Exploration of mental health problems in association with health-promoting lifestyle profile in Iranian medical students: A cross-sectional study

Psychological distress, health-promoting lifestyle and sociodemographic factors in Honduran university students: a structural equation model

This study sought to analyze an explanatory model on the relationship among sociodemographic factors, health-promoting lifestyle behaviors and psychological distress (depression, anxiety and stress) in college students. This is an observational, analytical and cross-sectional study conducted on a national sample of 4203 students who entered a macro university in Honduras in 2021, 2022 and 2023. We used a sociodemographic survey, the Health-Promoting Lifestyle Profile (HPLP-II) and the Depression, Anxiety and Stress Scales (DASS-21). Univariate analysis and a multivariate structural equation model were conducted. The average HPLP-II score was 117.45 (± 23.41), and the average DASS-21 score was 20.06 (± 14.16). The multivariate model showed a good data fit (comparative fit index = 0.951; Tucker-Lewis index = 0.957; root mean square error of approximation = 0.067 [90% CI = 0.067-0.068]). Results indicate that being a woman (β = 0.11; p < 0.001) and being enrolled in biological and health sciences (β = 0.09; p < 0.001) significantly predict HPLP-II scores. Furthermore, being a woman (β = 0.17; p < 0.001), age (β = 0.10; p < 0.001) and having pre-existing medical conditions (β = 0.16; p < 0.001) significantly explain part of the variance of DASS-21. A significant reverse relationship between health-promoting behavior and psychological distress was shown (r = -0.36; p < 0.001). This study identifies protective and risky sociodemographic factors linked to health-promoting lifestyle behaviors and psychological distress. Our findings have implications for developing comprehensive intervention policies and strategies to promote health in higher education settings.

Reliability and Validity of the Health-Promoting Lifestyle Profile II Spanish Version in University Students

AIM

The purpose of this study was to assess the reliability and validity of the Spanish version of the Health Promoting Lifestyle Profile II (HPLP-II) scale in Colombian university students.

METHODS

This was a methodological study to verify reliability and construct validity. A total of 763 undergraduate university students in Cali, Colombia, agreed to participate in the study by filling out a form that included information on sociodemographic characteristics and the HPLP-II scale Spanish version. Data were collected between February and June 2021. To determine construct validity, a confirmatory factor analysis was performed, and internal consistency was determined through Cronbach's alpha.

RESULTS

The confirmatory factor analysis of the proposed theoretical model showed that the goodness-of-fit indices of the scale demonstrated an acceptable level of validity nearing an excellent level of fit (χ2 = 7168.98; gl = 1268; p < 0.001; root mean square error of approximation = 0.08; normed fit index, adjusted goodness-of-fit index = 0.95). Cronbach's alpha coefficient of the scale was 0.94, and the subscales ranged from 0.68 to 0.89.

CONCLUSIONS

The HPLP-II Spanish version is a valid and reliable instrument to assess the health-promoting lifestyle profile of university students.

Healthy lifestyle behaviors among teachers working in public primary schools and affecting factors

Healthy lifestyle behaviors have been recognized as a key strategy to achieve a policy of health for all. The aim of this study was to determine the levels of health promotion lifestyle behavior among teachers working in public primary schools. The present study also investigated the effects of selected socio-demographic characteristics on these behaviors. The research was designed using the survey model, one of the quantitative research methods. The sample of the research consisted of public primary school teachers (n = 372). Research data were collected using the Health-Promotion Lifestyle Profile-II (HPLP-II) scale. As a result of the research, it was put forward that there were statistically significant differences in levels of health promotion lifestyle behaviors based on taking courses on health promotion, and following programs and articles about healthy living (p < 0.05). It was revealed that primary teachers' taking courses on health promotion, and following programs and articles affected their healthy lifestyle behaviors. Public primary school teachers' health promotion lifestyle behaviors were found to be moderate. It was found that the primary teachers obtained the highest mean score for the spiritual growth subscale of the health promotion lifestyle behaviors scale; however, the primary school teachers had the lowest mean score for the physical activity subscale, which indicates that they need support in improving their healthy lifestyle. Male teachers had higher mean scores in the physical activity subscale, whereas females had higher mean scores in all other subscales. Training programs to protect and improve the health of teachers should be organized.

