This study investigated the effects of an educational intervention to promote healthy behaviors in nursing students. The development of the intervention was based on the relationships among the variables of health-promoting self-care behaviors, self-care self-efficacy, and self-care agency. The purpose of the study was to identify if the intervention, which focused on spiritual growth as the foundation of health, would lead to an increase in the practice of healthy behaviors in nursing students.
The educational intervention was developed using three models/theories as its framework. Orem’s Self-Care Model directed the supportive-educative nursing intervention. Pender’s Health Promotion Model defined the healthy behavior topics of the intervention which include spiritual growth, stress management, nutrition, physical activity, interpersonal relations, and health responsibility. Bandura’s Theory of Self-Efficacy guided the intervention activities that increase self-efficacy of these healthy behaviors. This educational intervention used spiritual growth as the foundation of healthy behaviors. Bryer, Cherkis, and Raman (2013), who performed a descriptive study that investigated the health-promotion behaviors of undergraduate nursing students, recommended that nursing students should not only learn about health promotion but should also participate in health promotion activities suggesting it could possibly improve the academic success of these students. Hensel and Laux (2014), who performed a longitudinal study that included measures of stress, self-care, and professional identity, suggested that integrating stress management strategies and spiritual growth practices in health promotion activities may be more effective in reducing stress levels in nursing students as well as improving their sense of fit with the profession.
Methods:
The intervention was conducted at a school of nursing. It consisted of six one-hour presentations on the healthy behavior topics of spiritual growth, stress management, nutrition, physical activity, interpersonal relations, and health responsibility. Each one-hour presentation included 30 minutes of Power Point information and 30 minutes of selected activities to increase self-efficacy. A pre-test post-test quasi-experimental design was used to investigate the effect of the intervention on students’ healthy behaviors. IRB approval was obtained through the university and a letter of support was obtained from the Dean of the School of Nursing. Students completed a consent form and the study instruments, which included the Health-Promoting Lifestyle Profile II Scale (Walker, Sechrist, & Pender, 1987) and a demographic questionnaire, one week before and one week after completion of the program. A paired t-test using SPSS 20 was performed to measure the effect of the educational intervention on the nursing students’ healthy behaviors.
Results: Thirty-six nursing students started the program, with 23 students completing all six sessions. The mean post-test score (164.4) was 18 points higher than the mean pre-test score (146.2). The paired t-Test result was significant (t = -5.2, p < .001). There were significant increases in all six subscale scores (spiritual growth, stress management, nutrition, physical activity, interpersonal relations, and health responsibility).
Conclusion: The models/theory that were used as the framework for this intervention were supported by the statistical results of this study as well as the educational intervention did have a significant effect on the practice of healthy behaviors in the nursing students. This intervention also introduced the nursing students to the importance of spirituality in holistic health promotion including the importance of self-care in their personal lives and professional practices. The study gives direction for nurse educators in the area of teaching students how to promote healthy behaviors in others through promoting their own healthy behaviors. It also provides a strategy for nurse educators to integrate stress management and spiritual growth health promotion practices into the curriculum that could lead to an improvement in nursing students’ academic success as well as an enhancement of their professional identities.
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