The Open Public Health Journal




ISSN: 1874-9445 ― Volume 13, 2020
RESEARCH ARTICLE

Investigation of Health-Promoting Lifestyle and its Determinants Among Students of Medical Sciences in Iran



Mohammad Amiri1, Ahmad Khosravi2, Niloofar Aboozarzadeh3, Leila Khojasteh4, Zakieh Sadeghi5, Mehdi Raei6, 7, *
1 Department of Public Health, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
2 Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
3 Babol University of Medical Sciences, Babol, Iran
4 Department of Medical Sciences, Shahroud Branch, Islamic Azad University, Shahroud, Iran
5 Department of Analytical Chemistry, Damghan University, Damghan, Iran
6 Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
7 Department of Epidemiology and Biostatistics, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract

Background:

A person's lifestyle plays an important role in his health. This study aimed at determining thehealth-promoting lifestyle and its related factors among the medical students of Shahroud Islamic Azad University.

Methods:

In this cross-sectional study, a total of500 students of medical sciences were selected using the stratified random sampling method and they completed the health-promoting lifestyle, self-efficacy, and well-being questionnaires. The collected data were entered into SPSS 16 and were analyzed with a T-test, Chi-square, Pearson correlation coefficient, and a backward regression model.

Results:

The mean age of the students was 22.25±1.45 and 65% of the participants were female. The mean scores of health-promoting lifestyle, well-being, and self-efficacy were 134.1±23.85, 14.41±5.09, and 41.67±8.05, respectively. Among the students, 32.8% had a health disorder and only 2.2% had a high self-efficacy. Well-being and self-efficacy were statistically correlated with the health-promoting lifestyle (p<0.001). The results showed that out of 17 independent variables, only 4 variables of educational level, academic year, marital status, well-being were the best predictors of health-promoting lifestyle.

Conclusion:

More than 90% of students had low self-efficacy and more than 30% of them did not have good well-being. Moreover, the health-promoting lifestyle of students was moderate. More attention to the above areas, such as well-being status and applying required interventions, can help to improve the situation.

Keywords: Health, Healthy lifestyle, Self efficacy, Exercise, Students, Medical.


Article Information


Identifiers and Pagination:

Year: 2020
Volume: 13
First Page: 627
Last Page: 633
Publisher Id: TOPHJ-13-627
DOI: 10.2174/1874944502013010627

Article History:

Received Date: 22/06/2020
Revision Received Date: 01/09/2020
Acceptance Date: 12/09/2020
Electronic publication date: 13/11/2020
Collection year: 2020

© 2020 Amiri et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; E-mail: mehdi_r_d@yahoo.com





1. INTRODUCTION

In any society, university students, as the future-building generation of the country, receive a major part of community planning and budgeting. Moreover, students' academic achievement and success are one of the important characteristics in evaluating higher education, and all countries attempt to achieve this goal [1Safarzadeh S, Marashian FS. Relations between goal orientation (skill-oriented, performance-oriented, performance-avoidance) and metacognition with subjective well-being and academic self-efficacy among the students. Education Strategies in Medical Sciences 2017; 9(6): 447-57.]. In other words, society and especially higher education are interested in and concerned about the individual's destiny, his or her successful growth and development, and position in society [2Raeisoon M, Mohammadi YMA, Gh S. An investigation of relationship between self-concept, and self esteem and academic achievement of student in nursing -midwifery faculty in Queen during 2012-2013. Mod Care J 2014; 11(3): 236-42.]. A multitude of factors, including a health-promoting lifestyle, a sense of self-efficacy, and well-being, play a role in this development [3Komarraju M, Nadler D. Self-efficacy and academic achievement: Why do implicit beliefs, goals, and effort regulation matter? Learn Individ Differ 2013; 25: 67-72.
[http://dx.doi.org/10.1016/j.lindif.2013.01.005]
].

Studying at a university is a time when students are increasingly making independent decisions about their lifestyle and health performance [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
]. A healthy lifestyle includes actions that are taken to improve well-being and prevent diseases [5Uphold CR, Holmes W, Reid K, Findley K, Parada JP. Healthy lifestyles and health-related quality of life among men living with HIV infection. J Assoc Nurses AIDS Care 2007; 18(6): 54-66.
[http://dx.doi.org/10.1016/j.jana.2007.03.010] [PMID: 17991599]
]. By choosing a lifestyle that promotestheir health and prevents diseases, people can do activities, such as sticking to a healthy diet, sleeping and physical activity, exercising, maintaining body weight, avoiding smoking and alcohol, and protecting against diseases. In contrast, an unhealthy lifestyle underlies many high-risk behaviors, such as unhealthy eating habits, physical inactivity, tobacco and alcohol use, and high-risk sexual behaviors, all of which lead to a variety of chronic diseases and disorders [6Igra V, Irwin CE. Theories of adolescent risk-taking behavior Handbook of adolescent health risk behavior 1996; 35-51.
[http://dx.doi.org/10.1007/978-1-4899-0203-0_3]
, 7Rew L, Carver T, Li C-C. Early and risky sexual behavior in a sample of rural adolescents. Issues Compr Pediatr Nurs 2011; 34(4): 189-204.
[http://dx.doi.org/10.3109/01460862.2011.619861] [PMID: 22010625]
].

The findings of a study in China showed that a small number of students had a healthy lifestyle [8Wang D, Xing XH, Wu XB. Healthy lifestyles of university students in China and influential factors. ScientificWorldJournal 2013; 2013412950
[http://dx.doi.org/10.1155/2013/412950] [PMID: 23935418]
]. However, the results of some other studies indicated a moderate lifestyle among medical students [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 9Lee DH, Kang S, Yum S. A qualitative assessment of personal and academic stressors among Korean college students: An exploratory study. Coll Stud J 2005; 39(3): 442-9.-19Lee RL, Loke AJ. Health-promoting behaviors and psychosocial well-being of university students in Hong Kong. Public Health Nurs 2005; 22(3): 209-20.
[http://dx.doi.org/10.1111/j.0737-1209.2005.220304.x] [PMID: 15982194]
]. But the results of some studies in Iran showed that medical students do not have a healthy and desirable lifestyle [20Baradaran Rezaie M, Shirvani M. Stress control status amongst Tabriz medical & non medical sciences universities’ students: Evidence from the university students life style survey. J Caring Sci 2006; 5: 54-63., 21Fayazbakhsh A, Khajeh KR, Soleymani NM, et al. The internet using and health: Students'knowledge, Attitude and Lifestyle related to the Internet 2011.].

