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ЗДОРОВЫЙ ОБРАЗ ЖИЗНИ В САМООЦЕНКЕ СТУДЕНТОВ-МЕДИКОВ
Монастырская Татьяна Игоревна.
Россия, Новосибирск, Сибирский государственный университет телекоммуникаций и информатики, кандидат социологических наук, доцент кафедры социологии, психологии и политологии, t.monastyrskaya@mail.ru.
Макарова Лилия Ивановна.
Россия, Новосибирск, Новосибирский государственный медицинский университет, кандидат медицинских наук, доцент кафедры госпитальной терапии, t. monastyrskaya@mail. ru.
Аннотация. В данной статье рассматривается отношение студентов-медиков к здоровому образу жизни на примере социологического исследования. В будущем эти студенты-медики должны помочь своим пациентам сформировать основу здорового образа жизни.
Ключевые слова: здоровый образ жизни, факторы здорового образа жизни, здоровый образ жизни, студенты - будущие врачи.
HEALTHY LIFESTYLE IN MEDICAL STUDENTS' SELF-ASSESSMENT
Monastyrskaya Tatyana Igorevna.
Russia, Novosibirsk, PhD in Sociology, Associate Professor, Department of Sociology, Psychology and Political Science, Siberian State University of Telecommunications and Informatics, t.monastyrskaya@mail.ru.
Makarova Liliya Ivanovna.
Russia, Novosibirsk, Candidate of Medical Sciences, Associate Professor, Department of Hospital Therapy, Novosibirsk State Medical University, t. monastyrskaya@mail. ru.
Abstract. This paper considers the attitude of medical students to the healthy lifestyle on the case of sociological research. In the future these medical students should help their patients to form the basis of the healthy lifestyle.
Key words: healthy lifestyle, factors of healthy lifestyle, living a healthy life, students-future doctors
Background. The attitude to healthy lifestyle in different social groups has been investigated by numerous scholars. In this literature review, we will dwell upon three categories in this regard, namely students in general, medical workers and students of medicine.
Healthy lifestyle in students. Regardless of the fact that healthy lifestyle is considered from different angles by experts from all over the world, it is still possible to single out some common points most of the studies share.
American authors are more prone to use the umbrella term "wellness" embracing healthy lifestyle and other constituents, thus broadening the subject under discussion. For instance, D.R. Baldwin and her co-authors pay attention to psychological health in American college students [1]. It is interesting to see that self-esteem turned out to be the driver of wellness (although authors admit that sampling in their research was nonrandom). At the same time, British specialists concentrate on their understanding of lifestyle as something broader than the concept of wellness [2].
Dong Wang et al. focus on the case study of healthy lifestyle and its role in the life of Chinese students [3]. The researchers point out that multiple factors influence students' aptness to leading a healthy lifestyle (among the most important ones are gender, grade, parents' education and type of institution). At the same time, it is shown that a lot of Chinese students do not display any proclivity for a healthy lifestyle.
Talking about other countries, we can dwell upon the example of Turkey. From the research undertaken by V. Bozlar and C. Arslanoglu, it can be seen that BMI (body mass index) can be regarded as one of the qualitative characteristics of a healthy lifestyle [4]. Curiously enough, according to the results of their survey among the students majoring in Physical Education and Sports as well as adjacent fields, there is a direct connection between high grades at the university and living a healthy lifestyle.
Another important aspect of a healthy lifestyle, such as diet and nutrition, was studied by Czech authors [5]. It was shown that dietary preferences among students may vary greatly: as such, male students prefer fast food (which can be interpreted as a sign of their relative freedom from parents' control). At the same time, there are also some positive signs: students mostly prefer unsweetened beverages, also adding vitamins and minerals to their daily menu.
Regarding the researchers' perspective as to healthy lifestyle in modern Russia, authors from Kazan state in their article that preventive approach in this regard has been studied quite extensively in the Russian scholarly literature [6]. They resorted to a pedagogical experiment in their university on the assumption of an overall low level of health in students. The experiment consisted in implementation of a programme devoted to developing skills characteristic of a healthy lifestyle, and the authors observed positive dynamics after the experiment was over.
