Changes and specificities in health behaviors among healthcare students over an 8-year period

Exploring barriers to physical activity participation among female nursing students adhering to specific social-cultural norms in Indonesia: A qualitative study

Background

The prevalence of insufficient physical activity is common among nursing students and impacts their academic performance. Research on obstacles to physical activity (PA) among religious women, notably Muslims, is limited.

Objectives

This study aimed to explore barriers to PA among Indonesian Muslim female nursing students and gather suggestions for overcoming those barriers.

Methods

This study used a qualitative descriptive design. Two focus groups were conducted with 12 Muslim female nursing students in Makassar, Indonesia. Interviews were audio-recorded and transcribed verbatim. The data were collected from May and July 2019. Inductive thematic analysis was used to identify core themes and sub-themes.

Results

Thematic analysis identified barriers to PA across four main themes: intrapersonal, interpersonal, institutional, and social-cultural related to religious context. Each theme included two to three sub-themes, totaling nine categories of PA participation barriers. Intrapersonal barriers consisted of low motivation, emotional states, and a sedentary lifestyle. Interpersonal challenges included a lack of family or friend support and family obligations. Institutional barriers involved academic workload prioritization, school environment inaccessibility, and absence of athletic curriculum policy. Socio-cultural barriers posed by religious expectations included gender-related concerns and modest dressing. Drawing from their perspectives as Muslim female nursing students, study participants proposed six strategies to address these barriers. Proposed solutions include promoting PA through Apps, forming female team-up clubs, providing designated exercise spaces, and implementing mandatory athletic courses for nursing students at the institutional level. Additionally, offering female instructors and private exercise rooms could reduce the barriers from a socio-cultural perspective caused by religious expectations.

Conclusions

The study found that Muslim female nursing students with dual roles face increased barriers to PA participation, driven by intrapersonal and interpersonal levels, nursing learning load, and religious norms. Schools could build environments to meet the religious expectations within Indonesian society to promote PA for Muslim female nursing students. For example, the practical strategies include offering private rooms or female instructors when they physically exercise in school.

An Umbrella Review and a Meta-analysis of Meta-analyses of Disordered Eating Among Medical Students

Objective

To prevent eating disorders in future physicians, this umbrella review and meta-analysis of previous meta-analyses estimates the prevalence of disordered eating (DE) among medical students worldwide and identifies key risk factors.

Methods

Four databases were searched electronically between their inception and February 1, 2023. The search was later updated to December 31, 2023.

Results

The search yielded prevalence rates for medical students who scored above established cutoffs on validated assessment measures for DE. These were computed to provide an overall pooled estimate. The data was taken from 2 previous reviews. Both these systematic reviews found a 15.1% (95% confidence interval [CI]: 14.7%-15.6%) prevalence rate of DE among medical students. The equivalent Hedges' G = 0.30 (95% CI: 0.29-0.31), the equivalent odds ratio = 1.74 (95% CI: 1.71-1.77), I2 = 97.6%, and the excess of statistical significance is P = .001. The trim and fill adjusted effect size was 16.0% (95% CI: 14.0%-20.0%).

Conclusion

Because eating disorders put students' safety and well-being at risk and because the health of early-stage physicians is vital to the welfare of a country, early signs of disordered eating must become a priority of medical schools and a signal for effective prevention and intervention. The recommendation is to ensure supportive environments, provide easy access to effective care, and hold clear expectations for student eating behavior.

Differences between Health and Non-Health Science Students in Lifestyle Habits, Perceived Stress and Psychological Well-Being: A Cross-Sectional Study

The aim of this study was to investigate lifestyle habits in health and non-health science students from the University of Split, Croatia, and to evaluate their association with perceived stress and psychological well-being. We surveyed 783 students during February-March 2021. Hierarchical multiple regression analysis was used in the analysis. Health science students spent less time using screens, were sitting less, slept less, but also showed better compliance with the Mediterranean diet compared to non-health science students (10.6% vs. 5.9%). There were no differences in stress and well-being perception between the two study groups. Female gender, lack of sleep, less daily sitting time, anxiety, and lower optimism were associated with higher stress in non-health science students, while anxiousness and more sitting were found to be significant among health students. Well-being among health science students was positively associated with BMI, having had COVID-19, being refreshed after waking up during working days, Mediterranean diet adherence, health perception, optimism, and quality of life, and negatively with TV time and anxiousness. Shorter sleep duration on non-working days, feeling refreshed after waking up on non-working days, higher quality of life and optimism, and lower anxiousness were associated with higher well-being among non-health students. Identifying unhealthy lifestyle habits in students is essential for implementing targeted interventions to better their health outcomes.

