An evaluation of the effectiveness of a dedicated health and well being course on nursing students' health

BackgroundMany studies have shown that the transition to college can have a negative effect on students' life style choices resulting in weight gain, increasing inactivity and stress. Additionally while this issue is well recognised there have been only limited attempts at targeted interventions aimed at the university student population. The establishment of poor behavioural choices at this stage in the student's life can lead to consistency of unhealthy lifestyle practices, ultimately placing students at risk of heart disease and other lifestyle related health issues. This is more problematic for nursing students who are identified within the public domain as health promoters and as such ought to model, or at least not grossly contradict, healthy lifestyle choices. The current intervention is proposed as a possible mechanism to interrupt this process and establish healthy lifestyle choices at this crucial time in students' life in the hope that this will have lifelong health benefits.AimThis is an innovative study aimed at evaluating the effectiveness of a health and well being module on nursing students' health.MethodsTeaching on Health and Well-Being, a new course in the University, was provided to all first year undergraduate students at one university site in the Republic of Ireland (ROI) (n = 110). Approximately half the sample (Nursing students) underwent an intervention while the other half served as a comparison group, health behaviours of both groups were compared using pre and post-test measures.FindingsThe most important finding from the study was a statistically significant increase in psychological well-being in the intervention group with a corresponding decrease in psychological well-being in the comparison group. Findings also indicated an initial significant increase in physical activity in the intervention group although this was not maintained over time.DiscussionTargeted health behavioural interventions that include stress management skills ought to be provided as mandatory to nursing students to ensure the health of our future professionals. Only in this way they can role model the behaviours required of clients in their care.     

Associations between sleep and lifestyle behaviours among Australian nursing students: A cross-sectional study

BackgroundNursing students are at risk of inadequate sleep and poor lifestyle behaviours due to academic, clinical and personal stressors faced throughout their training. However, the relationship between lifestyle and sleep in this population is not well understood.AimThe aim of this study was to determine whether inadequate sleep was associated with poor diet, physical inactivity, alcohol consumption and smoking in Australian nursing students.MethodsUsing a cross-sectional design, nursing students (n = 470) completed an online questionnaire that assessed sleep and lifestyle behaviours. One-way ANOVA, t-tests, Pearson’s bivariate correlation and multiple regression testing were used to determine relationships between variables.FindingsMost nursing students experienced inadequate sleep (78%). Patterns of irregular eating, increased intake of discretionary foods, high-risk alcohol consumption and smoking were associated with indicators of inadequate sleep (p < 0.05). Frequent lunch intake (4–7 times per week) was associated with lower global sleep quality scores than irregular lunch intake (β: ?1.060, 95% confidence interval ?2.022, ?0.099), whereas alcohol score was associated with higher global sleep quality scores (β: 0.088, 95% confidence interval 0.011, 0.165) indicating poorer quality sleep, even after adjusting for confounding variables. No significant associations were found between sleep parameters and level of physical activity.ConclusionThis study highlights that nursing students experience inadequate sleep, and that poor lifestyle behaviours were associated with inadequate sleep in this sample. Strategies are needed to address inadequate sleep and poor lifestyle behaviours in nursing students, to support health, academic and clinic performance, as well as the transition to professional nursing practice.     

Do nurses’ personal health behaviours impact on their health promotion practice? A systematic review

BackgroundThere is a growing expectation in national and international policy and from professional bodies that nurses be role models for healthy behaviours, the rationale being that there is a relationship between nurses’ personal health and the adoption of healthier behaviours by patients. This may be from patients being motivated by, and modelling, the visible healthy lifestyle of the nurse or that nurses are more willing to promote the health of their patients by offering public health or health promotion advice and referring the patient to support services.MethodsAn integrated systematic review was conducted to determine if nurses’ personal health behaviour impacted on (1) their health promotion practices, and (2) patient responses to a health promotion message. Medline, CINAHL, SCOPUS, and PsycINFO databases were searched. A narrative synthesis was conducted.Results31 studies were included in the review. No consistent associations were noted between nurses’ weight, alcohol use, or physical activity level and their health promotion practice, although smoking appeared to negatively impact on the likelihood of discussing and engaging in cessation counselling. Nurses who reported confidence and skills around health promotion practice were more likely to raise lifestyle issues with patients, irrespective of their own personal health behaviours. The two studies included in the review that examined patient responses noted that the perceived credibility of a public health message was not enhanced by being delivered by a nurse who reported adopting healthy behaviours.ConclusionsAlthough it is assumed that nurses’ personal health behaviour influences their health promotion practice, there is little evidence to support this. The assertion in health care policy that nurses should be role models for healthy behaviours assumes a causal relationship between their health behaviours and the patient response and adoption of public health messages that is not borne out by the research evidence.     

