Psychological distress and lifestyle behaviour of undergraduate university students: implications for health promotion
Résumé
Poor diet, physical inactivity, tobacco smoking and alcohol
consumption are known risk factors for chronic disease
and premature mortality. These behaviours are frequently
reported among higher education students and may be
linked to psychological distress, which is also problematic
particularly for students on programmes with practical
components such as nursing and teaching. Understanding
how risk behaviours aggregate and relate to psychological
distress and coping among this population is important
for health promotion.
A cross-sectional survey examined lifestyle behaviours
(Lifestyle Behaviour Questionnaire) and their relationship
to psychological distress (General Health Questionnaire
(GHQ)1 and coping processes (Ways of Coping Questionnaire
(WOC);2 among a total sample of undergraduate
nursing/midwifery and teacher education students
(n=1,577) in a university in Ireland.
The response rate was 71% of the total sample. The
respondents were registered on nursing/midwifery
(36.5%) and teacher education (63.5%) programmes. Of
these, 53.1% were female, most were under the age of
26(90.5%) and single (89.7%).Health risk behaviours
were common, including alcohol consumption (93.2%),
unhealthy diet (26.3%), physical inactivity (26%), tobacco
smoking (17%), cannabis use (11.6%) and significant
psychological stress (41.9%). Females were more
distressed than males (p=0.0001). Nursing students were
more distressed than teacher education students
(p=0.0027).
Bivariate analyses identified strong links between lifestyle
behaviours and demographic characteristics including
gender, age, programme of study and place of residence.
Multivariate logistic regressions confirmed the relationships
between risk behaviours, demographic characteristics,
distress and coping. Compared with males, females
had lower levels of physical activity (OR=1.58 for females)
and consumed less alcohol (OR=1.85 for males). Younger
students were more likely to eat convenience food
(OR=1.67) than older students. Nursing/midwifery students
were less physically active (OR=1.75) and smoked
more (OR=2.48) than teacher education students. Those
who did not enjoy their programme were more likely to
drink alcohol (OR=1.60). Compared with students who
worked full time, those who worked part-time, those
financially supported by their families or grant-aided had
healthier diets (OR=0.42 and 0.35, respectively) but were
less physically active (OR=2.44 and 2.16, respectively).
Conversely, students who worked part-time consumed
more alcohol than those with grant or family support
(OR=2.07).
High psychological stress scores were correlated with poor
diet (OR=1.03), increased consumption of convenience
foods (OR=1.04), physical inactivity (OR=1.05) and
tobacco smoking (OR=1.04). Passive coping strategies
were correlated with poor diet (OR=1.55) and eating
convenience food (OR=1.62). Those who mostly used
escape avoidance coping were more likely to drink alcohol
(OR=2.13) and have lower levels of physical activity
(OR=1.84). Exposure to any unhealthy behaviour
increased the risk for other risk behaviours. For example
those who smoked tobacco had an increased risk of poor
diet (OR=1.65), low levels of physical activity (OR=1.54)
and alcohol consumption (OR=1.56). Cluster analysis
identified a tendency for students to cluster into two
groups: those with risk behaviours (n=733) and those
with positive health behaviours (n=379). The group with
risk behaviours had high psychological distress and used
mostly passive coping strategies such as escape avoidance.
The group with positive health behaviours
comprised students who reported a healthy diet, regular
physical activity and who did not use substances (tobacco,
alcohol, cannabis).
The potential multiplicative effect of these risks on
students’ health and subsequently on their academic
performance is a concern. As these students are the
nurses and teachers of the future, their risk behaviours,
elevated psychological distress and poor coping also raise
concerns regarding their roles as future health educators/
promoters. Attention to promotion of health and wellbeing
among this population is essential.