Cross-sectional survey of health literacy among health science students in Singapore

Background

Health literacy proficiency is essential for health care professionals to provide quality patient care. There is limited research exploring health literacy proficiency among undergraduate health science students.

Objectives

To determine health literacy among health science students in Singapore using the electronic Health Literacy Questionnaire (HLQ).

Design

A cross-sectional survey using purposive sampling was conducted among undergraduate health science students.

Methodology

This study hypothesises that health literacy is influenced by gender, and it increases with the level of health science education, attributed to the increased exposure to the health care system and health care education as undergraduates progress through the years of study. Eligible students from the 4-year entry-level programmes of diagnostic radiography, dietetics, occupational therapy, physiotherapy, radiation therapy and speech and language therapy, aged from 21 to 50, were invited. Exclusion criteria were students who were no longer studying due to dropping out or having immediately graduated from these programmes and students in the accelerated programmes whose studies would be completed in less than 4 years.

Results

In total, 111 respondents (72 females and 37 males) completed surveys (response rate, 7.7%) returned from physiotherapy (n = 69), occupational therapy (n = 25), diagnostic radiography (n = 12) and dietetics (n = 5), with nil from radiation therapy and speech and language therapy. All participants were English literate. Female participants demonstrated higher HLQ with a mean total score of 30.67 (standard deviation (SD) = 0.61) versus male participants 29.83 (SD = 0.53). Year 2, 3 and 4 students generally scored higher than Year 1 across all nine HLQ scales. Overall, dietetics students had the highest total score on the HLQ, while the diagnostic radiography students had the lowest scores for all the nine HLQ scales.

Conclusion

This study established the health literacy level of health science students in Singapore. Gender and years of study influenced health literacy levels, supporting the hypothesis.

Assessment of health literacy in patients with polycystic ovary syndrome and its relationship with health behaviours: a cross-sectional study

OBJECTIVE

Healthy behaviours are important for people with polycystic ovary syndrome (PCOS). However, adopting and maintaining lifestyle changes involves a complex set of behavioural changes, which most patients fail to adhere to. The current research on health literacy, which includes individual and social skills needed in health self-management, in patients with PCOS is limited. Therefore, this study aimed to explore health literacy, health behaviours and the relationship between the two to expand research on PCOS management.

DESIGN

Cross-sectional study.

SETTING

A gynaecological outpatient clinic.

PARTICIPANTS

A total of 286 patients with PCOS (≥18 years, diagnosed via Rotterdam criteria, able to self-report and give informed consent) were recruited from March to June 2022.

OUTCOME MEASURES

Health literacy and health behaviours in patients with PCOS were assessed using the Health Literacy Management Scale and the Health Promoting Lifestyle Profile (Chinese version). Multiple logistic regression was used to analyse the factors influencing health literacy, and linear regression to assess the relationship between health literacy and health behaviours, with an F-significance test; p<0.05 was considered statistically significant.

RESULTS

Overall, most patients with PCOS had insufficient health literacy (55.9%). The influencing factors of health literacy in patients with PCOS were age (β=0.154, p<0.05), Body Mass Index (β=-0.140, p<0.05), income (β=1.228, p<0.05), duration of illness (β=0.110, p<0.05) and educational level (β=1.552, p<0.05). Moreover, 40.6% of patients with poor health behaviours, and 31.8% with moderate health behaviours, needed to improve their health behaviours. Health literacy was positively correlated with health behaviours in patients with PCOS (r=0.473, p<0.05).

