Journal of pediatric nursing · 2026
The mediating role of daytime sleepiness in the relationship between Smombie behavior and injury-related health beliefs in adolescents.
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Temuçin Mine Nur, Küçük Alemdar Dilek
Аннотация
PURPOSE: The aim of this study was to examine the mediating role of daytime sleepiness in the relationship between smombie behavior and injury-related health beliefs in adolescents.
METHODS: This cross-sectional and correlational study included 425 adolescents aged 14-18 years and was conducted between April and June 2025. Data were collected using the Health Belief Model-Based Injury Scale (HBM-Injury), the Cleveland Adolescent Sleepiness Questionnaire (CASQ), and the Adolescent Smombie Scale (SSA). Data were analyzed using Pearson correlation, regression, and PROCESS Macro Model 4 mediation analyses.
RESULTS: The mean age of participants was 15.84 ± 0.88 years, and most participants were female. Daily phone usage time was positively associated with SSA and CASQ scores (p < .001). Sleep problems, morning tiredness, and phone use while walking in traffic were significantly correlated with both SSA and CASQ scores (p < .001). Female adolescents had higher CASQ and HBM scores (p < .001). SSA was positively correlated with CASQ (r = 0.377, p < .001); however, CASQ did not mediate the relationship between SSA and HBM.
CONCLUSIONS: This study suggests that smombie behavior in adolescents may be more closely associated with technology usage habits and daytime sleepiness than with injury-related health beliefs.
IMPLICATIONS FOR PRACTICE: Routine assessment of adolescents' smartphone use habits, sleep quality, and daytime sleepiness may be integrated into pediatric nursing care, and school- and community-based preventive interventions may be promoted to reduce smombie-related risks.
METHODS: This cross-sectional and correlational study included 425 adolescents aged 14-18 years and was conducted between April and June 2025. Data were collected using the Health Belief Model-Based Injury Scale (HBM-Injury), the Cleveland Adolescent Sleepiness Questionnaire (CASQ), and the Adolescent Smombie Scale (SSA). Data were analyzed using Pearson correlation, regression, and PROCESS Macro Model 4 mediation analyses.
RESULTS: The mean age of participants was 15.84 ± 0.88 years, and most participants were female. Daily phone usage time was positively associated with SSA and CASQ scores (p < .001). Sleep problems, morning tiredness, and phone use while walking in traffic were significantly correlated with both SSA and CASQ scores (p < .001). Female adolescents had higher CASQ and HBM scores (p < .001). SSA was positively correlated with CASQ (r = 0.377, p < .001); however, CASQ did not mediate the relationship between SSA and HBM.
CONCLUSIONS: This study suggests that smombie behavior in adolescents may be more closely associated with technology usage habits and daytime sleepiness than with injury-related health beliefs.
IMPLICATIONS FOR PRACTICE: Routine assessment of adolescents' smartphone use habits, sleep quality, and daytime sleepiness may be integrated into pediatric nursing care, and school- and community-based preventive interventions may be promoted to reduce smombie-related risks.