Assessment of the individual lifestyle of school adolescents

Original Article

Vol. 16 nº 3 - Jul/Sep - 2019
Pages:22-
31

Assessment of the individual lifestyle of school adolescents

Authors: ^¹, ^², ^³

¹Professional Master’s Degree in Health Education (Child and Adolescent Health) from the State University of Ceará (UECE). Social Worker from the Federal Institute of Education, Science and Technology of Ceará (IFCE). Crato, CE, Brazil

²PhD in Biological Sciences (Toxicological Biochemistry) from the Federal University of Santa Maria (UFSM). Professor at the Regional University of Cariri (URCA). Crato, CE, Brazil

³PhD student in Human Movement Sciences at the Federal University of Rio Grande do Sul (UFRGS). Master’s Degree in Human Movement Sciences from the Federal University of Rio Grande do Sul (UFRGS). Professor at the Regional University of Cariri (URCA). Crato, CE, Brazil

Correspondence:

Maria Lucileide Costa Duarte
( lucileideduarte@hotmail.com or lucileide@ifce.edu.br )
Federal Institute of Education, Science and Technology of Ceara (IFCE), Department of Student Affairs, Crato Campus,
CE Highway 292, Gisélia Pinheiro Neighborhood,
Crato, CE, Brazil. Postal Code: 63115-500

Submitted on 12/12/2018
Approved on 18/03/2019

Keywords: Adolescent; Life Style; Quality of Life.

Abstract

OBJECTIVE: The aim of this study was to evaluate the lifestyle of students enrolled in technical courses integrated into high school at a Federal Institute of Education in Ceará, Crato campus.
METHOD: This is a cross-sectional, quantitative and census study with 202 adolescents aged between 14 and 19 years. Three cases were not included in the database, resulting in 199 participants. The Individual Lifestyle Profile – Pentacle of Well-Being and descriptive statistics (mean and standard deviation) were used, adopting a significance level of p < 0.05.
RESULTS: The students presented a regular overall lifestyle. The lowest mean was in preventive behavior. Boys had better results than girls in all components of the Individual Lifestyle Profile.