CONCLUSION

The positive correlation between health literacy and health behaviour in patients with PCOS indicates that promoting health literacy in future treatment and management of PCOS may be beneficial.

Passive exposure and perceptions of smoke-free policies in hospital and university campuses among nursing students: A cross-sectional multicenter study

INTRODUCTION

Outdoor smoke-free regulations reduce exposure to secondhand smoke (SHS) and help to denormalize tobacco use. As future key agents in health promotion, nursing students' attitudes should agree with tobacco-control policies. The objectives of this study were: 1) assess nursing students' exposure to SHS in nursing schools, 2) explore their perceptions of compliance with the existing smoke-free regulations in acute-care hospitals; and 3) describe their support for indoor and outdoor smoking bans on hospital and university campuses.

METHODS

This was a cross-sectional multicenter study conducted in 2015-2016 in all 15 university nursing schools in Catalonia, Spain. A questionnaire gathered information on SHS exposure, awareness of the smoke-free regulation in acutecare hospitals, and support for smoke-free policies in indoor and outdoor areas of hospitals and university campuses. Participants were nursing students attending classes on the day of the survey. We performed descriptive analyses and calculated adjusted prevalence ratios (APR) and 95% confidence interval (CI).

RESULTS

Of 4381 respondents, 99.1% had seen people smoking in outdoor areas of their university campus, and 75.2% had been exposed to SHS on the campus (6.0% indoors and 69.2% outdoors). Nearly 60% were aware of the smoking regulation in place in acute-care hospitals. There was widespread support for smoke-free indoor hospital regulation (98.7%), but less support (64.8%) for outdoor regulations. Approximately 33% supported the regulation to make outdoor healthcare campuses smoke-free, which was higher among third-year students compared to first-year students (APR=1.41; 95% CI: 1.24-1.62), among never smokers (41.4%; APR=2.84; 95% CI: 2.21-3.64) compared to smokers, and among those who were aware of the regulation (38.4%; 95% CI: 1.37-1.75).

CONCLUSIONS

Exposure to SHS on university campuses is high. Nursing students express low support for strengthening outdoor smoking bans on hospital and university campuses. Interventions aiming to increase their support should be implemented.

Physical Activity Levels, Eating Habits, and Well-Being Measures in Students of Healthcare Degrees in the Second Year of the COVID-19 Pandemic

BACKGROUND

When the first cases of COVID-19 (caused by SARS-CoV-2 virus infection) were discovered, exceptional norms to fight the spread of the virus were established by applying movement restrictions (lockdown) in many countries. These unprecedented norms led to sedentary behaviours and less healthy diets which could persist for much longer after lockdown. The aim of this study was to analyse the physical activity, eating habits, self-perceived well-being, and toxic habits, as well as the perceived changes of these habits with respect to the pre-pandemic period, in a population of university students in the second year of the COVID-19 pandemic.

METHODS

A single-centre, cross-sectional study was conducted in a population of university students of healthcare degrees. A total of 961 students (639 (66.5%) women and 322 (33.5%) men) signed the informed consent and completed the questionnaire. The study was conducted through an anonymous survey, which was voluntarily self-completed by the students on an online platform. The questionnaire was based on the Spanish Health Survey and it was divided into six main parts: demographic and anthropometric characteristics, physical activity, eating habits, well-being measures (sleeping habits, health state, and stress), toxic habits, and perception of the influence of the COVID-19 pandemic on the variables described.

RESULTS AND CONCLUSIONS

The results showed that, during the second year of the pandemic, statistically significant dependence was identified for those students that showed higher levels of physical activity with greater perceived physical activity (p < 0.05), healthier eating habits (p < 0.05), and a better self-perceived health state (p < 0.05), with respect to the 12 months before the COVID-19 pandemic. On the other hand, there was a negative correlation between the sedentary students and greater perceived physical activity (p < 0.05). With regard to toxic habits and physical activity, a significant correlation was only detected between sedentary behaviour and cocaine consumption (p < 0.05). Analysing eating habits, it was observed that the students who smoked, consumed alcohol, and binge drank had low adherence to the Mediterranean diet (p < 0.05). In addition, those students with high stress levels slept less than 7 h (p < 0.05).

