HEALTH PROMOTION PRACTICES AMONG ALL LEVELS

OF STUDENT NURSES AT ADVENTIST MEDICAL

CENTER COLLEGE, ILIGAN CITY

An Undergraduate Thesis

Presented to the Faculty of the School of Nursing

Adventist Medical Center College
Brgy. San Miguel, Iligan City

In Partial Fulfillment
of the Requirements for the Degree
BACHELOR OF SCIENCE IN NURSING

LUMASAG, ANJELLIE
MEDINA, DONEVA LYN
MONTERO, AMBER DAWN

DECEMBER 2021
APPROVAL SHEET
DEDICATION
ACKNOWLEDGMENT
ABSTRACT
 TABLE OF CONTENTS

Page

TITLE PAGE i
APPROVAL SHEET ii
DEDICATION iii
ACKNOWLEDGMENT iv
ABSTRACT vi
TABLE OF CONTENTS ix
LIST OF TABLES xi
LIST OF FIGURES xii
Chapter
1 THE PROBLEM AND ITS SCOPE

Introduction
Theoretical Framework
Conceptual Framework
Statement of the Problem
Hypotheses
Significance of Study
Scope and Delimitation
Definition of Terms

2 REVIEW OF RELATED LITERATURE AND STUDIES

Related literature
Related Studies

3 RESEARCH METHODOLOGY

Research Design
Research Locale
Respondents of the Study
Sampling Design
Research Instruments
Scoring of the Instrument
Data Gathering Procedures
Statistical tools

4 PRESENTATION, ANALYSIS, AND INTERPRETATION

OF DATA

5 SUMMARY, FINDINGS, CONCLUSIONS, AND

RECOMMENDATIONS

Summary
 Findings
Conclusions
Recommendations

REFERENCES
APPENDICES

Letter
Questionnaire

CURRICULUM VITAE
LIST OF TABLES
LIST OF FIGURE
 Chapter 1

THE PROBLEM AND ITS SCOPE

Introduction

All people need to be healthy physically and in all dimensions of life, but there are

subgroups or populations that do not mind so much about their health. Maybe of so many factors

that sometimes influenced their decisions to practice a healthy behavior. It would be too late for

them to stay on the level of wellness. As for us, young researchers, we would like to find out

who are these group of people and what are their health promotion practices if they have any.

College years serve as a period of life changing decisions for many people.

During this time, students make the majority of their choices without a great deal of outside

influence on what to study, where to live, and what to eat, to name a few. Many students struggle

with their weight at some point during their years in college. Some students are also having

trouble budgeting their meals due to financial difficulties. These factors affect an individual’s

overall health. A health promotion practices will help an individual manage and make healthier

choices.

The World Health Organization (WHO) has one of the most well-known definitions of

health promotion which is the “process of enabling people to increase control over, and to

improve, their health (Ottawa Charter, 1986)”. Many people are unaware that health promotion is

a concept distinct from health education and health maintenance in the sense that it has an

umbrella effect over the other two terminologies and focuses on improving people's health,

goodness, and wellness, as well as enhancing their capacities for living (McKenzie, et al, 2005),

regardless of any impairment on their physical, mental, social, environmental, and spiritual
condition. Health promotion encourages people to strive for their best health. If health

maintenance refers to practices that help people prevent diseases, impairments, and other

problems, and etc. (Murray, 2009), the term "health promotion" refers to efforts that attempt to

encourage people to pursue better health. Health Promotion Practices are the real acts that people

engage in in order to improve their health.

Health is a complex and dynamic process that constantly changes throughout life. One of

the main strategies for maintaining health is to have a healthy lifestyle. In other words, lifestyle

is one of the most important factors affecting an individual's health and sickness. Lifestyle is the

pattern of daily life, including nutrition type, dietary habits, relaxation and rest, smoking,

physical activity, stress management, and use of health services. One of the most important

objectives of promoting health is for individuals in a community to be able to control their health

and increase their health level. In fact, a healthy lifestyle is considered a valuable resource by

which to reduce health problems, promote health, manage health, and improve lifestyle. Lifestyle

plays an important role in the biological and psychological health of a society (Esmaili, 2016).

This study describes the health promotion practices among all levels of student nurses’ at

Adventist Medical Center College, Iligan City. Therefore, the purpose of the study is to

determine the relationship of the student nurses’ personal profile to their health promotion

practices.

Theoretical Framework

The study made used of Bandura’s theory Social Learning Theory (1977), Pender’s

theory of Health Promotion Model (1941) and Hochbaum et al., Health Belief Model (1958).
 Social learning theory, proposed by Albert Bandura, emphasizes the importance of

observing, modelling, and imitating the behaviors, attitudes, and emotional reactions of others.

