Factors Affecting Health-Promoting Behaviors among Nursing Students

Examining Well-Being and Healthy Lifestyle Interventions among Nursing Students Worldwide: A Scoping Review

Purpose: The purpose of this scoping review was to identify intervention studies related to well-being and healthy lifestyles in nursing students to identify research gaps in the literature for future research. Methods: The review followed the Joanna Briggs Institute (JBI), JBI Manual for Evidence Synthesis, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. Five databases were searched to retrieve the articles assessed by this review: APA PsycINFO, CINAHL Complete, PubMed, Scopus, and Web of Science. Inclusion criteria included articles with a sample population of nursing students; addressed the well-being, wellness, health, or healthy lifestyle(s) of nursing students; tested an intervention(s), lifestyle change, behavioral change interventions, or behavior change technique. Findings: Twenty-four articles were included for analysis. Three categories of interventions were found: interventions related to (1) educational and curricular strategies, (2) psychological related interventions, and (3) supportive environments. Conclusion: This review adds to the literature by identifying future interventions that can increase the well-being of nursing students. The ability to cope with the stressors of school and competing demands is essential to meet academic requirements and goals. Therefore, understanding how to address nursing student well-being is vital to the future of the nursing profession.

Health-promoting lifestyle behaviors and its association with sociodemographic characteristics in hospital clinical staff

Objective

The aim of this study was to determine hospital clinical staff' health-promoting lifestyle behaviors, and explore associations between nurse demographic factors and lifestyle behaviors.

Methods

This cross-sectional investigation focused on the clinical personnel employed at hospitals associated with Baqiyatullah University. A sample of 341 clinical staff of hospitals was collected using convenience sampling. In this study, the questionnaire of Health Promoting Lifestyle Profile II (HPLP-II) was used to assess health-promoting behaviors.

Results

In the present study, the mean HPLP score was 131 ± 23. The score of health-promoting behaviors was significantly higher in the nursing major (p = 0.029). Also, a difference was found between the major and the subscales of health responsibility (p = 0.000), stress management (p = 0.004), physical activity (p = 0.004) and nutrition (p = 0.001). The score of health responsibility, stress management, physical activity and nutrition subscales was higher in nursing. There was a significant relationship between education and stress management (p = 0.033) and physical activity subscales (p = 0.001). The physical activity score was also higher in individuals with master's and doctoral degrees, and the stress management score was higher in participants with master's degrees. Based on the findings presented herein, age (p = 0.001) and gender (p = 0.016) were associated with the nutrition subscale, and the nutrition score was higher in the age group of over 30 years and in women. Additionally, a significant relationship was observed between marriage and the subscales of spiritual growth (p = 0.013) and nutrition (p = 0.024), and the score of spiritual growth, and nutrition was higher in married people. There was a significant relationship between job and health responsibility (p = 0.013) and nutrition (p = 0.022), and the score of health responsibility and nutrition score was found to be higher in nurses.

Conclusion

Health-promoting behaviors of hospital employees are at an average level and are related to the educational levels of the employees, so these behaviors are more in nurses, while this relationship was not present in physicians. These findings may be helpful in providing recommendations for developing healthy lifestyle programs for clinical staff aimed at promoting health behaviors.