Analysis of Knowledge of Smoking-Related Diseases in Spanish Nursing Students

Smoking causes significant morbidity and mortality worldwide, mainly in developed countries. In addition, it is the cause of numerous diseases in the body, despite the fact that the prevalence of tobacco use is decreasing. Nursing students, as future professionals, should be aware of action plans for cessation and information designed for smokers. To determine the level of knowledge among nursing students about smoking-related diseases and analyze the prevalence of student who smoke at the University of Leon, Spain, a descriptive cross-sectional study was carried out in which students were given an anonymous questionnaire, which was previously validated, during the 2021-2022 academic year. In a sample of 477 (79.5%) nursing students, a smoking prevalence of 17.6% was obtained. In addition, students' knowledge about the diseases directly caused by tobacco consumption and others associated with exposure to environmental smoke was assessed, and in both cases (8.03 points of 9 for consumption and 5.24 of 6 to exposure), scores were obtained that allow us to state that students do not know for sure the types of diseases that are related to tobacco use and passive smoking. In spite of this, it is necessary to continue to reduce the prevalence of smoking through different programs implemented in schools and universities, as it is also necessary to improve teaching plans when explaining smoking-related diseases, so that students, in the future, will be able to advise patients correctly.

Nutrition education intervention improves medical students' dietary habits and their competency and self-efficacy in providing nutrition care: A pre, post and follow-up quasi-experimental study

Objective

Most doctors and medical students report inadequate competencies in nutrition care. We evaluated the impact of a nutrition education intervention on medical students' lifestyle habits, dietary diversity, nutrition care knowledge, attitude toward nutrition care, and their level of self-efficacy in the provision of nutrition care.

Methods

All 2nd-year medical students were enrolled into a 5 week, 24-h nutrition education intervention that involved both deductive and practical sessions. Pre-, post and 4 weeks follow-up assessments were conducted.

Results

At post- and 4-weeks post-intervention the number of days participants consumed vegetables and engaged in moderate-to-vigorous physical activity significantly (p = 0.003 and 0.002) improved respectively from baseline. Mean nutrition care knowledge scores of participants increased by 3.27 points (95% Cl: 1.98-4.56, p < 0.001) from 19.49 at baseline through to 24.78 post- and 22.76 4 weeks follow-up. No significant [X ( 2 ) 2 = 1.568, p = 0.457] change in mean attitude toward nutrition care score was recorded. Mean level of self-efficacy in the provision of nutrition care improved significantly by 1.73 (95% Cl: 1.17-2.28, p < 0.001) at post-intervention and 4 weeks follow-up compared to the baseline scores.

Conclusion

The intervention improved the nutrition care knowledge, self-efficacy in the provision of nutrition care as well as medical students' own consumption of vegetables, dietary diversity and their engagement in moderate-to-vigorous physical activity. However, continuous implementation of nutrition education interventions is needed to sustain these outcomes and further improve the nutrition education experience of medical students.

The prevalence and risk factors of screen-based disordered eating among university students: a global systematic review, meta-analysis, and meta-regression

PURPOSE

The purpose of this review was to estimate the prevalence of screen-based disordered eating (SBDE) and several potential risk factors in university undergraduate students around the world.

METHODS

An electronic search of nine data bases was conducted from the inception of the databases until 1st October 2021. Disordered eating was defined as the percentage of students scoring at or above established cut-offs on validated screening measures. Global data were also analyzed by country, research measure, and culture. Other confounders in this review were age, BMI, and sex.

RESULTS

Using random-effects meta-analysis, the mean estimate of the distribution of effects for the prevalence of SBDE among university students (K = 105, N = 145,629) was [95% CI] = 19.7% [17.9%; 21.6%], I2 = 98.2%, Cochran's Q p value = 0.001. Bayesian meta-analysis produced an estimate of 0.24, 95% credible intervals [0.20, 0.30], τ = 92%. Whether the country in which the students were studying was Western or non-Western did not moderate these effects, but as either the mean BMI of the sample or the percentage of the sample that was female increased, the prevalence of SBDE increased.