Social learning theory considers how both environmental and cognitive factors interact to

influence human learning and behavior (McLeod, 2016).

Albert Bandura’s social learning theory is based on the belief that learning takes place in

a social context, that is, people learn from one another and that learning is promoted by modeling

or observing other people. It is anchored on the fact that persons are thinking beings with self-

regulatory capacities, capable of making decisions and acting according to expected

consequences of their behavior. The environment affects learning, but learning outcomes depend

on the learner’s individual characteristics (Banduraa, 1977).

According to Nola J. Pender (1987), “each person's personal features and experiences,

according to the health promotion model, influence subsequent actions. It explores many

biopsychosocial factors that influence individuals to pursue health promotion activities. It depicts

the complex multidimensional factors with which people interact as they work to achieve

optimum health. This model contains seven variables related to health behaviors as well as

individual characteristics that may influence a behavioral outcome (Famorca, Nies & McEwen,

2016). The set of behavioral specific information and emotion factors has a lot of motivational

power. Nursing interventions can change these variables. The desired behavioral consequence

and the HPM's end aim is health-promoting behavior. At all phases of development, health-

promoting practices should result in greater health, increased functional capacity, and a higher

quality of life. The immediate competing demand and preferences influence the final behavioral

demand, which can derail planned health-promoting acts (Murray, 2009).

 In 1996, Pender stated that the model depicts the multifaceted natures of persons

interacting with the environment as they pursue health. The health promotion model has a

competence- or approach-oriented focus. Health promotion is motivated by the desire to enhance

well-being and to actualize human potential. The health promotion model expands to encompass

behavior for enhancing health and applies across the life span (Pender, 1996; Pender, Murdaugh

& Parsons, 2002).

The Health Promotion Model is similar in construction to the third used theory/model, the

Health Belief Model (HBM) which is initially proposed in 1958. It provides the basis for much

of the practice of health education and health promotion today. The HBM was developed by a

group of social psychologists to explain why the public failed to participate in health screening.

Through their work, this group found that information alone is rarely enough to motivate one to

act. Individuals must know what to do and how to do it before they can take action. Also, the

information must be related in some way to the individual’s needs. One of the most widely used

conceptual frameworks in health behavior, the HBM, has been used to explain behavior change

and maintenance of behavior change and to guide health promotion interventions (Janz et al.,

2002).

Conceptual Framework

The Health Promotion Model aims to explain the factors underlying motivation to engage

in health-promoting behaviors and it focuses on people’s interactions with their physical and

interpersonal environments during attempts to improve health. This model emphasizes the active

role that a person has in initiating and maintaining health-promoting behavior, and in shaping

their own environment to support health-promoting behaviors (Laranjo, 2016).

 This study focus into the independent variables of the student nurses, sociodemographic

profile which include age, gender, religion, education, occupation, marital status and monthly

income. According to Pender, factors such as race, ethnicity, acculturation, education, and

socioeconomic status are included in sociocultural factors that has direct and indirect effects on

the likelihood of engaging in health-promoting behaviors.

In addition, the health promotion practices serves as the dependent variable of the study.

The practices will be measure by the Health Promoting Lifestyle Profile II with six (6) sub-

scales: healthy responsibility, physical activity, nutrition, interpersonal relations, spiritual

growth, and stress management. It provides assessment of a health-promoting lifestyle of

individuals (Walker, Sechrist, & Pender, 1987).

INDEPENDENT VARIABLES DEPENDENT VARIABLES

PERSONAL HEALTH PROMOTION
PROFILE PRACTICES
 Age  Health Responsibility
 Gender  Interpersonal Relations
 Religion  Nutrition
 Year Level  Physical Activity
 Spiritual Growth
 Stress Management

Figure 1. The Schematic Diagram Showing the Interplay of Independent and Dependent
Variables

Statement of the Problem

The study aims to determine the health promotion practices among all levels of student

nurses at Adventist Medical Center College, Iligan City.

Specifically, it sought to answer the following questions:

1. What is the personal profile of the faculty members’ in terms of:

 1.1 Age

1.2 Gender

1.3 Religion

1.4 Year Level

2. What are the health promotion practices of the faculty members’ in terms of:

2.1 Health Responsibility

2.2 Interpersonal Relations

2.3 Nutrition

2.4 Physical Activity

2.5 Spiritual Growth

2.6 Stress Management

3. Is there a significant relationship between the student nurses’ year level and their health

promotion practices?

Null Hypothesis

HO1: There is no significant relationship between the student nurses’ personal profile and

their health promotion practices.

Significance of the Study

This study will be beneficial to the following:

Nursing students. This study will help empower individuals to make healthier choices

and reduce their risk of disease and disability.