Photovoice and Health Perception in a Group of Early-Career Nurses

Background. Nurses' perceptions of health are essential to decision making and communicating with clients. However, little is known about their own perceptions of this phenomenon. This study focuses on health-related beliefs among young nurses enrolled in a master's-level nursing program using a modified photovoice methodology. Methods. The study population was 87 nurses undergoing a master's degree in nursing at Jagiellonian University Medical College in Krakow, Poland, participating in an obligatory health psychology course. For the modified photovoice activity, the participants took three photos related to their perceptions of (1) health, (2) health protective factors, and (3) health risk factors. The data interpretation involved a thematic analysis of these photos and captions; a narrative analysis to distinguish between documentary and symbolic photos; and a descriptive analysis of the photo production. Results. Eighty-seven students completed the photography assignment. The mean age was 22.1 years (SD = 1.1). Most photos (91%) documented real-life health behaviours. Some photos (9%) used everyday objects such as sunflowers to create symbols related to health. A photo series showed a model of the human brain in different environments and activities. Conclusions. Student participation in the photovoice activity appeared to strengthen observation and interpretation skills, which are essential to client care. Students used this opportunity to reflect on their own lives and environments and show their perceptions of health, health protective factors, and health risks. The activity planted seeds for changes in students' health perceptions and critical thinking. Future research could explore whether participation in a modified photovoice activity as experiential learning in a required health psychology course contributes to changes in master's-level nursing students' personal health behaviours and client care.

Does health-related college major have an effect on health-promoting behaviors? Evidence from Iranian's staff

Background

Health-promoting behaviors and lifestyle changes can reduce the cost of health services, stress, and disease complications. This study examined the status of health-promoting behaviors and its influencing factors.

Methods

This cross-sectional study was conducted on 171 staff members of Zanjan University of Medical Sciences, Iran, in 2023. The Persian version of the health-promoting lifestyle profile II questionnaire was used. Analyzes were performed in R 4.3.2 software.

Results

Mean ± SD age was 37.67 ± 7.58 years. 83 % had the low levels of health-promoting behaviors, while 17.0 % had moderate levels. The physical activity and interpersonal relation had the lowest and highest scores. The most significant strong and weekly correlations was between health responsibility and physical activity with total score of health-promoting behavior scores (r = 0.81, r = 0.66). Staff with health-related college major performed better in the areas of nutrition, stress management, spiritual growth.

Conclusion

Health-related college major is the most important factor affecting health-promoting behaviors. Also, health responsibility is most related to these behaviors. Educational interventions should be done at the community level, regardless of people's field of study, to increase people's knowledge and awareness about risk factors and improve the level of health.

The association between stair climbing and modifiable cardiovascular disease risk factors: the Suita Study

BACKGROUND

Stair climbing is a readily available form of physical activity with potential cardiovascular benefits. This study aimed to investigate the association between stair climbing and numerous modifiable cardiovascular disease (CVD) risk factors.

METHODS

In this cross-sectional study, we used data from 7282 Japanese people (30-84 years) residing in Suita City, Osaka. CVD risk factors and stair climbing frequency were assessed during the Suita Study health examination. Logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for CVD risk factors across stair climbing frequencies.

RESULTS

After adjustment for age, sex, lifestyle, and medical conditions, stair climbing >60% of the time, compared to <20% of the time, was inversely associated with obesity, smoking, physical inactivity, and stress: ORs (95% CIs) = 0.63 (0.53, 0.75), 0.81 (0.69, 0.96), 0.48 (0.41, 0.55), and 0.67 (0.58, 0.78), respectively (p-trends < 0.05).

CONCLUSION

Stair climbing was inversely associated with obesity, smoking, physical inactivity, and stress; suggesting a potential role for cardiovascular disease prevention.

Nutrient intake, alcohol consumption, emotional eating and anxiety in women nursing students

Objective

The aim of the study was to analyze dietary habits, alcohol habits, emotional eating and anxiety in a sample of Spanish nursing students. These students appear to be essential to the field of public health and to teaching their future patients about their own good practices.

Methods

A cross-sectional investigation was conducted. Participants completed the Emotional Eater Questionnaire, the Alcohol Use Disorder Identification Test (AUDIT) test to evaluate alcohol intake, the State-Trait anxiety Inventory (STAI) test to measure levels of anxiety as a state and anxiety as a trait, and self-reported sociodemographic data. Following classroom instruction, three-day food records were used to gauge food intake.

