Study design
This was an analytical cross-sectional university-based study that was conducted during the academic year 2020–2021. The research was carried out virtually at the Faculty of Medicine at the University of Khartoum in Khartoum, Sudan.
Study area
The research was carried out virtually at the University of Khartoum’s Faculty of Medicine (UofK-MED). UofK-MED is Sudan’s oldest medical school, having been founded in 1924. It was also the first medical school in Sudan to be accredited by the World Federation of Medical Education. Every year, thousands of students apply for admission to UofK-MED, attracted by its unique medical education and extracurricular opportunities.
Study population
During the academic year 2020–2021, there are 2335 students enrolled at the college. All of the participants were undergraduate medical students, with the majority of them ranging in age from 18 to 23. In terms of inclusion criteria, all undergraduate students at the University of Khartoum–Faculty of Medicine in Khartoum in the first (batch 96), second (batch 95), third (batch 94), fourth (batch 93), fifth (batch 92), and sixth (batch 91) academic years were included in the study, and no students were excluded.
Sample size and sampling
A random sample of 323 students was chosen from the medical students at the University of Khartoum, Faculty of Medicine, using stratified random sampling. Sample size (n) was calculated according to the formula: n = [z2 * p * (1−p)/e2]/[1 + (z2 * p * (1−p)/(e2 * N))] where z = 1.96 for a confidence level (α) of 95%, p is the proportion (expressed as a decimal), N is the population size, and e is the margin of error.
$$ \mathrm{z}=1.96,\mathrm{p}=0.5,\mathrm{N}=1994,\mathrm{e}=0.05 $$
$$ \mathrm{n}=\left[1.962\ast 0.5\ast \left(1--0.5\right)/0.052\right]/\left[1+\left(1.962\ast 0.5\ast \left(1-0.5\right)/\left(0.052\ast 1994\right)\right)\right] $$
$$ \mathrm{n}\approx 323 $$
The sample size (with finite population correction) is equal to 323.
The study population was subdivided into 6 groups according to their academic classes, and list containing all students in each academic class was obtained. Since the study sample size was 323, a proportionate random sample from each group was selected using the online sample randomizer at https://www.randomizer.org.
Fifty-two out of 325 were selected from the sixth-year students (batch 91), 51 out of 313 from the fifth-year students (batch 92), 56 out of 349 from the fourth-year students (batch 93), 58 out of 358 from the third-year students (batch 94), 54 out of 333 from the second-year students (batch 95), and 52 out of 326 from the first-year students (batch96).
Data collection methods and tools
During the academic year, all targeted students completed online self-administered closed-ended questionnaires. Before filling out the Arabic version of the Maladaptive Daydreaming Scale, participants were asked demographic and general information questions: age, gender, marital status, and academic class. Each individual was approached separately, either directly using their personal social media accounts, or through the students’ representing bodies within UofK-MED; this process proved to be effective, yielding a 100% response rate.
The Arabic Version of the Maladaptive Daydreaming Scale (MDS-16-AR) is a new 16-item scale proposed and validated in 2019 by Hisham Motkal Abu Raya, Professor Eli Somer, and Suha Meari-Amir [7]. It consists of 16 items that assess some of the most important aspects of MD. The scale responses range from 0 to 100%, with 10% intervals (0% = never/never; 100% = all of the time/extreme amounts). The MDS-16-AR was chosen as the measurement tool for MD in this study not only because it uses the research subjects’ mother tongue, but also because it demonstrated high sensitivity (89), specificity (87), and overall validity (85.5) with a cutoff composite score of 45 (out of a maximum of 100) [7, 9, 10].
Data management and statistical analysis
Data was entered and encoded then analyzed by the computer programs by using the SPSS software (version 21). The collected data was analyzed through descriptive analysis and using the chi square and t-tests. P value <0.05 was considered statistically significant. Data were displayed and presented in form of tables.