Nursing Practice. This study will help understand why people have these practices.
 Nursing Education. This study can enrich the health promotion literature by providing a

documentation of the health promotion practices. Findings in this study can be used as a

reference material in teaching Health Promotion in the Colleges of Nursing and Public Health.

Nursing Research. This study can provide a scientific and statistical reference on the

current health promotion practices done in a rural community which can be used as a document,

reference material, and a guide to future researchers who wish to conduct a similar study. This

study can be used as a building block for subsequent research that can raise questions that would

entail a more complex, experimental research.

Scope and Delimitations of the Study

The primary concern of the study is to determine the health promotion practices among

all levels of student nurses. The respondents are all enrolled for the second semester AY 2021-

2022 at Adventist Medical Center College.

The primary concern of the study is to determine the respondents’ personal profile (age,

gender, religion and year level) and perceptions of nursing students on the extent of the clinical

instructors’ caring behavior. The respondents are all nursing students enrolled for the second

semester AY 2017-2018 at Adventist Medical Center College.

Definition of Terms

The following key terms are operationally defined for better understanding of the study:

Age. This refers to the respondents’ numbers of years from age 17-21 yrs.old.

Gender. This connotes whether the respondent is a male or female.

 Health Promoting Lifestyle Profile II. This measures the health promotion practices of

all levels of student nurses in term of the the six (6) sub-scales: healthy responsibility, physical

activity, nutrition, interpersonal relations, spiritual growth, and stress management. (Walker,

Sechrist, & Pender, 1987).

Health Responsibility. This implies to the student nurses’ conscious sense of personal

responsibility for their own well-being (Ardell, 1986; Travis & Ryan, 1988; Walker, Sechrist, &

Pender, 1987).

Interpersonal Relations. This refers to the student nurses’ sense of intimacy and

closeness with others in meaningful, rather than casual, relationships (Travis & Ryan, 1988;

Walker, Sechrist, & Pender, 1987) .

Physical Activity. This denotes the student nurses engagement in modest, moderate,

and/or vigorous action on a regular basis (Bouchard, Shepard, Stephens, Sutton, & McPherson,

1990; Dishman, 1988; USDHHS, 1991).

Religion. This denotes the spiritual belief of the respondents.

Spiritual Growth. This is the focus of the growth of internal resources and is

accomplished through advancing, connecting, and transcending of the student nurses (Dossey,

Keegan, Kolkmeir, & Guzzetta, 1989; Lane, 1987; Travis & Ryan, 1988).

Stress Management. This connotes the student nurses’ control or relieve tension

whenever face with a stressor (Antonovs ky, 1987; Ardell, 1986; USDHHS, 1991).

Year Level. This refers to all levels of student nurses who are currently enrolled in

academic year 2021-2022 at Adventist Medical Center College: freshman (1 st year), sophomore

(2nd year), junior (3rd year) and senior (4th year).

 Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter discusses the importance of the study with the aid of related literature and

studies gathered.

Related Literature

Foreign

Health Promotion Behavior, or Health Promotion Practices are used interchangeably in

this study, although the term Health-promoting behavior is now being used more often in health

literature and bears a renewed interest as behavior is motivated by a desire to promote personal

health and well-being (Pender, et al., 2006).

Health Promoting Practices or Behaviors of an individual differ from one person to

another. Pender (2006) stated it best that “each person has unique personal characteristics and

experiences that affect subsequent actions”. There are five levels that affect a person’s behavior

(Sharma, 2008). First, are the individual factors, like the attitude of a person. If a person believes

that a healthy body will permit him to perform more challenging tasks, then engaging in health

promotion activities would come naturally. According to Fawcett (2005), “Environment, culture,

family background, work ethic, educational level, social standing, and gender may contribute to

the individual’s perception of heath and illness”. Then personal view and understanding on the

concept of health and illness also falls on this level.

One must bear in mind that human health promotion is a moral endeavor. In the

individual level, health promotion provides services that will assist humans in their functioning

taking into consideration their particular circumstance. Therefore, a need to include the factors
that influence a person’s health status like mental, physical, spiritual, and environmental factors

in the assessment of an individual is a must (Edelman, et al., 2006).

Lifestyle, according to Pender (2006), is defined as “discretionary activities that are

regular and part of one’s daily pattern of living and significantly influence health status”. In this

study, the term lifestyle is synonymous with Health Promoting Behaviors.

Spiritual growth or health is defined as the “ability to develop one’s inner nature to its

fullest potential which includes the ability to discover and articulate one’s basic purpose; to learn

how to experience love, joy, peace, and fulfillment (Pender, et al., 2006, p. 104)”. Spiritual

health is essential in assessing the heath-promoting practices because this “affects the client’s

interpretations of life events and health (Chuengsatiansup, 2003 as cited in Pender, et al. 2006)”.

