Health-related Lifestyle Factors Research Articles

Healthcare choices in Mumbai slums: A cross-sectional study.

Background: Informal urban settlements, known as slums, are the home for a large proportion of the world population. Healthcare in these environments is extremely complex, driven by poverty, environmental challenges, and poor access to formal health infrastructures. This study investigated healthcare challenges faced and choices made by slum dwellers in Mumbai, India. Methods: Structured interviews with 549 slum dwellers from 13 slum areas in Mumbai, India, were conducted in order to obtain a population profile of health-related socio-economic and lifestyle factors, disease history and healthcare access. Statistical tools such as multinomial logistic regression were used to examine the association between such factors and health choices. Results: Private providers (or a mixture of public and private) were seen to be preferred by the study population for most health conditions (62% - 90% health consultations), apart from pregnancy (43% health consultations). Community-based services were also preferred to more remote options. Stark differences in healthcare access were observed between well-known conditions, such as minor injuries, pulmonary conditions, and pregnancy and emerging challenges, such as hypertension and diabetes. A number of socio-economic and lifestyle factors were found to be associated with health-related decisions, including choice of provider and expenditure. Conclusions: Better planning and coordination of health services, across public and private providers, is required to address mortality and morbidity in slum communities in India. This study provides insights into the complex landscape of diseases and health providers that slum dwellers navigate when accessing healthcare. Findings suggest that integrated services and public-private partnerships could help address demand for affordable community-based care and progress towards the target of universal health coverage.

Healthcare choices in Mumbai slums: A cross-sectional study

Background: Informal urban settlements, known as slums, are the home for a large proportion of the world population. Healthcare in these environments is extremely complex, driven by poverty, environmental challenges, and poor access to formal health infrastructures. This study investigated healthcare challenges faced and choices made by slum dwellers in Mumbai, India. Methods : Structured interviews with 549 slum dwellers from 13 slum areas in Mumbai, India, were conducted in order to obtain a population profile of health-related socio-economic and lifestyle factors, disease history and healthcare access. Statistical tools such as multinomial logistic regression were used to examine the association between such factors and health choices. Results : Private providers (or a mixture of public and private) were seen to be preferred by the study population for most health conditions (62% - 90% health consultations), apart from pregnancy (43% health consultations). Community-based services were also preferred to more remote options. Stark differences in healthcare access were observed between well-known conditions, such as minor injuries, pulmonary conditions, and pregnancy and emerging challenges, such as hypertension and diabetes. A number of socio-economic and lifestyle factors were found to be associated with health-related decisions, including choice of provider and expenditure. Conclusions: Better planning and coordination of health services, across public and private providers, is required to address mortality and morbidity in slum communities in India. This study provides insights into the complex landscape of diseases and health providers that slum dwellers navigate when accessing healthcare. Findings suggest that integrated services and public-private partnerships could help address demand for affordable community-based care and progress towards the target of universal health coverage.

Sexual Activity and Cognitive Decline in Older Adults.

This prospective study tested whether sexual activity and emotional closeness during partnered sexual activity relate to cognitive decline (episodic memory performance) in older adulthood. In total, 6016 adults aged 50 and over (2672 men, 3344 women; M age = 66.0 ± 8.8years) completed an episodic memory task and self-report questions related to health, sexual activity, and emotional closeness. Two years later, participants again completed the episodic memory task. After controlling for demographic and health-related lifestyle factors, more frequent sexual activity and greater emotional closeness during partnered sexual activity were associated with better memory performance. The association between sexual activity and memory performance was stronger among older participants in the sample. Memory performance worsened over 2years, but change in memory performance was unrelated to sexual activity or emotional closeness during partnered sexual activity. These findings build on experimental research that has found sexual activity enhances episodic memory in non-human animals. Further research using longer timeframes and alternative measures of cognitive decline is recommended.

