Determine of Midwifery Students Dietary and Physical Activity Attitudes and Behaviors: Analytic Study
Department of Midwifery, Kutahya Health Sciences University, Turkey
Submission: December 28, 2018; Published: January 11, 2019
*Corresponding author: Department of Midwifery, Kutahya Health Sciences University, Turkey
How to cite this article: Aysegul Durmaz. Determine of Midwifery Students Dietary and Physical Activity Attitudes and Behaviors: Analytic StudyJOJ
Nurse Health Care. 2019; 10(1): 555780. DOI: 10.19080/JOJNHC.2019.10.555780.
Background: The less physical activity and an unhealthy diet are the factors contributing to the poor health among university students. This study aims to address this, by investigating the factors that influence eating behaviour and attitudes.
Methods: This is an analytic study. The study was carried out on May 2018 in Kutahya, Turkey. The research was completed with the participation of 333 students. The Diet-Exercise Behaviour Scale (DEBS) and The Diet-Exercise Attitude Scale (DEAS) were used to determine the diet behaviours and attitudes of the students.
Results: This is an analytic study. The study was carried out on May 2018 in Kutahya, Turkey. The research was completed with the participation of 333 students. The Diet-Exercise Behaviour Scale (DEBS) and The Diet-Exercise Attitude Scale (DEAS) were used to determine the diet behaviours and attitudes of the students.
Conclusion: Habitual physical activity, regular and balanced diet established during the university years may provide the greatest likelihood of impact on morbidity and longevity. Efforts should be focused on facilitating an active lifestyle for a person in an effort to put a stop to the increasing prevalence of obesity.
A healthy diet is crucial for the growth and the development, that contributed to prevent future illness and improve the quality and the length of the life . The World Health Organization (WHO) addresses two of the major risk factors which are responsible for the heavy and growing burden. Up to 60% of the global deaths and almost half (47%) of the global burden disease have been related to an unhealthy diet and physical inactivity. Poor eating and physical inactivity are associated with the higher health risks that are high blood pressure, elevated blood cholesterol, low intake of fruits and vegetables and high body mass index .
The initiating to university has been identified as an anxiety period of transition for many young adults. For instance; the first time living away from the home causes to the high rates of unhealthy behaviours which are common in this particular population. The less physical activity and an unhealthy diet are the factors contributing to the poor health among university students. Therefore, university students are considered as a risk group [3,4]. The recent studies about eating disorders were focused mainly on adolescents . The other important
strategy is the reducing excessive sedentary behaviour [6,7]. The sedentary lifestyle automatically leads to the obesity. The regular physical activity fixed during the early life years may provide the greatest likelihood of impact on the mortality and the longevity . Midwives are in a unique position, given the emphasis of the philosophy of midwifery care on incorporating a holistic approach with the aim of promoting health and preventing illness . Therefore, this specific population is important because of the support for the health promotion. This study was aimed to determine the eating and the physical activity behaviours and the attitudes in midwifery students.
This is an analytic study. The study was carried out on May 2018 in Kutahya, Turkey. The target population of this study was midwifery student. 444 students of the Department of Midwifery of 2017-2018 academic year formed the research sample. All students were planned to include the sampling. The research was completed with the participation (participation rate 75%) of 333
students. The study was approved by The Institution and Ethics
Committee and carried out in accordance with the Declaration of
Helsinki. The participants signed an informed consent
Inclusion criteria: Those who voluntarily agree to participate
in the research after being informed by the researchers. Fully
fill in the questions of the Diet-Exercise Attitude Scale and Diet-
Exercise Behaviour Scale. The participants who can completely
fill the questions of the scales and who can understand, read and
write in Turkish are included in the research.
Measures: Data collection: the basic information
questionnaire form, diet-exercise attitude scale and diet-exercise
behaviour scale were used. The basic information questionnaire
included information about age, height, weight, residence, family
type, family history of obesity and dietary history
The Diet-Exercise Attitude Scale (DEAS) was used to determine
the attitudes of the students towards diet. The DEAS which was
adapted from the work of Yurt (2015), consisted of 13 items with
Likert responses (Each item uses five points Likert type ranging
from “always” to “never”. A score of five points was given for
“always”, four points for “usually”, three points for “sometimes”,
two points for “rarely,” and one for “never”), and were summed
to create a score ranging from 13 to 65. All items in the scale
contain positive expression. The higher is the score, the better is
the attitude at diet and exercise behaviours .