Numerous studies have been done supporting this significant correlation of spirituality and health

experiences. One of these is a study entitled “Spiritual health, clinical practice stress, depressive

tendency and health promoting behaviors among nursing students by Hsiao Y. et al. (2010)

wherein Spirituality was positively associated with health-promoting behaviors. This relationship

will contribute to the holistic approach in assessing the health promotion practices of an

individual.

Interpersonal Relations, likewise, is also vital in assessing health promotion practices as

this reflects the social relationship an individual possess. According to Lucas (2005), positive

social relationships “stimulate the production of a health-promoting hormone and block the

production of hormones usually related to stress”. Positive social relationships offer a venue for

verbalization of feelings of the individual which is necessary for the individual to get in touch

with their feelings and emotions and enables the individual to select the most appropriate

strategy in dealing with stress through feedbacks from others. This dimension is related to the
third dimension of the HPLP II which is Stress Management as “high levels of social support

have also been linked to positive affect, and may thus protect against distress from life events

associated with high stress (Lucas, et al., 2005 p. 130)”. Stress is defined as anything that may

threaten the physical and psychological well-being of a client. Assessment of how an individual

handles these stresses may serve as a better predictor of his health promoting practices.

Fourth and fifth dimensions of the HPLP II are the Nutrition and Physical Activity,

respectively. Nutrition involves the way an individual selects and consumes foods that are

essential in promoting a health well-being. Their selection of food must be consistent with the

guidelines provided by the Food guide Pyramid. Physical Activity, on the other hand, “involves

regular participation in light, moderate, and/or vigorous activity (Walker, et al., 1996).

Assessment of physical activity is important since “sedentary lifestyle, for many individuals,

begin with childhood and continues until adulthood (Pender, et al., 2006, p. 102)” and lack of

physical exercise has been directly related with the occurrence of cardiovascular diseases.

A health-promoting lifestyle has been defined as patterns of activities that enhance the

health of the individual (Walker, Sechrist, & Pender, 1987). Engaging in health promotion

behaviors was associated with high internal locus of control, perceived self-efficacy, the belief in

one’s personal competence to carry out a specific action (Duffy, 1997), and quality of life

(Stuifbergen, Seraphine, & Roberts, 2000).

Local

The need for health promotion in the Philippines goes back to the time of the Ramos

Administration, when the Administrative Order No. 341 entitled Implementing Philippine Health

Promotion Program through Healthy Places was created. It was written along with the belief that

there is a “need to undertake more health promotion and disease prevention measures as a result
of the reported increase in the incidence of preventable diseases in Asia and in the country (AO

No. 341, 1997)”.

Time went on and health promotion was given a renewed interest as a result of the

association of degenerative diseases with the lifestyle of an individual. In 2002, Mortality

statistics showed that 7 of the 10 leading causes of deaths in the country are associated with the

unhealthy lifestyle of the client: tobacco smoking, physical inactivity, and an unhealthy diet

(Cuevas, et al., 2007). This rise in the occurrence of degenerative and lifestyle diseases called for

a need to take on a new approach to health promotion that will go beyond the interaction

between the client and a physician. Hence, the creation of the National Policy on Health

Promotion (Administrative Order No. 58 s. 2001). This Administrative Order promotes the

utilization of a “socio-ecological approach” to health promotion that would include the

environment and other sectors that affect the over-all well-being of a person. The vision for

Health Promotion, “By the year 2010, Filipinos are managing their own health” serve as the

framework for health promotion. This study will contribute to the attainment of the said goal

through the creation of appropriate health promotion programs/strategies that can change the

lifestyle of the target population by starting with proper assessment of their current health

promotion practices. This fulfills a fraction of the health sector’s responsibility to “build capacity

for policy development, leadership, health promotion practice, knowledge transfer and research,

and health literacy (Anden, 2010)”.

