Journal of Medical Society

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 34  |  Issue : 3  |  Page : 144--148

Medical students' practice, attitudes, and motives toward physical activity: A cross-sectional study


Vanlalduhsaki1, Jalina Laishram2, Brogen Singh Akoijam3,  
1 Assistant Professor, Department of Community Medicine, Zoram Medical College, Mizoram, India
2 Assistant Professor, Department of Community Medicine, RIMS, Imphal, Manipur, India
3 Professor & Head, Department of Community Medicine, RIMS, Imphal, Manipur, India

Correspondence Address:
Jalina Laishram
Department of Community Medicine, Regional Institute of Medical Sciences, Imphal, Manipur
India

Abstract

Background: Medical students have substantial knowledge of the benefits of regular physical activity. A person's motives for physical activity are important in determining whether the person will be physically active. Objectives: The purpose of this study was to explore the attitude and motivation to be physically active among undergraduate medical students. Materials and Methods: This was a cross-sectional study conducted in a tertiary care medical institute in Manipur between July 18, 2016, and August 16, 2016. Self-administered questionnaire was used for data collection. Data collected were analyzed in IBM SPSS version 21. The results were summarized in frequencies and proportions for categorical variables and in means and standard deviations for continuous variables. Chi-square test, ANOVA, and Student's t-test were employed and P < 0.05 was considered statistically significant. Results: Out of 361 participants, 180 (49.9%) were females. The mean age of the participants was 22.55 ± 2.08 years (range: 18–34 years). Body mass index of majority of the participants (59%) fell within the normal range. About 62.3% of the students were currently engaged in physical activity. Attitude of the students toward physical activity was favorable and the total mean attitude score was 3.82. Intrinsic motivation was identified as the most important motive for being physically active. Conclusions: The participants displayed a favorable attitude toward physical activity with no difference in attitude compared to male and female students. Those who were active identified intrinsic motivation as the most important motive for being physically active.



How to cite this article:
Vanlalduhsaki, Laishram J, Akoijam BS. Medical students' practice, attitudes, and motives toward physical activity: A cross-sectional study.J Med Soc 2020;34:144-148


How to cite this URL:
Vanlalduhsaki, Laishram J, Akoijam BS. Medical students' practice, attitudes, and motives toward physical activity: A cross-sectional study. J Med Soc [serial online] 2020 [cited 2021 Jun 21 ];34:144-148
Available from: https://www.jmedsoc.org/text.asp?2020/34/3/144/315096


Full Text



 Introduction



Physical inactivity is an important risk factor for the development of noncommunicable diseases (NCD) including coronary artery disease, hypertension, diabetes, cancers, obesity, and osteoporosis.[1] According to a report published by the World Health Organization (WHO), physical inactivity leads to 3.2 million deaths each year with a 20%–30% increased risk of all-cause mortality in individuals who are insufficiently active compared to those who are sufficiently active.[2] There has been a projection that NCD will account for 73% of deaths and 60% of the global disease burden by 2020.[1],[3]

Regular physical activity of moderate intensity such as walking, cycling, or doing sports has significant benefits for health. At all ages, the benefits of physical activity outweigh the potential harm. It is a well-established fact that regular physical activity is a protective factor for the prevention and treatment of noncommunicable diseases. Beyond health, increasing participation in physical activity has multiple social and economic benefits.[4]

Despite the well-known benefits of physical activity, the crude worldwide prevalence of physical inactivity is 21.4%.[4] The current levels of physical inactivity are partly due to people being less active during leisure time and an increase in sedentary behaviors.[4] Change in lifestyles has also been attributed to the decrease in levels of physical activity, especially among the student population.[1] Students are more likely to demonstrate several unhealthy lifestyle behaviors, including physical inactivity.[5] College life is a period during which individuals are for the most part exposed to stress and lack of time, posing a barrier to the adoption of healthy practices. Physical activity among adolescents is consistently related to higher levels of self-esteem and self-concept and lower levels of anxiety and stress.[6]

Deci and Ryan in 1985 developed a framework to explore motivation to be physically active. Intrinsic and extrinsic motivation makes up the continuum that distinguishes individual self-determination.[7] Intrinsic motivation is the highest level of self-determination. Individuals who are intrinsically motivated to exercise do not do so to achieve an outcome. Rather, they engage in physical activity as an end in itself.[7],[8],[9] Those who are extrinsically motivated perform the activity for some benefit they will receive or to avoid negative consequences.[7],[8] Identified regulation occurs when individuals freely choose to participate in an activity because they begin to value it and feel that it is important. At this level, the individual is moving closer to becoming more self-determined and is approaching an autonomous level.[8],[10] The highest form of extrinsic motivation, closest to intrinsic motivation, is integrated regulation. Individuals who are motivated at a level of integrated regulation do not exercise for the sake of the activity itself but instead regulate their behavior to achieve some outcome, such as to improve or maintain fitness.[7],[8],[10],[11]

