Screen use, health status, and self-perceived academic performance among Swedish dental and nursing students: an exploratory cross-sectional survey study

Abstract Background This study examined how screen use, physical and mental health, and 3-question temporomandibular disorders (3Q-TMD) screening status relate to self-perceived academic performance among Swedish undergraduate dental and nursing students. Methods Ninety-one first-semester dental and nursing students completed a survey comprising sociodemographic items, estimated daily screen use by purpose, and twelve self-report instruments. Self-perceived academic performance was measured with the Academic Performance Scale (APS) and analyzed as a continuous score. Bivariate group comparisons between lower and higher self-perceived academic performance used the Mann-Whitney U test or Welch’s t-test with effect sizes, and the Holm-Bonferroni procedure to control the family-wise error rate within families of outcomes. The primary analysis was a hierarchical linear regression on the continuous APS score, entering demographics, then total screen time, then purpose-specific screen use, then a psychological symptom burden composite and 3Q-TMD screening status. Results Total screen time was unrelated to academic performance in every analysis. Purpose-specific screen use added 19.0% of explained variance beyond total duration (F(3,81) = 6.78, p < 0.001), whereas total duration added 2.2% beyond purpose and was not significant (F(1,81) = 2.37, p = 0.127). In the full model (R2 = 0.341, adjusted R2 = 0.266), academic screen use was positively associated with performance (β = 0.426, p < 0.001), while work-related screen use (β = -0.299, p = 0.003) and psychological symptom burden (β = -0.361, p = 0.001) were negatively associated with performance. Students reporting lower performance also reported poorer health-related quality of life in five of eight RAND-36 domains and were more likely to have a positive 3Q-TMD screening result, although the latter association did not survive adjustment for oral parafunctional behavior. Conclusions Self-perceived academic performance was associated with the purpose of screen use and with psychological symptom burden, but not with total screen-time duration.