Walker and colleagues define health-promoting lifestyle as includingsix dimensions of health responsibility, nutrition (having a food pattern and food choice), physical activity (exercise and following a regular work-out program), stress management (identifying stress sources and taking actions to manage it), interpersonal relationships (maintaining close relationships), and spiritual growth. They believe a person’s lifestyle impactshis self-efficacy and well-being [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 22Walker S, Hill-Polerecky D. Psychometric evaluation of the Health-Promoting Lifestyle Profile-II [unpublished manuscript]. University of Nebraska Medical Center, 1996 2010.-25Vahedi H, Khosravi A, Sadeghi Z, et al. Health-Promoting Lifestyle in Patients with and without Diabetes in Iran. Health Scope 2017; 6(2)]. An unhealthy lifestyle during young age is strongly associated with disability and health problems in adulthood, and if unhealthy behaviors are detected and altered in the early stages, manyadulthood health risk factors can be prevented and, hence the efficacy of the person will increase [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
].

According to Bandura and Adams, self-efficacy is a person's judgment of his or her skills and abilities to perform tasks required in special situations [26Cheng VM. Infusing creativity into Eastern classrooms: Evaluations from student perspectives. Think Skills Creativity 2011; 6(1): 67-87.
[http://dx.doi.org/10.1016/j.tsc.2010.05.001]
]. Self-efficacy reduces tensions in the face of life's stressful events and indirectly influences a person's life satisfaction and well-being, and enhances his or her' lifestyle and brings about future career success [27Amiri M, Khosravi A, Mokhtari AA. Job satisfaction and its influential factors. J Res Health Sci 2010; 10(1): 42-6.
[PMID: 22911916]
].

Academic self-efficacy also refers to a person's belief in his or her ability to perform a task successfully, and it is considered as a determining factor in the success of students at the university [28Tsang SK, Hui EK, Law B. Self-efficacy as a positive youth development construct: A conceptual review. The Scientific World Journal 2012; 2012
[http://dx.doi.org/10.1100/2012/452327]
]. Evidence suggests that self-efficacious students are more likely to attempt to understand the course materials; they think more deeply about the materials and the coursework and plan to do their tasks, and this factor plays a role in their current and future success [29Altunsoy S, Çimen O, Ekici G, Atik AD, Gökmen A. An assessment of the factors that influence biology teacher candidates’ levels of academic self-efficacy. Procedia Soc Behav Sci 2010; 2(2): 2377-82.
[http://dx.doi.org/10.1016/j.sbspro.2010.03.340]
]. People with high self-efficacy remove barriers by improving their self-management and perseverance skills and are more resilient to problems, therefore, having a higher self-efficacy can help maintain health-promoting behaviors. People with low self-efficacy, upon confronting problems, are easily persuaded that their actions are futile and easily give up [30Mirzaei-Alavijeh M, Hosseini SN, Motlagh MI, Jalilian F. Academic self-efficacy and its relationship with academic variables among Kermanshah University of Medical Sciences students: A cross sectional study. Pajouhan Scientific J 2018; 16(2): 18-25.
[http://dx.doi.org/10.21859/psj.16.2.28]
]. Although the results of some studies indicate high self-efficacy in participants [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 24Amiri M, Vahedi H, Mirhoseini SR, Eghtesadi AR, Khosravi A. Study of the relationship between self-efficacy, general health and burnout among iranian health workers. Osong Public Health Res Perspect 2019; 10(6): 359-67.
[http://dx.doi.org/10.24171/j.phrp.2019.10.6.06] [PMID: 31897365]
, 30Mirzaei-Alavijeh M, Hosseini SN, Motlagh MI, Jalilian F. Academic self-efficacy and its relationship with academic variables among Kermanshah University of Medical Sciences students: A cross sectional study. Pajouhan Scientific J 2018; 16(2): 18-25.
[http://dx.doi.org/10.21859/psj.16.2.28]
], the results of a study in Tehran showed that university students had a low sense of self-efficacy [31Hayati D, Ogbahi A, Abedin HAS, Mohsen AA. Investigating the relationships between quality of learning experience’s components and self-efficacy on academic burnout among students of Allamme Tabatabaei University of Tehran. educational development of jundishapur 2012; 3(4): 18-29.].

Since, during the college years, students are exposed to many well-being and high-risk lifestyle behaviors [8Wang D, Xing XH, Wu XB. Healthy lifestyles of university students in China and influential factors. ScientificWorldJournal 2013; 2013412950
[http://dx.doi.org/10.1155/2013/412950] [PMID: 23935418]
], it is necessary to study the health-promoting lifestyle and its determinants so that their well-being can be improved. Therefore, the present study aimed at determining the status of a health-promoting lifestyle and its related factors among the medical students of Shahroud Islamic Azad University.

2. METHODS

In this cross-sectional study, a total of 500 students of medical sciences (medicine, nursing, anesthesiology, and laboratory sciences) of Islamic Azad University of Shahroud (a non-governmental university) were randomly selected using a stratified sampling procedure, and health-promoting lifestyle [22Walker S, Hill-Polerecky D. Psychometric evaluation of the Health-Promoting Lifestyle Profile-II [unpublished manuscript]. University of Nebraska Medical Center, 1996 2010., 32Mohammadi Zeidi I, Pakpour Hajiagha A, Mohammadi Zeidi B. Reliability and validity of Persian version of the health-promoting lifestyle profile. Majallah-i Danishgah-i Ulum-i Pizishki-i Mazandaran 2012; 21(1): 102-13.], well-being [33Khosravi A, Mousavi SA, Chaman R, et al. Reliability and validity of the Persian version of the World Health Organization-five well-being index. Int J Health Stud 2015; 1(1): 17-9.] and self-efficacy [34Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The self-efficacy scale: Construction and validation. Psychol Rep 1982; 51(2): 663-71.
[http://dx.doi.org/10.2466/pr0.1982.51.2.663] [PMID: 7089151]
] questionnaires were administered to them in the year2018. First, the list of students in each field in different semesters was taken from the teaching affairs office, and then 30% of the students in each field were randomly selected in each academic semester. The selected students completed the questionnaires and the collected data were analyzed.