Healthy lifestyle in doctors. It goes without saying that doctors (particularly, physicians) following a healthy lifestyle can give a great example for their patients, as it helps prevent various diseases and improves overall wellness. As is shown by E.B. Oberg and E. Frank, this is true not only for chronic diseases but also for health-promoting practices [7]. Personal experience is what matters the most in this situation, as visitors are especially perceptible to such examples.
Authors from Bahrain [8] came to similar conclusions, however, showing that in Bahrain the situation is rather complicated, as a considerable amount of physicians suffer from obesity, which can lead to high blood pressure and other serious problems with cardiovascular system. The researchers emphasised the need for encouraging public and private healthcare institutions to pay attention to the promotion of a healthy lifestyle among medical workers.
As for the professional problems, one of the most pressing issues for doctors is sleep deprivation. All in all, physicians, just like general public, need to concentrate more on improving the quality of their diet and increasing the amount of physical activity [9].
Healthy lifestyle in medical students. Medical students, as future doctors, have to focus their attention on their own lifestyle, being potential role models for their clients. Leeds University conducted an educational experiment, introducing a course on healthy lifestyle for students of medicine, which was highly evaluated by them [2]. However, doctors (in particular, physicians) proved unable to effectively consult their patients if they do not lead a healthy lifestyle themselves.
An investigation undertaken by Pakistani authors was also focused on medical students' dietary habits [10]. In their case study they claim that good knowledge of healthy lifestyle does not necessarily result in the improvement of future doctors' professional skills. The students themselves displayed lack of time management skills, features of an unhealthy lifestyle (such as skipping breakfast or excessive consumption of caffeine). These factors resulted in sleep deprivation, high blood pressure and other interconnected problems.
Another cross-sectional study of medical students' attitude towards a healthy lifestyle was presented by a group of Turkish specialists [11]. They used HPLPS (Health Promoting Lifestyle Profile Scale) as a methodological approach. Interestingly enough, there were no substantial differences in the results when it comes to gender, BMI and other components. As for the recommendations, authors highlight the need for promoting a healthy lifestyle for students of medicine.
As it can be seen from the literature and sources analysis above, sometimes researchers can come to different conclusions in assessing healthy lifestyle and its role in the professional development of students (including medical students) and practical workers in the area of medicine, notably, physicians. Thus, the given study aims to bridge this gap in understanding the issue and its potential implications for the society.
Russian authors also pay special attention to the healthy lifestyle problem, a considerable amount of research papers belongs to the field of medicine. Certain works are devoted to a healthy lifestyle in separate professional groups [12]. Healthy lifestyle in students and youth has been studied in works by M.Yu. Bardina (2016), A.E. Bolotin, O.V. Mironova and others [8, 13]. I.V. Zhukova and A.G. Khayrullin have analysed the healthy lifestyle structure [14]. A group of authors from Orenburg Medical University have studied students' attitude to a healthy lifestyle [15]. A.S. Kariauli has made an attempt to consider the issue of how and to what extent students stick to healthy lifestyle norms [16]. During the last two years the role of physical culture in forming a healthy lifestyle in students has been actively studied [17].
In our study on the basis of a sociological survey of students at the medical university (Novosibirsk) we attempted to identify whether they follow the principles of a healthy lifestyle.
Methods. A written survey (questionnaire) was chosen as a method of research. When developing a questionnaire such issues as
• medical students' idea about a healthy lifestyle;
lifestyle;
students' awareness about unhealthy habits that interfere with a healthy
• the availability of a good quality sleep;
• proper nutrition;
• drinking and smoking;
• physical activity.
The study involved 213 second and third year medical students enrolled at the Novosibirsk State Medical University.
