Health Promoting Lifestyle among Students at Guilan University of Medical Sciences

Sedigheh Pakseresht¹, Komeil Rezaei^2*, Afsaneh Pasha³, EhsanKazemNejad Leili⁴, FatemehHasan Doost⁵

1Social Determinants of Health Research Center (SDHRC), Department of Midwifery, Associate Professor, Guilan University of  Medical Sciences, Rasht, Iran

²Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran

³Department of Nursing, Instructor, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran

⁴Social Determinants of Health Research Center (SDHRC), Bio-Statistics, Associate Professor, Guilan University of Medical Sciences, Rasht, Iran

⁵Department of Nursing, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran

*Corresponding author: Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran, E-mail: Rezaei.komeil@yahoo.com

Received: 2014August25; Accepted: 2015December02

Introduction

Lifestyle involves individuals’ ordinary daily activities which affect their lives [1]. Individuals may maintain and improve their health and prevent diseases through a lifestyle which includes activities such as adopting a healthy diet, appropriate sleep and activity patterns, exercise, weight control, avoiding smoking and alcoholic drinks, and immunizing the body against diseases [2].

Health promotion is the science and art of lifestyle modification aimed at attaining perfection [6]. The habits and behaviors of the students change during university years [3]. Students go through a dynamic transition period of growth and perfection that bridges adolescence to youth [4]. This is thus the right time to form health promoting lifestyle behaviors [5] which lead to rapid changes in the students’ body, soul, and social relations [6]. With a different way of studying and new living conditions, many students are exposed to a wide range of unhealthy habits including unhealthy diet, inadequate rest, and insufficient physical activity [7]. Six major components of health promoting lifestyle include health accountability, physical activity, diet, stress management, spiritual development, and interpersonal relations [8]. In their studies on health promoting lifestyle among students, Wei et al. and Peker et al. demonstrated that the lowest scores related to health accountability [7, 8]. Moreover, according to Rejali and Mostajeran, 48.6% of medical and health students were active in terms of moderate physical activity and 51.4% were inactive. In terms of high physical activity, 32.6% of the students were active and 76.4% were inactive [9]. MohammadiZeidi et al. reported the physical activity of medical university students as insufficient [10]. A study by Salem et al. indicated that 10.7% of medical students were overweight and 13% were underweight or malnourished [11].

Other studies reported depression, anxiety, and stress in respectively 51.6%, 39.5%, and 71.7% of the students. Furthermore, 52% of the students had abnormal stress [12-14]. Meanwhile, the highest score in health promoting lifestyle was related to spiritual development [2, 8, 15]. Wei et al. found that students were more capable and skilled in interpersonal relations [7].

Special attention is currently paid to the youth and students due to their major role in any country’s future. In fact, students not only constitute the bulk of specialists in various scientific, technical and artistic fields, they will also play a key role in helping any nation to achieve perfection and its lofty goals [16]. Age and social status of the students, as the well-educated part of the society, can set an example for others. Apparently, universities are the right place to assess the efficacy of educational health programs. Practical management of health conditions among the adolescents and youth requires timely prevention of health problems among this group. After acquiring the necessary information, knowledge, and skills during their studies, medical students will serve as medical and health staff members. They are hence expected to adopt all they have learned in their behavior and performance. Nevertheless, according to available research, the students lack adequate efficiency despite having acquired scientific and theoretical knowledge [17]. Therefore, given the high costs of health care and the need for the health workers to adopt preventive approaches rather than treatment approaches, this study tried to determine the health promoting lifestyle of medical students. The results could be helpful in the development of appropriate methods of improving health and productivity and preventing unhealthy habits among the youth.