2.1. Ethical Consideration

Prior to the commencement of the study, the proposal had been reviewed and approved by the Ethics Committee of Medical Sciences Research at the Islamic Azad University of Shahroud.

2.2. Instruments

The questionnaires were divided into two sections: demographic information, including 15 items about age, gender, marital status, education, the field of study, semester, student's local or non-local status or locality, student's current residence, family's economic status, economic activity along with education, parental residence, number of family members, father's job, and specific questionnaires included:

A) A fifty-two item health-promoting lifestyle questionnaire [22Walker S, Hill-Polerecky D. Psychometric evaluation of the Health-Promoting Lifestyle Profile-II [unpublished manuscript]. University of Nebraska Medical Center, 1996 2010., 32Mohammadi Zeidi I, Pakpour Hajiagha A, Mohammadi Zeidi B. Reliability and validity of Persian version of the health-promoting lifestyle profile. Majallah-i Danishgah-i Ulum-i Pizishki-i Mazandaran 2012; 21(1): 102-13.] which has 6 domains of nutrition (8 items), physical activity (8 items), health responsibility (13 items), stress management (5 items), interpersonal relationships (8 items), and spiritual growth (10 items)was used. The response to each item ranges on a four-point Likert scale from1 (never) to 4 (always), and the total score on the questionnaire can range from the minimum 52 to the maximum 208. The scores obtained on each subscale are divided into 3 categories. On each subscale as well as on the whole questionnaire, if respondents’ scoresare equal toor less than 49% of the maximum score, they were interpreted as poor on that subscale, while a total score of 50% to 74% indicates they are moderate and scores equal to or exceeding 75% are indicative of a good condition. The reliability coefficients of 0.82 and 92.9 were reported for the questionnaire in Iran and in Shahroud, respectively [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 25Vahedi H, Khosravi A, Sadeghi Z, et al. Health-Promoting Lifestyle in Patients with and without Diabetes in Iran. Health Scope 2017; 6(2), 35Ahmadnia E, Shakibazadeh E, Emamgholi Khoshechin T. Life style-related osteoporosis preventive behaviors among nursing and midwifery students. Hayat (Tihran) 2010; 15(4): 50-9.].

B) Sherer's Self-Efficacy Scale [34Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The self-efficacy scale: Construction and validation. Psychol Rep 1982; 51(2): 663-71.
[http://dx.doi.org/10.2466/pr0.1982.51.2.663] [PMID: 7089151]
] includes 17 five-point items on a Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Items 1, 13, 8, 9, 3, and 15 are scored normally, but other items are scored in reverse. A higher score indicates a higher level of self-efficacy and a lower score indicateslower self-efficacy. This scale has a maximum score of 85 and a minimum score of 17. A score of 58 or higher indicates high self-efficacy and a score of less than 58 indicates low self-efficacy. The reliability of the scale administered to students was reported to be 0.83 [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
].

C) World Health Organization’s Well-being Index contains 5 items. The response to each can range from 0 to 5, and the total score can range between 0 and 25. A score of less than 13 indicates a well-being disorder anda score of 13 or above indicates a good well-being status. The reliability of this tool among students was reported to be 0.94 [33Khosravi A, Mousavi SA, Chaman R, et al. Reliability and validity of the Persian version of the World Health Organization-five well-being index. Int J Health Stud 2015; 1(1): 17-9.].

2.3. Statistical Analysis

The collected data were analyzed using SPSS16 through ANOVA and Chi-square, t-test, Pearson correlation coefficient, and a backward regression model at the significance level of 0.05.

3. RESULTS

The mean age of the students was 22.25 ± 1.45 and 65% of the participants were female. Among them, 32.8% had a well-being disorder; 2.2% had high self-efficacy, and the mean score of the health-promoting lifestyle was 134.01± 23.85, which is moderate, and the mean score of physical activity was 16.8±5.07, which is poor. The mean score of well-being was 14.41 ± 5.09 and the mean score of self-efficacy was 41.67±8.05.

The findings showed no significant relationships between gender, the locality of the student, the family's economic status, the parents' place of residence, the student's economic activity, the parental life status, the student's field of study, academic semester and year, with self-efficacy and well-being. But there was a significant relationship between marital status and parental place of residence with self-efficacy. Moreover, the relationships of well-being with economic activity along with education and student academic year were significant. Also, there was a significant relationship between health-promoting lifestyle status and field of study (Table 1).

Table 1
Relationship between some demographic variables with self-efficacy, well-being, and health-promoting lifestyle.


Table 2
Correlation matrix (r coefficient) of the main variables.


The linear correlations between well-being, self-efficacy, and health-promoting lifestyle scores were significant (P <0.001). (Table 2).

Comparison of mean scores of quantitative variables in terms of well-being, health-promoting lifestyle, and self-efficacy categories are shown in Table 2 . Results showed significant differences between self-efficacy, overall health-promoting lifestyle, spiritual growth, health responsibility, interpersonal relationships, stress management, nutrition and physical activity, and semester scores within two well-being categories (P <0.05) ( Table 3 ). Spiritual growth scores were significantly different between self-efficacy categories. Furthermore, mean scores of self-efficacy, well-being, spiritual growth, health responsibility, interpersonal relationships, stress management, nutrition, physical activity, and age were significant in three categories of health-promoting lifestyle (P ≤0.05) ( Table 3 ).

In order to examine the simultaneous relationships of age, gender, number of family members, the rank of birth, field of study, level of education, marital status, locality, place of residence, family economic status, student economic activity, student's parental residence, father's job, parental life status, well-being, the student's academic year, and self-efficacy with the health-promoting lifestyle, a backward linear regression model was run. The results showed that out of 17 independent variables, only 4 variables of academic level, marital status, academic year, and well-being status were the best predictors of the health-promoting lifestyle scores. Moreover, significant relationships were observed between the health-promoting lifestyle and the academic level (p <0.001) and well-being (p <0.001). It can be said that if the well-being scores of students increase by one unit, the mean score of their health-promoting lifestyle will increase by 2.38 units. The mean score of health-promoting lifestyle for undergraduate students was 6.38 units higher than that for students of medicine. The regression coefficients, 95% confidence intervals, and p-values ​​are displayed in Table 4.