Adherence To Lifestyle Recommendations Regarding Physical Activity, Diet, Smoking And BMI in Cancer Survivors

PURPOSE: Assess adherence to lifestyle recommendations for physical activity, diet, smoking and BMI in cancer survivors in Central Pennsylvania. METHODS: A survey on health-related lifestyle factors was send to cancer survivors in Central Pennsylvania (PA) facilitated by the PA Cancer Registry in 2017. The survey included questions on current BMI, smoking status, physical activity level, and diet. From this, we assessed adherence to the WCRF/AICR recommendations for cancer prevention, as they are also recommended for cancer survivors. Respondents were assigned 1 point for each of the following recommendation they adhered to: BMI between 20-25 kg/m2, currently not smoking, consumption of 5 or more servings of fruits/vegetables per day and being physically active at least 30 minutes/day (maximum score 4 points). RESULTS: The response rate to the survey was ~27%, and varied from 23% (lung) to 30% (breast). The average age of the respondents was 66 years. The overall score for adherence was 1.6 points which was largely driven by the high adherence to the recommendation not to smoke; adherence to the other guidelines was significantly lower. Survivors who adhered to the recommendation on physical activity had a similar score for the other lifestyle recommendations (1.1 out of 3) compared to 1.0 of 3 for survivors who did not adhere to the recommendation on physical activity.Table: No title available.CONCLUSION: In this survey among cancer survivors in central PA, adherence to lifestyle recommendations was low for all types of cancer. Response rate was 27%; possibly, cancer survivors who were higher educated and more health-conscious were more likely to respond. Thus, the adherence to lifestyle recommendations among cancer survivors in central PA may even be lower than what is presented here.

Healthcare choices in Mumbai slums: A cross-sectional study

Background: Informal urban settlements, known as slums, are the home for a large proportion of the world population. Healthcare in these environments is extremely complex, driven by poverty, environmental challenges, and poor access to formal health infrastructures. This study investigated healthcare challenges faced and choices made by slum dwellers in Mumbai, India. Methods: Structured interviews with 549 slum dwellers from 13 slum areas in Mumbai, India, were conducted in order to obtain a population profile of health-related socio-economic and lifestyle factors, disease history and healthcare access. Statistical tools such as multinomial logistic regression were used to examine the association between such factors and health choices. Results: Private providers (or a mixture of public and private) were seen to be preferred by the study population for most health conditions (62% - 90% health consultations), apart from pregnancy (43% health consultations). Community-based services were also preferred to more remote options. Stark differences in healthcare access were observed between well-known conditions, such as minor injuries, pulmonary conditions, and pregnancy and emerging challenges, such as hypertension and diabetes. A number of socio-economic and lifestyle factors were found to be associated with health-related decisions, including choice of provider and expenditure. Conclusions: Better planning and coordination of health services, across public and private providers, is required to address mortality and morbidity in slum communities in India. This study provides insights into the complex landscape of diseases and health providers that slum dwellers navigate when accessing healthcare. Findings suggest that integrated services and public-private partnerships could help address demand for affordable community-based care and progress towards the target of universal health coverage.

The prevalence rate of deviations in body constitutions and related factors in follow-up stage breast cancer patients—A nationwide study

ObjectivesThe aim of this study was to apply a rigorous traditional Chinese medicine (TCM) body constitution questionnaire (BCQ) to survey the prevalence rate of deviations in body constitution and to explore the health-related lifestyle behavior factors of deviations in body constitution. DesignA cross-sectional study was administered through postal mail. Subjects were recruited from a national organization for breast cancer patients (Taiwan Breast Cancer Alliance). Setting/main outcome measuresData were obtained from 311 breast cancer patients by questionnaires including a demographic record sheet, lifestyle behavior scales and the BCQ (Yang-Xu, Yin-Xu, and Stasis). Differences concerning the presence of body constitutions were analyzed by Chi-square tests and analyses of variance, and potential predictive factors were analyzed using multivariate logistic regression. ResultsIn total, 55.3% of the subjects had a Yang-Xu constitution, 61.0% had a Yin-Xu constitution, and 47.6% had a Stasis constitution. A total of 42.8% of the patients displayed a combination of the three types of body constitutions. Feeling stressed, physical exercise, and favoring fried food were predictors of the combined Yang-Xu, Yin-Xu and Stasis constitutions (p<0.05). Staying up late was significantly associated with Yin-Xu (p=0.017), and favoring salty food was significantly associated with Stasis (p=0.019). ConclusionsA high prevalence of deviations in body constitutions was observed in the follow-up stage of breast cancer patients. Increasing the adherence to healthy lifestyle behaviors might strengthen and balance body constitution, which could improve supportive care in breast cancer survivors.

