PROLONGED VIDEO GAMING ON SLEEP PATTERN QUESTIONNAIRE (PVGSQ)
SECTION A: CONSENT FORM

Dear participant,

You are invited to participate in a research survey regarding “video gaming and sleep pattern”for my thesis which is a part of my bachelor’s degree in Psychology from the Islamic Online University. The intention behind this study is to probe the impact of prolonged video gaming on sleep pattern in adults through this study. You were chosen as a suitable participant for this as you are an active gamer.

If you are willing to take part in the research, please complete the enclosed survey. It will take about 15-20 minutes to complete it. The survey does not attract any monetary or any other benefit but your responses will enrich the findings of the research study as well as provide remedial solutions to sleep related problems.  Any possible inconvenience to you will be solely from the time duration of the survey.

CONFIDENTIALITY AND ANONMITY

Any information collected in connection to the research study and that relates to you will be kept with utmost confidential. The information will only be used for research purpose and not for personal use or disclosed in any manner.

All identifying information obtained by participating in this research study will be kept strictly confidential unless State or Federal law mandates disclosure. The results of this study may be used in reports, papers, presentations, and publications; however, any identifying information will be omitted or disguised to ensure confidentiality and anonymity.

In order to maintain anonymity and confidentiality you will be asked to create a unique code. This code will be used to identify the data in case you wish to withdraw from the study. Password protected accounts will store your data which will only be accessible to the researcher. All the data will then be destroyed in 2 weeks followed by the study completion. All the responses will only be used for the current study.

PARTICIPATION

Your participation to this research survey is entirely voluntary and you may choose to leave anytime without accountability to the researcher. If you wish to complete the survey then your responses will be highly appreciated.

However, if you wish to withdraw after completing the survey, there is a maximum time of 2 weeks. In that case, you may email the researcher with your unique code. In case of withdrawal, there will be no penalty on your part.

Please feel free to email the researcher, if you have any additional questions regarding the study:
Nida Usman, Islamic Online University, Email: nidausman6789@gmail.com Tel: 00966541891542.

Thank you for your time.

Sincerely,

Nida Usman

Project Supervisor:
Dr. G.HusseinRassool,

        Department of Psychology,

        Islamic Online University


INSTRUCTIONS FOR PARTICIPANTS

I am researching the effects of video game play on the symptoms of insomnia. In order to participate in this research study, you must be a video game player of age 18+. You will not be receiving a clinical diagnosis of a mental health disorder by participating in this study. Symptoms include fatigue, insomnia, restlessness, body aches, bad dreams, disturbed sleep pattern or difficulty falling asleep and/or staying awake.

To participate in this study and help further research on video games, you will complete a brief subjective measure instrument- a survey questionnaire. This survey may take approx. 20 minutes to complete. Please make sure you take this survey in a distraction-free environment and with good internet connection.
First, you will be asked some demographic data. Then you will be asked to fill in the questionnaire about your sleep and gaming habits. Please make sure to continue to the debriefing information before you have completed the mentioned tasks. Once you have read the debriefing information and wish to submit your results, please click “Submit” before closing the browser window.
Thank you for your time. Your participation is greatly appreciated!

DEBRIEFING FORM

I, Nida Usman, (nidausman6789@gmail.com), Student of IOU- Qatar, will be carrying out the above mentioned  research project under the guidance of the faculty supervisor of IOU.

You are hereby requested to give your voluntary consent to participate in this study titled Impact of Prolonged Video Gaming on Sleep Pattern among Adults which is being carried out as part of the academic requirements of Post Graduate course in Psychology. Any information collected from you during the process would be kept confidential and will be used strictly for research purposes only. You are free to withdraw from the study at any point of time without any prejudice.
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Measure Capacity to Consent to Participation in the Study
The next set of questions are about you consenting to participant in the study and confirming you are informed of what this involves (please see earlier information for details of what the study involves).

Please read the following statements carefully and tick each box below to confirm your participation and ensure that you agree with each statement:


I understand that my participation is 100% voluntary and I have the right to withdraw after completing it without providing any reason. *
Pflichtfrage
I understand that there is deadline of 2 weeks if I wish to withdraw after completing the survey *
Pflichtfrage
I confirm that I am 18 or above 18 years of age.   *
Pflichtfrage
I confirm that I am not on any medications and have not suffered any kind of brain injury. *
Pflichtfrage
I understand that the unique identifying code will be required to maintain data confidentiality and anonymity. *
Pflichtfrage
I have read and understood the nature of the research project as outlined in the participant information sheet above *
Pflichtfrage
I agree and give consent to take part in the study. *
Pflichtfrage
Unique participant Code: Please create a unique ID code by entering the last three letters of your surname and last two digits of your mobile number. For example, if the surname is Williams and the last two digits of my mobile number are 63, the code will be: AMS63 *
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