by Huynh Ngoc Linh, Ngo Thi Tam, Tran Quoc Thang, Nguyen Thi Lan Huong, Nguyen Bich Nguyet, Hoang Duc Hanh

Objective: This study assessed smartphone addiction, internet addiction, eHealth literacy, social support, loneliness, depression, and sleep quality among health sciences students, and examined their structural relationships using structural equation modeling (SEM).
Method:A cross-sectional survey was conducted among 447 Medicine, Nursing, and Pharmacy students at a university in Hanoi. Data were collected using a self-administered paper questionnaire incorporating validated instruments: SAS-SV, IAT-6, eHEALS, DUFSSQ-8, UCLA-3, PHQ-9, and B-PSQI. Descriptive statistics, correlation analyses, and SEM were performed using Stata 17 and SmartPLS 3.0.
Results: Participants reported moderate levels of smartphone addiction (35.7 ± 8.9) and internet addiction (13.1 ± 4.8). Internet addiction demonstrated direct effects on higher depression (β = 0.36, p < 0.001), poorer sleep quality (β = 0.27, p < 0.001), and lower social support (β = −0.25, p < 0.001). Smartphone addiction was positively associated with eHealth literacy (β = 0.21, p < 0.001) and loneliness (β = 0.16, p = 0.003). Social support showed strong inverse associations with depression, loneliness, and poor sleep, and mediated the effects of internet addiction on all three outcomes. eHealth literacy did not attenuate adverse effects.
Conclusions: Among Vietnamese health science students, problematic smartphone and internet use is associated with greater loneliness, depressive symptoms, and sleep disturbances. Enhancing social support ‒ rather than relying solely on eHealth literacy ‒ appears critical to reducing these harms. Universities should implement strategies that foster digital well-being, limit problematic technology use, and strengthen peer connectedness and supportive campus environments.

Key words: smartphone addiction, internet addiction, ehealth literacy, social support, depression, sleep quality, structural equation modeling