4. DISCUSSION

About one-third (32.8%) of the students had a well-being disorder. In a study of students at Shahroud University of Medical Sciences, 34% of students had a well-being disorder that is slightly higher than the one in the present study [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
]. The results of studies in Yazd and Zahedan showed that 54.4% and 38.8% of students had poorwell-being, respectively, which is more than the present results [36Khazir Z, Abbasi-Shavazi M. The study of general health status in the students of shahid sadoughi university of medical sciences in yazd. J Commun Health Res 2019; 8(3): 131-8.
[http://dx.doi.org/10.18502/jchr.v8i3.1568]
, 37Ansari H, Bahrami L, Akbar Zadeh L, Bakhshani N. Assessment of general health and some related factors among students of Zahedan University of Medical Sciences in 2007. Zahedan J Res Med Sci (Tabib-E-Shargh) 2008; 9(4): 295-304.]. In another study in Tehran, 28.6% of students showed poor well-being, which is lower than the results of this study [38Samimi R, Rodsary DM, Hosseini F, Tamadonfar M. Correlation between lifestyle and general health in university students. Iran J Nurs 2007; 19(48): 83-93.].

Table 3
Relationship between some variables with self-efficacy, well-being, and health-promoting lifestyle.



Table 4
Backward regression model for factors related to students’ lifestyle.


Moreover, the mean score of well-being was 14.41± 5.09, which indicated the normal state of health, and it is consistent with the results of a previous study conducted in Shahroudas well assome other studies [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 39Rahimian bugar E, Mohammadifar M, Najafi M, Dehshiri GR. Life skills influence on students’general health. Clinical Psychology & Personality 2013; 2(8): 23-34., 40Semyari H, Heravi-Karimooi M, Nasiri M, Arabi F. The relationship of Dentistry students’ spiritual intelligence to general health. Iran J Psychiatric Nur 2015; 3(1) [IJPN].]. However, it is not consistent with the results of the study conducted in Kermanshah [30Mirzaei-Alavijeh M, Hosseini SN, Motlagh MI, Jalilian F. Academic self-efficacy and its relationship with academic variables among Kermanshah University of Medical Sciences students: A cross sectional study. Pajouhan Scientific J 2018; 16(2): 18-25.
[http://dx.doi.org/10.21859/psj.16.2.28]
]. It seems that the reasons for the similarity and differences between the results are due to geographical and cultural differences and the studied environments. However, students seem to suffer from some degrees of well-being. Since students are the future makers of the country and should have the best social performance, attempts should be made, and the cooperation of experts, consultants, and professors should be sought to decrease their well-being problemsso thatpublic health problems are reduced.

Only a small percentage (2.2%) of students had high self-efficacy. In other studies at Shahroud University of Medical Sciences (a public university), 68% of students had self-efficacy that did not match the present study [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 24Amiri M, Vahedi H, Mirhoseini SR, Eghtesadi AR, Khosravi A. Study of the relationship between self-efficacy, general health and burnout among iranian health workers. Osong Public Health Res Perspect 2019; 10(6): 359-67.
[http://dx.doi.org/10.24171/j.phrp.2019.10.6.06] [PMID: 31897365]
]. Perhaps one of the reasons for this discrepancy is the private and public nature of the universities studied.

The mean score of health-promoting lifestyle indicated that students had a moderate lifestyle, which is consistent with the results of some studies [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 11Geok SK, Yusof A, Lam SK, Japar S, Leong OS, Fauzee MSO. Physical activity and health-promoting lifestyle of student nurses in Malaysia. J Biosci Med (Irvine) 2015; 3(03): 78.
[http://dx.doi.org/10.4236/jbm.2015.33012]
-13Nassar OS, Shaheen AM. Health-promoting behaviours of university nursing students in Jordan. Health 2014; 6(19): 2756.
[http://dx.doi.org/10.4236/health.2014.619315]
, 15Altun I. Effect of a health promotion course on health promoting behaviours of university students 2008.-19Lee RL, Loke AJ. Health-promoting behaviors and psychosocial well-being of university students in Hong Kong. Public Health Nurs 2005; 22(3): 209-20.
[http://dx.doi.org/10.1111/j.0737-1209.2005.220304.x] [PMID: 15982194]
]. Some studies have reported poor lifestyles among medical students, which is not consistent with the results of this study (20, 21). The obtained score of the health-promoting lifestyle indicates a moderate lifestyle that is partly acceptable. However, more precise planning is needed to improve the current situation of students.

The mean score of physical activity was 16.8+5.07, which was low. The findings of this study are consistent with the results of some studies conducted in Iran and the world [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 11Geok SK, Yusof A, Lam SK, Japar S, Leong OS, Fauzee MSO. Physical activity and health-promoting lifestyle of student nurses in Malaysia. J Biosci Med (Irvine) 2015; 3(03): 78.
[http://dx.doi.org/10.4236/jbm.2015.33012]
-14Shaheen AM, Nassar OS, Amre HM, Hamdan-Mansour AM. Factors affecting health-promoting behaviors of university students in Jordan. Health 2015; 7(01): 1.
[http://dx.doi.org/10.4236/health.2015.71001]
, 16Babanejad M, Rajabi A, Mohammadi S, Partovi F, Delpisheh A. Investigation lifestyle and prediction of changes in its associated factors amongst health students. J Health 2013; 4(2): 147-55., 41Kreutz G, Ginsborg J, Williamon A. Health-promoting behaviours in conservatoire students. Psychol Music 2009; 37(1): 47-60.
[http://dx.doi.org/10.1177/0305735607086047]
] but not consistent with some other studies [10Mansorian M, Qorbani M, Solaimani M, Masoodi R, Rahimi E, Asayesh H. A survey of life style and its influential factors among the University Students in Gorgan. J Jahrom Univ Med Sci 2009; 7(1): 62-71.
[http://dx.doi.org/10.29252/jmj.7.1.2.62]
, 15Altun I. Effect of a health promotion course on health promoting behaviours of university students 2008., 18Maheri AB, Bahrami M-N, Sadeghi R. The situation of health-promoting lifestyle among the students living in dormitories of Tehran University of Medical Sciences, Iran. Iran J Health Development 2013; 1(4): 275-86., 19Lee RL, Loke AJ. Health-promoting behaviors and psychosocial well-being of university students in Hong Kong. Public Health Nurs 2005; 22(3): 209-20.
[http://dx.doi.org/10.1111/j.0737-1209.2005.220304.x] [PMID: 15982194]
]. It seems that taking necessary measures to inform students, creating opportunities, and allocating appropriate space and facilities arerequired to encourage medical students to put physical activity in the daily routines.