INTRODUCTION The socioeconomic, political, cultural and environmental transformations caused by the technical-scientific revolution have influenced the behavior and lifestyle of individuals, including adolescents, influencing their quality of life. According to the World Health Organization (WHO), quality of life is “the perception that the individual has in relation to his/her position in life, considering the cultural context, values, as well as his/her goals, expectations, standards and concerns” ¹ . According to Nahas ² , quality of life results from a set of individual and socio-environmental parameters that may or may not be modifiable, thus characterizing the conditions of how human beings live. He understands that lifestyle is a “set of habitual actions that reflect the attitudes , values and opportunities in people’s lives” ² . The author states that these actions include eating habits, stress control, habitual physical activity, social relationships and prevention of risk behaviors. It is observed that this parameter is something inherent to all age groups, including adolescence. This is a phase marked by changes in the adolescent’s body, way of being, thinking and acting. There are biological, social and behavioral transformations that significantly affect eating habits, social, family, cultural and spiritual relationships, and, to a certain extent, a (mis)understanding of one’s own self ³ . In this sense, the relevance of acquiring and maintaining healthy habits aimed at improving quality of life and health has been highlighted recently, through encouraging regular physical activity, adequate and healthy eating, sufficient hours of sleep, restriction on alcohol consumption and smoking, as well as having leisure time, and emotional and stress control ⁴ . It is noteworthy that during adolescence, behavioral patterns and lifestyles gain space for formation. Such behaviors will influence the pattern of morbidity and future health care. Considering that risk factors for chronic diseases can begin during this period, this phase is seen as essential for interventions and modifications of adolescent habits and behaviors ⁵ . Research conducted in Brazil and around the world, linked to the behavior of schoolchildren, proves excesses in the behavior of adolescents, raising the need for studies on the subject ⁶ . In this regard, Farias et al. ⁷pointed out that high school students experience a phase marked by many discoveries, uncertainties and insecurities and, in general, adolescents are influenced in the construction of their personality, which can determine their way of life. During this period, incorporating more information about adopting a healthy lifestyle can be decisive for their future well-being. In view of the above, the objective of this study is to evaluate the general lifestyle of adolescent students in Technical courses integrated with high school education at a Federal Education Institution of Ceará (IFCE) in the city of Crato. METHODOLOGY Study prepared based on the database of the research “Sociodemographic and behavioral determinants of lifestyle and quality of life in adolescent students” of the Professional Master’s Degree in Child and Adolescent Health of the State University of Ceará (UECE), in partnership with the Regional University of Cariri (URCA). This is a cross-sectional, quantitative, census study, carried out at a Federal Education Institute of Ceará (IFCE). A total of 202 students participated in the study, of which three were not included in the database, resulting in 199 participants for the analysis (111 boys and 88 girls). The students were between 14 and 19 years old and enrolled in the Integrated Courses for High School-Technical in Agriculture and Technical in Computer Science for the Internet. Data collection took place in the last two weeks of February 2018, with the researcher present on scheduled dates and times in the classroom. The students participated in the study after returning the Free and Informed Consent Forms (FICF), signed by their parents/guardians, as well as the Free and Informed Assent Forms (FICF), in accordance with the ethical standards required by Resolution No. 466/12 of the National Health Council. ⁸ This study was approved by the Research Ethics Committee (CEP) under Opinion Number: 2,421,758. Students who were temporarily or permanently absent, those who were not physically or mentally able to answer the questionnaires, and students whose parents/guardians did not sign the informed consent form were excluded from the study. The wishes of those who did not wish to participate in the study were respected. To assess lifestyle, the Individual Lifestyle Profile instrument, derived from the Pentacle of Well-Being, validated in Brazil by Nahas, Barros, and Francalacci ⁹ , was applied . This is a self-administered questionnaire, consisting of questions to be answered individually, on a scale of zero to three (zero means total absence of that characteristic in the lifestyle and three expresses complete implementation of the behavior in question). The instrument has 15 items to be completed and participants are encouraged to color in the representative bands of each of the self-assessed items with colored pencils. The more colorful the graphic representation, the more appropriate their lifestyle will be. The Pentacle of Well-Being is represented in the form of a five-pointed star, each of which refers to a specific factor: nutrition, physical activity, preventive behavior, relationships and stress ² . The data obtained were digitized in an Excel 2016 spreadsheet and analyzed in the R and Python 3.6 programming languages. Descriptive statistics (mean and standard deviation) were used, which allowed the construction of the figures and the construction of the bar graph according to the frequency of responses to the items, and a significance level of p < 0.05 was adopted. RESULTS The analysis of the lifestyle components was performed according to the mean values of each dimension of the Pentacle of Well-Being. It was found that in the Nutrition component, the average was 1.29% and 1.22% for boys and girls, respectively. In the Physical Activity component, males had a score of 1.42% and girls, 1.04%. In Preventive Behavior, an average of 1.08% was observed for male students and 1.02% for female students; in the Social Relationship component, male adolescents had a score of 1.96% and girls, 1.80; in the Stress Management component, the scores were 1.59% and 1.37% for boys and girls, respectively. The Overall Lifestyle for male students was 1.46% and for girls, it was 1.29%. All variables presented significant results, with the component with the highest score being Social Relationship and the lowest being Preventive Behavior (Table 1).

In order to promote a better visualization of the results of the Lifestyle Profile of adolescents, Figure 1 is presented below, representing the five-pointed star that describes the five factors related to lifestyle ² .

Figure 1. Pentacle Star of Well-Being

Figures 2 and 3 present the percentage data of the responses for each lifestyle dimension (nutrition, physical activity, relationships, preventive behavior and stress control) separated by the sex of the adolescents analyzed.