Results

The calorie intake for the macronutrients Ca, Mg, K, and Fe were below the Recommended Dietary Intakes (DRI) and imbalanced. The percentage E of proteins was 132.7 % more than recommended, while the percentage of carbohydrates is below the recommended level. Dietary energy consumption barely equaled 78 % of the total energy consumed by this sex and age group. With respect to emotional eating, nursing women students were low emotional eater (44 %) > emotional eater (30 %) > non-emotional eater (22.7 %). The students' emotional eating is substantially connected with fast food and sweets, or less healthy food intake behaviors. According to the Alcohol Use Disorder Identification Test (AUDIT), 82.7 % of female students used alcohol on a regular basis in a low-risk manner.

Conclusion

The findings demonstrated a link between anxiety and dietary fat intake. Trait anxiety was negatively connected with emotional eating (EE), whereas state anxiety was positively correlated with meat consumption. It is crucial to consider these findings when creating prevention/intervention plans and profiles of harmful eating behaviors.

Influence of Personal Factors on Health-Promoting Behavior in College Students: A Structural Equation Modeling Approach

Purpose

This study aimed to determine how personal factors influence health-promoting behavior in university students using a structural equation modeling approach guided by the Health Promotion Model.

Patients and Methods

An analytical cross-sectional study was conducted. The study included 763 health science students from four universities in Cali, Colombia, who answered a questionnaire on personal factors and Health Promoting Lifestyle Profile II, Spanish version, which was validated in the study population. The direct and indirect relationships between personal factors and health-promoting behaviors were assessed using structural equation modeling. Data analysis was performed using descriptive statistics and structural equation modeling.

Results

A significant relationship was noted between the biological and psychological personal factors of the measurement model (p < 0.05). Psychological personal factors (self-esteem and perceived health status) positively influence health promoting behavior in university students (Hypothesis 2). It's not possible to demonstrate that health promoting behavior is positively influenced by personal biological factors (Hypothesis 1) and by personal sociocultural factors (Hypothesis 3).

Conclusion

There is a need for interventions that help improve the health-promoting lifestyle profile and are focused on enhancing the self-esteem and perceived health status of university students.

Health-promoting lifestyle and its predictors among health-related and non-health-related university students in Taiwan: a cross-sectional quantitative study

BACKGROUND

University students majoring in different disciplines are believed to have different personality traits, courses exposure, and future roles, which may further affect their health behaviors and health status. The purpose of this study was to investigate the differences in health-promoting lifestyle (HPL) and its predictors among health-related and non-health-related students.

METHODS

The research participants were university students in the main island of Taiwan, and a two-stage sampling approach was adopted to obtain the samples from November 2020 to March 2021. First, 37 universities were randomly selected based on the ratio of public and private universities in each region of Taiwan. Then, based on the ratio of health-related and non-health-related majors of selected university, 25-30 students were randomly drawn from each university according to the student ID number to complete self-administered questionnaires, which included items for personal factors, perceived health status (PHS), health conception (HC), and health-promoting lifestyle profile (HPLP). A total of 1062 valid questionnaires were recovered, including 458 from health-related students and 604 from non-health-related students. Chi-squared test, independent samples t-test, one-way ANOVA, Pearson product-moment correlation analysis, and multiple regression analysis were performed.

RESULTS

The results showed that gender (p < 0.001), residential status (p = 0.023), body mass index (p = 0.016), and daily sleep duration (p = 0.034) of the students majoring in different disciplines were different. Health-related students having better HC (p = 0.002) and HPLP (p = 0.040) than non-health-related students. In addition, for both majors, females, low PHS scores, and low scores for functional/role, clinical, and eudaimonistic dimensions of HC were important indicators of a relatively negative HPLP, while health-related students who exercised 75 min or less per week and non-health-related students with a monthly disposable income of 15,000 TWD or less or who dined out 15 times or more per week also required attention in the promotion of HPL (health-related majors: adjusted R² = 0.481, p < 0.001; non-health-related majors: adjusted R² = 0.443, p < 0.001).

