The article focuses on exploring ways in which physical activity can improve psychological well-being. However, the author noted that this subject had not been extensively researched in a population such as nursing students. Accordingly, a research study was conducted to establish the relationship between physical activity and psychological health. The main objective of the article was to determine if the nurses’ level of physical activity conformed to the standard established by the health department. As a consequence, the aim of the paper was to identify the level of mental well-being associated with the physical development of the medical student. The article ‘Physical activity and mental well-being in student nurses’ was assessed according to methodological quality using a structured critical framework of quantitative Holland and Rees tools. Therefore, the weaknesses and strengths of the paper can be evaluated with this instrument.
Evaluation of Scientific Evidence to Explain Acute and Long-term Disease in Relation to Body Tissues and Systems, Morbidity and Mortality
It is well-known that an unstable mental state and the effects of stress negatively influence not only mental health but also impact the physical functioning of the body. Hence, it is possible to distinguish a short-term perspective, when the muscles and tissues of the body are suddenly tensed and then released when the stressor disappears (Djulbegovic and Guyatt, 2017). However, from the long-term perspective, when the muscles are constantly contracting, then the medical student may develop problems such as tension headaches and migraines, and other chronic pain, in the same way that other people do. Thus, considering the multiple cellular targets of chemical stress mediators, one would expect that prolonged, stress-dependent neuroendocrine dysregulation can damage directly or through the functional circuits of virtually all organs and tissues.
As a consequence, it produces a large number of illnesses and causes mortality. Holland and Rees note that when evaluating a research article for quality, one must pay attention to whether the purpose of the paper and the questions are clearly indicated. At the same time, the structure chosen must be the most appropriate to provide answers to the questions posed. The article ‘Physical activity and mental well-being in student nurses’ focus on physical activity and its level in medical students (Hawker, 2012). However, the aim of the paper was not to determine the degree of stress and other phenomena on physical activity and the long-term progression of tissue and whole-body morbidity. Accordingly, it can be assumed that the article did not address this issue because it did not set this aspect of the research as a goal.
Within the Holland and Rees tool, in order for a research article to be considered high quality, the data collection method must be designed for the purposes of the current study. It should have a type, content, or form of validity (LoBiondo-Wood and Haber, 2021). Notably, the article indicated that a relationship between physical activity and the psychological state of student nurses needed to be established, but the emphasis was only on the effect of physical development on the mental state of the student.
Accordingly, the research techniques were limited because they measured anxiety, depression, and self-esteem symptoms based on the Likert and Rosenberg scales. However, a brief International Physical Activity Questionnaire was selected for physical activity level (Hallam et al., 2021). The author states that it was chosen because of its high validity and reliability in evaluating the rate, duration, and strength of physical activity reported by the participants themselves over five days. It is essential to point out that this method does not allow estimating the intensity of physical activity to explain the acute and long-term progression of the disease in relation to the body tissues and systems.
Accordingly, a problem arises with the validity of the research because the method measures only motivations for physical activity among medical students. In order to obtain meaningful results, an additional test was needed that estimated physical health (Hong et al., 2018). It was the basis of scientific data to explain acute and long-term disease progression in relation to body tissues and systems. Consequently, scientific data in this way could be used to compare how physical activity influences physical health too. Moreover, in conjunction with the other research techniques mentioned in the paper, the connection between physical activity, mental health, and their impact on the occurrence and progression of the disease could be established (Holland and Rees, 2010). As a result, the proposed survey methods cannot be considered valid and sufficient to answer this question. Under the Holland and Rees approach, this study was limited because even when measuring physical activity, the intensity of walking as a type of physical activity was not taken into account.
Accordingly, it can be deduced that the article did not focus on the collection of scientific evidence to explain acute and long-term disease progression in relation to body tissues and systems. However, the Holland and Rees evaluation technique required that the effects of stress, mental state, and physical activity on the physical health of nursing students be examined for sufficient validity of the evidence (Holland and Rees, 2010). This decision provided more reliable scientific support for the impact of physical exercise on nurses’ morale and their ability to meet medical school nursing education’s increasing academic and clinical demands.