Results. To assess the attitude to a healthy lifestyle, we should identify the precise students' idea of a healthy lifestyle. The students were asked to write in free format which components, in their opinion, comprise a healthy lifestyle. Representations of students were grouped into 5 semantic groups (Fig. 1). Students divided sports and physical activity into different groups. Important factors for a healthy lifestyle in their opinion are proper, balanced nutrition, quitting bad habits and a complex of self-preservation behaviour, including, according to students, psycho-emotional health, hygiene, immunity, preventive visits to doctors and sleep. The most significant factors for students turned out to be a complex of self-preserving behavior (31.7%). We should emphasize the fact that although the students identified sports and physical activity as the main components of a healthy lifestyle, they had little choice.
The students were offered to define, which unhealthy habits they would have to give up to lead a healthy lifestyle (Fig. 2).
31,70%
1. Doing sports
15,02%
■ 2. Self -protecting behaviour 2j,jd/o (hygiene, psyhological and
emotional health, medical exams, 17,52% resting time rules
■ 3. Giving up unhealthy habits
12,40%
4. Healthy balanced diet
5. Physical culture
Healthy lifestyle components
1. Addiction ( alcohol, smoking, gadgets)
□ 2. Stressful situations
□ 3. Sleep-wake routine irregularities
□ 4.
Imbalanced/unhealt
hy diet
□ 5. No unhealthy habits
Habits
Fig. 1. What components does a healthy lifestyle include?
ig. 2. What habits will you have to give up to start leading a healthy lifestyle?
2
1
3
5
4
More than one third of those surveyed (37.1%) noted that they have no unhealthy habirs. Medical students consider unhealthy or irregular diet to be the most dangerous behaviour pattern. Given the fact that students study internal human diseases and their causes, non-observance of dietary guidelines and regime witnesses that students do not acknowledge the necessity of following this principle to the full extent or do not have such a possibility.
We have analysed dietary peculiarities of the future medics as well as whether they have irregularities in their dietary regime (Fig. 3 and 4).
44,60%
19,72%
29,11%
2,82%
3,76%
4
1. 1-2 times a day
2. 3-4 times a day
□ 3. More than 4 times a day
□ 4. I don't count, just snack whenever I'm hungry
□ 5. Varies
Number of meals
Dietary regime at the university
1. Snacking In the bars (coffee, pizza, buns etc.)
2. Just some coffee (e.g. from vending machines)
3. Hot dishes at the cafeteria (inasmuch as possible)
4. Take food from home
5. I don't eat at the university
2
5
1
Fig. 3. How many times a day do you Fig. 4. How do you eat at the have meals? university/facility?
Almost half of the students stick to the correct dietary regime (44.6%). However, quite a considerable number of the students eat 1-2 times a day (19.72%); 6.1% of the respondents noted that they do not eat at the university at all, which means that pauses in their dietary pattern can be very long. The following students' habits which do not go well with a healthy lifestyle also arouse concern: 1) Snacking at the bars; 2) Having nothing more than coffee during the day, i.e. lack of proper nutrition. The fact that more than 50% of students in total eat cooked meal or bring their meals from home, thus preferring healthier food than fast food or snacks, is a positive sign.
Fig. 5 and 6 present an analysis of a good quality sleep as one of the most important components of a healthy lifestyle. During the weekdays almost a half of the students (46.95%) sleep for less than 6 hours. Given a significant academic load of the medical university students, constant sleep loss does not contribute to a healthy lifestyle. 48.7% of the respondents compensate for the lack of a good quality sleep during weekends (sleeping for 7-8 hours), 30.5% of those surveyed sleep less than 6 and no more than 7 hours even during weekends.
46,95%
26,29%
3,29% 2
20,19%
3,29%
4
Duration
1. Less than 6 hours
2. 6-7 hours
3. 7-8 hours
«4. 9-10 hours
y 5. Varies
48,36%
27,70%
2,82%
17,37%
3,76%
4
1. Less than 6 hours
2. 6-7 hours
3. 7-8 hours
y 4. 9-10 hours
v.5. Varies
Duration
1
3
3
2
5
5
Fig. 5. How many hours do you sleep Fig. 6. How many hours do you normally (excluding weekends)? sleep on weekends and holidays?
