Physical Activity and Mental Well-Being of Student Nurses

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Introduction

This study critiques a qualitative research article, using Holland and Rees’s framework. The publication is Physical activity and mental well-being in student nurses, assessing the relationship between physical activity and mental well-being among them (Hawker, 2012). It is well written, grammatically correct, concise, and well organized. The author avoided jargon, and the paper has a logical flow (Coughlan et al., 2007 p. 659). The study explores a cross-section of students taking an undergraduate course in nursing and evaluates the correlations between physical activities against psychological wellness variables, such as satisfaction with life, self-esteem, and self-sufficiency. The study asserts that incorporating physical activity strategies and interventions will positively influence their mental health.

Focus

The article’s focus is to assess whether the student nurses’ physical activity levels align with the Director of Health’s recommendations and evaluate if the exercise intensity is linked with mental well-being. This topic is critical for student nurses as they form the bulk of future employment in the field. The outbreak of COVID-19 caused stress and anxiety to the frontline medical officers (Labrague, 2021). Consequently, there were increased mental and psychological issues among student nurses.

The hospital is a stressful work environment for patients, families, or medical practitioners. Student nurses face many stressors, involving both physical and mental challenges (Kumar et al., 2020 p. 2). Consequently, it is critical to equip them with efficient strategies to cope with the different stressors and ensure good mental health. Physical activity is essential to guarantee a healthy mental state and elevated self-esteem (Jacob et al., 2020). Thus, the student nurses need to engage more in physical activity to support their mental well-being.

Background

Hawker (2012) examines the vital topic of mental health and physical activity among students. The well-being of healthcare workers is claimed to have a direct correlation with the efficacy of the services. Consequently, this issue is widespread within the United Kingdom due to solid evidence and might become an impediment to providing high-quality care. Moreover, the author stresses that only a few studies contribute to the examination of nursing students’ physical levels, and they do not reinforce the topic. Most of the literature used was also published more than ten years ago and, therefore, does not represent the actual situation. Moreover, few studies have examined the relationship between student nurses. Hence the review of the literature is limited to this condition while the qualitative data are quite informative for guiding further research. The most recent publication was investigating the relationship between mental well-being and physical activity in the UK population.

Aim of the Study

The stated aim of the study was to examine the relationship between participation in physical activity and the mental well-being of British undergraduate student nurses. This research seeks to build upon previous studies by examining the diverse categories of mental well-being (Hawker, 2012, p. 326). The research questions aim to evaluate the student nurses’ activities, compare them to the country’s population, and explore the student BMI with the general population. The author also seeks to examine engagement in physical activity against self-esteem levels and whether there is a relationship between BMI, mental well-being, and physical activity indicators.

Methodology

The researcher employed a cross-sectional approach to study the relationship between the engagement in physical activity and the mental well-being of the students. The work focuses on a broad qualitative design since it explores the “why” of a correlation between physical activity and mental health in student nurses. The author relied mainly on the lived experiences of the participants (Maltby et al., 2010). Ethnography and field research would have produced quality results as the author would have examined the behaviour of physically active students and investigated how they respond to the different stressors in the work environment to assess their mental well-being (Seim, 2021). The method of qualitative approach used does not match the statement of the aim. The aim was to examine the relationship; however, the answers depended on the respondents’ evaluation of their state of well-being, which leaves room for biases.

Tool of Data Collection

In this paper, the researcher used questionnaires for data collection, which seems effective due to the absence of relevant and up-to-date information on the subject. Hence, it worked well for the purpose, and the author established the credibility of their research method by indicating that the respondents filled out the questionnaires anonymously. The researcher provided the respondents with details on the purpose of the study and assured them that the process was confidential.

The tool worked well considering the phenomenological approach of the study. It allowed the researches to provide the readers with well-defined answers and solutions. However, direct observation and taking notes on the participants using the ethnographic approach could have delivered credible results since the design is not subject to the respondent’s interpretation of mental health. In this respect, the observations could be devoid of evidence distortion.

Methods of Data Analysis and Presentation

The author used a questionnaire made up of several instruments to assess physical activity and other different variables of mental well-being. The researcher examined the following dimensions of psychological health: satisfaction with life, self-esteem, physical activity engagement, outcome expectation for exercise, and self-efficacy. The study employs The Satisfaction with Life Scale (SWLS), which requires every participant to assess how satisfied they are with their lives. It measures each item on a 7-point scale where one equals “strongly disagree” and 7 equals “strongly agree.”

