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Health-promoting lifestyle and quality of life among Chinese nursing students

  • Yim Wah Mak (a1), Angela H. F. Kao (a2), Lucia W. Y. Tam (a3), Virginia W. C. Tse (a4), Don T. H. Tse (a4) and Doris Y. P. Leung (a5)...



This study aimed to examine the relationships between socio-economic status, health-promoting lifestyles, and quality of life among Chinese nursing students.


Nursing students will be future health promoters, but they may not always adopt the recommended healthy lifestyle. Currently, there are insufficient studies examining the health-promoting lifestyles of Chinese nursing students, and the impact of socio-economic status and health-promoting lifestyle on their health.


This was a cross-sectional survey. Data were collected from nursing students studying in pre-registration nursing programs of a university in Hong Kong. The survey was conducted through a self-administered questionnaire that solicited information regarding their socio-economic status, health-promoting lifestyle, quality of life, and perceptions of the barriers to adopting a health-promoting lifestyle.


A total of 538 students returned completed questionnaires for analysis. Among the health-promoting lifestyle subscales, the participants performed best in interpersonal relations and worst in physical activity, and the vast majority of them did not actively engage in health-risk behaviors. Hierarchical regression analyses revealed that only 5% of the variance in quality of life was explained by socio-economic variables, whereas a total of 24% of the variance was explained when health-promoting lifestyle variables were added. In particular, health responsibility, physical activity, spiritual growth, and stress management were statistically significant predictors of quality of life.


Early concerns about how prepared nurses are to take on the role of promoting health still apply today. School administrators should plan the nursing curriculum to include activities that encourage student nurses to participate in health-promoting lifestyles. Future studies are needed to explore the barriers that prevent students from practicing health-promoting behavior.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Yim Wah Mak, GH506, School of Nursing, The Hong Kong Polytechnic University, Yuk Choi Road Hung Hom, Kowloon, Hong Kong SAR, China.


