How does the self-reported health of undergraduate nursing students change during their degree programme? Survey results from a Scottish University

Abstract

Background The lifestyle behaviours, and the physical and mental health of nurses, are poorer than those of other allied health professionals, and of the general population. However, these were no less favourable among first year undergraduate nursing students at a Scottish Higher Education Institution (HEI) than among similar people of the same age. We compared health and health behaviours among the same cohort of undergraduate nursing students over the course of their degree. Methods An anonymous self-complete repeat cross-sectional survey was administered during a timetabled teaching session at three time-points to undergraduate nursing students at the start of Years 1, 2 and 3 of their programme. They had received written information about the study previously. Results Self-reported health did not change significantly over time, but there was a clear decline over the 3 years in the proportions of students rating their mental health as excellent/very good/good and a concomitant increase in those rating their mental health as fair/poor. Correspondingly, the mean WEMWBS wellbeing score declined over the 3 years, with the proportion of students with a score of < 46 (indicating either high risk of major depression, or in high risk of psychological distress and increased risk of depression) increasing from one quarter to one half. This effect was captured and described using a Bayesian regression analysis. The most noticeable change in health behaviours was a decline in physical activity levels over the study period. The proportion of students managing 150 min of weekly physical activity decreased from three quarters to two thirds. This was reflected in higher self-reported sedentary time, although there were no observable trends over time in mean BMI, or proportions of students categorised as overweight or obese. Conclusions This paper suggests that there may be a decline in mental health and in participation in physical activity among nursing students over the course of their degree. We recommend the incorporation of an intervention into the undergraduate nursing curriculum that promotes and encourages regular physical activity, offering students the opportunity to learn about health promotion and lifestyle change in practice, to improve their own physical health, and to address mental wellbeing.

Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study

“…Nevertheless, 4 out of 10 students reported sleep problems. This is in contrast to previous research among nursing students, where only 1 in 10 students reported sleep problems during the first year of higher education [ 39 ] although sleep problems did increase during the third year [ 40 ]. Sleep could have an impact on anxiety and depression [ 13 ], and is essential to serve several important physical functions, such as recuperation from infectious diseases and consolidation of memories [ 48 ].…”

“…In the results, most students reported good general health and good general well-being. This is consistent with previous research among nursing students [ 39 ]; however, previous studies have also found that general health and well-being decline during the 3-year bachelor programme [ 40 ]. Examples of health-promoting strategies that higher education can implement to maintain good general health and general well-being and create more incentives for a health-promoting perspective include integrating knowledge of sustainable working life into the programme through the courses’ content and pedagogical structure.…”

“…Of all students, most were non-smokers and non-daily snuff users; over half the students reported low alcohol consumption. The prevalence of smoking and alcohol consumption among the participating students is in line with research from other countries in Europe [ 40 , 44 , 45 ].…”

“…Previous research has stated that higher education students’ health-related lifestyle give cause for concern and suggests that universities need to focus on health-promotion work among students [ 44 ]. However, it is lower than previous research among nursing students, in which three-quarters met the recommendations for physical activity in their first year of higher education [ 39 ] although this rate declined during the 3-year bachelor programme [ 40 ]. Based on research from other industrialised countries, around two-thirds met the recommendations for physical activity of 150 min of moderate activity per week, in Australia and Spain [ 6 , 45 ], whereas only one-third did so in England, Greece and the United States [ 4 , 7 , 44 ].…”

Priorities and directions for future research on student mental health within Scottish Higher Education Institutions: A scoping review protocol

“…Extant research highlights how financial stressors are a predictor of both physical and mental health problems (Cutherbertson et al, 2004) and difficulties with disclosure and the stigma of mental health help-seeking (Quinn et al, 2009). Further work has emphasised the importance of close relationships in moderating the effect of depressive symptoms on declining mental health, reduced physical activity and suicidal ideation over the course of a degree course (Evans et al, 2021;Murray et al, 2016). Such research has, however, tended to be specific to one HEI and/or student population and thus further, targeted work is needed to understand the broader mental health issues and research priorities facing diverse student populations throughout Scotland .…”