CONCLUSIONS

These findings support previous studies indicating that many undergraduate students are struggling with disordered eating or a diagnosable eating disorder, but are neither receiver effective prevention nor accessing accurate diagnosis and available treatment. It is particularly important to develop ever more valid ways of identifying students with high levels of disordered eating and offering them original or culturally appropriate and effective prevention or early treatment.

LEVEL OF EVIDENCE

I, systematic review and meta-analysis.

Toxic Habits and Well-Being Measures in Spanish Healthcare University Students during the COVID-19 Pandemic

BACKGROUND

Unhealthy lifestyles are strongly entrenched in healthcare universities and have sometimes been linked to stress or lack of sleep. This study investigated the prevalence of toxic habits (smoking, patterns of harmful alcohol use, and illicit drug use), stress levels, perceived health status, and sleep duration and assessed the connections between toxic habits and said well-being measures, as well as healthcare students' perception of the influence of the COVID-19 pandemic on these health-related behaviors.

METHODS

In a cross-sectional study, healthcare students from Alfonso X University (Spain) completed a health survey composed of Alcohol Use Disorders Identification Test (AUDIT-C), Perceived Stress Scale (PSS-10), self-perceived health status, and the number of hours of sleep.

RESULTS

A total of 997 healthcare students completed the survey, of which 982 were analyzed. Being a smoker (32.2%) was associated with worse health status and insufficient sleep. Risk drinkers (33.2%) were associated with being female, and the consumption of cannabinoids (6.7%), with being male. These three toxic habits were related to each other. High levels of stress (28.2%) were correlated with worse ratings in the perception of health status (29.2%) and with insufficient sleep (45.8%), and all of them were associated with the female sex. Respectively, 49.3% and 44.2% of students recognized a worsening in their perception of stress and their sleep habits during the pandemic.

CONCLUSION

Healthcare universities must carry out health promotion programs for stress management, sleep habits, and unhealthy lifestyles.

Professionalism, Resilience and Reflective Thinking: How Do These Influence Occupational Therapy Student Fieldwork Outcomes?

The relationship between entry-level, undergraduate occupational therapy students' fieldwork performance and measures of professionalism, reflective thinking and resilience was examined. A group of 135 undergraduates (86% female) completed a self-report questionnaire containing the standardized instruments measuring professionalism, resilience and reflective thinking. The Australian Student Practice Evaluation Form-Revised (SPEF-R) measured fieldwork performance. Linear regression analyses identified Staying Healthy and Relationships with Others as significant predictors of students' fieldwork performance in Professional Behaviors, Self-Management and Information Gathering. The findings highlight the importance of interpersonal skills and engagement in healthy lifestyles in key fieldwork performance areas.

The prevalence of feeding and eating disorders symptomology in medical students: an updated systematic review, meta-analysis, and meta-regression

PURPOSE

Medical students have a higher risk of developing psychological issues, such as feeding and eating disorders (FEDs). In the past few years, a major increase was observed in the number of studies on the topic. The goal of this review was to estimate the prevalence risk of FEDs and its associated risk factors in medical students.

METHODS

Nine electronic databases were used to conduct an electronic search from the inception of the databases until 15th September 2021. The DerSimonian-Laird technique was used to pool the estimates using random-effects meta-analysis. The prevalence of FEDs risk in medical students was the major outcome of interest. Data were analyzed globally, by country, by research measure and by culture. Sex, age, and body mass index were examined as potential confounders using meta-regression analysis.

RESULTS

A random-effects meta-analysis evaluating the prevalence of FEDs in medical students (K = 35, N = 21,383) generated a pooled prevalence rate of 17.35% (95% CI 14.15-21.10%), heterogeneity [Q = 1528 (34), P = 0.001], τ2 = 0.51 (95% CI 0.36-1.05), τ = 0.71 (95% CI 0.59-1.02), I2 = 97.8%; H = 6.70 (95% CI 6.19-7.26). Age and sex were not significant predictors. Body mass index, culture and used research tool were significant confounders.