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Al‐Kandari, F Vidal, VL (2007) Correlation of the health‐promoting lifestyle, enrollment level, and academic performance of College of Nursing students in Kuwait. Nursing & Health Sciences 9, 112119.
Alpar, ŞE, Şenturan, L, Karabacak, Ü Sabuncu, N (2008) Change in the health promoting lifestyle behaviour of Turkish University nursing students from beginning to end of nurse training. Nurse Education in Practice 8, 382388.
Amir, M, Marcelo, F, Herrman, H, Lomachenkov, A, Lucas, R Patrick, D, and LIDO Group (2000) Reliability, validity and reproducibility of the WHOQOL. BREF in six countries. Quality of Life Research 9, 320.
Can, G, Ozdilli, K, Erol, O, Unsar, S, Tulek, Z, Savaser, S, Ozcan, S Durna, Z (2008) Comparison of the health‐promoting lifestyles of nursing and non‐nursing students in Istanbul, Turkey. Nursing & Health Sciences 10, 273280.
Carlson, GD Warne, T (2007) Do healthier nurses make better health promotors? A review of the literature. Nurse Education Today 27, 506513.
Carnethon, MR, Evans, NS, Church, TS, Lewis, CE, Schreiner, PJ, Jacobs, DR, Sternfeld, B Sidney, S (2010) Joint associations of physical activity and aerobic fitness on the development of incident hypertension. Hypertension 56, 4955.
Centre for Health Protection (2017) Statistics on behavioral risk factors. Hong Kong: Department of Health.
Cockerham, WC (2005) Health lifestyle theory and the convergence of agency and structure. Journal of Health and Social Behavior 46, 5167.
Cohen, S, Janicki‐Deverts, D, Chen, E Matthews, KA (2010) Childhood socioeconomic status and adult health. Annals of the New York Academy of Sciences 1186, 3755.
Conry, MC, Morgan, K, Curry, P, McGee, H, Harrington, J, Ward, M Shelley, E (2011) The clustering of health behaviours in Ireland and their relationship with mental health, self-rated health and quality of life. BMC Public Health 11, 692.
El Ansari, W, Stock, C, John, J, Deeny, P, Phillips, C, Snelgrove, S, Adetunji, H, Hu, X, Parke, S, Stoate, M Mabhala, A (2011) Health promoting behaviours and lifestyle characteristics of students at seven universities in the UK. Central European Journal of Public Health 19, 197204.
Eriksson, MK, Hagberg, L, Lindholm, L, Malmgren-Olsson, EB, Österlind, J Eliasson, M (2010) Quality of life and cost-effectiveness of a 3-year trial of lifestyle intervention in primary health care. Archives of Internal Medicine 170, 14701479.
French, SA Jeffery, RW (1994) Consequences of dieting to lose weight: effects on physical and mental health. Health Psychology 13, 195212.
Hancox, RJ, Milne, BJ Poulton, R (2004) Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. The Lancet 364, 257262.
Hsiao, YC, Chien, LY, Wu, LY, Chiang, CM Huang, SY (2010) Spiritual health, clinical practice stress, depressive tendency and health‐promoting behaviours among nursing students. Journal of Advanced Nursing 66, 16121622.
Hui, WHC (2002) The health-promoting lifestyles of undergraduate nurses in Hong Kong. Journal of Professional Nursing 18, 101111.
Keith, KD Schalock, RL (1994) The measurement of quality of life in adolescence: The quality of student life questionnaire. The American Journal of Family Therapy 22, 8387.
Kolbe, LJ, Kann, L Collins, JL (1993) Overview of the youth risk behavior surveillance system. Public Health Reports 108 (Suppl 1), 210.
Lane, IF (2010) Professional competencies in health sciences education: from multiple intelligences to the clinic floor. Advances in Health Sciences Education 15, 129146.
Langford, R, Campbell, R, Magnus, D, Bonell, CP, Murphy, SM, Waters, E, Komro, KA Gibbs, LF (2011) The WHO Health Promoting School framework for improving the health and well-being of students and staff. Cochrane Database of Systematic Reviews 1, doi: 10.1002/14651858.CD008958.
Lau, JT, Kim, JH Tsui, HY (2005) Prevalence, health outcomes, and patterns of psychotropic substance use in a Chinese population in Hong Kong: a population-based study. Substance Use & Misuse 40, 187209.
Lee, A, Tsang, KK, Lee, SH To, CY (2001) A YRBS survey of youth risk behaviors at alternative high schools and mainstream high schools in Hong Kong. Journal of School Health 71, 443447.
Lee, FH Wang, HH (2005) A preliminary study of a health-promoting lifestyle among Southeast Asian women in Taiwan. The Kaohsiung Journal of Medical Sciences 21, 114120.
López‐Guimerà, G, Neumark‐Sztainer, D, Hannan, P, Fauquet, J, Loth, K Sánchez‐Carracedo, D (2013) Unhealthy weight‐control behaviours, dieting and weight status: a cross‐cultural comparison between North American and Spanish adolescents. European Eating Disorders Review 21, 276283.