Secondly, the study used the Rosenberg Self-Esteem Scale, a ten-item instrument that scores on a 4 point Likert scale ranging from strongly agreed to strongly disagreed. It employed the International Physical Activity Short-Format Questionnaire to assess physical activity. Thus, respondents self-reported their physical activity from five categories: leisure, transport, occupational, sedentary, and household physical activities. The research also measured the outcome expectations for exercise and self-efficacy to understand factors, affecting participants’ decisions. The outcome expectations for exercise are a scale containing ten items measured on a 5-point Likert scale. One on the scale represents low expectation outcomes, while 5 equals strong expectation outcomes for physical activity. Moreover, the study assessed self-efficacy using a self-developed Likert scale.

Sample

Two hundred and fifteen student nurses responded to the questionnaire; 79% of the entire student group comprised only the first and third-year students. There were no inclusion or exclusion criteria stated in the research, and the reasonability of this provision is conditional upon the reported scarcity of data. However, all the students who were present filled out the questionnaires. The rest of the students were not available to participate in the study in school. The selection criteria of the given research limit to whom the results may apply. The reason for this is the fact that the convenience sample included female representatives. As a result, the research is prone to bias since gender differences are well-known. This might be considered inappropriate since the research question covers the nursing students in general.

The selected sampling strategy was purposeful, implying the participation of individuals with an expertise in the field. Its appropriateness for the research question and the overall design is determined by the need for collecting credible data for further analysis since no information on the subject was available. Therefore, this sample size did not accurately represent the variety of student nurses as it left out students in other years of study. For instance, the experiences of a first-year student nurse are different from those of a second year. The units and the learning objectives differ at all levels of study; consequently, the research left room for bias as the second year could present different results.

Ethical Considerations

The study can be viewed as ethically rigorous due to the particular attention of the scholar to the transparency of the procedures and findings and the approval of involved entities. Thus, the inclusion of the University of Bristol Department of Exercise, Nutrition, and The Health Sciences Ethics Committee corresponded to the latter claim. Moreover, the School of Nursing and Midwifery studies, Cardiff University provided a permission to recruit students for the purpose of the study, which contributes to the ethics. As for the honest approach to the matter, it was shown by receiving informed consent while protecting privacy and confidentiality (Carpenter, 2018 p. 35). Thus, the paper can be considered ethically rigorous since it oversees the principles mentioned above.

Main Findings

Several themes can be highlighted in the study: the relationship between the different intensities of physical activity and the psychological well-being scores. The results also established a positive correlation between self-esteem and total physical activity engagement. The article found no meaningful correlation between the physical activity variables and depression, anxiety, and life satisfaction. The research also established that there were significant relationships between self-efficacy for exercise and BMI and age. Furthermore, there was a negative correlation between satisfaction with life and BMI. Therefore, the higher the respondents’ BMI, the lower their satisfaction with life.

The researcher conducted a further regression analysis to investigate whether the variables of physical activity and BMI produced different psychological well-being variables. The results showed minimal variance in the participants’ mental well-being from the BMI and physical activity variables. Nevertheless, it is vital to indicate that the research did not include attempts to ensure the accuracy of the results. There is only one author of the study and no peer-checking.

Conclusion and Recommendations

The study’s aim statement says that there is a significant relationship between participation in physical activity and mental well-being among student nurses. The paper is well-argued and supported by the fact that participants usually face increasing nursing and academic demands, which threaten their physical activities. A high percentage of the respondents were obese or overweight, implying the clarity of answers to the research question. Therefore, the research argues that promoting physical activity will boost their self-esteem, life satisfaction, and decrease the likelihood of depression and anxiety, thereby improving the nurses’ mental well-being.

The article explicitly recommends that universities and the NHS play a significant role in ensuring that they protect the mental well-being of students by promoting physical activity. It proposes physical activity in the curriculum to promote healthy living and solve obesity. Furthermore, the university needs to put more effort into incorporating dedicated time for engaging in physical activity into nursing programs. The study also recommends that there should be physical activity interventions, counselling, and educational strategies through the student support services in universities to cater to learners who have impaired mental well-being.

Strengths and Limitations

The strengths of the study are its thorough explanation of the relationship between physical activity and mental well-being. The aim was initially clear, and the author evaluated possible correlations and variables adequately, and recommendations and conclusions were detailed. The study further examined critical components, such as satisfaction with life levels, self-esteem, the outcome of exercise expectance, and the level of engagement in physical activity. The research also promised anonymity and confidentiality, so the respondents were likely to give accurate results on age and weight.

However, it had many limitations that could influence the study’s credibility. The author acknowledged them by stating that the study used a cross-sectional design (Parahoo, 2014). Therefore, one could infer no causal relationships, and the cross-sectional design left out a section of students (Harvey & Land, 2016). Also, the use of questionnaires depended on the self-reported responses of the participants. Therefore, the research assumes that the participants accurately recorded their BMI, age, and physical engagement levels.