CONCLUSION

The prevalence of FEDs symptoms in medical students was estimated to be 17.35%. Future prospective studies are urgently needed to construct prevention and treatment programs to provide better outcomes for students at risk of or suffering from FEDs.

LEVEL OF EVIDENCE

Level I, systematic review and meta-analysis.

Lifestyle factors influencing medical and nursing student's health status at the rural health-care institute

BACKGROUND

Noncommunicable diseases (NCDs) may be influenced by lifestyle behavior, acquired during transition in student life at university. Health is a major concern globally. The developing counties are facing a double burden of disease, both communicable and NCD. This study is aimed to assess the lifestyle and its associated factors that can affect the health status of medical and nursing students.

MATERIALS AND METHODS

A community-based cross-sectional study was conducted among medical and nursing students of Sasaram, Bihar, by universal sampling. The study population consisted of 303 medical and 233 nursing students. The 536 students in the study, included 195 from rural areas and 341 from urban areas. Simple Lifestyle Indicator Questionnaire was used and Chi-square statistics was computed to determine the association of demographic variables with lifestyle behavior using Epi InfoTM 7 analysis software.

RESULTS

Mean age and body mass index were 21 ± 2.59 years and 22.12 ± 3.77, respectively. After statistical analysis utilizing the Chi-square test, it was shown that the difference was found to be nonsignificant (P > 0.05) in all the following variables, such as gender, age, marital status except in designation, and alcohol and tobacco intake which showed the difference to be highly significant.

CONCLUSIONS

The maximum number of students in the study population showed intermediate healthy lifestyle (57.1%), despite being the upcoming health-care providers of future. Fruits were rarely present in diet in 82%, no physical activity in 21.2%, and tobacco and alcohol were consumed by 11.7% and 13%, respectively. Targeted intervention for healthy diet, physical activity, stress, tobacco, and alcohol reduction can lead to healthy lifestyle. Independence and autonomy gained in the transition phase in student life needs guided supervision to raise responsible adults. It may help to assist or to plan accordingly in future to improve lifestyle of the students.

Knowledge, Attitudes, and Training in Tobacco Dependence and Cessation Treatment Among Nursing Students in Catalonia (ECTEC Study): Cross-Sectional Study

Nursing students are part of the future health labor force; thus, knowing their knowledge and participation in tobacco control is of importance. Multicentre cross-sectional study conducted to assess nursing students' knowledge, attitudes, and training in tobacco dependence and treatment at 15 nursing schools in Catalonia. We employed a self-administered questionnaire. 4,381 students participated. Few respondents (21.1%) knew how to assess smokers' nicotine dependence, and less than half (41.4%) knew about the smoking cessation therapies. Most (80%) had been educated on the health risks of smoking, 50% about the reasons why people smoke and, one third on how to provide cessation aid. Students in the last years of training were more likely to have received these two contents. Nursing students lack sufficient knowledge to assess and treat tobacco dependence and are rarely trained in such subjects. Nursing curricula in tobacco dependence and treatment should be strengthened to tackle the first preventable cause of disease worldwide.

Awareness of COVID-19 influences on the wellness of Thai health professional students: An ambulatory assessment during the early "new normal" informing policy

The COVID-19 global pandemic has had a socioeconomic effect, including many people suffering from stress and mental disorders. Health professional students are at risk of health issues as well when compared to their age-matched counterpart in the population. The present study aimed to find out the impact of COVID-19 awareness on the wellness of Thai health professional students. The awareness of COVID-19 and wellness among Thai health professional students, such as medical, physical therapy, nursing, pharmacy, and medical technology students were surveyed during the early “new normal” informing policy. The participants included 1,001 students, aged 17 to 25 years old, who responded to a Google form questionnaire set by request. The results showed that the prominent health risks among the Thai health professional students included sedentary behavior, obesity, and mental symptoms. A positive rating in attitude towards the COVID-19 epidemic was mostly observed. There was a negative influence on anxiety symptoms (standardized coefficient beta = -0.079, p-value = 0.012), but a positive impact on social well-being (standardized coefficient beta = 0.158, p-value < 0.001) and quality of life (standardized coefficient beta = 0.136, p-value < 0.001) among the students even when the situation was improving. To relieve the domino effect of the COVID-19 pandemic on students’ wellness, an updated policy for enhancing awareness and providing updated information is continuously required. Improvements on self and situational awareness may help prevent health risk behaviors and promote health among Thai health professional students.

