Health-related behaviors, self-rated health, and predictors of stress and well-being in nursing students.

BACKGROUND: Nursing students are at increased risk for the consequences of stress on wellbeing. Little is known about nursing students' health promoting behaviors and how these relate to health, stress, and well-being. PURPOSE: The purpose was to describe perceived stress and measures of well-being (self-compassion, happiness, and life satisfaction) along with self-reported health promoting behaviors and health status in order to identify factors that could affect stress and well-being in nursing students. METHODS: A multi-site team employed cross-sectional research methods to explore well-being, stress, and potential physical and emotional health-relevant factors in undergraduate nursing students. Baccalaureate Nursing students from three nursing programs in North Texas participated in a web-based survey. Undergraduate students (n = 417) reported being junior or senior level in a traditional (74.1%) or an alternative nursing training program (on-line, fast-track, or weekend nursing program; 24.9%) in the fall of 2019. Recruitment fliers went to a total of 2264 potential participants via university e-mail. Consenting students completed online surveys collecting demographic and health related factors as well as measures of well-being and stress. RESULTS: More than half (56.6%) of students reported worsening health since starting nursing school. Exercise and meditation were related to higher measures of well-being and lower stress, but this relationship diminished in the multivariate model when considering individual demographic and health related factors. Our multivariate model suggests that self-rated health status remains a main potential predictor of reduced stress and improved well-being. CONCLUSIONS: Self-reported health factors are related to wellbeing in nursing students. Targeted interventions to improve well-being among nursing students may be necessary and would fit with national recommendations for nursing education programs. Resiliency skills training with mindfulness practices may help nursing students reduce stress, improve overall well-being, and equip students to avoid burnout and stress-related illness once in the workforce.

A Qualitative Investigation of the Self-Perceived Health Behavior Changes in Seniors After Their Transitions Into a Retirement Home.

PURPOSE/AIMS: It is important for seniors to engage in positive health behaviors to reduce the incidence of health-related consequences associated with aging. The purpose of this research study was to examine self-perceived changes in physical activity, nutrition, and alcohol consumption behaviors of seniors living in a retirement home through consideration of previous behaviors and self-perceptions of behavior changes. DESIGN: A qualitative research design was used for this study. METHODS: Semistructured one-on-one interviews were conducted with 9 Canadian women living in a retirement home. RESULTS: Two key themes, each with 3 subthemes, highlighted the various factors that influenced changes in health behaviors. The 2 themes consisted of (a) aging and adapting and (b) the transition: give a little to gain a lot. CONCLUSIONS: Participants' insights revealed the importance of maintaining a positive attitude, the influence of the social environment on health behaviors, and the nutritional sacrifices of retirement living. Future research should investigate ways in which nurses can assist seniors in enhancing health behaviors throughout transitions into retirement homes.

Behavior change techniques in mobile applications for sedentary behavior.

OBJECTIVE: Mobile applications (apps) are increasingly being utilized in health behavior change interventions. To determine the presence of underlying behavior change mechanisms, apps for physical activity have been coded for behavior change techniques (BCTs). However, apps for sedentary behavior have yet to be assessed for BCTs. Thus, the purpose of the present study was to review apps designed to decrease sedentary time and determine the presence of BCTs. METHODS: Systematic searches of the iTunes App and Google Play stores were completed using keyword searches. Two reviewers independently coded free (n = 36) and paid (n = 14) app descriptions using a taxonomy of 93 BCTs (December 2016-January 2017). A subsample (n = 4) of free apps were trialed for one week by the reviewers and coded for the presence of BCTs (February 2017). RESULTS: In the free and paid app descriptions, only 10 of 93 BCTs were present with a mean of 2.42 BCTs (range 0-6) per app. The BCTs coded most frequently were "prompts/cues" (n = 43), "information about health consequences" (n = 31), and "self-monitoring of behavior" (n = 17). For the four free apps that were trialed, three additional BCTs were coded that were not coded in the descriptions: "graded tasks," "focus on past successes," and "behavior substitution." CONCLUSIONS: These sedentary behavior apps have fewer BCTs compared with physical activity apps and traditional (i.e., non-app) physical activity and healthy eating interventions. The present study sheds light on the behavior change potential of sedentary behavior apps and provides practical insight about coding for BCTs in apps.

Physical activity policies and legislation in schools: a systematic review.