Related Studies

Foreign

many college
students are living away from home for the first time. They
are faced with the responsibility for their personal health,
lifestyle, and behaviors. Young adults develop behaviors
that may remain part of their lifestyle into adulthood [4] o r
that may jeopardize their health status in later life.
University students are in a dynamic transition period of
growth and development that bridges adolescence (high
school students) and adulthood (people in the community).
This period sees many rapid changes in the body and mind,
and in social relationships [5]. At this stage, there are
various difficult life conditions and different lifestyles in
the university environment. With the changes in study style
and unfamiliar life conditions, many students engage in a
wide range of unhealthy habits, such as inadequate nutri-
tional intake, rest, and exercise [6–10]
many college
students are living away from home for the first time. They
are faced with the responsibility for their personal health,
lifestyle, and behaviors. Young adults develop behaviors
that may remain part of their lifestyle into adulthood [4] o r
that may jeopardize their health status in later life.
University students are in a dynamic transition period of
growth and development that bridges adolescence (high
school students) and adulthood (people in the community).
This period sees many rapid changes in the body and mind,
and in social relationships [5]. At this stage, there are
various difficult life conditions and different lifestyles in
the university environment. With the changes in study style
and unfamiliar life conditions, many students engage in a
wide range of unhealthy habits, such as inadequate nutri-
tional intake, rest, and exercise [6–10]
many college
students are living away from home for the first time. They
are faced with the responsibility for their personal health,
lifestyle, and behaviors. Young adults develop behaviors
that may remain part of their lifestyle into adulthood [4] o r
that may jeopardize their health status in later life.
University students are in a dynamic transition period of
growth and development that bridges adolescence (high
school students) and adulthood (people in the community).
This period sees many rapid changes in the body and mind,
and in social relationships [5]. At this stage, there are
various difficult life conditions and different lifestyles in
the university environment. With the changes in study style
and unfamiliar life conditions, many students engage in a
wide range of unhealthy habits, such as inadequate nutri-
tional intake, rest, and exercise [6–10]
According to Perston (1990), many college students are living away from home for the

first time. They are faced with the responsibility for their personal health, lifestyle, and

behaviors. Young adults develop behaviors that may remain as part of their lifestyle until

adulthood or it may jeopardize their health status in later life. University students are in a

dynamic transition period of growth and development that bridges adolescence (high school

students) and adulthood (people in the community). This period sees many rapid changes in the

body and mind, and in social relationships (WHO, 1997). At this stage, there are various difficult

life conditions and different lifestyles in the university environment. With the changes in study

style and unfamiliar life conditions, many students engage in a wide range of unhealthy habits,

such as inadequate nutritional intake, rest, and exercise (Werch, 2007).

College is a critical time where students are presented with a number of challenges

including changes in the social and built environments, developing new social networks, having

more behavioral autonomy, and adapting to new schedules (Greaney et al., 2009). During this

period of life, college students are more prone to engage in risky health behaviors known to

negatively affect well-being, such as physical inactivity, stress, and poor dietary habits (Yahia,

2016).

With increasing age, the prevalence of chronic diseases increases. The most common

causes of death in all age groups above 50 years are cardiovascular diseases, cancers, respiratory

diseases, and accidents; all these diseases can be prevented by health-promoting behavior

(McGuire, 2003). According to Rowley et al. (2000), among the determinants of health, health
promotion behavior has been acknowledged as the basic way of preventing disease, especially

chronic disease, so health, health promotion behavior and lifestyle should be considered the main

strategy to maintain and improve health. A healthy lifestyle is a way of life that provides,

maintains and improves the health and wellbeing of a person. The most important health, health

promotion behavior includes healthy eating, physical activities, stress management, interpersonal

communication, spiritual growth, and health responsibility. The attitude indicating it is too late to

change or modify poor health behaviors in older adults is totally wrong. Studies show that a

higher level of health, health promotion behavior among elderly people correlates with a lower

mortality rate. To increase the level of health, health promotion behavior, it is necessary to

evaluate these behaviors (Baheiraei, 2011).

According to Sakura (2001), a health-promoting lifestyle is an important determinant of

health status. In the United States and Japan, plans such as ‘‘Healthy People 2010’’, ‘‘Healthy

Japan 21’’, and ‘‘Healthy Campus 2010’’ have been designed to enhance the quality of life of

citizens, improving their lifestyles through health-promotion programs. In the Healthy Japan 21

plan, even though the health-promotion projects cover the entire life span and involve all periods

of life from the fetal stage (including the health of the expectant mother) to infancy, childhood,

puberty, and adolescence, young adulthood, middle and late middle age, and advanced and late

advanced age, the population of university students has been widely neglected as a target group.

University students are not viewed as a priority for health-promotion efforts in Japan. However,

many college students are living away from home for the first time. They are faced with the

responsibility for their personal health, lifestyle, and behaviors. Young adults develop behaviors

that may remain part of their lifestyle into adulthood or that may jeopardize their health status in

later life (Perston, 1990).