The mean score of the feeling of self-efficacy was 41.67±8.05, which indicates a low self-efficacy. The findings of this study are consistent with the results of some studies [31Hayati D, Ogbahi A, Abedin HAS, Mohsen AA. Investigating the relationships between quality of learning experience’s components and self-efficacy on academic burnout among students of Allamme Tabatabaei University of Tehran. educational development of jundishapur 2012; 3(4): 18-29., 42Arshadi H, Homam M, Mohamadi E, Sanjar Musavi N. A comparative study of self-efficacy and self-esteem among students of islamic azad university of medical sciences mashhad branch. Future Med Edu J 2014; 4(1): 17-21.] but inconsistent with some other studies [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 24Amiri M, Vahedi H, Mirhoseini SR, Eghtesadi AR, Khosravi A. Study of the relationship between self-efficacy, general health and burnout among iranian health workers. Osong Public Health Res Perspect 2019; 10(6): 359-67.
[http://dx.doi.org/10.24171/j.phrp.2019.10.6.06] [PMID: 31897365]
, 30Mirzaei-Alavijeh M, Hosseini SN, Motlagh MI, Jalilian F. Academic self-efficacy and its relationship with academic variables among Kermanshah University of Medical Sciences students: A cross sectional study. Pajouhan Scientific J 2018; 16(2): 18-25.
[http://dx.doi.org/10.21859/psj.16.2.28]
]. It seems that teaching the skills needed to empower students and increasing their sense of self-efficacy can improve the situation.

There was no significant relationship between gender and self-efficacy, which is consistent with the results of some studies [24Amiri M, Vahedi H, Mirhoseini SR, Eghtesadi AR, Khosravi A. Study of the relationship between self-efficacy, general health and burnout among iranian health workers. Osong Public Health Res Perspect 2019; 10(6): 359-67.
[http://dx.doi.org/10.24171/j.phrp.2019.10.6.06] [PMID: 31897365]
, 30Mirzaei-Alavijeh M, Hosseini SN, Motlagh MI, Jalilian F. Academic self-efficacy and its relationship with academic variables among Kermanshah University of Medical Sciences students: A cross sectional study. Pajouhan Scientific J 2018; 16(2): 18-25.
[http://dx.doi.org/10.21859/psj.16.2.28]
]. Some studies have suggested a link between gender and self-efficacy that is not consistent with the present results [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 42Arshadi H, Homam M, Mohamadi E, Sanjar Musavi N. A comparative study of self-efficacy and self-esteem among students of islamic azad university of medical sciences mashhad branch. Future Med Edu J 2014; 4(1): 17-21.]. The results indicate the need to pay more attention to both genders in educational planning.

There was no significant relationship between the field of study, locality of the student, the place of residence, the economic status of the family, the semester and the student's academic year, and the degree of self-efficacy. The findings of this study are consistent with the results of a previous study conducted in Shahroud [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
]. Some of the findings of this study are inconsistent with the results of a study conducted in Mashhad [42Arshadi H, Homam M, Mohamadi E, Sanjar Musavi N. A comparative study of self-efficacy and self-esteem among students of islamic azad university of medical sciences mashhad branch. Future Med Edu J 2014; 4(1): 17-21.]. Perhaps one of the reasons for the difference in study environments.

Furthermore, a significant relationship was observed between health-promoting lifestyle and self-efficacy, well-being, and age. The findings of this study are consistent with some of the results of studies conducted in Iran and the world [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 12Nacar M, Baykan Z, Cetinkaya F, et al. Health promoting lifestyle behaviour in medical students: A multicentre study from Turkey. Asian Pac J Cancer Prev 2014; 15(20): 8969-74.
[http://dx.doi.org/10.7314/APJCP.2014.15.20.8969] [PMID: 25374238]
-14Shaheen AM, Nassar OS, Amre HM, Hamdan-Mansour AM. Factors affecting health-promoting behaviors of university students in Jordan. Health 2015; 7(01): 1.
[http://dx.doi.org/10.4236/health.2015.71001]
, 19Lee RL, Loke AJ. Health-promoting behaviors and psychosocial well-being of university students in Hong Kong. Public Health Nurs 2005; 22(3): 209-20.
[http://dx.doi.org/10.1111/j.0737-1209.2005.220304.x] [PMID: 15982194]
, 24Amiri M, Vahedi H, Mirhoseini SR, Eghtesadi AR, Khosravi A. Study of the relationship between self-efficacy, general health and burnout among iranian health workers. Osong Public Health Res Perspect 2019; 10(6): 359-67.
[http://dx.doi.org/10.24171/j.phrp.2019.10.6.06] [PMID: 31897365]
, 38Samimi R, Rodsary DM, Hosseini F, Tamadonfar M. Correlation between lifestyle and general health in university students. Iran J Nurs 2007; 19(48): 83-93., 41Kreutz G, Ginsborg J, Williamon A. Health-promoting behaviours in conservatoire students. Psychol Music 2009; 37(1): 47-60.
[http://dx.doi.org/10.1177/0305735607086047]
]. Due to the similarities in the relationship between these variables in different studies, it is necessary to pay more attention to the issue of self-efficacy and the well-being of students of medical sciences in Islamic Azad University.

Results also showed a significant relationship between health-promoting lifestyle and age. The findings of this study are consistent with the results of some studies conducted in Iran and the world(4, 14, 19, 24, 38, 41). However, it is not consistent with the results of some studies [10Mansorian M, Qorbani M, Solaimani M, Masoodi R, Rahimi E, Asayesh H. A survey of life style and its influential factors among the University Students in Gorgan. J Jahrom Univ Med Sci 2009; 7(1): 62-71.
[http://dx.doi.org/10.29252/jmj.7.1.2.62]
, 16Babanejad M, Rajabi A, Mohammadi S, Partovi F, Delpisheh A. Investigation lifestyle and prediction of changes in its associated factors amongst health students. J Health 2013; 4(2): 147-55., 18Maheri AB, Bahrami M-N, Sadeghi R. The situation of health-promoting lifestyle among the students living in dormitories of Tehran University of Medical Sciences, Iran. Iran J Health Development 2013; 1(4): 275-86.]. Perhaps one of the reasons for the discrepancy is due to the heterogeneity of the ages of the people studied.