CONCLUSIONS

Students majoring in each discipline who had poor HPLP which is mentioned above should be prioritized in the provision of appropriate exercise or nutritional support programs on campus to promote their awareness and ability to pay attention to their health.

The influence of eHealth literacy, reproductive health knowledge, and self-esteem on health-promoting behaviors in early adult women: a cross-sectional survey

PURPOSE

The purpose of this study was to investigate the influence of eHealth literacy, reproductivehealth knowledge, and self-esteem on early adult women's health-promoting behaviors (HPB). Thisstudy was based on Pender's health promotion model as a theoretical underpinning.

METHODS

Early adult women aged 18 to 35 years (n=165) were recruited by posting advertisements on social network sites for a student club and a faith-based community in Ansan, Korea. Willing individuals were invited to participate in the online survey from June 1 to June 30, 2022. Standardized instruments were used to measure HPB, eHealth literacy, reproductive health knowledge,and self-esteem. General characteristics included income level, perceived subjective health, and internet usage time. The collected data were analyzed using the independent t-test, one-way analysisof variance, Pearson correlation coefficients, and multiple regression.

RESULTS

The mean age of the respondents was 21.97±3.87 years. The total HPB score was 120.69,corresponding to a moderate level; and the total scores for eHealth literacy (30.24), knowledge ofreproductive health (23.04), and self-esteem (35.62) were higher than the midpoint. The model explained 53.3% of variance in HPB, and self-esteem (β=.48, p<.001) was the most influential factor.Other influential factors were, in descending order, higher economic level, higher subjective healthstatus, greater eHealth literacy, and less internet use time (<2 hours/day).

CONCLUSION

In order to promote the health of early adult women, counseling or programs that positively improve self-esteem appear promising, and eHealth literacy should be considered as a way topromote HPB using information technology.

Predictors of Higher-Order Affective Skills in Health Promotion Among Indonesian Nursing Students: Assessment and Evaluation

AIM

We examined health-promoting lifestyle in undergraduate nursing students and its potential as a predictor of health-promoting behaviors and basis for curriculum improvement.

BACKGROUND

A health-promoting lifestyle is essential among students for their future nursing roles. Development requires the internalization of healthy behaviors beyond the cognitive learning domain.

METHOD

Guided by Pender's health promotion model, this multisite, cross-sectional, and descriptive-correlational study surveyed 1,634 undergraduate nursing students in Bali, Indonesia.

RESULTS

The regression analysis revealed that student profiles explained the 5 percent variation in their overall health-promoting lifestyle. Perceived health status was observed to be a significant predictor ( p < .05) of health-promoting behaviors among a diverse sample of undergraduate nursing students.

CONCLUSION

The study findings emphasize the role of nursing education in instilling healthy behaviors among undergraduate students and the importance of integrating student-centered and context-responsive health promotion strategies into the nursing curriculum.

Health-promoting behaviors and self-efficacy among nursing students in times of uncertainty

BACKGROUND

Nursing students are often faced with academic and personal stressors that threaten their Health-Promoting Behaviors (HPB) and well-being. Research on how living in a context of high political uncertainty can impact nursing students' HPB is limited. The aim of this study was to investigate the associations between HPB and self-efficacy among nursing students in a context of high political uncertainty.

METHODS

This was a cross-sectional, descriptive study that included 120 undergraduate nursing students from Lebanon who completed an electronic self-reported questionnaire.

RESULTS

The results indicated that HPB measured by HPLP-II scores were negatively correlated with overall uncertainty scores (r = -.29, p < .01) and positively correlated with the General Self-Efficacy (GSE) scale scores (r = .41, p < .001). Results from the multiple linear regression model indicated that physical activity frequency and GSE were independent predictors of the total health-promoting lifestyle profile and the model explained 30.28% of the variance in the total HPLP-II scale.