Individuals should be responsible for
their personal wellbeing while they are
young because it is difficult for behavior
habits change for adults or elderly
unhealthy ,so must be adopted them
during their young(6) .Insert the health
promotion concepts in the curricula of
nursing colleges to provide students with
awareness, knowledge and skills to
teach students about strategies for
improving health and behavior change.
Therefore, students become after
graduation
for aware to understand the importance
of their personal healthy (7). Increasing
knowledge of healthy lifestyle
behavior is essential considering the fact
that lifestyle behavior are difficult
especially in adolescents (8). Colleges
have been recognized as appropriate
settings for health promoting lifestyle
among peoples and the period of
studying
as the big chance for development and
improve of lifestyle of students(9)
. Based on Walker and others , the
individual’s health promoting lifestyle
behavior involved 6 dimensions;
Responsible for wellbeing, diet, social
relations, exercise, spiritual growth, and
stress management. The aim of the
research was to assess of health
promoting lifestyle profit (HPLP)
among undergraduates in Mosul City
Lifestyle is the way of living of individuals, families, and societies which can be healthy

or unhealthy in terms of personal behaviors such as nutrition, physical activity, and stress

management. A healthy lifestyle may result in better health and happiness, and in contrast, an

unhealthy lifestyle may cause illness and morbidity (Safari et al.,2013). Pender et al. (2005)

indicated that health promoting behaviors (HPBs), including self-initiated actions, behaviors, and

health perceptions may have an impact on individual happiness and well-being.

Health-promoting behaviors comprise of six-dimensions including health responsibility, physical

activity, nutrition, interpersonal relations, spiritual growth, and stress management. Increasing

evidence indicate that if individuals can practice properly and routinely, it would result in better

health and lifestyle. Considering the changes happened in the study modes and living in campus

dormitories, there is an assumption that many students may experience a wide range of unhealthy

habits such as high level of fast-food intake, low level of physical activity and irregular sleep, as

well. Moreover, the young age of students may lead them to believe that they are in good health,

and this would be a possible reason why they are not very conscious of their health behaviors

(Wei, 2012).

University students are in a dynamic progress time of development and growth, bridging the gap

between adolescence and adulthood. During this period, people’s physical, mental and social

relations have undergone rapid changes. At this stage, there are different life conditions and

lifestyle in a university environment. With the change learning style and new life conditions,

many students develop a series of unhealthy habits, such as insufficient nutrition intake, rest and

exercise (Harada, et al., 2011).

Chapter 3

RESEARCH METHODOLOGY

This chapter presents the research design, research locale, respondents of the study,

research instrument, sampling design, data gathering procedure, and statistical tools of the study.

Research Design
 The study used the descriptive correlational design. Descriptive research aims to

accurately and systematically describe a population, situation or phenomenon. It primarily

concerned with finding out "what is,"(McCombes, 2020). It is quantitative in nature as it

attempts to collect information and statistically analyze it. This is also a correlating research

determining the relationship between the nursing students’ personal profile and their health

promotion practices.

In the study, participants will answer questions administer through questionnaires. After

participants answer the questions, researchers will describe the responses given. In order for the

survey to be both reliable and valid, the researcher used a validated questionnaire. Questions

should be written so they are clear and easy to comprehend (Hale, 2011).

Research Locale

This study will be conducted at a Seventh-day Adventist institution, the Adventist

Medical Center College, formerly the Mindanao Sanitarium and Hospital College located at the

Brgy. San Miguel, Tibanga, Iligan City, Lanao Del Norte. It offers primary, secondary, and

tertiary education. The following courses are being proffer: Bachelor of Science in Physical

Therapy, Nutrition and Dietetics, Radiologic Technology, Nursing, Medical Technology, and

Pharmacy.

Respondents of the Study

The respondents of the study will be comprise of 200 student nurses from all levels: level

1 (freshmen), level 2 (sophomores), level 3 (juniors), and level 4 (seniors) currently enrolled

academic year 2021- 2022 at Adventist Medical Center College.

Sampling Design

The study utilizes the purposive sampling to determine the sample. A method that is

selected based on characteristics of a population and the objective of the study. The researcher

listed currently student nurses using it to select a sample of respondents.

Research Instruments

The study will utilize a 52 item survey questionnaire to assess student nurses’ health

promotion practices.

Part I is composed of the student nurses’ personal profile which include age, gender,

religion, and year level.

Part II is the adopted Health Promotion Lifestyle Profile II, an instrument that assesses

and measures health promoting behavior of an individual, focusing on the six domains of health

responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress

management. These dimensions are reflected in the following items:

1) Health-Promoting Lifestyle 1 to 52

2) Health Responsibility 3, 9, 15, 21, 27, 33, 39, 45, 51

3) Physical Activity 4, 10, 16, 22, 28, 34, 40, 46

4) Nutrition 2, 8, 14, 20, 26, 32, 38, 44, 50

5) Spiritual Growth 6, 12, 18, 24, 30, 36, 42, 48, 52

6) Interpersonal Relations 1, 7, 13, 19, 25, 31, 37, 43, 49

7) Stress Management 5, 11, 17, 23, 29, 35, 41, 47

 Susan Walker, Professor Emeritus of the University of Nebraska, College of Nursing,

created this instrument in 1987, based on Nola J. Pender's Health Promotion Model. This 52-item

test used a 4-point Likert Scale to measure the individual's behavior, with responses ranging

from "Never," "Sometimes," "Often," and "Routinely."