Health-Related Lifestyle Factors and Sexual Functioning and Behavior in Older Adults

ABSTRACTThis study explored associations between health-related lifestyle factors and sexual functioning and behavior in 6,916 adults aged 50 and over. Results showed that an active lifestyle was associated with a higher sex drive, more sexual activity, and lower levels of sexual dysfunction (with stronger associations among men). Poor sleep was associated with less sexual activity, higher levels of sexual dissatisfaction, and higher levels of sexual dysfunction. A healthier diet and a higher alcohol intake were associated with more sexual activity and a higher sex drive. Taken together, these findings demonstrate that health-related lifestyle factors are important for sexual functioning and behavior in older adulthood.

Five factor personality traits and inflammatory biomarkers in the English longitudinal study of aging

Inflammatory processes are putative mechanisms underlying chronic disease. In this study we explore linear and non-linear associations between personality and change in inflammatory markers (C–reactive protein [CRP], fibrinogen, and white blood cell count [WBC]). In total, 5294 older adults (Mage=64.51±8.34years) provided blood samples in 2008 with 3751 providing follow-up samples four year later. Midway between the two assessments, participants completed a measure of personality. After controlling for participant demographics (e.g., age, gender) and health-related lifestyle factors (e.g., exercise, cigarette smoking), we found that higher levels of agreeableness and lower levels of conscientiousness were associated with higher CRP levels, and (for conscientiousness) an increase in CRP over time. Age moderation effects indicated that agreeableness and conscientiousness were related to WBC among older participants in the sample (over~70years of age). These findings provide evidence that agreeableness and conscientiousness traits are important for inflammatory biomarkers in older adulthood.

Health Behaviors, Knowledge, Life Satisfaction, and Wellbeing in People with Mental Illness across Four Countries and Comparisons with Normative Sample.

People with chronic mental illness have poorer physical health and higher mortality than the general population. We investigated lifestyle factors in people with mental illness across four countries and compared with a normative sample. Data were collected from N = 672 people (Germany, n = 375; Palestine, n = 192; London, n = 63; Australia, n = 42) with substance abuse disorder (n = 224), schizophrenia (n = 158), mood disorders (n = 227), and somatoform disorders (n = 63). The General Health Behaviour Questionnaire measured behaviors and knowledge related to nutrition, physical activity, alcohol, smoking, sleep, life satisfaction, and wellbeing. The normative samples were derived from a German population (N = 1,019). Data were analyzed using ANOVAs and t-tests. The Palestine sample did not differ from the Western samples on reported life satisfaction and wellbeing. However, they reported unhealthier diets, less physical activity, and lower knowledge about the impact of diet, physical activity, smoking, and sleep on health than the Western samples. Comparing the Western and normative samples, people with mental illness reported lower intake of healthy foods/drinks, higher intake of unhealthy foods, higher exercise, higher alcohol consumption, less cigarettes, less sleep, and more sleep problems. Their knowledge was lower for nutrition, physical activity, and smoking. All participants reported lower life satisfaction and wellbeing than the normative sample (P-values <0.001). Education on health-related lifestyle factors present important targets for primary care, quality of life and prevention of illness in people with mental illness. Further research will clarify specific predictors of health behaviors in each country.

Happiness and health behaviors in South Korean adolescents: a cross-sectional study

OBJECTIVES:We examined the associations between happiness and a wide range of health behaviors in South Korean adolescents.METHODS:Study data were derived from the ninth Korea Youth Risk Behavior Web-based Survey administered from June to July 2013. In addition to happiness levels, the questionnaire included items on sociodemographics and health-related lifestyle factors (smoking, drinking, eating breakfast, fruit and vegetable consumption, physical activity, sedentary behavior, and hours of sleep).RESULTS:The multivariate analysis revealed that higher levels of happiness were associated with not smoking or drinking, eating breakfast, eating fruits daily, vegetable consumption, participating in at least 60 minutes of physical activity a day, avoiding sedentary behavior, and hours of sleep. Additionally, sex differences were found in relationships between happiness and eating fruit daily, participation in physical activity, and sedentary behavior.CONCLUSIONS:These results encourage public health professionals to consider the psychological aspects of adolescent life in working to improve their health behaviors and outcomes.

