Study design and settings<\/p>\n
This cross-sectional observational study was conducted between January and March 2024 using an anonymous online questionnaire after obtaining institutional review board approval from Princess Nourah bint Abdulrahman university (23-1049) and following the Declaration of Helsinki, the International Medical Association\u2019s code of ethics.<\/p>\n
Study population<\/p>\n
Saudi residents aged 18 and above were recruited through various social media platforms. Participants were informed about the study\u2019s objectives and provided electronic informed consent prior to participation. Responses that were incomplete or submitted by individuals under the age of 18 were automatically excluded from the analysis.<\/p>\n
Sample technique<\/p>\n
The sample size was calculated using G-power based on an expected difference of 0.10, a margin of error of 2.5%, a 95% confidence interval (alpha\u2009=\u20090.05), and a study power of 99%. This yielded a sample size of 912, which was increased to 1377 to ensure adequate data quality and to account for potential issues like incomplete responses. A convenience sample from various regions across Saudi Arabia were recruited. While this method enabled efficient data collection, it may introduce selection bias and limit the generalizability of the results due to potential over- or under-representation of certain groups. However, the relatively large sample size might have improved representativeness and allowed for more detailed subgroup analyses, thereby increasing statistical power and the relevance of the findings. Moreover, data quality was maintained by applying defined inclusion criteria, and by utilizing standardized, validated Arabic versions of the Cyberchondria Severity Scale12<\/a>, and the Somatic Symptom Scale13<\/a>.<\/p>\n Data collecting instrument<\/p>\n The questionnaire was designed to collect information on participants prevalence of internet self-diagnosis, cyberchondria severity score, somatic symptom score, and sociodemographic details. Sociodemographic section gathered information on age, gender, marital status, nationality, area of residence, educational level and background, monthly income, chronic diseases, weight, and height.<\/p>\n The prevalence of participants\u2019 use of internet self-diagnosis and its impact on their medical-seeking behavior were evaluated through a series of questions. Participants reported the frequency of their self-diagnosis behaviors on a five-point Likert scale, ranging from \u201cNever\u201d to \u201cVery often; more than six times.\u201d This section also examined motivating factors driving the use of internet self-diagnosis, such as the types of health conditions and symptom severity they searched for, assessed through six yes\/no questions. Additionally, participants indicated their preference for self-diagnosis over seeking professional advice using yes\/no question and rated their reasons for this preference, using a five-point Likert scale from \u201cStrongly disagree\u201d to \u201cStrongly agree.\u201d The outcome of internet self-diagnosis on participants\u2019 self-management behaviors was also evaluated through multiple-selections question.<\/p>\n Cyberchondria Severity Scale (CSS) was used to measure excessive internet health-related use and associated anxiety. The validated Arabic version of the questionnaire12<\/a> was used to ensure linguistic and cultural appropriateness for the Saudi population. It contained 12-items scored on a Likert-type system ranging from 1 (never) to 5 (always). Total scores ranged from 12 to 60 where higher scores indicated greater severity and likelihood of cyberchondria. The scale assessed four factors: excessiveness, distress, compulsion, and reassurance showing high internal consistency, with a Cronbach\u2019s alpha of 0.92. In the current study, Cronbach\u2019s alpha of the CSS was 0.88.<\/p>\n Somatic Symptom Scale (SSS) had strong psychometric properties and consisted of 8-item scale that assessed the somatic symptom burden on individuals with overall Cronbach\u2019s alpha of 0.8014<\/a>. The Arabic version of the 8-item scale had been utilized by Alalawi et al.13<\/a> to assess somatic symptom disorder among Arabic-speaking populations at the primary healthcare level, indicating its applicability in this context13<\/a>. Each item was scored on a Likert-type system ranging from 0 (not at all) to 4 (very much); total scores ranged from 0 to 32. Scores of 0\u20133 indicated no to minimal burden, 4\u20137 indicated low burden, 8\u201311 indicated medium burden, 12\u201315 indicated high burden, and 16\u201323 indicated very high burden13<\/a>. In the current study, the Cronbach alpha of SSS was 0.82.<\/p>\n Participant recruitment and data quality assurance<\/p>\n