Figure 2. Percentage data, males and responses of each lifestyle dimension of adolescents enrolled in Technical Courses Integrated with High School at a Federal Institute of Education. CE, 2018 Figure 3. Percentage data, females and responses of each lifestyle dimension of adolescents enrolled in Technical Courses Integrated with High School at a Federal Institute of Education. CE, 2018

DISCUSSION Knowing the factors that contribute to the development of a healthy lifestyle, especially during adolescence, is of fundamental importance. The experiences during this phase are common to most people, but they are not only dependent on organic or economic issues, but also on the psychosocial context in which they are inserted, which affects attitudes and decision-making (behaviors), making them subjects with comprehensive and more specific needs ¹⁰ . In this understanding, it is clear that the results evidenced in the lifestyle of the students in this study indicate a situation that requires care. This situation is somewhat similar to the study carried out by Orsano et al. ¹¹ , when evaluating the lifestyle and physical fitness of high school students in Demerval Lobão – PI. The authors observed an overall average of VE of 1.79%, which was classified as “regular”. In the studies by Westphal et al. ¹² , the overall average reached a much higher score (2.09%), indicating a positive lifestyle of the participants. The mean physical activity component observed in this study was similar to the results of these investigations, in which boys had higher means than girls. A similar situation was found in the National School-Based Student Health Survey – 2015 ¹³ , in the Global School-Based Student Health Survey – 2015 ¹⁴ , and in international studies conducted in Kuwait, Indonesia, Guatemala and Mozambique. In other words, it seems to be a global trend for girls to practice less physical activity than boys. The literature has recorded a higher proportion of active boys in relation to girls and it seems that being male is a factor positively associated with a higher level of physical activity. This can be explained by the sociocultural context. Since childhood, boys are motivated to practice physical exercises such as climbing trees, riding a bike, and playing ball, while girls are encouraged to develop typically sedentary activities ¹⁵ . In addition to sociocultural factors, there are also biological and educational factors ¹⁶ . Given the above, it is interesting to motivate students, especially adolescents, to take advantage of the physical school environment available to them, such as: gyms, sports courts, gyms, green areas, as well as other extracurricular activities. In addition to physical education classes, other mechanisms can be used to foster interest in sports and provide innovative meanings to be added to the daily lives of girls and adolescents in general. Regarding the social relationships component, an overall score very close to level 2 was found, the minimum desirable on the individual lifestyle profile scale. The findings of Orsano et al. ¹¹ reached a score of 2.6%, considered “positive” for the lifestyle. This same positivity (average 2.1%) was obtained in a study with high school students from Alfenas – MG ¹⁷ , and in a study with high school adolescents from Canoinhas – SC, where a “good” level was also achieved, expressed in the score of 2.3% ¹² . The social relationships component is one of the most relevant in the Pentacle. The social integration promoted by the inclusion of children and adolescents in meetings with friends, group sports activities and participation in associations leads to psychological well-being and balance between their values, culture and habits. However, social relationships have been losing ground to technology, motivating adolescents and young people to adopt characters from the virtual world without knowing them personally, putting their health and safety at risk ¹⁸ . In reference to this component, good interpersonal relationships have been seen in the literature as a fundamental characteristic for the construction of a social identity. By seeking to cultivate friendships and better relate to others, individuals try to better understand social dynamics, adopting a more flexible stance when faced with barriers that exist in society ¹⁹ . This is true for all stages of life for every human being and, in this sense, through relationships, adolescents expand their circle of friends and are naturally invited to participate in the most diverse activities in their extra-family world. Regarding preventive behavior, it is clear that the average presented a warning sign, requiring guidance and changes in the participants’ lifestyle. These findings differ significantly from the results found in other studies with high school adolescents ¹² , which found a score of 2.5%. Flausino et al. ¹⁷ observed an average of 1.46% and Orsano et al. ¹¹ found a value of 2%. Other studies with