Healthy eating and physical activity among new graduate nurses: A qualitative study of barriers and enablers during their first year of clinical practice

BackgroundNew graduate nurses entering the workforce experience numerous barriers to maintaining a healthy lifestyle including shift work, the high cost of healthy foods at the workplace and high levels of exhaustion which reduce motivation to participate in regular physical activity. Research has documented unhealthy lifestyles among nurses across the profession. However, few studies focus on graduates' experiences during their transition into their careers.AimTo investigate the barriers and enablers to healthy eating and participation in physical activity for new graduate nurses during their first year of clinical practice, and to explore attitudes to participation in workplace health promotion programs.MethodsSemi-structured interviews informed by the socioecological model were conducted with 24 new graduate nurses and analysed using thematic analysis.FindingsFour key themes emerged as barriers to healthy eating and physical activity: time, shift work, work environment, and work culture. Participants indicated a high interest in workplace health promotion programs.DiscussionLimited time and shift work impact on the eating and physical activity behaviours of new graduate nurses which leads to unhealthy snacking to maintain energy, as does high levels of exhaustion, reduced motivation to eat healthy foods, and decreased participation in physical activity. The work culture and environment also influence eating behaviours. Inadequate breaks lead to consumption of foods that are quick to eat but often low in nutrients.ConclusionNew graduate nurses experience the same difficulties in maintaining healthy lifestyles as more experienced nurses. Understanding the barriers which influence their dietary and physical activity behaviours can help inform strategies to improve the health of nurses at a critical time when they enter the nursing workforce.     

Undergraduate registered nursing students working as assistants in nursing within the acute care environment: Program development and discussion

BackgroundMost pre-registration nursing students require employment during their studies which may entail undertaking another qualification.This paper describes how one university developed a program whereby undergraduate nursing students complete the national vocational education – HLT33115 Assistant in Nursing qualification through recognition of prior learning, a self-directed education package and completion of an objective structured clinical examination.ObjectiveTo discuss the development of an ‘Assistant in Nursing’ in the acute care environment program for pre-registration undergraduate nursing degree students using the national vocational education framework.DesignThis program maps the national ‘Assistant in Nursing- Acute Care’ vocational qualification to the pre-registration registered nurse degree. Upon successful completion of this program students can work as Assistants in Nursing within the acute care environment.ConclusionsThis program enables student nurses to work as Assistants in Nursing within the acute care environment. This provides employment in a health facility and opportunities for students to immerse themselves in the clinical environment whilst continuing their studies. This may assist students to gain a deeper insight into their future role as a nurse, build networks within the nursing community and assimilate into the clinical environment. This program design may prove useful as a template for other nursing faculties wishing to implement a similar program.     

What works to encourage student nurses to adopt healthier lifestyles? Findings from an intervention study

The health and lifestyles of student nurses has been widely explored internationally finding relatively high levels of smoking, low levels of physical activity and unhealthy diets. Not only does this have implications for productivity, personal health and the ability to do the demanding job of nursing, but unhealthy behaviours are also associated with a reluctance to undertake health promotion in their roles. Stress, time constraints and the irregular routine of nurse training were cited as barriers to a healthy lifestyle.Three types of accessible interventions were piloted to encourage the adoption of healthier lifestyles by student nurses: an educational session on having ‘healthy conversations’ with patients, an accelerometer to record steps, and an online personal wellness tracker. There was low take up of the offers designed to motivate behaviour change but students did welcome the educational input on how to have a ‘healthy conversation’ with a patient.This project highlights the need to incorporate programmes that addresses student nurses' health behaviours within nurse education, and at salient time points (e.g. induction or just before going on placement) over the course of study.     

Development of a novel empathy-related video-feedback intervention to improve empathic accuracy of nursing students: A pilot study

BackgroundStressed family carers engage in health-risk behaviours that can lead to chronic illness. Innovative strategies are required to bolster empathic dialogue skills that impact nursing student confidence and sensitivity in meeting carers' wellness needs.PurposeTo report on the development and evaluation of a promising empathy-related video-feedback intervention and its impact on student empathic accuracy on carer health risk behaviours.DesignA pilot quasi-experimental design study with eight pairs of 3rd year undergraduate nursing students and carers.MethodsStudents participated in perspective-taking instructional and practice sessions, and a 10-minute video-recorded dialogue with carers followed by a video-tagging task. Quantitative and qualitative approaches helped us to evaluate the recruitment protocol, capture participant responses to the intervention and study tools, and develop a tool to assess student empathic accuracy.Main ResultsThe instructional and practice sessions increased student self-awareness of biases and interest in learning empathy by video-tagging feedback. Carers felt that students were ‘non-judgmental’, inquisitive, and helped them to ‘gain new insights’ that fostered ownership to change their health-risk behaviour. There was substantial Fleiss Kappa agreement among four raters across five dyads and 67 tagged instances.ConclusionIn general, students and carers evaluated the intervention favourably. The results suggest areas of improvement to the recruitment protocol, perspective-taking instructions, video-tagging task, and empathic accuracy tool.     

