this population. The causal arrow, however, cannot be determined from cross-sectional data: it is equally plausible that anxious, phone-dependent individuals gravitate toward longer use, or that prolonged use itself cultivates dependence.

Why does the disconnect between nomophobia and performance matter? One plausible interpretation is that modern clinical environments have absorbed the smartphone into the workflow itself. Nurses routinely use phones for shift coordination, drug references, and institutional messaging, so device access may no longer function purely as a distraction. Alternatively, the IWPQ captures perceived performance, and self-assessments may be insensitive to subtle attentional lapses that nomophobia could produce—objective measures such as medication error rates or task-completion times might reveal effects that self-reports miss. The study’s authors emphasize that their findings should be interpreted cautiously given the sample size and the exploratory nature of the secondary analyses, and this restraint is warranted: a single-site study of 111 nurses cannot speak for the profession globally.

Nevertheless, the research adds a valuable data point to a growing literature on digital behavior in high-stakes workplaces. Its most actionable finding may be the strong link between daily smartphone duration and nomophobia scores, which identifies heavy users as a group worth monitoring—not because their performance is demonstrably suffering, but because the psychological burden of phone dependence is real and the long-term consequences in safety-critical settings remain unresolved. As hospitals worldwide grapple with mobile device policies, this study suggests the conversation should be grounded in measured evidence rather than reflexive alarm: the fear of being phoneless is prevalent among nurses, but its impact on the quality of care they deliver is, for now, statistically unproven and scientifically undecided.

Subject of Research: The relationship between nomophobia and job performance among hospital nurses

Article Title: Investigation of the relationship between nomophobia and job performance among nurses

Article References: Ersoy, F., & Karaca, A. (2026). Investigation of the relationship between nomophobia and job performance among nurses. BMC Nursing. https://doi.org/10.1186/s12912-026-05445-7

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05445-7

Keywords: nomophobia, nurses, job performance, smartphone use, BMC Nursing, cross-sectional study, NMP-Q, IWPQ, occupational health psychology, nursing research, statistical correlation, hospital workforce