LINKING EVIDENCE TO ACTION

This study further emphasizes the importance of regular physical activity (at least 3 h a week) as a strategy to improve HPB among nursing students. Culturally sensitive strategies that aim to enhance HPB should be embedded in undergraduate nursing curricula. Public health nurses and university counselors should join efforts to develop strategies to maintain or enhance self-efficacy and to promote regular physical activity among nursing students. Future research should further study the association between self-efficacy, resilience, and uncertainty in contexts of ongoing conflicts.

The relationship between sleep quality, neck pain, shoulder pain and disability, physical activity, and health perception among middle-aged women: a cross-sectional study

BACKGROUND

Sleep quality is an important physical requirement for a healthy life, and good sleep quality has been recognized as a significant component in physical and mental health and well-being. The purpose of this study was to identify the factors that affect sleep quality as well as the relationship between sleep quality and neck pain, shoulder pain and disability, physical activity, and health perception.

METHODS

We conducted surveys on 494 women between the age of 35 and 64 years. The study evaluated neck pain, shoulder pain and disability, physical activity, self-health perception and sleep quality with self-reported questionnaires in middle-aged women. Data were analyzed using SPSS 23.0.

RESULTS

The results showed that the more severe the neck pain and shoulder pain and disability, the worse the sleep quality was in middle-aged women and the better the health perception, the lower the sleep quality score was, indicating good sleep quality. Shoulder pain, self-perceived task difficulty, and health perception were identified as variables that affected the sleep quality in middle-aged women. The explanatory power of the model in explaining sleep quality was 22.9%.

CONCLUSIONS

Worsened shoulder pain, self-perceived task difficulty, and negative health perception can affect poor sleep quality; therefore, it is necessary to develop health interventions for pain management and emotional and social support for improving daily sleep quality. To improve the sleep quality in middle-aged women, healthcare workers should consider the subjects' pain and functional disability, in accordance with their health perception.

Food Preferences in Undergraduate Nursing Students and Its Relationship with Food Addiction and Physical Activity

The transition to college is a decisive stage for the acquisition of eating habits that continue into adulthood. The aim of this study is to assess the consumption of healthy elements of the Mediterranean diet in a group of university students and to evaluate whether the consumption pattern was related to sex, Body Mass Index (BMI), food addiction or the amount of physical activity performed. A total of 515 nursing students participated. The Mediterranean diet adherence questionnaire (PREDIMED), the food addiction scale (YFAS 2.0) and the International Physical Activity Questionnaire (IPAQ) were completed. For data analysis, multivariate analysis was performed with multiple linear regression and adjusted for sex, age, and BMI. The results showed that females consumed various types of meats (white/red, processed) in a healthier proportion (p < 0.05). Students that consumed more than one per day (unhealthy) of red/processed meats (mean difference (MD) = −0.49; 95% CI: −0.83; −0.15), soft drinks (MD = −0.82; 95% CI: 82−1.36; −0.27) and pastries (MD = −0.63; 95% CI: −0.97; −0.30) displayed higher food addiction scores. In addition, students who skipped breakfast also scored higher on food addiction (MD = 0.75; 95% CI: 0.31−1.19). Higher values of physical activity were observed in those who presented a healthy consumption of vegetables (MD = 140.86; 95% CI: 72.71−209.02), fruit (MD = 145.78; 95% CI: 69.35−222.21), legumes (MD = 136.46; 95% CI: 60.43−212.50) and nuts (MD = 74.36; 95% CI: 14.23−134.49). Students who consumed more red or processed meats, more pastries and more soft drinks had higher values of food addiction, while those who consumed more vegetables, fruits, legumes, and nuts had more minutes of physical activity per week. These findings invite us to insist on expanding knowledge regarding the health benefits of consuming a Mediterranean-type diet as a whole. The healthy consumption of fish, fruit and legumes should also be emphasized, especially among university students.