Nursing students' perceptions of the importance of caring behaviors

Title. Nursing students’ perceptions of the importance of caring behaviours Aim. This paper is a report of a study to determine the nursing students’ perceptions of the importance of caring behaviours. Background. Caring has been considered as the essence of nursing. It is believed that caring enhances patients’ health and well‐being and facilitates health promotion. Nursing education has an important role in educating the nurses with adequate caring abilities. Method. Ninety nursing students (response rate 75%) responded to a questionnaire consisting of 55 caring behaviours adapted from items on Caring Assessment Questionnaire (Care‐Q). Behaviours were ranked on a 5‐point Likert‐type scale. The caring behaviours were categorized in seven subscales: ‘accessibles’, ‘monitors and follows through’, ‘explains and facilitates’, ‘comforts’, ‘anticipates’, ‘trusting relationship’ and ‘spiritual care’. Data were collected in Iran in 2003. Findings. The students perceived ‘monitors and follows through’ (mean = 4·33, SD = 0·60) as the most and ‘trusting relationship’ (mean = 3·70, SD = 0·62) as the least important subscales. ‘To give patient’s treatments and medications on time’ and ‘to do voluntarily little things…’ were the most and least important caring behaviours, respectively. ‘Explains and facilitates’ statistically and significantly correlated with age (r = 0·31, P = 0·003) and programme year (r = 0·28, P = 0·025). Gender had no statistically significant influence on students’ perceptions of caring behaviours. Conclusion. Further research is needed, using longitudinal designs, to explore nursing students’ perceptions of caring behaviours in different cultures, as well as evaluation studies of innovations in curriculum and teaching methods to improve learning in relation to cultural competence and caring concepts.     

Prepare,a randomized trial to promote and evaluate weight loss among overweight and obese women planning pregnancy: Study design and rationale

BackgroundWomen who are overweight or have obesity at pregnancy onset, and those who gain excessive weight during pregnancy, are at increased risk of pregnancy-related complications and large for gestational age infants.ObjectiveThis report describes methodology for the Prepare study, a randomized, controlled clinical trial testing a preconception and pregnancy weight management program for women who are overweight or have obesity (BMI ≥ 27 kg/m²).OutcomesThis trial examines multiple pregnancy and neonatal outcomes, with the primary outcome being gestational weight gain (GWG). Secondary outcomes include change in weight before conception, offspring birth weight adjusted for gestational age, offspring weight for length, and pregnancy diet quality and physical activity level.MethodsNonpregnant women who anticipate becoming pregnant in the next 2 years are randomly assigned to an intervention program or a usual care control condition. Intervention participants receive weight management counseling by telephone before and during pregnancy, with weekly contacts during the first 6 months and monthly contacts for the next 18 months. Intervention participants also have unlimited access to a study website that provides self-management tools. All participants who become pregnant are contacted at 20 weeks' gestation to assess physical activity levels and dietary habits. All other outcome data are obtained from medical records. Intervention satisfaction is assessed via questionnaire.SummaryThis clinical trial tests the efficacy of an intervention program designed to help overweight and obese women achieve healthy lifestyle changes that will result in a healthy weight prior to pregnancy and appropriate weight gain during pregnancy.     

The role of stress in the relationships between gender and health‐promoting behaviours

Scand J Caring Sci; 2010; 24; 572–580
The role of stress in the relationships between gender and health‐promoting behaviours Studies have shown that in Western societies, women live longer than men. Among other factors, this has been attributed to health behaviours; men engage in health‐risking behaviours, while women perform health‐promoting behaviours. These tendencies were argued to align with cultural notions of masculinity and femininity. There may be some evidence, however, that men and women engage in different types of health‐promoting behaviours, and stress may play a role in these tendencies. This study attempts to examine the various types of health‐promoting behaviours women engage in and compare them to the tendencies of men. Secondly, it examines the mediating role of stress in the relationships between gender and health‐promoting behaviours. The sample was comprised of 402 young Israeli adults. Half were undergraduate university students majoring in social work. The remaining participants were sampled by ‘snowball sampling’. Participants completed a questionnaire containing 63 closed‐ended questions on various health issues. For the purpose of this study, gender, stress and health‐promoting behaviours measures were used. Data were collected over three academic years by the teacher responsible for the course and were received by the author at the end of the data collection phase. The study was approved by the institution’s internal review board. The results indicate that,‐while women engage in ‘type 2 behaviours’‐ refraining from smoking and drinking, eating breakfast regularly and sleeping 7–8 hours per night‐men engage in ‘type 1 behaviours’‐ physical exercise, refraining from snacking, and maintaining an appropriate body mass. We also found that, to some extent, women refrain from ‘type 1 behaviours’ because of their levels of general stress. Our study suggests that the social construction of masculinity and femininity which undermines individuals’ health needs to be challenged and addressed. In particular, the enduring role of stress in women’s health outcomes should be addressed.     