adolescents that used different methodological instruments also demonstrated warning signs. It was found that the participants were involved in one or more risk behaviors, such as: insufficient levels of physical activity, low consumption of fruits/vegetables, smoking, alcohol abuse, use of illicit drugs, involvement in fights, irregular use of condoms and sedentary behavior ^20-22 . In a systematic review on lifestyle, Pôrto et al. ²³concluded that there is a consensus on the need for certain attitudes to maintain a healthy lifestyle. Thus, it is understood that adolescents need to adopt preventive attitudes for their well-being, since according to the World Health Organization (WHO), most health threats arise from behavioral factors such as physical inactivity, substance abuse and eating disorders ²⁴ . Regarding the Nutrition component, the overall average demonstrated a critical position considering the positivity on the scale from score 2 onwards. This situation is similar to that found in other studies ^11-17 . In a study conducted by Vasconcelos et al. ²⁵ they found that 78.3% of adolescents ate cookies, juices, snacks and soft drinks at school and only 21.7% ate fruit. Diverging somewhat from these results, Maria et al. ^{26 pointed out in their study that, in general, adolescents had positive behavior, but the habit of eating at}fast food restaurants was a concern. Farias, Souza and Santos ⁷ found a satisfactory level of nutritional behavior among their subjects, highlighting greater positivity in males. According to Noll et al. ²⁷ , the current profile of eating habits is based on high consumption of fatty products, especially those rich in saturated and trans fats, simple sugars, sodium, preservatives and with small amounts of fiber and micronutrients, with ready-to-eat or processed foods standing out over natural products . It should also be added that habits formed in childhood and adolescence are likely to continue into adulthood and excess weight is a risk factor for other diseases such as cardiovascular diseases, metabolic syndrome, diabetes and some types of cancer. As for the stress control component, this presented an average similar to other studies ^11,17,26 . Contrary to these findings, studies have demonstrated positive behaviors in this component for lifestyle. In this element, Westphael et al. ¹² observed a score of 2.29% and Farias, Souza and Santos ⁷ considered unsatisfactory behavior in a small number of adolescents. In the view of Flausino et al. ¹⁷ , stress is constituted by social, environmental and physical factors. Exercising control over stress is a continuous and vital obligation in urban life and in the modern world. This situation is required by the cumulative succession of stressful factors, which demand constant adaptation in the daily lives of individuals. Therefore, stress is usually a result of the lifestyle that the individual adopts and the way in which he or she faces adversity. It is possible that the individual does not feel capable of eliminating the situations that cause it, but one can change the strategies for responding to these situations ² . CONCLUSION This analysis demonstrated that the general lifestyle of adolescents in Technical courses integrated with high school education at IFCE in the city of Crato requires care. Males had more satisfactory results than females in all components of the Individual Lifestyle Profile. Although both sexes presented vulnerability, females had a higher degree. It is worth noting that promoting a healthy lifestyle implies a better quality of life. It is also worth noting that this promotion is the responsibility of the entire society, starting in the family environment and continuing in the various instances that support the adolescent, including educators. The physical education teacher is a motivating tool for adopting healthy lifestyle habits, and the earlier these habits are incorporated, the easier they are to consolidate in adult life. It is also important to take a closer look at girls in order to identify the reasons that interfere with adopting better attitudes for their physical, social, and mental well-being, since boys had higher scores than girls. It is worth highlighting a strong point of this research, which was revealed by the participation of 60% of adolescents enrolled in 2018. However, some limitations should be highlighted: regarding the Individual Lifestyle Profile instrument, it does not provide the researcher with the LS result, but rather the report of this construct, as it is marked by subjectivity. As for the findings, they refer to adolescents in technical courses integrated into high school at a federal educational institution in the city of Crato/CE, and cannot be generalized to those who, for some reason, are out of school, to other high school students, or to those who live in other areas or regions. It is also a cross-sectional study that does not allow cause and effect inferences.