PRS46 - The Association Between Smoking Status And Quality Of Life: Factoring In Lifestyle Variables

Smoking status, which has been shown to be associated with quality of life (QoL), may be associated with other lifestyle factors. Yet, most studies assessing the relationship between smoking status and QoL fail to account for other health-related lifestyle factors. This study’s objectives were to assess 1) the relationship between smoking status and other health-related lifestyle factors (flu vaccination, alcohol use, and physical activity) and 2) how these factors affect model fit. Data were extracted from the 2014 Behavioral Risk Factor Surveillance Survey dataset (N=332,680). Chi-square was used to address the first objective. For the second objective, quality of life, measured using eight domains (general health, physical health, mental health, activity limitations, pain, depressive symptoms, anxiety, and vitality) dichotomized into frequent positive (≥14 days/month) and negative (<14 days/month) experience was regressed on smoking status controlling for age, race, gender, education, marital status, income, employment, healthcare coverage, comorbidity, and body mass index (Model 1). Lifestyle factors were included in a second model. Compared to non-smokers and current smokers, former smokers were more likely to have at least one chronic condition (p<0.001) and get a flu vaccination (p<0.001). However, non-smokers were more likely to have avoided alcohol (p<0.001) and engaged in physical activity in the past month (p<0.001). For all eight QoL measures, Model 2 fit significantly better than Model 1 (p<0.001). The relationship between smoking status and QoL remained in model 2 with the odds of frequent positive experience being significantly lower for smokers on all QoL measures except vitality (p<0.001) and significantly lower on general, physical, and mental health for former smokers (p<0.05), compared to non-smokers. Further research is needed to determine if the decision to quit smoking coincides with the decision to make other lifestyle changes as this might suggest the need for more comprehensive smoking cessation programs.

Factors Associated with Receipt of Pre-pregnancy Preventive Dental Care Among Women in West Virginia: Pregnancy Risk Assessment Monitoring System (PRAMS) Survey 2009-2010.

To examine the association between sociodemographic, economic and health-related lifestyle factors and receipt of pre-pregnancy dental cleaning in West Virginia. A population-based secondary data analysis was conducted using the 2009-2010 West Virginia Pregnancy Risk Assessment Monitoring System (PRAMS) dataset. The study population consisted of 3050 women who answered the survey question about pre-pregnancy dental cleaning. Approximately 47% of the participants visited a dentist during the 12 months before pregnancy. Results from the logistic regression model showed that pre-pregnant Non-Hispanic white women were more likely to get their teeth cleaned compared to women from other racial/ethnic backgrounds (OR = 1.75; 95% CI: 1.01-3.04). Women with more than a high-school education (OR = 1.79; 95% CI: 1.22-2.62), young women < 20 years of age (OR = 2.75; 95% CI: 1.86-4.06), women with private health insurance (OR = 2.65; 95% CI: 1.98-3.55) and women who had intended pregnancy (OR = 1.3; 95% CI: 1.04-1.64) were more likely to have dental cleaning before pregnancy compared to women with less than a high-school education, women between the ages of 20-29, uninsured women and women who had unintended pregnancy, respectively. Identifying factors associated with dental cleaning can aid healthcare providers and policy makers in developing approaches to promoting oral care among women of childbearing age.

Health-related lifestyle factors and mammography screening attendance in a Swedish cohort study.

To determine whether health-related lifestyle factors are associated with attendance at a population-based invitational mammography screening program in southern Sweden, data on health-related lifestyle factors (smoking, alcohol use, physical activity, BMI, diet, self-rated health, and stress) were obtained from the Malmö Diet and Cancer Study and linked to the Malmö mammography register (Sweden, 1992-2009). Women (n=11 409) who were free from breast cancer at study entry were included in the cohort, and mammography attendance was followed from cohort entry to 31 December 2009. Generalized estimating equations were used to account for repeated measures within patients. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported. Nonattendance occurred in 8% of the 69 746 screening opportunities that were observed. Nonattendance was more common among women who were current or former smokers [OR=1.60 (1.45-1.76) and OR=1.15 (1.05-1.28)], had not used alcohol in the past year [OR=1.55 (1.32-1.83)], were less physically active outside of work [OR=1.10 (1.00-1.20)], had high physical activity at work (OR=1.13, 95% CI: 1.00-1.28), were vegetarians or vegans [OR=1.49 (1.11-1.99)], had not used dietary supplements [OR=1.11 (1.01-1.21)], had poor self-rated health [OR=1.24 (1.14-1.36)], and were experiencing greater stress [OR=1.25 (1.14-1.36)]. In this cohort, nonattendance was associated with smoking, alcohol abstinence, physical activity, poor self-rated health, stress, and following a vegetarian/vegan diet. These findings generally support the notion that women with less healthy lifestyles are less likely to engage in mammography screening.