CONTEXT: Current physical activity levels of youth are alarmingly low. One way to promote higher levels of physical activity to youth is through school-based government policies. The current review examines evaluation of school-based physical activity policies for youth over the past 10 years. EVIDENCE ACQUISITION: Articles included met the following criteria: was an original research study published in an academic journal in English; examined or was related to physical activity behavior; applied to a youth population in a school setting; highlighted a law, bill, or policy reflective of physical activity based on government initiatives; and involved an evaluation. After searching five databases in January 2011, a total of 13 articles were selected for inclusion. EVIDENCE SYNTHESIS: All policies came from the U.S.; seven studies highlighted the federal Child Nutrition and Women, Infants, and Children Reauthorization Act of 2004 whereas the other six studies highlighted state-level policies dealing with safe routes to schools, physical activity-only initiatives, or physical activity as well as other initiatives. Eight articles evaluated policy implementation, three examined policy implementation and impact, and two articles considered only policy impact. CONCLUSIONS: This evaluation of the impact of policies on school-based physical activity indicates that such policies can affect health outcomes, specifically by increasing levels of physical activity. This study highlights the value of policy reform and calls attention to the need for independent evaluation of such policies.

Ontario's daily physical activity policy for elementary schools: is everything in place for success?

OBJECTIVES: The development, implementation, and evaluation of policies may play an important role in promoting health behaviours such as physical activity. The Ontario Ministry of Education (OME) recently mandated Memorandum No. 138 requiring daily physical activity (DPA) for Ontario elementary students in grades one through eight. The purpose of this paper is to examine implementation strategies. METHODS: Hogwood and Gunn's 10 preconditions for "perfect implementation" are used to examine publicly available Ministry DPA policy documents to assess whether these implementation strategies have been considered in the policy documents. RESULTS: Several preconditions (e.g., allocation of resources, task specification) appear to have been considered, however a number of preconditions (e.g., the sustainability of resources, extent to which the policy is valued, and evaluation plans) thought to be important require additional attention to ensure optimal DPA implementation. CONCLUSIONS: Additional reflection upon Hogwood and Gunn's implementation preconditions would, in our opinion, assist in facilitating optimal DPA implementation as per Memorandum No. 138.

Social-ecological correlates of active commuting to school among high school students.

PURPOSE: It has been suggested that health benefits from physical activity may be accrued through active commuting to school. Considering that active commuting is modifiable via policy and that there is limited research examining active commuting among high school students, this is a domain that warrants further investigation. The purpose of this study is to explore the relationships between demographic, behavioral, social/psychological, and environmental correlates of active commuting to school among a sample of high school students. METHODS: Students (N = 21,345) from 76 Ontario high schools (grades 9-12) completed the School Health Action, Planning and Evaluation System Physical Activity Module between 2005-2006. Demographic (gender, grade, body mass index), behavioral (smoking status, physical activity, sedentary time), social/psychological (perceived athletic ability, weight status, parental encouragement), and environmental (school location, type, weather) predictors of active commuting (daily or mixed mode) were assessed. RESULTS: Only 42.5% of high school students reported actively commuting to school. Students were less likely to actively commute to school if they were girls, in grade 12, smoked daily, were low-moderate in physical activity, or attended a rural school. CONCLUSIONS: Patterns of active commuting to school are influenced by multiple factors, some of which are modifiable through intervention. This has important implications for future school-based programming designed to enhance health and physical activity of adolescents through using active modes of transportation to school.

Fever management audit: Australian nurses' antipyretic usage.

Do nurses manage fevers of children hospitalized for a febrile illness ritualistically or rationally? Nurses recorded temperatures more frequently during the first 8 hours in the ward with a mean frequency of 13.36 (SD = 4.76, range 5 to 24) during the first 24 hours following admission. In the majority of cases, there was a strong second hourly pattern of temperature monitoring according to the time of day (e.g., 0600 hr, 0800 hrs, 1000 hr). Seventy-six percent (51) of the children received at least one antipyretic. The mean temperature when antipyretics were administered was 38.34 degrees C (SD = 1.02, range 35.9 degrees C to 40.8 degrees C). The highest antipyretic administration occurred during the daytime, and the highest temperature recording occurred during the nighttime. Antipyretic administration and mean temperatures generally followed a similar pattern, except at 0800 and 1600 hours when antipyretic administration was high and mean temperatures low. This study revealed a need to further investigate the knowledge, attitudes, and decision-making criteria of nurses toward fever management.