There were 207 questionnaires returned by first year students in 2016, 175 by second years in 2017 and 103 by third years in 2018. Students were predominately female, with proportions of 86%, 73% and 84% each year respectively. Mean (median) ages were 24 (22) years, 25 (23) years and 27 (25) each year. From the numbers of student identified within each year group, the response rates were 88%, 81% and 52% respectively. Table 1 presents summary results (results for Year 1 have been published previously2).
|
Year 1
(207 responses)
n (%)
|
Year 2
(175 responses)
n (%)
|
Year 3
(103 responses)
n (%)
|
General physical health
Excellent
Very good
Good
Fair
Poor
Total
|
12 (5.8)
36 (17.4)
100 (48.3)
50 (24.2)
8 (3.9)
206
|
4 (2.3)
28 (16.0)
86 (49.1)
49 (28.0)
7 (4.0)
174
|
7 (6.8)
19 (18.4)
40 (38.8)
30 (29.1)
6 (5.8)
102
|
Mental Health
Excellent
Very good
Good
Fair
Poor
Total
WEMWBS score <46
Mean (median) WEMWBS score
|
19 (9.2)
81 (39.1)
83 (40.1)
19 (9.2)
5 (2.4)
207
n= 198
48 (24.2)
50.9 (50.9)
|
12 (6.9)
50 (28.6)
70 (40.0)
29 (16.6)
11 (6.3)
172
n=173
60 (34.7)
49.0 (50.0)
|
6 (5.8)
21 (20.4)
33 (32.0)
34 (33.0)
6 (5.8)
99
n=96
49 (51.0)
44.8 (45.0)
|
Physical activity
≥150 mins/week
Mean (median) sedentary hours
Weekday
Weekend
|
157 (76.2)
6.0 (6.0)
6.4 (6.0)
|
143 (81.7)
6.1 (6.0)
6.2 (5.5)
|
65 (63.1)
8.9 (8.0)
8.0 (8.0)
|
Diet
Very healthy
Healthy
Average
Unhealthy
Very unhealthy
Total
Breakfast most days
≥5 fruit/veg per day
Takeaway at least once/week
|
1 (2.9)
26 (21.3)
63 (58.5)
19 (15.9)
0 (1.4)
207
142 (68.9)
25 (12.1)
88 (42.7)
|
3 (1.7)
43 (24.6)
101 (57.7)
26 (14.9)
2 (1.1)
175
108 (61.7)
22 (12.6)
75 (42.9)
|
3 (2.9)
33 (32.0)
46 (44.7)
21 (20.4)
-
103
56 (54.4)
15 (14.6)
41 (39.8)
|
BMI
Mean (median)
BMI 25-30 (overweight) BMI ≥ 30 (obese)
|
n=165
25.2 (24.1)
48 (29.0%)
30 (18.2)
|
n=133
24.8 (24.1)
37 (27.8%)
19 (14.3)
|
n =84
25.4 (24.2)
22 (26.1%)
16 (19.0)
|
Sleep
Very well
Well
Average
Badly
Very badly
Total
<7 hours sleep/night
Mobile device > 30 mins
|
35 (16.9)
71 (34.3)
79 (38.2)
21 (10.1)
1 (0.5)
207
70 (34.0)
129 (62.3)
|
33 (18.9)
43 (24.6)
70 (40.0)
23 (13.1)
6 (3.4)
175
63 (36.0)
99 (56.6)
|
19 (18.4)
27 (26.2)
39 (37.9)
14 (13.6)
4 (3.9)
103
44 (42.7)
66 (64.1)
|
Alcohol
Consumes any alcohol
Drinks alcohol
occasionally/never
Drinks ≥14 units/wk
Weekly binge drinking
|
n=204
186 (92.1)
134 (65.7)
12 (5.9)
32 (15.7)
|
n=173
154 (89.0)
115 (66.5)
16 (9.2)
35 (20.2)
|
n=100
86 (86.0)
78 (78.0)
3 (3.0)
15 (15.0)
|
Smoking
Daily
<daily
|
32 (15.8)
18 (8.9)
|
16 (9.1)
22 (12.6)
|
9 (8.7)
11 (10.7)
|
Table 1: Summary results for health and health behaviour measures for a cohort of undergraduate nursing students in the first, second and third years of their degree programme
In relation to physical health, a higher proportion of students in Year 3 (25.2%) rated their health as excellent or very good compared to proportions within the two previous year groups (23.2% in Year 1 and 18.3% in Year 2). However, only 38.8% rated their health as good, compared to 48.3% in Year 1 and 49.1% in Year 2. A higher proportion in Year 3 (34.9%) rated their health as fair/poor, compared to 28.1% in Year 1 and 32.0% in Year 2).