Health-related behaviors, self-rated health, and predictors of stress and well-being in nursing students

BACKGROUND

Nursing students are at increased risk for the consequences of stress on wellbeing. Little is known about nursing students' health promoting behaviors and how these relate to health, stress, and well-being.

PURPOSE

The purpose was to describe perceived stress and measures of well-being (self-compassion, happiness, and life satisfaction) along with self-reported health promoting behaviors and health status in order to identify factors that could affect stress and well-being in nursing students.

METHODS

A multi-site team employed cross-sectional research methods to explore well-being, stress, and potential physical and emotional health-relevant factors in undergraduate nursing students. Baccalaureate Nursing students from three nursing programs in North Texas participated in a web-based survey. Undergraduate students (n = 417) reported being junior or senior level in a traditional (74.1%) or an alternative nursing training program (on-line, fast-track, or weekend nursing program; 24.9%) in the fall of 2019. Recruitment fliers went to a total of 2264 potential participants via university e-mail. Consenting students completed online surveys collecting demographic and health related factors as well as measures of well-being and stress.

RESULTS

More than half (56.6%) of students reported worsening health since starting nursing school. Exercise and meditation were related to higher measures of well-being and lower stress, but this relationship diminished in the multivariate model when considering individual demographic and health related factors. Our multivariate model suggests that self-rated health status remains a main potential predictor of reduced stress and improved well-being.

CONCLUSIONS

Self-reported health factors are related to wellbeing in nursing students. Targeted interventions to improve well-being among nursing students may be necessary and would fit with national recommendations for nursing education programs. Resiliency skills training with mindfulness practices may help nursing students reduce stress, improve overall well-being, and equip students to avoid burnout and stress-related illness once in the workforce.

Health-promoting behaviors among American and Lebanese nursing students

BACKGROUND

Although there are well-known benefits of maintaining a healthy lifestyle, few nursing students practice health-promoting behaviors (HPBs).

AIMS

The aim of this study was to compare the HPBs of undergraduate nursing students from two different cultures-the United States of America (U.S.), a high-income country, and Lebanon, a low-income country.

METHODS

A cross-sectional, descriptive study included 320 undergraduate nursing students, of which 200 were from the U.S. and 120 were from Lebanon.

RESULTS

The results indicated significant differences between the groups in their HPBs, as measured by the total Health-Promoting Lifestyle Profile-II score of t(318) = 6.66, p = .001, and its subscales of health responsibility, t(318) = 5.06, p = .001; physical activity, t(318) = 6.29, p = .001; interpersonal relations, t(318) = 4.24, p = .001; nutrition, t(318) = 3.54, p = .001; spiritual growth, t (318) = 3.05, p = .002; and stress management, t(318) = 3, p = .003.

LINKING EVIDENCE TO ACTION

The significant differences in HPBs of nursing students from two different countries indicated that cultural factors may influence students' healthy lifestyle. Therefore, nursing education should consider exploring strategies that promote student participation in health-promoting activities.

The Relationship Between International Students' Health Perceptions and Their Healthy Lifestyle Behaviors

This study was carried out to examine the relationship between international students' health perceptions and their healthy lifestyle behaviors. This descriptive and relational study was conducted with 216 international students studying at a university in Turkey. Study data were collected using the descriptive information form, the Perception of Health Scale (PHS) and the Health-Promoting Lifestyle Profile II (HPLP-II). Data were evaluated using descriptive statistics and Pearson correlation analysis. It was determined that the health perception and healthy lifestyle behaviors of the international students involved in this study were moderately positive. The study found a weak and positive relationship between PHS and the physical activity, nutrition and stress management subdimensions of HPLP, while a moderate positive relationship was identified between PHS and the spiritual growth and interpersonal relations subdimensions of HPLP. No relationship was observed between PHS and the health responsibility subdimension of HPLP. The fact that students have a positive perception of health reflects positively on their healthy lifestyle behaviors. It is important to disseminate education programs aimed at improving the health perception and healthy lifestyle behaviors of international students within the university.