Figures pertaining to smoking and drinking alcohol in future doctors do not cause much tension (Fig. 7 and 8). A high percentage of non-smoking students can be regarded as a positive result. Only 8.92% of the respondents pointed out that they can drink alcohol quite frequently. As compared with the results indicated by one of the first studies dealing with deviant behaviour in students in Russia with the participation of university students from Novosibirsk which was conducted as a part of the thesis project 20 years ago [18], one can conclude that students changed their attitude towards a healthy lifestyle in a positive manner.
31,92%
■ 1. Once a week 33,80% and more often
22,54%
,92%
2,82%
2
i
2. Several times a month
3. Once a month
4. Less often than once a month
5. I don't drink alcohol
Drinking alcohol
Fig. 7. Do you smoke?
Fig. 8. How often do you drink alcohol?
5
3
4
1
We can single out one more factor negatively influencing a healthy lifestyle, namely searching for various information on the Internet, using social networks and communicating with the help of mobile phones (Fig. 9 and 10).
31,92%
33 33% H1- 0-5-2 hours a day
30,05%
a 2. 2-4 hours a day
m 3. More than 4 hours a day
«4. Varies
y 5. I'm not interested in such communications
2,82%
1,88% 4 5
Time spent communicating and searching for information
62,44% " I- An hour or less
2. 1-2 hours a day
3. 2-5 hours a day
4. No
data/missing value
Time spent communicating using a mobile phone
3
2
1
Fig. 9. How much time do you spend Fig. 10. How much time do you communicating and searching for communicate using your mobile phone
information in the social networks every day?
One third of students spend more than 4 hours a day communicating and searching for information in the networks. Given the academic load in general (in hours per day), students of this group have difficulties leading a healthy lifestyle and keeping their bodies in tone. It is quite difficult to determine an average span of time students spend to communicate using mobile connection. 62.44% did not answer the question as their mobile phones virtually "became their third hands". They are used in any period of free time. This factor can be and should be researched additionally, since the brink between "a necessary use of mobile connection" and addiction linked with people's dependency on a mobile device becomes more and more opaque.
As for future doctors' physical activity (Fig. 11), here we can see both a positive result and a result leaving a lot to be desired. Since more than one third of students do sports in groups or clubs (which is a positive result), unfortunately morning exercises, an important element of overall physical condition, is not displayed well. This element of overall physical culture was actively promoted during the Soviet period, people in certain countries (e.g. Vietnam) still stick to it. 28.64% of students have no physical activity. For future medics who acknowledge the necessity of a healthy lifestyle, such a percentage of students who do nothing to support their health is extremely high.
The attitude towards a healthy lifestyle in general was shown by the students as follows (Fig. 12).
1. Jogging in the mornings/evenings
28,64% ■ 2. Doing morning exercises every day
3. Doing sports in a sports group
4. Working out
5. Riding a bike/skiing on weekends
6. Going to a swimming pool 1-2 times a day
7. No physical activity
Physical activities
Attitude towards a healthy lifestyle
1. Healthy lifestyle is great but I do not have the time to think about it due to the lack of time
2. I live according to the Health First principle, I am all for a healthy lifestyle
□ 3. I try to do something so as not to get sick and lead a healthy lifestyle but that is not always successful
Fig. 11. Do you have any physical Fig. 12. Attitude towards a healthy
activities lifestyle
The students were offered to answer the question: "How would you characterise your attitude towards a healthy lifestyle?" We suppose we could single out the following three groups of students:
1) the group of active medical students, which both understand the importance of maintaining a healthy lifestyle and follow its principles;
2) the group of students, which understand the importance of a healthy lifestyle, try to do something to maintain their health but cannot always cope with this task due to a number of reasons;
3) the group of "theoreticians", which live according to the "I know it, it is great, but I have no time for this" principle.
As a result, the active group is represented just by 11.74% of students, "theoreticians" account for 38.97% whereas 49.30% are those trying to do something to maintain their health. The analysis of the results of the study conducted allows us to single out certain tendencies and choose strategies in promoting the ideas of leading a healthy lifestyle in medical students.
Findings.
1. Promoting the principle of leading a healthy lifestyle, being one of the important principles of society's activity, prompts the youth (including the students) to lead a healthier lifestyle. This principle is of special significance for the future medics, however, students do not fully acknowledge their responsibility for their own health.