The Discursive Concept of Stress, Explaining the Experience of Poor Health, Behavior, and Personality the Social and Physical Consequences of the Disease
The first critical fact is that exposure to stress is unevenly distributed in the population, similar to health. Students who are learning a medical course in order to contribute to the treatment of patients in the future will potentially experience a large amount of stress throughout their training and professional life (He et al., 2018). This is because they spend a lot of time mastering the curriculum, which can cause anxiety and depression. At the same time, during their professional practice, their work will require constant concentration and emotional connection with patients, which will consume a lot of physical and mental energy from the future nurses. The article ‘Physical activity and mental well-being in student nurses,’ according to the Holland and Rees assessment tool, explains the importance of researching the concept of stress (Kozleski, 2017). Thus, the paper specifies the term ‘mental well-being,’meaning self-esteem, anxiety, depression, and life satisfaction.
The article emphasizes that physical activity should be strengthened to improve the physical and mental well-being of the workforce. The NHS is also expected to lead this process, a health and well-being strategy developed by 2010-2011 (Hawker, 2012). However, the paper points out that nurses comprise a large part of the workforce in the NHS, which is the most significant employer in the United Kingdom. A serious problem is the low health status of NHS workers, which directly affects the efficiency of services.
Nonetheless, while the article explains the need for stress management, it does not sufficiently develop the concept of stress to describe experiences of poor health, behavior, and personality. The paper’s methodology is designed to investigate more only how mental health depends on the level of physical exertion (Hawker, 2012). That is, the article points out that in a recent study of university students in the United Kingdom.
It was found that those who participated in higher levels of physical activity reported lower levels of anxiety than groups with medium and low levels of exercise. However, by applying the Holland and Rees quantitative appraising tool to the methodology in the article, it can be noted that other drivers of stress in nursing trainees have also been investigated (Lu, Wei and Li, 2021). That is, the methodology also considers factors affecting physical health, such as long-term obesity. Moreover, the techniques of the article ‘Physical activity and mental well-being in student nurses,’ also provided such features of human personality as self-confidence, anxiety, depression, life satisfaction, and self-esteem. The conduct of this type of survey made it possible to determine how behavior and personal factor into the overall formation of stress. In accordance with Holland and Rees tool, the research paper should have a qualitative method of data collection, and it should be elaborated for the goals of the current study (Holland and Rees, 2010). Consequently, in order to evaluate different factors that affect stress, the writer applied different scales, which enabled a reliable result to be obtained.
For example, the author found that most of the participants were single and smoked. At the same time, students from different courses participated in the research, which ensured a larger sample on the criteria of experience and knowledge. Although the limitation is that the central part of the group participants is female, but it is typical for this sample of learners (Hawker, 2012). The sample of participants also conformed to the Holland and Rees quantitative appraising tool to form the concept of stress. This is because 160 first-year and 125 third-year trainees were involved, and all trainees had the right to refuse to be questioned anonymously before the study was conducted (Hawker, 2012). Additionally, the fact that the research was authorized by the ethics committee and was voluntary suggests that the students answered the questions honestly.
Although a limitation of this survey was that only wasting weight and obesity were considered health factors. Consequently, the criterion of other health conditions that might have influenced the students’ deteriorating mental state was not considered (Holland and Rees, 2010). Therefore, in order to fully explain the concept of stress, all of the elements were not involved, which is the limitation of the paper. In contrast, all of these factors can produce stress, especially in the aggregate.
The Process and Features of Death and Dying and Related Priorities in Medical Care for Adults
It is essential to remark that nurses in professional practice are faced with the fact that patients can become long-term sick and, as a consequence, die. Hence, there are five main priorities in a nurse’s job: recognizing that the patient is dying and communicating sensitively with the patients and their loved ones. At the same time, all significant decisions concerning the person should be accepted together with their relatives, create an individualized plan of care for the patient and provide support for the dying person (SeolHwa and Hong, 2020). It is also vital to notice that in general, when death is coming to a human being, the body processes start working more slowly.
