Abstract
PURPOSE: The rapid process of urbanization in China had led to a large number of laborers migrating from rural areas to cities, leaving their children behind in the rural areas. Internet gaming disorder (IGD) among left - behind children (LBC) had become a prominent social concern. Especially during the COVID-19 pandemic, LBC studied at home and had long-term exposure to electronic devices, which increased the risks and harms of IGD. The research aimed to analyze the formation, damage and factors of IGD among LBC sociologically, and explored its processes, harms and causes in China through data collection and in - depth analysis. PATIENTS AND METHODS: Between August 15, 2022, and March 25, 2023, with the consent of the participants, we conducted in - depth interviews with 21 sixth - grade students, 7 parents, and 7 teachers from 5 primary schools in Chinese rural areas. Employing the Grounded Theory method, we carried out three - level coding to analyze the interview data. RESULTS: The study found that left - behind children's IGD went through four processes: entering - immersing - exiting - re - entering video games. The causes involved the popularization of video game equipment, the deficiency of rural cultural infrastructure, incorrect guidance from parents and peers, as well as children's experiences in video games. Our analysis showed that IGD had a negative impact on children in four key aspects: cognition, physical and mental health, educational outcomes, and parent - child interaction. DISCUSSION: Left - behind children's IGD was a process from initial involvement to recurrence. The negative impacts of left - behind children's IGD interacted with each other. Multiple factors jointly led to left - behind children's IGD. Resolving children's IGD required the joint efforts of families, schools, communities, and the whole society.