This contrasted with results for mental health. There was a clear decline over the three years in the proportions of students rating their mental health as excellent/very good/good (from 48.3% in Year 1 to 26.2% in Year 3) and a concomitant clear increase in those rating their mental health as fair/poor (from 11.6% in Year 1 to 38.8% in Year 3). This result was backed up by the results of the WEMWBS score. Not only did the mean score decline from 50.9 to 44.8 over the three years, but the proportion of students with a WEMWBS score of <46 indicating either high risk of major depression, or in high risk of psychological distress and increased risk of depression) increased from 24.1% in Year 1 to 51.0% in Year 3.
Health behaviours were also investigated. Physical activity levels declined over the study period, with the proportion of students managing 150 minutes of physical activity per week decreasing from 76.2% in Year 1 to 63.1% in Year 3. This was reflected in higher self-reported sedentary time. The results for dietary behaviour were less clear cut. Fewer students over time reported their diets as average (58.5% in Year 1 compared with 44.7% in Year 3), with higher proportions over time rating their diets as either healthy or very healthy, or as unhealthy or very unhealthy. There was a decrease in the proportion of students eating breakfast most days, from 68.9% in Year 1 to 54.4% in Year 3 (but no difference for consumption of fruit and vegetables, and takeaways). However, there were no clear differences over time in mean BMI, or proportions of students with a BMI categorising them as overweight or obese.
There was a small increase over time in the proportions of students who reported sleeping poorly or very poorly (from 10.6% in Year 1 to 17.5% in Year 3), and there were higher proportions of students who reported sleeping for less than seven hours per night (from 34.0% in Year 1 to 42.7% in Year 3). There was evidence of a possible decline in alcohol consumption over time, with any alcohol consumption declining from 92.1% in Year 1 to 86.0% in Year 3, and an increasing proportion of students drinking alcohol only occasionally or never. Binge drinking appeared to peak in Year 2. The proportion of students smoking (current or occasional) decreased from 24.7% to 19.4% over the course. The decline was most marked for current smokers; whereas occasional smoking was higher in Year 2, perhaps indicating that some smokers were cutting down and moving from daily to occasional smoking.
We identified 51 students for whom data was available for all three time-points. The results of the regression analyses, using a Bayesian approach, are presented in Table 2. They suggest a clear effect of worsening WEMWBS score over time, but no effect on smoking or physical activity behaviour. The other notable result was that males had poorer WEMWBS scores. However, among this sub-sample of 51 students, the proportion of smokers (15%) was lower, and the proportion achieving 150 minutes of physical activity (84%) was higher than in the overall sample during the first year. In contrast, their mean WEMWBS score as baseline was very similar to that of the overall cohort.
|
Mean
|
Standard deviation
|
10%
|
50%
|
90%
|
|
Dependent variable: Non-smoking
|
Age
|
0.1
|
0.2
|
-0.2
|
0.1
|
0.3
|
|
Not female v female
|
-1.6
|
2.3
|
-4.5
|
-1.6
|
1.3
|
|
Not first gen. Uni v first gen. Uni
|
1.7
|
1.8
|
-0.8
|
1.7
|
4.0
|
|
Year 2 v Year 1
|
0.0
|
0.3
|
-0.4
|
0.0
|
0.4
|
|
Year 3 v Year 1
|
0.0
|
0.3
|
-0.4
|
0.0
|
0.4
|
|
Dependent variable: Self-reporting 150 minutes of PA per week
|
Age
|
0.1
|
0.2
|
-0.3
|
0.1
|
0.1
|
|
Not female v female
|
-0.3
|
2.0
|
-2.9
|
-0.3
|
2.3
|
|
Not first gen Uni v first gen. Uni
|
0.1
|
1.6
|
-1.9
|
0.1
|
2.1
|
|
Year 2 v Year 1
|
0.0
|
0.2
|
-0.3
|
0.0
|
0.3
|
|
Year 3 v Year 1
|
0.0
|
0.2
|
-0.3
|
0,0
|
0.3
|
|
Dependent variable: WEMWBS score
|
Age
|
0.2
|
0.2
|
-0.1
|
0.2
|
0.5
|
|
Not female v female
|
-6.4
|
4.6
|
-12.4
|
-6.4
|
-0.4
|
|
Not first gen. Uni v first gen. Uni
|
1.5
|
2.8
|
-2.2
|
1.4
|
5.0
|
|
Year 2 v Year 1
|
-2.6
|
0.4
|
-3.1
|
-2.6
|
-2.1
|
|
Year 3 v Year 1
|
-7.0
|
0.3
|
-7.5
|
-7.0
|
-6.6
|
|
Table 2: Mean, standard deviation, 10th, 50th, and 90th percentiles of the posterior distribution of the parameters estimates for the three regression models, constructed for 51 students for whom data were available at all three time-points