Psychological distress and lifestyle behaviour of undergraduate university students: implications for health promotion

International audiencePoor diet, physical inactivity, tobacco smoking and alcoholconsumption are known risk factors for chronic diseaseand premature mortality. These behaviours are frequentlyreported among higher education students and may belinked to psychological distress, which is also problematicparticularly for students on programmes with practicalcomponents such as nursing and teaching. Understandinghow risk behaviours aggregate and relate to psychologicaldistress and coping among this population is importantfor health promotion.A cross-sectional survey examined lifestyle behaviours(Lifestyle Behaviour Questionnaire) and their relationshipto psychological distress (General Health Questionnaire(GHQ)1 and coping processes (Ways of Coping Questionnaire(WOC);2 among a total sample of undergraduatenursing/midwifery and teacher education students(n=1,577) in a university in Ireland.The response rate was 71% of the total sample. Therespondents were registered on nursing/midwifery(36.5%) and teacher education (63.5%) programmes. Ofthese, 53.1% were female, most were under the age of26(90.5%) and single (89.7%).Health risk behaviourswere common, including alcohol consumption (93.2%),unhealthy diet (26.3%), physical inactivity (26%), tobaccosmoking (17%), cannabis use (11.6%) and significantpsychological stress (41.9%). Females were moredistressed than males (p=0.0001). Nursing students weremore distressed than teacher education students(p=0.0027).Bivariate analyses identified strong links between lifestylebehaviours and demographic characteristics includinggender, age, programme of study and place of residence.Multivariate logistic regressions confirmed the relationshipsbetween risk behaviours, demographic characteristics,distress and coping. Compared with males, femaleshad lower levels of physical activity (OR=1.58 for females)and consumed less alcohol (OR=1.85 for males). Youngerstudents were more likely to eat convenience food(OR=1.67) than older students. Nursing/midwifery studentswere less physically active (OR=1.75) and smokedmore (OR=2.48) than teacher education students. Thosewho did not enjoy their programme were more likely todrink alcohol (OR=1.60). Compared with students whoworked full time, those who worked part-time, thosefinancially supported by their families or grant-aided hadhealthier diets (OR=0.42 and 0.35, respectively) but wereless physically active (OR=2.44 and 2.16, respectively).Conversely, students who worked part-time consumedmore alcohol than those with grant or family support(OR=2.07).High psychological stress scores were correlated with poordiet (OR=1.03), increased consumption of conveniencefoods (OR=1.04), physical inactivity (OR=1.05) andtobacco smoking (OR=1.04). Passive coping strategieswere correlated with poor diet (OR=1.55) and eatingconvenience food (OR=1.62). Those who mostly usedescape 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 behaviourincreased the risk for other risk behaviours. For examplethose who smoked tobacco had an increased risk of poordiet (OR=1.65), low levels of physical activity (OR=1.54)and alcohol consumption (OR=1.56). Cluster analysisidentified a tendency for students to cluster into twogroups: those with risk behaviours (n=733) and thosewith positive health behaviours (n=379). The group withrisk behaviours had high psychological distress and usedmostly passive coping strategies such as escape avoidance.The group with positive health behaviourscomprised students who reported a healthy diet, regularphysical activity and who did not use substances (tobacco,alcohol, cannabis).The potential multiplicative effect of these risks onstudents’ health and subsequently on their academicperformance is a concern. As these students are thenurses and teachers of the future, their risk behaviours,elevated psychological distress and poor coping also raiseconcerns regarding their roles as future health educators/promoters. Attention to promotion of health and wellbeingamong this population is essential