Use of vitamin and mineral supplements and related variables among university students in Seoul

Purpose: Despite the popularity of dietary supplements, little data are available on their use by university students. The purpose of this study was to examine the use of vitamin mineral supplements and to identify factors related to supplement use among university students. Methods: University students (N = 345) in Seoul were surveyed. Survey questions included descriptive demographics, types of vitamin and mineral supplements used, health related lifestyle factors, mini dietary assessment, and knowledge and behaviors related to supplement use. Results: Of university students surveyed, 41% consumed vitamin and mineral supplements. Among the supplement users, multivitamins were the most commonly used dietary supplements (68.6%), followed by vitamin C (31.4%) and calcium (17.1%). In particular, the use of vitamin C and iron supplements was more common in females than males (p < 0.05). For the number of supplements taken daily, 32.1% of supplement users consumed 2 or more supplements; 20% of supplement users had almost no knowledge of the supplements being taken. Based on the results of multivariable logistic regression analysis, supplement use was associated with higher interest in their own health, non-smoker, and supplement use by family (p < 0.05). In addition, supplement use was slightly associated with healthy dietary behavior such as consuming a variety of foods (p = 0.05) and current disease status (p = 0.05). Conclusion: University students with relatively healthy lifestyles appear to take vitamin and mineral supplements, but they had little knowledge of the supplements. Given high prevalence of dietary supplement use among university students, nutrition education regarding supplement use is needed.

Obesity and Health-Related Lifestyle Factors in the General Population in Romania: a Cross Sectional Study

Obesity and Health-Related Lifestyle Factors in the General Population in Romania: a Cross Sectional Study

Identifying dietary patterns and associated health-related lifestyle factors in the adult Danish population

To identify and describe dietary patterns in Danish adults and to examine which demographic and health-related lifestyle factors are associated with dietary patterns. Data derived from the Danish national survey of diet and physical activity collected in 2003-2008 and included 1569 men and 1785 women. Diet was assessed by a 7-day pre-coded food diary. Information on age, gender, weight, height, physical activity, smoking habits, educational level and attitudes towards healthy eating habits was derived from face-to-face interviews. Principal component analysis was applied to explore dietary patterns. Associations with lifestyle factors were examined by means of multiple regression analyses. Three major dietary patterns were identified: a 'traditional' pattern correlated with intake of rye bread, white bread, fat on bread, cheese, jam, cold meat, minced meat, potatoes and gravy, and cake and biscuits; a 'health-conscious' pattern correlated with coarse bread, fruit, vegetables, low-fat dairy, nuts, water and tea; and a 'fast food' pattern correlated with pizza, hamburger/spring rolls, crisps, rice and pasta, sugar-sweetened soft drinks and sweets. The 'traditional' pattern was positively associated with male gender and age, whereas the 'health-conscious' pattern was positively associated with being female, increasing age and educational level. The 'fast food' pattern was inversely associated with age and smoking. Three distinct dietary patterns were identified, and associated lifestyle and demographic factors were characterised. The findings are valuable in targeting future nutrition education and will enable more focused strategies in communicating food-based dietary guidelines.

Body mass index, blood pressure, and glucose and lipid metabolism among permanent and fixed-term workers in the manufacturing industry: a cross-sectional study