The relationship between health-promoting lifestyle and field of study was also found significant. This is consistent with the results of studies conducted in Tehran and Shahroud [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 16Babanejad M, Rajabi A, Mohammadi S, Partovi F, Delpisheh A. Investigation lifestyle and prediction of changes in its associated factors amongst health students. J Health 2013; 4(2): 147-55.]. However, there was no significant relationship between the health-promoting lifestyle and gender, which is consistent with the findings of some studies [12Nacar M, Baykan Z, Cetinkaya F, et al. Health promoting lifestyle behaviour in medical students: A multicentre study from Turkey. Asian Pac J Cancer Prev 2014; 15(20): 8969-74.
[http://dx.doi.org/10.7314/APJCP.2014.15.20.8969] [PMID: 25374238]
, 14Shaheen AM, Nassar OS, Amre HM, Hamdan-Mansour AM. Factors affecting health-promoting behaviors of university students in Jordan. Health 2015; 7(01): 1.
[http://dx.doi.org/10.4236/health.2015.71001]
, 16Babanejad M, Rajabi A, Mohammadi S, Partovi F, Delpisheh A. Investigation lifestyle and prediction of changes in its associated factors amongst health students. J Health 2013; 4(2): 147-55., 18Maheri AB, Bahrami M-N, Sadeghi R. The situation of health-promoting lifestyle among the students living in dormitories of Tehran University of Medical Sciences, Iran. Iran J Health Development 2013; 1(4): 275-86., 19Lee RL, Loke AJ. Health-promoting behaviors and psychosocial well-being of university students in Hong Kong. Public Health Nurs 2005; 22(3): 209-20.
[http://dx.doi.org/10.1111/j.0737-1209.2005.220304.x] [PMID: 15982194]
, 43Suraj S, Singh A. Study of sense of coherence health promoting behavior in north Indian students. Indian J Med Res 2011; 134(5): 645-52.
[PMID: 22199103]
, 44Wei CN, Harada K, Ueda K, Fukumoto K, Minamoto K, Ueda A. Assessment of health-promoting lifestyle profile in Japanese university students. Environ Health Prev Med 2012; 17(3): 222-7.
[PMID: 21987366]
] and inconsistent with the findings of some others [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 10Mansorian M, Qorbani M, Solaimani M, Masoodi R, Rahimi E, Asayesh H. A survey of life style and its influential factors among the University Students in Gorgan. J Jahrom Univ Med Sci 2009; 7(1): 62-71.
[http://dx.doi.org/10.29252/jmj.7.1.2.62]
, 13Nassar OS, Shaheen AM. Health-promoting behaviours of university nursing students in Jordan. Health 2014; 6(19): 2756.
[http://dx.doi.org/10.4236/health.2014.619315]
].

There was no significant relationship between health-promoting lifestyle and marital status. It is not consistent with the results of some studies [10Mansorian M, Qorbani M, Solaimani M, Masoodi R, Rahimi E, Asayesh H. A survey of life style and its influential factors among the University Students in Gorgan. J Jahrom Univ Med Sci 2009; 7(1): 62-71.
[http://dx.doi.org/10.29252/jmj.7.1.2.62]
, 12Nacar M, Baykan Z, Cetinkaya F, et al. Health promoting lifestyle behaviour in medical students: A multicentre study from Turkey. Asian Pac J Cancer Prev 2014; 15(20): 8969-74.
[http://dx.doi.org/10.7314/APJCP.2014.15.20.8969] [PMID: 25374238]
, 18Maheri AB, Bahrami M-N, Sadeghi R. The situation of health-promoting lifestyle among the students living in dormitories of Tehran University of Medical Sciences, Iran. Iran J Health Development 2013; 1(4): 275-86., 45Al-Kandari F, Vidal VL, Thomas D. Health-promoting lifestyle and body mass index among College of Nursing students in Kuwait: A correlational study. Nurs Health Sci 2008; 10(1): 43-50.
[http://dx.doi.org/10.1111/j.1442-2018.2007.00370.x] [PMID: 18257831]
] but is consistent with the results of a previous study conducted in Shahroud [8Wang D, Xing XH, Wu XB. Healthy lifestyles of university students in China and influential factors. ScientificWorldJournal 2013; 2013412950
[http://dx.doi.org/10.1155/2013/412950] [PMID: 23935418]
]; neither was there a significant relationship between health-promoting lifestyle and economic status, which is not consistent with the results of some studies [10Mansorian M, Qorbani M, Solaimani M, Masoodi R, Rahimi E, Asayesh H. A survey of life style and its influential factors among the University Students in Gorgan. J Jahrom Univ Med Sci 2009; 7(1): 62-71.
[http://dx.doi.org/10.29252/jmj.7.1.2.62]
, 12Nacar M, Baykan Z, Cetinkaya F, et al. Health promoting lifestyle behaviour in medical students: A multicentre study from Turkey. Asian Pac J Cancer Prev 2014; 15(20): 8969-74.
[http://dx.doi.org/10.7314/APJCP.2014.15.20.8969] [PMID: 25374238]
, 44Wei CN, Harada K, Ueda K, Fukumoto K, Minamoto K, Ueda A. Assessment of health-promoting lifestyle profile in Japanese university students. Environ Health Prev Med 2012; 17(3): 222-7.
[PMID: 21987366]
] but is in line with some others [4Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
, 14Shaheen AM, Nassar OS, Amre HM, Hamdan-Mansour AM. Factors affecting health-promoting behaviors of university students in Jordan. Health 2015; 7(01): 1.
[http://dx.doi.org/10.4236/health.2015.71001]
].

Good study design and large sample size and use of standard questionnaires were the strengths of this study. The present study also had some limitations, including the cross-sectional study, data collection through a questionnaire which allows for social desirability, and a focusonly on medical student and excluding students of other majors.