The Impact of a Healthy Lifestyle on Psychological Well-Being Among Saudi Adolescent Girls Attending Secondary Schools in Taif City, Saudi Arabia

Background and objective A healthy lifestyle encompasses healthy eating, regular exercise, getting enough sleep, and avoiding smoking, drug abuse, and alcohol, which will help improve mental health and manage the symptoms of anxiety, stress, and depression. In this study, we aimed to evaluate the relationship between a healthy lifestyle and psychological well-being among Saudi adolescent girls. Materials and methods A cross-sectional study was conducted among adolescent girls in secondary schools in Taif City, Saudi Arabia. The main outcome measures were the Simple Lifestyle Indicator Questionnaire (SLIQ), Patient Health Questionnaire-2 (PHQ-2) and PHQ-9 (if PHQ-2-positive), Generalized Anxiety Disorder 7-item (GAD-7) questionnaire, and Perceived Stress Scale (PSS) scores. Results The age of the respondents ranged between 15 and 19 years with an arithmetic mean of 16.72 and a standard deviation (SD) of 0.96 years. Most of the students (58.3%) followed a healthy lifestyle whereas only 6.7% followed an unhealthy one. The prevalence of depression was 52.5%; moderately severe depression was observed in 14.8% and severe depression was seen in 6.9% of the schoolgirls. Moderate or severe anxiety was observed in 24.3% and 17.8% of schoolgirls, respectively. High perceived stress was observed in 18% of the students. There was a statistically significant association between students' lifestyle and the severity of depression, anxiety, and perceived stress (p<0.001). Conclusion While unhealthy lifestyles are not common among secondary schoolgirls in Taif City, we found a significant association between such lifestyles among students and the deterioration of their psychological well-being.

Helping a Patient With a Pre-Existing Mental Health Condition Cope With Depression and COVID-19 Using the Neuman Systems Model: A Single Intrinsic Case Study

Nursing theories and conceptual models shape nursing knowledge. This study applied the philosophical and theoretical basis of the Neuman Systems Model, which focuses on the use of primary, secondary, and tertiary nursing prevention for retention, attainment, and maintenance of patient system wellness, to a patient with pre-existing mental health conditions struggling to cope with depression and COVID-19 in a dedicated COVID-19 hospital in an urban area of Iran. The single intrinsic case study design used interviews, nursing observations, and document analysis to evaluate environmental factors and intra-, inter-, and extra-personal stressors. An advanced, outcome-oriented nursing care plan was developed.

Association between lifestyle choices and mental health among medical students during the COVID-19 pandemic: A cross-sectional study

INTRODUCTION

Mental health is recognized as a critical component of public health Given the close relationship between mental health and life style and the importance of students as valuable human resources, the present study aimed at determining the relationship between life style and mental health among medical students in Sousse during COVID-19 pandemic.

METHODS

We conducted a cross-sectional observational study in university students from the first to the fifth grade of the Faculty of Medicine of Sousse during the academic year 2020/2021. Data were collected anonymously via an online questionnaire published on the Facebook groups of each grade, on december 2020. The online survey consisted of three sections. The first one aimed to collect sociodemographic information. The second section of the survey addressed recent lifestyle choices and the third one assessed psychological distress using the French version of 12 items of The General Health Questionnaire (GHQ-12). The significance level was considered 0.05.

RESULTS

Overall 147 were studied. Using the bimodal scoring, the total score was between 0 and 12, to evoke psychiatric disorders, we set the threshold of 4. For our sample, the median scale was 7 [4-9], and more than half of the students (68%; n = 100) had a score higher than 4. Psychiatric disorder was significantly more frequent in female students (73.3% vs 42.3%; p = 0.002). Higher GHQ-scale was found in younger students, foreigners, students who need more than 30 minutes to get to the faculty, unemployed students, and students of fifth grade. However, differences were not statistically significant. Regarding lifestyle choices, we found that physical inactivity, no smoking habits, no alcohol use, no illicit substance use, other substance use, changing in eating habits, and absence of coping methods of stress were higher in students with psychiatric disorders. However, this association was statistically significant only for physical activity (p = 0.016). The results of the regression analysis suggest female gender as an independent predictor of high GHQ-12 scores. Practicing physical activity was found as protective factor for psychiatric disorders.

CONCLUSION

Considering the vital role of medical students in providing and promoting community health, the need for more detailed planning and interventions to improve their life style and mental health is essential.

The mediating role of motivated strategies in the relationship between formative classroom assessment and academic well-being in medical students: a path analysis

BACKGROUND

The support of students' academic well-being is one of the main agendas of medical education. For medical students, well-being can help prevent burnout and provides students with grounds for their future healthcare setting. The aim of this study was to examine the mediating role of motivated strategies for learning in the relationship between formative assessment and academic well-being.