2. The situation in which a significant number of medical students cannot organise their lives based on the principles of a healthy lifestyle needs a detailed investigation, one should mark out internal and external barriers obstructing a healthy lifestyle (as well as opportunities for overcoming those).
3. A person who is to take care of other people's health should first learn to do so for himself or herself. This should be empowered by a new concept of organisational culture in a medical university, university environment upbringing students based on the principles of a healthy lifestyle. Developing such a concept could become an innovative step in training future medics.
Bibliography:
1. Baldwin D.R., Towler K., Oliver M.D., Datta S. (2017). An Examination of College Student Wellness: A Research and Liberal Arts Perspective. Health Psychology Open. 4, 2. https://doi.org/10.1177/2055102917719563. Available at: https: // journals.sagepub.com/doi/full/10.1177/2055102917719563 (accessed 12 May 2019).
2. Malatskey L., Essa-Hadad J., Willis T.A., Rudolf M.C.J. (2019). Leading Healthy Lives: Lifestyle Medicine for Medical Students. American Journal of Lifestyle Medicine. 13 (2), 213-219. https://doi.org/10.1177/1559827616689041. Available at: http://eprints.whiterose.ac.uk/! 16111/7/revised3-
%20american_journal_of_lifestyle_medicine_article.pdf (accessed 12 May 2019).
3. Dong Wang, Xiao-Hui Xing, Xian-Bo Wu (2013). Healthy Lifestyles of University Students in China and Influential Factors. The Scientific World Journal. 6. http://dx.doi.org/10.1155/2013/412950. Available at: https://www.hindawi.com/journals/tswj/2013/412950/ (accessed 12 May 2019).
4. Bozlar V. Arslanoglu C. (2016). Healthy Life Style Behaviors of University Students of School of Physical Education and Sports in Terms of Body Mass Index and Other Variables. Universal Journal of Educational Research. 4(5), 1189-1195. DOI: 10.13189/ujer.2016.040532. Available at: https://files.eric.ed.gov/fulltext/EJ1099851.pdf (accessed 12 May 2019).
5. Kubova P., Smolova H., Urbancova H. (2018). Adherence to Healthy Lifestyle Principles Among College Students: A Case Study. Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis. 66(2) 54, 521-530. DOI: 10.11118/actaun201866020521.
6. Biktagirova G.F., Kasimova R.Sh. (2016). Formation of University Students' Healthy Lifestyle. International Journal of Environmental & Science Education. 11(6), 1159-1166. doi: 10.12973/ijese.2016.385a. Available at: https://files.eric.ed.gov/fulltext/EJ1114286.pdf (accessed 12 May 2019).
7. Oberg E.B., Frank E. (2009). Physicians' Health Practices Strongly Influence Patient Health Practices. The Journal of the Royal College of Physicians of Edinburgh. 39(4), 290-291. doi:10.4997/JRCPE.2009.422. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058599/ (accessed 12 May 2019).
8. Bardina M.Ju. (2016). Sostavljajuschie zdorovogo obraza zhizni sovremennogo studenta [Components of a Healthy Lifestyle for a Modern Student]. Nauchnye issledovanija: ot teorii k praktike. 2-1 (8), 76-79.
9. Tyzuk K. (2012). Physician Health: A Review of Lifestyle Behaviors and Preventive Health Care Among Physicians. British Columbia Medical Journal. 54(8), 419-423.
10. Sajwani R., Shoukat S., Raza R., Shiekh M., Rashid Q., Siddique M., Panju S., Raza H., Chaudhry S., Kadir M. (2009). Knowledge and Practice of Healthy Lifestyle and Dietary Habits in Medical and Non-Medical Students of Karachi, Pakistan. Journal of the Pakistan Medical Association. 59(9), 650-655. Available at: https: //pdfs.semanticscholar.org/6ca1/8b9340ec 587f3f732b9a83386d1abafedcf1.pdf (accessed 12 May 2019).