The Diet-Exercise Behaviour Scale (DEBS) was used to
determine the nutritional behaviours of the students. The DEBS
comprise 45 items with Likert responses, and is summed to
create a score ranging from 45 to 225. Items 7, 8, 9, 10, 11, 12,
14, 15, 17, 18, 20, 22, 30, 31, 32, 34, 35, 36, 37, 38, 39, 42, 43 are
encoded in the opposite direction. The scale interpretation is
based on the scores obtained from the subscales. DEBS include
four subscales: 1-psychological eating, 2-healthy eating-exercise
behaviour, 3-unhealthy eating-exercise behaviour, 4-meal scheme.
Psychological eating consists of 11 items. The total possible score
ranges from 11 to 55 (higher scores indicate that psychological
eating behaviour is high.). Healthy eating-exercise behaviour consists of 14 items. The total possible score ranges from 14 to 70
(higher scores indicate that healthy eating-exercise behaviour is
high). Unhealthy eating-exercise behaviour consists of 14 items.
The total possible score ranges from 14 to 70 (higher scores
indicate that unhealthy eating-exercise behaviour is high). Meal
scheme consists of 6 items. The total possible score ranges from 6
to 30 (the higher the score, the better is the meal scheme).
The statistical analyses were performed using IBM SPSS
(Statistical Package for Social Sciences) Statistics 22 software.
Descriptive statistics (mean, standard deviation, number,
percentage) were used to summarize demographic data.
Kolmogorov-Smirnov test was used to test the normality of
distribution before the further analysis. As a result, the Mann-
Whitney U and Kruskal-Wallis Test were used for comparing
variables. Correlations between the DEAS and the DEBS subscales
were determined using Spearman correlation coefficient. To
explain the relationship between DEBS Subscales mean and DEAS
total score, linear logistic regression analysis (OR, CI, R2) was
applied to the total sample. Statistical significance was set at the
level of p<0.050.
Demographic and selected lifestyle characteristics of the 333
midwifery students who participated in the present study are
summarized in Table 1. The average age of all participants was
20.07±1.49 years. The participants were generally within the range
of healthy weight (22.73±3.55) and physically active (65.8%).
More than half of participants (65.8%) were in the nuclear family
structure. For family monthly income it was found that 44.1%
(n = 147) was answered equal to revenue expense. 45% of the
participants had obesity in their family history. The frequency of
fast food consumption included once a week (37.2%). About half
of participants (46.2%) do something else (watching television
(TV)/video, reading newspaper, novel, working at the desk, sitting
in front of the computer, driving a car etc. while eating. A half of
participants (58.6%) eating in front of TV, computer or smart
phone screens (Table 1).
*watching TV/video, reading newspaper/book, working at the desk, sitting in front of the computer, driving a car, etc.
**TV, computer or smartphone screens.
The mean of the DEAS total scores was 49.11±13.47. The
mean of the DEBS’s subscales scores were shown on (Table 2).
The psychological eating subscale mean score was 34.62±13.18,
a healthy diet-exercise behaviour subscale mean score was
48.39±16.35, unhealthy diet-exercise behaviour mean score was
43.20±15.95 and meal scheme mean score was 22.01±6.09. The
DEBS’s subscales mean scores were higher than its subscales
average score. There was a statistically significant difference
(p<0.000) between the DEBS subscales (except healthy dietexercise
behaviour and meal scheme) mean score and DEAS total
score. The psychological eating (power correlate) and unhealthy
diet-exercise behaviour (weak correlate) mean score negatively correlate with DEAS total score. A healthy diet-exercise behaviour
and meal scheme mean score positively power correlate with
DEAS total score (Table 2).