That is, the heart beats a little slower or with a bit less force, causing the blood to move through the body less quickly. This means that the brain and other organs receive less oxygen they need and do not function at their full capacity (SeolHwa and Hong, 2020). As a consequence, depending on how much oxygen the brain obtains, the patient’s condition determines whether or not they can understand and respond to the situation.
As time passes, the body ceases to fight, and the heart stops; accordingly, the person no longer breathes. Within minutes after that, the patient’s brain becomes completely dysfunctional, and the skin begins to cool down. Thus, it can be stated that the individual has passed away. Indeed, there are still such signs as pale and waxy skin, fixed pupils, and the human being cannot be awakened. It is significant that the article ‘Physical activity and mental well-being in student nurses’ was not intended to investigate the nurses’ emotional state and mental health as a result of a patient’s death (Hawker, 2012). Accordingly, it is understandable that the questionnaire did not include a question about the impact of a dying patient on student nurses’ mental and emotional well-being.
However, it is clear that physicians often observe the death of people, which affects their mental health. As a consequence, they need to have hobbies, such as sports training, to distract them from their thoughts about work. Hence, the Holland and Rees quantitative appraising tool cannot be used because the priorities of caring for dying individuals were not part of this research (Holland and Rees, 2010). Nevertheless, the author of the article pointed out that there are other influences on nurses that require a separate study.
Accordingly, after evaluating the article with the Holland and Rees quantitative appraising tool, its strengths, such as the different scales of questionnaire evaluation and the voluntary participation of students, can be pointed out. Moreover, the questions in the survey are approved by the ethics committee. They have been in development for a long time, which, together with the anonymity of the questionnaire, provides reasons to consider it reliable. At the same time, there are negative characteristics in the sample of participants other than positive ones. That is, almost all members are female but from various courses of study, which allows the experience to be evaluated. Concerning the questions posed to the survey participant, there are no issues about their illnesses, which can affect their emotional state; therefore, the concept is not sufficiently clarified.
Additionally, the paper only investigated the impact of physical health on the nurse’s psychological well-being. Still, it did not consider the effect on the body’s physical functioning, i.e., the muscles. Furthermore, the scope of the writer’s study did not include the influence of a patient’s death on the emotional state of the physician. Thus, besides its positive characteristics, the article under investigation has numerous limitations.
Hawker C.L. (2012) ‘Physical activity and mental well-being in student nurses’, Nurse Education Today, 32 (3), pp. 325-331.
Djulbegovic, B. and Guyatt, G. H. (2017) ‘Progress in evidence-based medicine: a quarter century on’, The lancet, 390, pp. 415-423.
Hallam, B. et al. (2021) ‘How are people with mild cognitive impairment or subjective memory complaints managed in primary care? A systematic review’, Family practice, 38(5), 669-683.
He, F. et al. (2018) ‘Assessing stress, protective factors and psychological well-being among undergraduate nursing students’, Nurse education today, 68, pp. 4-12.
Holland, K. and Rees, C. (2010) Nursing evidence-based practice skills. Oxford: Oxford University Press.
Hong, Q. et al. (2018) ‘The mixed methods appraisal tool (MMAT) version 2018 for information professionals and researchers’, Education for information, 34 (4), pp. 285-291.
Kozleski, E. B. (2017) ‘The uses of qualitative research: powerful methods to inform evidence-based practice in education’, Research and Practice for Persons with Severe Disabilities, 42(1), pp.19-32
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Lu, S., Wei, F. and Li, G. (2021) ‘The evolution of the concept of stress and the framework of the stress system’, Cell stress, 5(6), p. 76.
SeolHwa, M. and Hong, G. (2020) ‘Predictive factors of mortality in older adult residents of long-term care facilities’, Journal of Nursing Research, 28(2), p. 82.