Materials and Methods

This cross-sectional descriptive, analytical study evaluated the health promoting lifestyle among students of Guilan University of Medical Sciences in 2013-14. The study was conducted at six faculties, i.e. ShahidBeheshti Nursing and Midwifery Faculty of Rasht (nursing and midwifery fields), Langeroud Faculty of Nursing and Midwifery (nursing and midwifery fields), Langeroud Paramedical Sciences (lab sciences, radiology technology, operation room and anesthesia fields), and Faculty of Health (engineering fields of environmental health, occupational health engineering, general and public health), medical sciences, and dentistry, of Guilan University of Medical Sciences. Third year students who aged below 35 years and did not have chronic or incurable diseases and disability were recruited. MSc or PhD students were not included. The students were only included if they consented to participated. Information was collected using relevant questionnaires.

A self-report questionnaire called the Health promoting Lifestyle Profile 2 (HPLPH) was completed by the participants. The questionnaire has two sections. The first part measures demographic characteristics (age, gender, field of study, academic year, marital status, parents’ educational background, parents’ job, place of residence, weight, height, and family’s average monthly income). The second part covers 52 phrases that measure health promoting behaviors in six domains including health accountability (nine items), physical activity (eight items), eating habits (nine items), stress management (eight items), inter personal relations (nine items) and spiritual growth (nine items). These items are answered on a four-point Likert scale between 1 (never) and 4 (always). Hence, the total scores range between 52 and 208. In this study, scores higher than the mean score (i.e. 130) indicate a desirable lifestyle and lower scores show an undesirable lifestyle. In four domains, i.e. eating habits, health accountability, interpersonal relations and spiritual growth, scores higher than 22.5 were indicative of desirable behavior. In the remaining two domains, i.e. physical activity and stress management, scores higher than 20 were considered to reflect desirable behavior. Psychometric analysis of this tool has been previously performed in Iran [18].

After obtaining the required documents and permissions from the heads of all faculties, the researcher selected 343 eligible students from the student lists in each field (provided by the Department of Education of the university). Convenience sampling was applied to randomly select the participants proportionate to the predetermined sample size at each faculty.

The participants were provided with explanations about the study objectives, the confidentiality of the collected data and method of completing the questionnaire. They were then asked to fill out the questionnaires while the researcher regularly visited them to resolve any possible issues.Data were analyzed using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (t-tests after the confirmation of normal distribution of health promoting lifestyle scores). All analyses were performed using SPSS 19. The participants were asked to provide informed consent and to complete the questionnaires anonymously.

Results

The mean age of the participants was 22.07 ± 1.41 years. Most students were female (68%; n =227), single (91.3%; n =305) and living with their family (51.8%; n =173). Moreover, fathers were self-employed and mothers were housewives in 41.9% and 17.4% of the cases, respectively. The monthly family income of 45.5% of the students exceeded 300 $.

ANOVA     ** T Test      *** Kruscal Wallis Test

Of the 6 faculties of Guilan University of Medical Sciences, the Faculty of Medicine had the highest frequency (36.5%) and the Dentistry and Nursing Faculties of Langeroud had the lowest frequency (6.9). According to the calculated body mass index (BMI) values, 7.5% of the participants were thin, 71.3% were normal, 19.2% were overweight, and 1.2% was obese. Evaluating the components of health promoting lifestyle showed interpersonal relations and spiritual development to be at the desirable level. Meanwhile, the total score of health promoting lifestyle was undesirable. Statistical tests did not reveal any significant relationships between the students’ total scores of health promoting lifestyle and their demographic characteristics, except for the family’s monthly income (Table 1).

Among the dimensions of health promoting lifestyle, the scores of spiritual development and interpersonal relations (table 3) were significantly different in the studied faculties (Tables 2). Moreover, one-way analysis of variance (ANOVA) suggested significant relations between gender and eating habits (P = 0.014), physical activity (P <0.001), and health accountability (P <0.001).In fact, girls scored significantly higher in eating habits (21.70 ± 3.87 which was undesirable) and health accountability (22.72 ± 3.89 which was desirable). While boys had significantly higher scores in physical activity, their mean score (18.72 ± 4.80) was still undesirable. T-test indicated a significant relation between BMI and gender (P <0.001), i.e. girls had significantly more desirable BMI (22.12 ± 3.0).

                       * ANOVA