A governmental program to encourage medical students to deliver primary prevention: experiment and evaluation in a French faculty of medicine

BACKGROUND

A public health student service was set up by the French government in 2018 with the aim of increasing awareness of primary health promotion among the 47,000 students of medicine and other health professions. It is an annual program involving community-based actions on nutrition, physical activity, addiction or sexuality. Our objective was to evaluate its implementation at local level and the different experiences of the stakeholders.

METHODS

A quasi-experimental study using process evaluation was performed in a Faculty of Medicine in Paris. Quantitative and qualitative data were collected from medical students who carried out preventive health actions, in the institutions in which the actions took place and from a subsample of beneficiaries.

RESULTS

One hundred and eight actions were carried out by 341 students in 23 educational or social institutions, mostly high schools (n = 12, 52%). Two thirds of the students did not feel sufficiently prepared to deliver preventive health interventions (65.7%, 224/341); however the beneficiaries found that the interventions were good (278/280, 99,2%). Nineteen (83%) of the host institutions agreed to welcome health service students again, of which 9 required some modifications. For students, the reporting of a satisfactory health service experience was associated with the reporting of skills or knowledge acquisition (p < 0.01). Delivering actions in high schools and to a medium-sized number of beneficiaries per week was associated with students' satisfaction. No effect of gender or theme of prevention was observed. For 248/341 (72.7%) students, the public health service program prompts them to address prevention issues in the future.

CONCLUSION

The public health service undertaken by medical students through the program is a feasible and acceptable means of delivering preventive actions. Reinforcement of training and closer interaction with the host institutions would improve results.

Assessing health science students' health literacy and its association with health behaviours

Health science students will play an important role in helping their patients to assess health information and thus to examine their health literacy level is crucial. We aimed to assess the health literacy (HL) status and its potential association with health behaviours. A cross-sectional study was conducted in 381 students (mean age of 20.68 ± 3.89 years). The HL questionnaire (HLS-EU-Q47) and the Health-Promoting Lifestyle Behaviors (HPLP-II) were used. The overall mean HL score was 36.52 ± 7.73. About 30.2% of students have inadequate or problematic HL. The HPLP-II total score (β = 0.188, 95% CI = 0.024, 0.352), physical activity (β = 0.062, 95% CI = 0.009, 0.116) and health responsibility domains (β = 0.042, 95% CI = -0.001, 0.086) were significantly associated with HL. Most health science students, as future healthcare providers, need to improve health literacy skills. Health literacy was linked to health behaviours, supporting the importance of including focus on health literacy in higher education curriculum.

Perception on the mind-nurse program among nursing students: A descriptive qualitative study

BACKGROUND

Nursing undergraduates are susceptible to stress from academic and clinical matters. We developed the MIND-NURSE program for nursing students.

OBJECTIVES

This study aimed to explore students' perceptions towards the program.

METHODS

This was a descriptive qualitative study. A convenience sampling was used to recruit nursing undergraduates from a university in Singapore. Participants attended the eight-week MIND-NURSE program. Each session comprised two components: Education and mindfulness practice. Three focus group interviews were conducted after completion of the program, using a semi-structured interview guide. Thematic analysis was used to identify emerging themes and subthemes.

RESULTS

Twenty students participated in the study. Overall, they reacted positively to the MIND-NURSE program, albeit some concerns raised regarding the mindfulness practice. Six themes were derived from the data including: a) enhanced awareness of the present moment; b) increased serenity through mindfulness practice; c) triad of thoughts, emotion and behaviors; d) working towards interpersonal mindfulness; e) adapting mindfulness into nursing practice; and f) overcoming the challenges for mindfulness practice.