BackgroundTemporary employment, a precarious form of employment, is recognized as social determinant of poor health. However, evidence supporting precarious employment as a risk factor for health is mainly obtained from subjective data. Studies using objective clinical measurement data in the assessment of health status are limited. This study compared body mass index (BMI), lipid and glucose metabolism, and health-related lifestyle factors between permanent workers and fixed-term workers employed in the manufacturing industry.MethodsData of 1,701 male manufacturing industry workers <50 years old in Japan were collected and analyzed. Anthropometric data were BMI, calculated using measured height and weight of study participants, and blood pressure. For lipid metabolism, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels were determined. For glucose metabolism, fasting plasma glucose and hemoglobin A1c (HbA1c) levels were measured. Multiple regression analysis adjusted for age and lifestyle factors was performed.ResultsBMI was significantly higher in permanent workers (22.9 kg/m2) compared with fixed-term workers (22.4 kg/m2). The leaner population (BMI < 18.5) was greater among fixed-term workers (8.3%) compared with permanent workers (4.0%), whereas the overweight population (BMI ≥ 25.0) was greater among permanent workers (21.4%) compared with fixed-term workers (18.1%). Although fixed-term workers tended not to be overweight, regression analysis adjusted for age and lifestyle factors suggested that fixed-term employment was significantly associated with higher blood pressure (systolic β = 2.120, diastolic β = 2.793), triglyceride (β = 11.147), fasting blood glucose (β = 2.218), and HbA1c (β = 0.107) compared with permanent workers (all p < 0.01).ConclusionsFixed-term workers showed more health risks, such as poorer blood pressure and lipid and glucose metabolism, even when adjusted for age and lifestyle variables, although BMI of fixed-term workers were lower than permanent workers. Precarious work might contribute to a deteriorating health status even among less overweight populations.

Community-Based Screening: Identifying Risk and Motivating Healthy Lifestyle Changes

Background: Smoking cessation, exercise, healthy diet, blood pressure control, and lipid management can substantially decrease patients' risk for cardiovascular disease. Methods: Data collected from cardiovascular screenings conducted by Life Line Screening, LLC, from a representative sample period (2005–2008) (n = 2 714 230), along with results of a 2012 follow-up survey (n = 1967), were evaluated. Participants were self-referred and screened across the United States for peripheral artery disease, abdominal aortic aneurysm, atrial fibrillation, and carotid artery stenosis. Participants also reported medical history and health-related lifestyle factors. Screening data were standardized to the US population aged ≥ 50 years by year, sex, age, and race. Risk factors, manifestations of cardiovascular disease, and Reynolds Risk Scores were examined. The representativeness of the unique Life Line Screening Database data set was compared with that of the Behavioral Risk Factor Surveillance System (n = 827 078) and the National Health Interview Survey (n = 42 755), both of which have been shown to be nationally representative. Results: Strong associations were found between dissimilar manifestations of cardiovascular disease. The data set was found to be broadly representative of Americans aged ≥ 50 years after standardization and provides insight on risk factors and disease progression. Survey results demonstrate the value of screening in enhancing physician engagement, and in motivating patients to maintain a healthier diet, engage in more exercise, stop smoking, and manage their medication, hereafter referred to as improved health behavior. Conclusion: Older Americans who seek community-based screening present with a variety of modifiable risk factors and asymptomatic vascular conditions, which are linked to adverse cardiovascular outcomes, including stroke and myocardial infarction. The follow-up survey indicated that community-based screening may be a motivating factor toward improved health behavior and use of medical resources.

Relationships of loneliness and mobile phone dependence with Internet addiction in Japanese medical students

We investigated factors contributing to Internet addiction in 105 Japanese medical students. The subjects were administered by a self-reporting questionnaire designed to evaluate demographic factors, Internet addiction, loneliness, health-related lifestyle factors, depressive state, patterns of behavior, and mobile phone dependence. Results of multivariate logistic regression analysis indicated that loneliness and mobile phone dependence were positively related to degree of addiction. Our findings suggest that Internet addiction is associated with loneliness and mobile phone dependence in Japanese students.

Decision-making competency, self-determination, and health lifestyle in nursing students

Introduction: This study identifies and analyzes the levels of relations between decision-making competency, self-determination, and health lifestyle in nursing students. Methods: This study was designed as a descriptive research to identify the relations of nursing students’ decision-making competency, self-determination, and health lifestyle. The subjects were 187 nursing students. Data were collected using a structured questionnaire and were analyzed by the IBM SPSS Statistics 19 program. Results: Decision-making competency of nursing students was 3.38 ± 0.41 points, and self-determination was 3.07 ± 0.38 points. Stress and physical exercise were the general and health-related lifestyle factors that contributed to the differences in decision-making competency. There were no differences in self-determination according to these factors. Conclusion: The results of the study showed that the levels of decision-making competency and self-determination in nursing students were moderate. Further studies are recommended for the development of these core abilities in nursing students.