College-aged years are a critical time when young adults make decisions about how active they will be in their everyday lives. In India, many studies have been conducted that investigated the attitude and practice of physical activity of medical students. However, there has been only limited investigation of the motivation of medical students to be physically active, and given that this is a critical period, more study is needed at this age level. Hence, this study was conducted to determine the practice, attitudes, and motives to be physically active among medical students in Imphal.

 Materials and Methods



This study was a cross-sectional design conducted among the undergraduate medical students of a tertiary care medical institute in Imphal, Manipur, from July 18, 2016, to August 16, 2016. As per the records from the academic section during this period, there were 528 medical students. After explaining the purpose of the study and the importance of honest answers, questionnaires were administered to the students by hand after classes/duties in their hostels, before lectures, and during breaks. Students who refused to participate and could not be contacted after three attempts were excluded from the study.

Taking 61% as the prevalence of practicing physical activity from a similar study,[6] the sample size was calculated using the formula, n = 4PQ/L2. Taking allowable error of 5% at 95% confidence interval and assuming a nonresponse rate of 10%, the calculated sample size was 418. Convenience sampling was used.

A self-administered questionnaire was used for data collection. The questionnaire consisted of four sections.

Section A addressed the sociodemographic profile of the respondents which included age, gender, semester, height, and weight.

Section B consisted of questions that assessed the undergraduate students' practice of physical activity.

Section C consisted of questions to assess the attitudes of undergraduates toward participation in physical activities, which was adopted from a similar study.[12] It has 17 items that assess the attitude using a 5-point Likert scale (1–5) across the opinions strongly disagree, disagree, neutral, agree, and strongly agree. The responses were weighed and their mean was calculated. The mean score was obtained by adding all the scores that were assigned from agree to disagree to a statement or an item and dividing it by the number of possible responses to the statement as follows:(5 + 4 + 3 + 2 + 1) ÷5 = 3. Attitude of the student was considered positive if his/her mean score of responses ≥3 and negative if his/her mean score of responses <3.

Section D consisted of the Behavioral Regulation in Exercise Questionnaire (BREQ). The BREQ is a 15-item questionnaire that measures the four regulations of exercise behavior: external/extrinsic, introjected, identified, and intrinsic motivation.[13],[14] It is scored on a 5-point Likert scale ranging from 1 (not true for me) to 5 (very true for me). The BREQ was used to assess levels of self-determination to be physically active among the participants.

Data were analyzed using IBM SPSS Statistics Version 21 for Mac OS (IBM Corp, 1989, 2012. Chicago, Illinois). The results were summarized in frequencies and proportions for categorical variables and in means and standard deviations for continuous variables. Chi-square test was used for comparison of physical activity between groups; ANOVA and Student's t-test were used to compare means. P < 0.05 was considered statistically significant.

The Research Ethic Board, RIMS, Imphal, approved the protocol of the study. Informed verbal consent from the participants was obtained before the administration of the questionnaire. The participants were informed about the usefulness of an honest answer. A code number was given and no names were taken to maintain confidentiality. Participation was completely voluntary.

 Results



A total of 440 students could be contacted and 417 returned the questionnaire giving 94.7% return rate. Out of the 417 that were returned, 56 were either incomplete or inconsistent; making 361 questionnaires usable for the analysis.

The study participants consisted of 180 (49.9%) females and 181 (50.1%) males. The mean age of the participants was 22.55 ± 2.08 years (range: 18–34 years). Body mass index (BMI) of majority of the participants (59%) fell within the normal range. Out of the total 361 participants, 225 (62.3%) were currently engaged in physical activity, of which 93 (41.4%) were females [Table 1]. Participants who were engaging in physical activity were analyzed based on their BMI. It was found that the participants who were in the normal BMI category were found to be significantly more engaged in some form of physical activity compared to students from the other BMI categories [Table 2].{Table 1}{Table 2}

[Table 3] shows the attitude of the participants toward physical activity. The total mean attitude score of the participants was 3.84 (±0.51) with no difference in attitude between male and female participants. A one-way ANOVA revealed that attitude toward physical activity differs among participants in various BMI categories. Students with normal BMI category score were higher in attitude when compared with the other categories and this was found to be statistically significant.