CONCLUSIONS

Mindfulness benefited the students in personal and professional ways. More research should be conducted to implement the program on nursing students in other universities.

Prevalence of smoking in nursing students worldwide: A meta-analysis of observational studies

BACKGROUND

Smoking is common among nursing students worldwide, but the reported prevalence is inconsistent across epidemiological studies. This is a meta-analysis of the prevalence of smoking in nursing students worldwide.

DESIGN

Meta-analysis of observational studies.

SAMPLE

A total of 46 studies were included in this meta-analysis.

METHOD

Electronic databases (PubMed, Medline, PsycINFO, EMBASE and Web of science) were independently and systematically searched by two investigators from their commencement date up to 12 May 2018. Studies that reported the smoking rate of nursing students were included and analyzed using random-effects model.

RESULTS

The pooled prevalence of current smoking was 26.6% (95% CI: 22.9-30.4%), while pooled prevalence of previous smoking was 15.5% (95% CI: 11.8-19.3%). Subgroup analyses showed that smoking rate was higher in male compared with female students (39% vs 25.2%, P < .001), while survey time, sample size, age, study design and academic year did not moderate the smoking rate (all P > .05).

CONCLUSION

This meta-analysis confirmed that smoking is common in nursing students. Considering the negative impact of smoking on health, appropriate smoking cessation measures for nursing students should be developed.

Pharmacy and Medical Students' Mental Health Symptoms, Experiences, Attitudes and Help-Seeking Behaviors

Objective. To examine and compare the prevalence of mental health problems, help-seeking attitudes, and perceptions about mental health problems among US pharmacy and medical students. Methods. A cross-sectional analysis was conducted using existing, anonymous survey data collected in the Healthy Minds Study during the 2015-2016 academic year. The analysis included 482 students (159 pharmacy students and 323 medical students) from 23 institutions in the United States. Analyzed topics included demographic characteristics, mental health status and symptoms, substance abuse, stigma related to mental health, help-seeking behaviors and attitudes, and mental health treatment perceptions. Results. Pharmacy and medical students experienced similar rates of depression (18% met clinical cut-offs), but pharmacy students were more likely to meet clinical cutoffs for anxiety (21% vs 11%). Pharmacy students were less likely to seek help from student counseling services (only 11% vs 49%) and also less likely to know where to seek help on campus if needed. Pharmacy students also reported having higher levels of stigma regarding mental health treatment. Conclusion. There are differences between pharmacy and medical students with regards to their experience of mental health symptoms, willingness to seek help, and perception of stigma. Despite the small sample, this analysis of national data indicates that opportunities exist to improve campus-based mental health education and offerings for pharmacy and medical students.

Types of Polydrug Use Among Spanish Students in Health Sciences

Polydrug use among university students may be a predictor for established patterns of multiple substance use and potentially entail long-term health problems. This study examined the types of polydrug use among Spanish students in health sciences. Undergraduate students (n = 968), aged 18-38 years (M = 21.09 years, SD = 4.10), completed the survey. A percentage of 44.3% of the participants were classified as polydrug users. Type A users (alcohol and cigarettes) made up 17.8% of the participants surveyed, whereas 20.1% were Type B (cannabis with cigarettes and/or alcohol), and a further 5.7% were Type C (cannabis with cigarettes and/or alcohol, plus at least another kind of illegal drug). Type A was the most common type among women, whereas Type C was the most common among men. Type B use was higher among women 18-19 years old than among women 25-29 years old, whereas there were no female Type C users younger than 20 years old. Weekend consumption was higher, than weekday consumption, across all polydrug user types and substances. These results suggest that the prevalence of polydrug use among Spanish students in health sciences was similar to students in other disciplines, with Type B as the most prevalent among healthcare and nonhealthcare students. Taking into account the differences based on gender, age, and time of consumption, a specific approach to the different typologies of polydrug users might be a vital step in the successful development of preventive interventions tailored to the changing reality of psychoactive substance use.