METHOD

The present cross-sectional study was performed on 391 undergraduate students of medical sciences selected by a convenient sampling method. The measuring instruments used in this study included motivated strategies for learning questionnaire (Pintrich and De Groot), classroom assessment approaches questionnaire (Yousefi Afrashteh et al.) and Academic well-being Questionnaire (Pietarinen et al.). In order to analyze the data, SPSS-26 software was used for descriptive statistics and correlation matrix, and LISREL-10.20 software was used to do path analysis and determine the relationships between variables within the model.

RESULTS

Findings showed that formative assessment is a significant resource in shaping subscale of motivated strategies for learning (self-efficacy, intrinsic value, test anxiety, cognitive strategies and self-regulation). Moreover, the results demonstrated that the self-regulated learning strategies is a crucial determinant of academic well-being and is a mediator between formative assessment and academic well-being.

CONCLUSION

These findings suggest the important value and necessity of formative assessment in medical science classes which can indirectly lead to improve students' academic well-being.

Factors affecting the prevalence of stress, anxiety, and depression in undergraduate Indian dental students

BACKGROUND

The objective was to assess the prevalence and the associated demographic factors of stress, anxiety, and depression among undergraduate (UG) Indian dental students and determine whether the pattern is different in government-run institutions and those managed by private authorities.

MATERIALS AND METHODS

A cross-sectional study was conducted among dental UG students from five dental colleges. Snowball sampling was used to approach 776 potential participants, resulting in a complete response from 507 students. The questionnaire consisted of demographic data; year of study; type of college; accommodation; and Depression, Anxiety, and Stress Scale (DASS)-42. Descriptive data and inferential statistics were obtained. Chi-square test was applied for categorical data to test for significance, and higher analysis was done using multiple linear regression.

RESULTS

Females and males comprised 71.8% (n = 364) and 28.2% (n = 143) of the study population, respectively. The prevalence of anxiety was highest (66.86%, n = 339), followed by depression (57.39%, n = 291) and stress (43.99%, n = 223). In terms of severity also, anxiety was the most prevalent condition as more than one-fourth of the students presented with severe and very severe scores in this aspect (25.43%, n = 129) compared to depression (14.39%, n = 73) and stress (10.09%, n = 51). Regression analysis revealed age as a strong positive predictor for all the three conditions, while staying in the hostel was a positive predictor for anxiety and stress. Being female was also an independent predictor for the high prevalence of stress.

CONCLUSION

Stress, anxiety, and depression are highly prevalent among Indian dental students. Clinical students and interns have a higher prevalence of stress than preclinical students. Age, being female, and staying in the hostel are positive predictors for the severity of stress. There is no significant difference between government and private colleges, regarding the prevalence of any psychological condition.

Mental health state in medical students during COVID-19 pandemic

BACKGROUND

Before the COVID-19 pandemic, medical students had reported experiencing high rates of distress, burnout, anxiety, and depression. The psychological impact of the COVID-19 in the general population suggested that the mental health impact was increased anxiety, depression, and stress. There were no exceptions if medical students also experience the same psychological impact. The aimed to this study is analyze the mental and emotional effects of the COVID-19 pandemic among medical students.

MATERIALS AND METHODS

An observational analytic study was used with a cross-sectional approach. Data were obtained with questionnaires distributed through social media platforms from July 14, 2020, to July 21, 2020. This study using the Fear of COVID-19 (FCV-19) Scale and the Depression, Anxiety, and Stress Scale-21 to assess FCV-19, anxiety, stress, and depression. statistical analysis used IBM SPSS Statistics 24 was used to analyze the two-tailed Chi-square test, the Mann-Whitney test, and the Kruskal-Wallis test, which were used with statistical significance as P < 0.05 for all tests.

RESULTS

Out of 1027 samples, 44.6% had stressed, 47.8% had anxiety, and 18.6% had depression. The gender (P = 0.000), educational stage (P = 0.000), and the comorbidity factor (P = 0.001 for stress and anxiety, P = 0.036 for depression, and P = 0.000 for FCV-19) had a significant association with stress, anxiety, depression, and FCV-19 in medical students. The hometown that showed zone risk of infection only showed significant differences in FCV-19 (P = 0.026).

CONCLUSIONS

Protection and psychological support for a medical student is extremely high importance given that COVID-19 is now a well-established pandemic and there will be other pandemics in the future.