References

1. The WHOQOL Group. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Social Science and Medicine 1995; 10:1403-09. 2. Nahas M V. Physical activity, health and quality of life: concepts and suggestions for an active lifestyle. Londrina: Midiograf; 2010. 318p. 3. Moreira RM, Boery EN, Oliveira DC, Sales ZN, Boery RNSO, Teixeira JRB et al. Social representations of adolescents about quality of life: a structural-based study. Ciênc. public health. 2015 Jan [accessed 2018 Dec 02]; 20(1): 49-56. Available at:http://www.scielo.br/scielo.php?script=sci_arttext&pid;=S1413-81232015000100049&lng;=en . 4. Rafhaelli CO, Pretto ADB, Dutra GF. Prevalence of lifestyle habits among schoolchildren in a municipality in southern Brazil. Adolesc. Health. 2016 [accessed 2018 Nov 22];13(2): 16-23. Available at: http://www.adolescenciaesaude.com/detalhe_artigo.asp?id=553 . 5. Silveira MF, Almeida JC, Freire RS, Ferreira RC, Martins AEBL, Marcopito LF. Quality of life among adolescents: a cross-sectional study using the SF-12. Sci. public health. 2013 Jul [accessed 2018 Jul 13]; 18(7): 2007-15. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid;=S1413-81232013000700016&lng;=en . 6. Fonseca FF, Sena RKR, Santos RLA. Dias OV, Costa SM. The vulnerabilities in childhood and adolescence and the Brazilian public policy intervention. Rev. paul. pediatr. 2013 Jun [accessed 2018 Jul 13]; 31(2): 258-64. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid;=S0103-05822013000200019&lng;=en . 7. Farias ES, Souza LG, Santos JP. Lifestyle of adolescent schoolchildren. Adolesc. Health. 2016 [accessed 2018 Nov 4]; 13 (2):40-9, Available at: < http://www.adolescenciaesaude.com/detalhe_artigo.asp?id=556 >. 8. Brazil. Resolution No. 466 of December 12, 2012. Approves the guidelines and regulatory standards for research involving human beings. Official Gazette of the Federative Republic of Brazil, Brasília, DF; 2013. 9. Nahas MV, Barros MVG, Francalacci V. The pentacle of well-being: conceptual basis for assessing the lifestyle of individuals or groups. Rev. bras. activi. phys. health. 2000 [accessed 2018 Jun 30]; 5(2). Available at: http://rbafs.org.br/RBAFS/article/view/1002/1156 . 10. Ponte Neto VF, Coelho MMF; MIRANDA KCL, Cabral RL, Beserra ST F, Almeida P C. Analysis of risk behaviors among adolescent students. Rev enferm UFPE. 2015 [accessed 2018 Apr 14]; 9(Suppl.3):7572-81. Available at: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/download/10496/11360 . 11. Orsano VSM, Lopes RS, Andrade DT, Prestes J. Lifestyle and health-related physical fitness levels in adolescents from Demerval Lobão/PI. R. bras. Ci. and Mov. 2010 [accessed 2018 Jul 9]; 18(4):81-89. Available at: https://bdtd.ucb.br/index.php/RBCM/article/viewFile/2419/1804 . 12. Westphal PV, Mascarenhas LPG, Queiroga MR, Grzelczak MT, Souza WC. Assessment of quality of life in high school adolescents from the municipality of Canoinhas/SC. Rev. Bras. Quality of life. 2016 [accessed 2018 Jul 9]; 8(3):218-28. Available at: https://periodicos.utfpr.edu.br/rbqv/article/view/4090 . 13. Brazilian Institute of Geography and Statistics. National school health survey. 2016 [accessed 2018 Jul 9]. Available at: https://biblioteca.ibge.gov.br/visualizacao/livros/liv97870.pdf . 14. Global School. Based student health survey: Guatemala. 2015 [accessed 2018 Aug 20]. Available at: http://www.who.int/ncds/surveillance/gshs/gshs_fs_guatemala_2015.pdf . 15. Matias ST, Martina KSBR, Camilie PS, Alexandro A. Physical activity and leisure habits of adolescents. Pensar a Prática. 