Scoring of the Instruments

The questionnaire will be score varying according to its parts.

Respondents will fill out the first section by ticking the appropriate box next to each

category's entry regarding their personal profile, which includes age, gender, religion, and year

level.

The second section of the questionnaire will be completed by ticking the number that

corresponds to the correct response. These statistics are accompany by a detailed description of

their expertise level. A score for overall health-promoting lifestyle is obtained by calculating a

mean of the individual's responses to all 52 items; six sub-scale scores are obtained similarly by

calculating a mean of the responses to sub-scale items. The use of means rather than sums of

scale items is recommended to retain the 1 to 4 metric of item responses and to allow meaningful

comparisons of scores across sub-scales.These are the descriptive rating scales or perception

scales that were utilized in the study and are listed below.

4 = Routinely (R)

3 = Often (O)

2= Sometimes (S)

1 = Never (N)
Data Gathering Procedure

The study follows a step-by-step strategy to verify that the data collection procedure

follows all of the relevant and related guidelines. The steps are being illustrated below:

First, a letter of approval is made by the researchers and to be noted by the research

adviser.

Second, the dean of the school of nursing will receive this letter of permission. The

respondents' letter will mirror all of the affix signatures.

Third, after the signatories is being gather. The implementation process will then be

conducted according to its designated date.

Fourth, during the data gathering process, answering of the questionnaire will be send

through an online platform (google doc).

Fifth, after the data will be gather, tabulation and tallying of data will be perform and this

will be subject for analysis and interpretation using the defined and appropriate statistical tools.

Statistical Tools

These are the statistical tools that were utilize to compute, analyze, and interpret the

study's data results.

1) Weighted Mean

The score for the over-all health promoting lifestyle will be obtained by computing the

Mean of the individual’s responses. Likewise, the scores for each subscale will be obtained using

the same computation. The mean, denoted by an x, is the most sensitive measure of center since

it takes into account all scores in a distribution when it is calculated (Bordens, 2007). The

formula for the mean is:

 ¿
x=
∑x
n
Where: Ex is the summation of scores

n is the number of scores in the distribution.

2) Frequency and Percentage Distribution

This statistical tool will be use in determining how many responses that fall in each

respondent’s answers.

Formula:

p = f / n (100)

Where:

p = Percentage

f = Frequency

n = total number of the respondents

3) Chi-square

This statistical tool will be use to investigate the relationship between the

sociodemographic profile of the faculty members and their health promotion practices.

Formula:

Where:

X2 = Pearson’s cumulative test statistic, which asymptomatically approaches a X2

distribution

Oi = an observed frequency
 Ei = an expected (theoretical) frequency, asserted by the null hypothesis;

n = the number of cells in the table

REFERENCES

A. BOOKS.

Alligood, M. A., (2016). Nursing Theorists and Their Work 9 th Edition. Singapore: Elsevier Pte.
Ltd.

Famorca, U., Nies, M., & McEwen, M., (2016). Nursing Care of the Community. A
comprehensive text on community and public health nursing in the Philippines.
Singapore: Elsevier Pte. Ltd.
 B. JOURNALS/ARTICLES

Kuan, G., Kueh, Y.C., Abdullah, N. et al., (2019). Psychometric properties of the health-
promoting lifestyle profile II: cross-cultural validation of the Malay language
version. BMC Public Health 19, 751; doi:10.1186/s12889-019-7109-2

Parisa, et al., (2016). Validity and Reliability of Health Promoting Lifestyle Profile II in
the Iranian Elderly; doi: 10.4103/2008-7802.182731

Mehri, Ali & Solhi, Mahnaz & Garmaroudi, Gholamreza & Nadrian, Haidar &
Sighaldeh, ShirinShahbazi. (2016). Health Promoting Lifestyle and its Determinants
Among University Students in Sabzevar, Iran. International Journal of Preventive
Medicine. 7. 65. 10.4103/2008-7802.180411

Chang-Nian Wei & Koichi Harada & Kimiyo Ueda & Kumiko Fukumoto & Keiko
Minamoto & Atsushi Ueda (2011). Assessment of health-promoting lifestyle
profile in Japanese university students. Environ Health Prev Med. DOI :
10.1007/s12199-011-0244- 8

C. PUBLISHED/UNPUBLISHED THESIS/DISSERTATION

Endelman, C. et al.,(2006). Health Promotion Throughout the Life Span 6th Edition.
Mosby.