Application to Practice

The findings relate to practice, indicating that nurses have high levels of obesity as they do not engage in health-promoting self-care. Their well-being has a direct impact on the quality of services. Consequently, nurses must practice self-care by participating in physical activities, eating healthily, and maintaining a work-life balance for their mental well-being (Ross et al., 2019 p. 607). Individuals who actively engage in physical activities are less likely to have psychological disorders such as anxiety and depression (Hanawi et al., 2020 p. 6). Also, they have elevated levels of self-esteem and satisfaction with life.

Aside from the influence of mental and physical health on the productivity of healthcare personnel, such aspects have a direct correlation with the responsibilities of nurses. For example, Ellis (2013) provides the standards to which the nurses must adhere. According to the author, patients expect nurses to promote both physical and mental well-being since such an attitude promotes safety at all times (Ellis, 2013). Thus, nurses are expected to both promote and adhere to well-being behaviour.

Consequently, physicians and nurses could use physical activity to manage psychological disorders. Therefore, exercise is a method for preventing non-communicable diseases such as hypertension and type 2 diabetes (Royal College of Nursing, 2021). A study also encourages engagement in physical activity as one of the interventions to improve mental health and influence lifestyle behaviours among physicians and nurses (Melnyk et al., 2020, p. 940). Physical activity is one of the interventions that will prevent student nurses from experiencing psychological challenges.

From various studies, students and registered nurses face many stressors in their work environment. However, many health workers do not engage in physical activities as required by the Department of Health to get 150 minutes of moderate exercise per week (NHS, 2021). Therefore, there are high rates of overweight and obesity cases among the practitioners. Consequently, universities and the NHS should formulate immediate strategies and interventions such as incorporating physical activities into work schedules and curricula to ensure physicians’ and nurses’ physical and mental well-being.

There is an increase in the quality and quantity of evidence suggesting the efficacy of physical activity for psychological disorders. Physical activity prevents depression, stress, and anxiety disorders. Engaging in exercise has been widely used to treat and manage postnatal depression, schizophrenia, stress, and anxiety disorders. However, there is still more room for a large population to examine the use of physical activity to assist individuals at risk of mental illness to assess if exercise can avert the development of psychosomatic disorders.

Reference List

Carpenter, D. (2018) ‘Ethics, reflexivity, and virtue’, in Ipholen, R. and Tolich, M. (eds.) The SAGE handbook of qualitative research ethics. London: SAGE Publications, pp. 35-50.

Coughlan, M., Cronin, P., and Ryan, F. (2007) ‘A step-by-step guide to critiquing research. Part 1: Quantitative research,’ British Journal of Nursing, 16(1), pp. 658-663.

Ellis, P. (2013) Understanding research for nursing students. 2nd edn. London: Learning Matters. Web.

Hanawi, S. A. et al. (2020) ‘Impact of a healthy lifestyle on the psychological well-being of university students,’ International Journal of Pharmaceutical Research & Allied Sciences, 9(2), pp. 1-7. Web.

Harvey, M. and Land, L. (2016) Research methods for nurses and midwives: Theory and practice. London: SAGE. Web.

Hawker, C. L. (2012) ‘Physical activity and mental well-being in student nurses,’ Nurse Education Today, 32, pp. 325-331.

Jacob, L. et al. (2020) ‘The relationship between physical activity and mental health in a sample of the UK public: A cross-sectional study during the implementation of COVID-19 social distancing measures,’ Mental Health and Physical Activity, 19.

Kumar, P. et al. (2020) ‘Academic stress among nursing students,’ Nursing & Healthcare International Journal, 4(4), pp. 1-6.

Labrague, L. J. (2021) ‘Resilience as a mediator in the relationship between stress-associated with the Covid-19 pandemic, life satisfaction, and psychological well-being in student nurses: A cross-sectional study,’ Nurse Education in Practice, 56, pp. 1471-5953.

Maltby, J., Williams, G., and Mcgarry, J. (2010) Research methods for nursing and healthcare. London: Pearson Education. Web.

Melnyk, B. M., Kelly, S. A., and Stephens, J. (2020) ‘Interventions to improve mental health, well-being, physical health, and lifestyle behaviours in physicians and nurses: A systematic review,’ American Journal of Health Promotion, 34(8), pp. 929-941.

NHS (2021) Exercise. Web.

Parahoo, K. (2014). Nursing research: Principles, processes, and issues. London: Palgrave Macmillan. Web.

Ross, A. et al. (2019) ‘Nurses and health-promoting self-care: do we practice what we preach?’ Journal of Nursing Management, 27(3), pp. 599-608.

Royal College of Nursing (2021) Physical activity. Web.

Seim, J. (2021) ‘Participant observation, observant participation, and hybrid ethnography,’ Sociological Methods & Research, pp. 1-32.

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