Among the four subscales measured by the BREQ tool [Table 4], intrinsic motive was found to be the most common motive to be physically active among the medical students attaining a mean score of 3.66 ± 0.72 followed by the identified motive, attaining a mean score of 3.45 ± 0.63. When compared between genders, there was no statistically significant difference between the motives of the students measured by the BREQ scale.{Table 3}{Table 4}

On comparing the mean scores of males and females for the various subscales of BREQ, there was no difference between the extrinsic and introjected subscales [Table 5]. However, there was a statistically significant difference between the intrinsic and identified motives between male and females students. Male medical students had higher mean scores in the identified (3.56 ± 0.60 vs. 3.30 ± 0.64) and intrinsic (3.75 ± 0.70 vs. 3.53 ± 0.71) motives when compared to female medical students (P = 0.003 and P = 0.022, respectively).{Table 5}

 Discussion



Out of 361 students who participated in this study, 225 (63.2%) were currently practicing some form of physical activity. This finding was similar to a study in Karnataka[6] where the current practice of physical activity in a medical college was 61.9%. Many studies revealed that among medical students, males are more active than their female counterparts.[1],[2],[15] Our study also revealed the same finding with male students practicing physical activity more than females (72.9% vs. 52.7%). On the contrary, Kumar et al. in their study found that a higher proportion of female medical students had high physical activity than their male counterparts, and the differences were statistically significant.[16]

A number of studies conducted to evaluate the physical activity, diet, and fitness status of university students have revealed that the physical condition and nutritional habits of students are very much associated with their own attitudes toward health promotion and illness prevention.[6] In this study, the mean attitude score of the medical students was 3.84 (0.51 standard deviation), which indicated that the students had favorable attitudes toward physical activity. Aniodo et al.[12] reported a mean attitude score of university students of 2.82, indicating they had positive attitudes toward physical activity.[12] The attitudes of boys and girls were both found to be favorable with no statistically significant difference, as evident from [Table 2]. Similar findings were observed in other studies.[17] Attitude scores among different classes of BMI revealed that students having normal BMI scored highest than the other classes. This could be the reason why the attitude of people with normal BMI is more favorable.

Motivational regulation to be physically active among the medical students was assessed using the BREQ. Remarkably in this study, intrinsic regulation was the most important motive to be physically active among the medical students in both sexes (mean score = 3.66 ± 0.72) followed by identified regulation (mean score = 3.45 ± 0.63). Individuals who are intrinsically motivated to exercise do not do so to achieve an outcome. Rather, they engage in physical activity as an end in itself. Individuals who belong to identified regulation category of motivation practice physical activities because they value the benefits of exercise.[8] It is noteworthy to find out that the medical students in this study reflected the highest form of motivation in both sexes combined. In a study by Wilson et al.,[18] identified regulation was found to be the most important predictor of exercise in both sexes.

Exercise regulations discriminated between motivational consequences among college men and women, with women having stronger introjected regulations than men.[18] On the contrary, this study revealed that there was no difference in extrinsic or introjected regulations between males and females [Table 4]. Nevertheless, male students have stronger identified (3.56 ± 0.60 vs. 3.30 ± 0.64; P = 0.003) and intrinsic (3.75 ± 0.70 vs. 3.53 ± 0.71; P = 0.022) regulations than female students. This study is consistent with previous studies that have provided evidence that exercise regulations can differentiate in predicting motivational consequences for both men and women.[19],[20]

A study in Karnataka[6] reported that physical activity was being practiced by 60.6% of normal BMI students, and the proportion of practice of physical activity increased as the BMI increased, i.e., 65.5% were exercising in the BMI group of ≥25 kg/m2. This study found out only 64.8% of students of normal BMI practiced physical activity. Nonetheless, those students having normal BMI were more physically active than the others in different BMI categories; however, this was not significant.

This study was not without any limitations. The height and weight of the participants were self-reported and were not verified by measuring individually. There could be a chance of self-reporting bias. However, to minimize this bias, the importance of an honest answer was stressed before distribution of the questionnaires. Attitude of the participants was found to be favorable and it is important to create an environment that will help them retain this favorable attitude. Further studies could be carried out to explore the motivations of the medical students with stages of change.

 Conclusions



Nearly two-third of the students were currently practicing some form of physical activity. The participants had a positive attitude in regard to physical activity with no difference in their attitude between male and female students. The most important motivational regulation possessed by the students to be physically active was intrinsic motivation, which is the highest form of motivation. Although there was no discrimination in the mean score of motivation between male and female students, males were found to have stronger identified and intrinsic motivation than female students.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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