11. Nacar M., Baykan Z., Cetinkaya F., Arslantas D., Ozer A., Coskun O., Bati H., Karaoglu N., Elmali F., Yilmaze G. (2014). Health Promoting Lifestyle Behaviour in Medical Students: A Multicentre Study from Turkey. Asian Pacific Journal of Cancer Prevention: APJCP. 15, 8969-8974. D0I:10.7314/APJCP.2014.15.20.8969.
12. Nikishina V.B., Petrash E.A. (2018). Zdorovyjj obraz zhizni s tochki zrenija mikroecnomicheskojj celesoobraznosti [Healthy lifestyle in terms of microeconomic expediency]. Innov: electronnyjj nauchnyjj zhurnal. 3 (36). Available at: http://www.innov.ru/science/economy/zdorovyy-obraz-zhizni-s-tochki-zren/ (accessed 12 May 2019).
13. Bolotin A.E., Mironova O.V., Lukina S.M., Jarchikovskaja L.V. (2016). Soderzhatel'nye i organizacionnye aspecty formirovanija navykov zdorovogo obraza zhizni u studentov vuzov [Healthy Lifestyle Skill Building Technology for University Students: Conceptual and Procedural aspects]. Teorija i praktika fizicheskojj kultury. 6, 18-20.
14. Zhukova I.V., Khairullin A.G. (2019). Analiz structury zdorovogo obraza zhizni studentov [Analysis of the Structure of a Healthy Lifestyle of a Student]. Fundamental'nye i prikladnye issledovanija: aktual'nye voprosy, dostizhenia I innovacii: Sbornik statejj XXI Mezhdunarodnojj nauchno-prakticheskojj konferencii. 180-182.
15. Sipatorova A.M., Melikhov Y.P., Ljashenko A.A. (2017). Zdorovyjj obraz zhizni v zhizni studentov Orenburskogo gosudarstvennogo medicinskogo universiteta [Healthy Lifestyle in Orenburg State Medical University Students' Life]. Nauka i obrazovanie segodnya. 10 (21), 93-94.
16. Kariauli, A.S. (2018). O sobljudenii studentami norm zdorovogo obraza zhizni [On Students' Adherence to the Norms of a Healthy Lifestyle]. E-Scio. 11 (26), 84-89.
17. Ljangina A.A. (2019). Zdorovijj obraz zhizni i fizkultura v zhizni sovremennogo studenta [Healthy Lifestyle and Physical Culture in Modern Students' Life]. Nauka -obrazovaniju, proizvodstvu, economike: Materialy XXIV (71) Regional'noy nauchno-prakticheskojj konferencii prepodavatelejj, nauchnykh sotrudnikov i aspirantov. Ed. by I.M. Prischepa et al. 91-93.
18. Monastyrskaja T.I. (1999). Deviantnoe povedenie rossijjskojj molodezhi kak fakt social'nojj patalogii duchovnojj zhizni obschestva [Russian Youth's Deviant Behaviour as a fact of Social Pathology of Society's Spiritual Life]. Cand. Sc. (Sociology) thesis. Novosibirsk, 200 p.
19. Arkhipov A.B. (2019). Rol' fizicheskojj kultury v formirovanii zdorovogo obraza zhizni studenta [Role of The Physical Culture in Forming a Students' Healthy Lifestyle], In Prikladnye nauchnye issledovanija: Sbornik statejj po materialam XXXIII Mezhdunarodnojj nauchno-prakticheskojj konferencii, 11-13.
20. Borgan S.M., Jassim G.A., Marhoon Z.A., Ibrahim M.H. (2015). The Lifestyle Habits and Wellbeing of Physicians in Bahrain: A Cross-sectional Study. BMC Public Health. 15, 655. doi:10.1186/s12889-015-1969-x. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499902/ (accessed 12 May 2019).
21. Volkova G.L., Volkov V.A., Antipov V.N. (2016). Formirovaie zdorovogo obraza zhizni v processe obuchenija v vyshejj shkole [Forming a Healthy Lifestyle in the Process of Training in Higher School]. Pedagogicheskij opyt: teorija, metodika, praktika. 2 (7), 1.