CONCLUSION

More than 90% of students had low self-efficacy and more than 30 percent of them did not have satisfactory well-being. Moreover, the health-promoting lifestyle of students was moderate. Students with low capacity of well-being must be referred for psychological counseling. Emphasizing lifestyle influencing factors in curricula, paying more attention, and making the required interventions in the above areas can help improve students' health-promoting lifestyles.

ETHICS APPROVAL AND CONSENT TO PARTICIPATE

Prior to the commencement of the study, the proposal had been reviewed and approved by the Ethics Committee of Medical Sciences Research at the Islamic Azad University of Shahroud, Iran.

HUMAN AND ANIMAL RIGHTS

Not applicable.

CONSENT FOR PUBLICATION

Informed consent was obtained from all participants involved in the research.

AVAILABILITY OF DATA AND MATERIALS

The raw data and materials used to support the findings of this study are available from the corresponding author [M.R] upon request.

FUNDING

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sector.

CONFLICT OF INTEREST

The authors declare no conflict of interest, financial or otherwise.

ACKNOWLEDGEMENTS

The researchers thank all the study participants and the Universityof Venda’s Directorate of Research and Innovation for supporting this project. Special thanks go to Vhembe District Hospitals that gave us access to their patients.

REFERENCES

[1] Safarzadeh S, Marashian FS. Relations between goal orientation (skill-oriented, performance-oriented, performance-avoidance) and metacognition with subjective well-being and academic self-efficacy among the students. Education Strategies in Medical Sciences 2017; 9(6): 447-57.
[2] Raeisoon M, Mohammadi YMA, Gh S. An investigation of relationship between self-concept, and self esteem and academic achievement of student in nursing -midwifery faculty in Queen during 2012-2013. Mod Care J 2014; 11(3): 236-42.
[3] Komarraju M, Nadler D. Self-efficacy and academic achievement: Why do implicit beliefs, goals, and effort regulation matter? Learn Individ Differ 2013; 25: 67-72.
[http://dx.doi.org/10.1016/j.lindif.2013.01.005]
[4] Amiri M, Chaman R, Khosravi A. The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health Res Perspect 2019; 10(4): 221-7.
[http://dx.doi.org/10.24171/j.phrp.2019.10.4.04] [PMID: 31497493]
[5] Uphold CR, Holmes W, Reid K, Findley K, Parada JP. Healthy lifestyles and health-related quality of life among men living with HIV infection. J Assoc Nurses AIDS Care 2007; 18(6): 54-66.
[http://dx.doi.org/10.1016/j.jana.2007.03.010] [PMID: 17991599]
[6] Igra V, Irwin CE. Theories of adolescent risk-taking behavior Handbook of adolescent health risk behavior 1996; 35-51.
[http://dx.doi.org/10.1007/978-1-4899-0203-0_3]
[7] Rew L, Carver T, Li C-C. Early and risky sexual behavior in a sample of rural adolescents. Issues Compr Pediatr Nurs 2011; 34(4): 189-204.
[http://dx.doi.org/10.3109/01460862.2011.619861] [PMID: 22010625]
[8] Wang D, Xing XH, Wu XB. Healthy lifestyles of university students in China and influential factors. ScientificWorldJournal 2013; 2013412950
[http://dx.doi.org/10.1155/2013/412950] [PMID: 23935418]
[9] Lee DH, Kang S, Yum S. A qualitative assessment of personal and academic stressors among Korean college students: An exploratory study. Coll Stud J 2005; 39(3): 442-9.
[10] Mansorian M, Qorbani M, Solaimani M, Masoodi R, Rahimi E, Asayesh H. A survey of life style and its influential factors among the University Students in Gorgan. J Jahrom Univ Med Sci 2009; 7(1): 62-71.
[http://dx.doi.org/10.29252/jmj.7.1.2.62]
[11] Geok SK, Yusof A, Lam SK, Japar S, Leong OS, Fauzee MSO. Physical activity and health-promoting lifestyle of student nurses in Malaysia. J Biosci Med (Irvine) 2015; 3(03): 78.
[http://dx.doi.org/10.4236/jbm.2015.33012]
[12] Nacar M, Baykan Z, Cetinkaya F, et al. Health promoting lifestyle behaviour in medical students: A multicentre study from Turkey. Asian Pac J Cancer Prev 2014; 15(20): 8969-74.
[http://dx.doi.org/10.7314/APJCP.2014.15.20.8969] [PMID: 25374238]
[13] Nassar OS, Shaheen AM. Health-promoting behaviours of university nursing students in Jordan. Health 2014; 6(19): 2756.
[http://dx.doi.org/10.4236/health.2014.619315]
[14] Shaheen AM, Nassar OS, Amre HM, Hamdan-Mansour AM. Factors affecting health-promoting behaviors of university students in Jordan. Health 2015; 7(01): 1.
[http://dx.doi.org/10.4236/health.2015.71001]
[15] Altun I. Effect of a health promotion course on health promoting behaviours of university students 2008.
[16] Babanejad M, Rajabi A, Mohammadi S, Partovi F, Delpisheh A. Investigation lifestyle and prediction of changes in its associated factors amongst health students. J Health 2013; 4(2): 147-55.
[17] Kaldi A, Kabiran EH, Mohagheghi KSH, Rezasoltani P. The evaluation of relationship between health-promoting lifestyle and quality of life (case of study: university of social welfare and rehabilitation sciences students in Tehran). J Iran Soc Develop Stud 2014; 6(4): 87-95.
[18] Maheri AB, Bahrami M-N, Sadeghi R. The situation of health-promoting lifestyle among the students living in dormitories of Tehran University of Medical Sciences, Iran. Iran J Health Development 2013; 1(4): 275-86.
[19] Lee RL, Loke AJ. Health-promoting behaviors and psychosocial well-being of university students in Hong Kong. Public Health Nurs 2005; 22(3): 209-20.
[http://dx.doi.org/10.1111/j.0737-1209.2005.220304.x] [PMID: 15982194]
[20] Baradaran Rezaie M, Shirvani M. Stress control status amongst Tabriz medical & non medical sciences universities’ students: Evidence from the university students life style survey. J Caring Sci 2006; 5: 54-63.
[21] Fayazbakhsh A, Khajeh KR, Soleymani NM, et al. The internet using and health: Students'knowledge, Attitude and Lifestyle related to the Internet 2011.
[22] Walker S, Hill-Polerecky D. Psychometric evaluation of the Health-Promoting Lifestyle Profile-II [unpublished manuscript]. University of Nebraska Medical Center, 1996 2010.