2012 [accessed 2018 Mar 11]; 15(3): 551-820, Available at: https://www.revistas.ufg.br/fef/article/view/14744 . 16. Fermino RC, Rech CR, Hino AA, Rodriguez ACR, Reis RS. Physical activity and associated factors in highschool adolescents in Southern Brazil. Rev Saude Publica. 2010 [cited 2018 Jun 30]; 44(6):986-95. Available at: http://www.scielo.br/pdf/rsp/v44n6/en_1886.pdf . 17. Flausino NH, Noce F, Mello MT, Ferreira RM, Penna EP, Costa VT. Lifestyle of adolescents from a public and a private school. R. Min. Educ. Fís. 2012 [accessed 2018 Jun 30]; 1: 491-500, 2012. Available at: https://www.researchgate.net/…/publication/…Estilo_de_vida_de_adolescentes_de_um 18. Garcia IC, Alexandre MC, Pereira LT, Manoel DBM, Santos LA; Cardos AL et al. Quality of life and physical fitness parameters of school-age students in the city of Içara/SC. Physical Education Research Collection. 2015 [accessed 2018 Jun 11]; 14(4) 1981-4313. Available at: https://ecitydoc.com/download/fontoura-virtual_pdf . 19. Marques LCSS, Samanta GS, Ademar Júnior AS, Lídia ASO. Individual lifestyle profile of university students with different backgrounds in the interior of Goiás. Movimenta Magazine. 2017 [accessed 2018 Mar 15]; 10(2):230-36. Available at: http://www.revista.ueg.br/index.php/movimenta/article/view/5875 . 20. Brito AS, Hardman CM, Barros MVG. Prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents. Rev. paul. pediatr. [accessed 2018 Jun 11]; 33(4): 423-30. Available at: http://www.scielo.br/pdf/rpp/v33n4/0103-0582-rpp-33-04-0423.pdf . 21. Coutinho RX, Santos WM, Folmer V, Puntel RL. Prevalence of risk behaviors in adolescents. Cad. health collet. 2013 [accessed 2018 Sep 03]; 21(4): 441-49. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid;=S1414-462X2013000400013&lng;=en . 22. Farias JR JC, Nahas MV, Barros MVG, Loch MR, Elusa SA. Oliveira ESA et al. Health risk behaviors in adolescents in southern Brazil: prevalence and associated factors. Rev. Panam Salud Publica. 2009 [accessed 2018 Aug 23]; 25(4):344-52. Available at:http://www.scielop.org/scielo.php?script=sci_arttexxt&pid;=S1020 . 23. Pôrto EF, Kümpel C, Castro AAM. Oliveira IM, Alfieri FM. How lifestyle has been assessed: a systematic review. Acta Fisiatr. 2015 [accessed 2018 Aug 23]; 22(4):199-205. Available at: http://www.revistas.usp.br/actafisiatrica/article/view/122509 . 24. Vieira TPF, Alves NJCRC, Lima DCS, Dias CSL, Fonseca AMLFM. Regional asymmetries. What differences in lifestyles and life satisfaction of adolescents? A study carried out with 3rd cycle basic education students in Portugal. Public health sciences. 2015 Jan [accessed 2018 Nov 03]; 20(1): 17-28. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid;=S1413-81232015000100017&lng;=en . 25. Vasconcelos TB, Lima AS, Farias MSQ, Câmara TMS, Pontes SMM, Sausa CT et al. Lifestyle of adolescents in public elementary schools in Fortaleza/CE, in relation to the risk of hypertension. J Health Biol Sci. 2013 [accessed 2017 Nov 03]; 1(1):10-5. Available at: http://www.periodicos.unichristus.edu.br/index.php/jhbs/article/view/3 . 26. Maria WB, Guimarães ACA, Matias TS. Lifestyle of adolescents from public and private schools in Florianópolis-SC. J Phys Educ. 2009 [accessed 2017 Nov 3]; 20(4):615-23. Available at: http://www.periodicos.uem.br/ojs/index.php/RevEducFis/article/view/6943 . 27. Noll PRS, Noll M, Neto JLR, Vilela PM. Anthropometric profile and eating habits of schoolchildren from different school systems. Adolesc Saude. 2016 [accessed 2018 Nov 3]; 13(4):15-24. Available at: http://www.adolescenciaesaude.com/detalhe_artigo.asp?id=615 .