Manuel, DG, Perez, R, Sanmartin, C, Taljaard, M, Hennessy, D, Wilson, K, Tanuseputro, P, Manson, H, Bennett, C, Tuna, M, Fisher, S Rosella, LC (2016) Measuring burden of unhealthy behaviours using a multivariable predictive approach: life expectancy lost in Canada attributable to smoking, alcohol, physical inactivity, and diet. PLoS Medicine 13, e1002082.
Mokdad, AH, Marks, JS, Stroup, DF Gerberding, JL (2004) Actual causes of death in the United States, 2000. Journal of American Medical Association 291, 12381245.
Mooney, B, Timmins, F, Byrne, G Corroon, AM (2011) Nursing students’ attitudes to health promotion to: implications for teaching practice. Nurse Education Today 31, 841848.
Neinstein, LS (2008) Adolescent health care: a practical guide (Vol. 414). Philadelphia: Lippincott Williams & Wilkins.
Patkar, AA, Hill, K, Batra, V, Vergare, MJ Leone, FT (2003) A comparison of smoking habits among medical and nursing students. Chest Journal 124, 14151420.
Pender, NJ, Murdaugh, CL Parsons, MA (2006) Health promotion in nursing practice, fifth edition. Upper Saddle River, NJ: Pearson/Prentice Hall.
Plotnikoff, RC, Costigan, SA, Williams, RL, Hutchesson, MJ, Kennedy, SG, Robards, SL, Allen, J, Collins, CE, Callister, R Germov, J (2015) Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: a systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity 12, 45.
Posadzki, P, Musonda, P, Debska, G Polczyk, R (2009) Psychosocial conditions of quality of life among undergraduate students: a cross sectional survey. Applied Research in Quality of Life 4, 239258.
Raudenbush, SW Bryk, AS (2002) Hierarchical linear models: applications and data analysis methods. Volume 1 Thousand Oaks, CA: Sage.
Rawana, JS, Morgan, AS, Nguyen, H Craig, SG (2010) The relation between eating-and weight-related disturbances and depression in adolescence: a review. Clinical Child and Family Psychology Review 13, 213230.
Rey-López, JP, Vicente-Rodriguez, G, Ortega, FB, Ruiz, JR, Martinez-Gómez, D, De Henauw, S, Manios, Y, Molnar, D, Polito, A, Verloigne, M, Castillo, MJ, Sjostrom, M, Bourdeaudhuij, LD Mareno, LA, on behalf of the HELENA Study group (2010) Sedentary patterns and media availability in European adolescents: The HELENA study. Preventive Medicine 51, 5055.
Royston, P, Altman, DG Sauerbrei, W (2006) Dichotomizing continuous predictors in multiple regression: a bad idea. Statistics in Medicine 25, 127141.
Saxena, S, Carlson, D, Billington, R Orley, J (2001) The WHO quality of life assessment instrument (WHOQOL-Bref): the importance of its items for cross-cultural research. Quality of Life Research 10, 711721.
Shirlee, D Neva, W (2004) Health promoting behaviors among African American women with faith-based support. Association of Black Nursing Faculty Journal 15, 8490.
Shriver, CB Scott-Stiles, A (2000) Health habits of nursing versus non-nursing students: a longitudinal study. Journal of Nursing Education 39, 308314.
Singer, MK (2012) Applying the concept of culture to reduce health disparities through health behavior research. Preventive Medicine 55, 356361.
Staib, S, Fusner, S Consolo, K (2006) How healthy are your nursing students? Teaching and Learning in Nursing 1, 5560.
Story, GW, Vlaev, I, Seymour, B, Darzi, A Dolan, RJ (2014) Does temporal discounting explain unhealthy behavior? A systematic review and reinforcement learning perspective. Frontiers in Behavioral Neuroscience 8, 120.
Stuifbergen, AK, Becker, H, Blozis, S, Timmerman, G Kullberg, V (2003) A randomized clinical trial of a wellness intervention for women with multiple sclerosis. Archives of Physical Medicine and Rehabilitation 84, 467476.
The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine 28, 551558.
Walker, SN, Sechrist, KR Pender, NJ (1987) The Health-Promoting Lifestyle Profile: development and psychometric characteristics. Nursing Research 36, 7681.
Wei, CN, Harada, K, Ueda, K, Fukumoto, K, Minamoto, K Ueda, A (2012) Assessment of Health-Promoting Lifestyle Profile in Japanese university students. Environmental Health and Preventive Medicine 17, 222227.
Whitehead, D (2007) Reviewing health promotion in nursing education. Nurse Education Today 27, 225237.
World Health Organization (WHO) (2004) The World Health Organization Quality of Life (WHOQOL)-BREF. Geneva: World Health Organization.
World Health Organization (WHO) (2009) Milestones in health promotion: statements from global conferences. Geneva: World Health Organization.
World Health Organization (WHO) (2013) Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva: World Health Organization.
Yao, G, Chung, CW, Yu, CF Wang, JD (2002) Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version. Journal of the Formosan Medical Association 101, 342351.



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