Time2bHealthy – An online childhood obesity prevention program for preschool-aged children: A randomised controlled trial protocol

BackgroundThe use of parent-focused internet-based programs for the prevention and treatment of childhood obesity has shown promise but there is an acknowledged gap in parent-focused interventions which target the early childhood stage.MethodsThe aim of this study is to determine the efficacy of Time2bHealthy - an online healthy lifestyle program for parents of preschool-aged children. The program will be evaluated using a two-arm, parallel, randomised controlled design. The 11-week program is underpinned by Social Cognitive Theory and consists of interactive modules on healthy eating, physical activity, screen-time and sleep. The intervention also involves elements of social media, where participants share discuss ideas and experiences and they can interact and obtain information with experts. Time2bHealthy is being compared to a comparison condition. Outcomes include change in BMI (primary outcome), dietary intake, physical activity, sleep, child feeding, parental role-modelling and parent self-efficacy. Process evaluation data, such as adherence and engagement with the online forums, will also be collected.DiscussionTime2bHealthy is the first randomised controlled trial to our knowledge to assess the efficacy of an online parent-focussed healthy lifestyle program for preschool-aged children in changing body mass index. Early childhood is a crucial time for establishing healthy lifestyle behaviours and parents play an important role. This study therefore fills an important gap in the literature. If found to be efficacious, Time2bHealthy has potential for broad-reach access and translation into primary health care services.Trial RegistrationThe study is registered with the Australian and New Zealand Clinical Trials Registry (12616000119493).     

Cross-sectional survey of the health behaviour of southeast Queensland women with cancer-treatment induced menopause: Implications for cancer and primary care nurses

PurposeWomen who experience cancer treatment-induced menopause are at risk of long-term chronic morbidity. This risk can be prevented or offset with adherence to health promotion and risk reduction guidelines. The purpose of this study was to explore health behaviours in younger female survivors of cancer and the variables (quality of life and psychological distress) believed to moderate health behaviours.DesignCross-sectional survey of a convenience sample of women (n = 85) in southeast Queensland.MethodsHealth behaviour and health status were elicited with items from the Australian Health Survey and the Behavioural Risk Factor Surveillance System. The WHO Quality of Life (Brief) measured participants’ self-reported quality of life and their satisfaction with their health. The Brief Symptom Inventory-18 measured psychological distress.FindingsHigher self-reported health status was associated with regular exercise and better quality of life. However, a substantial proportion of participants did not engage in the physical activity, dietary or cervical screening practices recommended by Australian guidelines.ConclusionsThe participants require education regarding the benefits of diet, exercise, weight loss and decreased alcohol intake, as well as information on future health risks and possible comorbidities. These education sessions could be addressed by a nurse-led health promotion model of care at the time of discharge or in the community.     

Learning from the lived experience of functionally healthy older adults: What does it mean to be “healthy”?

BackgroundReports of older adults’ perceptions of ageing and health generally do not consider individual health status, instead presenting large cohort data or focussing on specific population groups. Moreover, qualitative studies have largely included participants with suboptimal health.AimThis study aimed to examine functionally healthy older adults’ perceptions of health and healthy ageing.MethodTwenty-two functionally healthy older adults living independently in the community (aged 61–83 years; 68% female) participated in six focus groups to explore their perceptions about “health” and “healthy ageing”. Quantitative measures were used to describe participants’ health status.FindingsSeven themes describing participants’ experiences of healthy ageing were identified: “know thyself”, “knowledge and information management”, “choices, agency, and control”, “autonomy and flexibility”, “being strategic”, “community connections”, and “getting more out of life”. Key competencies for healthy ageing were subsequently derived, drawing connections between beliefs, behaviours, and knowledge about healthy ageing.DiscussionThe identified health behaviours perceived to be important for healthy ageing align with previous reports. The subsequent overarching healthy-ageing competencies (“recognise opportunity”, “strategise”, “maximise benefits”, and “active participation”) present important pillars underpinning the process of healthy ageing that have not been previously considered in this context.ConclusionThe behaviours perceived to influence older adults’ health are varied, and the competencies identified in this study present a broad framework underpinning these behaviours. The identified competencies have the potential to inform public health initiatives, practice, and policy, empowering individuals to optimise their health.