[23] Walker SN, Sechrist KR, Pender NJ. The health-promoting lifestyle profile: Development and psychometric characteristics. Nurs Res 1987; 36(2): 76-81.
[http://dx.doi.org/10.1097/00006199-198703000-00002] [PMID: 3644262]
[24] Amiri M, Vahedi H, Mirhoseini SR, Eghtesadi AR, Khosravi A. Study of the relationship between self-efficacy, general health and burnout among iranian health workers. Osong Public Health Res Perspect 2019; 10(6): 359-67.
[http://dx.doi.org/10.24171/j.phrp.2019.10.6.06] [PMID: 31897365]
[25] Vahedi H, Khosravi A, Sadeghi Z, et al. Health-Promoting Lifestyle in Patients with and without Diabetes in Iran. Health Scope 2017; 6(2)
[26] Cheng VM. Infusing creativity into Eastern classrooms: Evaluations from student perspectives. Think Skills Creativity 2011; 6(1): 67-87.
[http://dx.doi.org/10.1016/j.tsc.2010.05.001]
[27] Amiri M, Khosravi A, Mokhtari AA. Job satisfaction and its influential factors. J Res Health Sci 2010; 10(1): 42-6.
[PMID: 22911916]
[28] Tsang SK, Hui EK, Law B. Self-efficacy as a positive youth development construct: A conceptual review. The Scientific World Journal 2012; 2012
[http://dx.doi.org/10.1100/2012/452327]
[29] Altunsoy S, Çimen O, Ekici G, Atik AD, Gökmen A. An assessment of the factors that influence biology teacher candidates’ levels of academic self-efficacy. Procedia Soc Behav Sci 2010; 2(2): 2377-82.
[http://dx.doi.org/10.1016/j.sbspro.2010.03.340]
[30] Mirzaei-Alavijeh M, Hosseini SN, Motlagh MI, Jalilian F. Academic self-efficacy and its relationship with academic variables among Kermanshah University of Medical Sciences students: A cross sectional study. Pajouhan Scientific J 2018; 16(2): 18-25.
[http://dx.doi.org/10.21859/psj.16.2.28]
[31] Hayati D, Ogbahi A, Abedin HAS, Mohsen AA. Investigating the relationships between quality of learning experience’s components and self-efficacy on academic burnout among students of Allamme Tabatabaei University of Tehran. educational development of jundishapur 2012; 3(4): 18-29.
[32] Mohammadi Zeidi I, Pakpour Hajiagha A, Mohammadi Zeidi B. Reliability and validity of Persian version of the health-promoting lifestyle profile. Majallah-i Danishgah-i Ulum-i Pizishki-i Mazandaran 2012; 21(1): 102-13.
[33] Khosravi A, Mousavi SA, Chaman R, et al. Reliability and validity of the Persian version of the World Health Organization-five well-being index. Int J Health Stud 2015; 1(1): 17-9.
[34] Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The self-efficacy scale: Construction and validation. Psychol Rep 1982; 51(2): 663-71.
[http://dx.doi.org/10.2466/pr0.1982.51.2.663] [PMID: 7089151]
[35] Ahmadnia E, Shakibazadeh E, Emamgholi Khoshechin T. Life style-related osteoporosis preventive behaviors among nursing and midwifery students. Hayat (Tihran) 2010; 15(4): 50-9.
[36] Khazir Z, Abbasi-Shavazi M. The study of general health status in the students of shahid sadoughi university of medical sciences in yazd. J Commun Health Res 2019; 8(3): 131-8.
[http://dx.doi.org/10.18502/jchr.v8i3.1568]
[37] Ansari H, Bahrami L, Akbar Zadeh L, Bakhshani N. Assessment of general health and some related factors among students of Zahedan University of Medical Sciences in 2007. Zahedan J Res Med Sci (Tabib-E-Shargh) 2008; 9(4): 295-304.
[38] Samimi R, Rodsary DM, Hosseini F, Tamadonfar M. Correlation between lifestyle and general health in university students. Iran J Nurs 2007; 19(48): 83-93.
[39] Rahimian bugar E, Mohammadifar M, Najafi M, Dehshiri GR. Life skills influence on students’general health. Clinical Psychology & Personality 2013; 2(8): 23-34.
[40] Semyari H, Heravi-Karimooi M, Nasiri M, Arabi F. The relationship of Dentistry students’ spiritual intelligence to general health. Iran J Psychiatric Nur 2015; 3(1) [IJPN].
[41] Kreutz G, Ginsborg J, Williamon A. Health-promoting behaviours in conservatoire students. Psychol Music 2009; 37(1): 47-60.
[http://dx.doi.org/10.1177/0305735607086047]
[42] Arshadi H, Homam M, Mohamadi E, Sanjar Musavi N. A comparative study of self-efficacy and self-esteem among students of islamic azad university of medical sciences mashhad branch. Future Med Edu J 2014; 4(1): 17-21.
[43] Suraj S, Singh A. Study of sense of coherence health promoting behavior in north Indian students. Indian J Med Res 2011; 134(5): 645-52.
[PMID: 22199103]
[44] Wei CN, Harada K, Ueda K, Fukumoto K, Minamoto K, Ueda A. Assessment of health-promoting lifestyle profile in Japanese university students. Environ Health Prev Med 2012; 17(3): 222-7.
[PMID: 21987366]
[45] Al-Kandari F, Vidal VL, Thomas D. Health-promoting lifestyle and body mass index among College of Nursing students in Kuwait: A correlational study. Nurs Health Sci 2008; 10(1): 43-50.
[http://dx.doi.org/10.1111/j.1442-2018.2007.00370.x] [PMID: 18257831]
Track Your Manuscript:


Endorsements



"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."


Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."


Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."


Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."


Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."


Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."


Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."


Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."


J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."


Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."


Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."


Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."


Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."


Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."


M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."


Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."


Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."


Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."


Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."


Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."


Jih Ru Hwu
(National Central University, Taiwan)


Browse Contents




Webmaster Contact: info@benthamopen.net
Copyright © 2020 Bentham Open