Lucas, K. et al., (2005). Health Promotion. Evidence and Experience. SAGE

Publications, Ltd.

Pender, N. et al., (2006). Health Promotion in Nursing Practice 5 th Edition. Pearson

Education.

Hsiao, Y., et al., (2010). Spiritual health, clinical practice stress, depressive tendency and
health promoting behaviours among nursing students. Journal of Advanced
Nursing.

Weyers S., et al., (2010). How does socio economic position link to health behaviour?
Sociological pathways and perspectives for health promotion. Global Health
Promotion; 17(2): 25-33

D. ELECTRONIC SOURCES
 QUESTIONNAIRE

Dear Respondents:

We are going to conduct a study entitled, “Health Promotion Practices among Faculty
Members at Adventist Medical Center College, Iligan City”. This is in partial fulfilment of
the requirements for the degree of Bachelor of Nursing. Your cooperation would really make this
study a successful one. Rest assured that your answers will be treated with utmost privacy and
confidentiality.

Thank you and God bless!

PART I. RESPONDENT’S SOCIODEMOGRAPHIC PROFILE.
Instruction: Check the corresponding answer of your choice.
 Age
( ) 15-17 ( ) 21-23
( ) 18-20 ( ) 24-56
( ) 57 above

 Gender
( )Male ( ) Female

 Religion
( ) Seventh- Day Adventist
( ) Roman Catholic
( ) Islam
( ) Others: Specify _

 Year Level
( ) Freshman
( ) Sophomore
( ) Junior
( ) Senior

PART II.HEALTH PROMOTING LIFESTYLE PROFILE II.

Directions: This questionnaire contains statements about your present way of life or
personal habits. Please respond to each item as accurately as possible, and try not to
skip any item.
N for never, S for sometimes, O for often, or R for routinely

Never Sometimes Often Routinely

1) Discuss my problems and concerns
with people close to me.
2) Choose a diet low in fat, saturated
 fat, and cholesterol.
3) Report any unusual signs or
symptoms to a physician or other
health professional.
4) Follow a planned exercise program.
5) Get enough sleep.
6) Feel I am growing and changing in
positive ways.
7) Praise other people easily for their
achievements.
8) Limit use of sugars and food
containing sugar (sweets).
9) Read or watch TV programs about
improving health.
10) Exercise vigorously for 20 or more
minutes at least three times a week
(such as brisk walking, bicycling,
aerobic dancing, using a stair
climber).
11) Take some time for relaxation each
day.
12) Believe that my life has purpose.
13) Maintain meaningful and fulfilling
relationships with others.
14) Eat 6-11 servings of bread, cereal,
rice and pasta each day.
15) Question health professionals in
order to understand their
instructions.
16) Take part in light to moderate
physical activity (such as sustained
walking 30-40 minutes 5 or more
times a week).
17) Accept those things in my life
which I can not change.
18) Look forward to the future.
19) Spend time with close friends.
20) Eat 2-4 servings of fruit each day.
21) Get a second opinion when I
question my health care provider's
advice.
22) Take part in leisure-time
(recreational) physical activities
(such as swimming, dancing,
bicycling).
23) Concentrate on pleasant thoughts at
 bedtime.
24) Feel content and at peace with
myself.
25) Find it easy to show concern, love
and warmth to others.
26) Eat 3-5 servings of vegetables each
day.
27) Discuss my health concerns with
health professionals.
28) Do stretching exercises at least 3
times per week.
29) Use specific methods to control my
stress.
30) Work toward long-term goals in my
life.
31) Touch and am touched by people I
care about.
32) Eat 2-3 servings of milk, yogurt or
cheese each day.
33) Inspect my body at least monthly
for physical changes/danger signs.
34) Get exercise during usual daily
activities (such as walking during
lunch, using stairs instead of
elevators, parking car away from
destination and walking).
35) Balance time between work and
play.
36) Find each day interesting and
challenging.
37) Find ways to meet my needs for
intimacy.
38) Eat only 2-3 servings from the meat,
poultry, fish, dried beans, eggs, and
nuts group each day.
39) Ask for information from health
professionals about how to take
good care of myself.
40) Check my pulse rate when
exercising.
41) Practice relaxation or meditation for
15-20 minutes daily.
42) Am aware of what is important to
me in life.
43) Get support from a network of
caring people.
44) Read labels to identify nutrients,
fats, and sodium content in
packaged food.
45) Attend educational programs on
personal health care.
46) Reach my target heart rate when
exercising.
47) Pace myself to prevent tiredness.
48) Feel connected with some force
greater than myself.
49) Settle conflicts with others through
discussion and compromise.
50) Eat breakfast.
51) Seek guidance or counseling when
necessary.
52) Expose myself to new experiences
and challenges.