Reduced Health-Related Quality of Life Due to Mobile Phone Dependence in a Sample of Chinese College Students: The Mediating Role of Chronotype and Sleep Quality

Purpose Presenting a chain mediation model to investigate whether mobile phone dependence results in a reduction in health-related quality of life (HRQoL) among Chinese college students, through the mediating effect of chronotype and sleep quality. Design and Setting A cross-sectional survey was conducted on students from a Chinese university using a validated structured questionnaire. Sample 2014 freshmen. Measures The study measured the students’ level of mobile phone dependence using the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use. Chronotype and sleep quality were measured by the Chinese version of the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburgh Sleep Quality Index (PSQI), respectively. HRQoL was evaluated using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L), including a descriptive system and a visual analog scale (VAS). Analysis Descriptive statistical analysis, correlation analysis, and mediation analysis. Results Mobile phone dependence had a significant negative effect on HRQoL as indicated by both the EQ-5D-5L index score and EQ-VAS score (P < .001 for both). Additionally, it was found to significantly predict chronotype (MEQ score) (β = −.546, P < .001) and sleep quality (PSQI score) (β = .163, P < .001). Chronotype negatively predict sleep quality (β = −.058, P < .001), and sleep quality was a significant negative predictor of HRQoL (EQ-5D-5L index score, β = −.008, P < .001; EQ-VAS score, β = −1.576, P < .001). Conclusion Mobile phone dependence negatively impacts students’ HRQoL through chronotype and sleep quality, and there is a chain mediating effect. Students should consider making lifestyle changes to improve their HRQoL and promote health.