In order to examine the relationship between DEBS Subscales
mean and DEAS total score, the logistic regression analysis
was conducted on the total sample. In the logistic regression
model, DEAS total score was used as the dependent variables.
The independent variables entered into the model were DEBS
subscales. In the regression, psychological eating, a healthy dietexercise
behaviour, unhealthy diet exercise behaviour and meal
scheme were associated with DEAS total score. As for each unit
increase in psychological eating and unhealthy diet exercise
behaviour subscales, the developing positive attitude at diet and
exercise behaviours decreases (OR=-0.776, 95% CI -0.848- -0.704;
OR=-0.151, 95% CI -0.241- -0.061). Higher scores in a healthy dietexercise
behaviour and meal scheme subscales indicated more
positive attitudes at diet and exercise behaviours (OR= 0.511,
95% CI 0.441-0.581; OR=0.878, 95% CI 0.658-1.097) (Table 3).
*Mann Whitney-U testi, **Kruskal Wallis Testi
Findings showed that the total score of DEAS, a healthy dietexercise
behaviour and meal scheme DEBS subscales increased
with the following features: High BMI (p<0.001), more than
revenue expense (p<0.050), absence of obesity in the family
history (p<0.050), frequently to do something else while eating
(p<0.050), eat fast food once per week (p<0.050), any time spent
in front of a screen (p<0.050), take part in sports/physical activity
regularly (4 times a week) (p<0.050). The mean subscales scores
for the entire study and levels of significance are given in Table 4.
The assessment of the eating attitudes can be useful to
understand people’s relationship with the foods and their
associated behavioural choices. Diet and physical activity
evaluation of the DEAS total score and the DEBS subscales mean
scores were performed on midwifery students. The findings
of this study reported a significant relationship between dietphysical
activity attitudes and behaviours [4,11]. There is a
significant effect of the DEAS total score and the DEBS subscales
mean scores on psychological eating and unhealthy diet-exercise
behaviours; the students who have high DEAS total scores, they
have less psychological eating and unhealthy diet-exercise
behaviours. In addition, in the agreement with the current study,
the mean scores of the high healthy diet-exercise behaviour and
meal scheme were also found among university students who had
high DEAS total scores. The findings of this study reported that
the diet-exercise attitude was strong correlated with diet-exercise
behaviour (psychological eating, healthy diet-exercise behaviour
and meal scheme). The similar studies also support this finding of
the present study [12-16].
The findings of this study reported a significant relationship
between Socio-demographic, diet, physical activity characteristics
and diet-exercise behaviour. This study underlined that the
values of the underweight, overweight and obese participants
were high and as the values increased, the psychological eating
and unhealthy diet-exercise behaviours increased. Also, the
participants who had the absence of obesity in family history
showed the more evidences of improved diet-exercise behaviour.
We found that the participants, who frequently do something else
while eating and eat fast food once per week, are more sedentary
(a lot of time spent in front of a screen) or less physically active.
Since the participants who do something else while eating, have
weekly fast food consumption and spend time in front of screen
may be associated with an increased risk for the psychological
eating and unhealthy diet-exercise behaviours. Our findings were
similar to previous studies [6,17-21]. Given the importance of the
university years in establishing lifelong dietary habits , it is
imperative to have better understanding of diet-exercise attitude
and behaviour of the university students. The maintaining healthy
habits, including reducing sedentary behaviour and improving
physical activity, is essential even in the fit person.
Diet-exercise attitudes and behaviours were moderate and
affected by some demographic characteristics. The results of
this study highlight the diet-exercise behaviours and attitudes
of the midwifery students, and also identifying and assessing
interventions that target reducing sedentary life, establishing the
healthy attitude and behaviour for the midwifery students. To
maximize physical wellness, we may obtain the greatest potential benefit based on reducing sedentary life and establishing the
healthy attitude and behaviour by providing a foundation for
a lifetime of positive behaviours. It is considered that students
should be encouraged to about regular and balanced diet-exercise.
A better understanding of the factors affecting the dietary patterns
of future health professionals can help improve the quality of diet,
which has significant implications for the overall reduction of
chronic disease risk.