I.

Definitions of Health and Wellness

a. Health
According to “WHO” Health is

b. Wellness
Wellness is defined by Anspaugh, Hamrick, and Rosato (2001) as “the
constant, active process of becoming aware of the different areas of one’s life,
identifying the areas that need improvement and then making choices that will
facilitate attainment of a higher level of health and well-being. It is a process,
rather than a goal. It means developing attitudes and engaging in behaviors that
enhance quality of life and maximize personal potential.
Rather than achieving goals, wellness is more of a process. Wellness
involves the development of certain attitudes and behaviors that would lead to a
better quality of life.

c. Healthy Lifestyle
According to the American Heart Association, "healthy lifestyle includes
(but is not limited to) healthy nutrition, regular physical activity, and other healthy
habits" (Healthy Lifestyle, 2014).It can also be a collective pattern of health‐
related behaviors based on choices from options available to people according to
their life chances.

1. Aspects Involved in a Healthy Lifestyle

a. Physical Wellness
i. Definition
The physical aspect of a person is his/her capability to perform some certain
activities involving the physical body. The ability to touch, to perceive things, to breathe,
to smell, in any activity involving a specific part of the body, is a physical activity.
Physical activities are activities that involve the movement of the body, with the
combined work of the muscular and skeletal system.
ii. Practices
There are plenty of practices of which involves little to no effort that could help
reinforce our physical health, such as choosing to take the stairs instead of using the
escalator or elevator, to eat more vegetables instead of junk food and drink water instead
of soft drinks, and many more, are examples of what we can do to build up our physical
body. The more strenuous activities such as sports and going to the gym, bear with them
more astounding results and benefits compared to the ones mentioned above. Since they
require more movement and strength, they result in an increased rate of development.
More specific examples are:

1. Static stretching - Static stretching is a technique involving the gradual

lengthening of a muscle to an elongated position. Hold that position for a brief
amount of time, about 10 to 30 seconds.
2. Swimming- the act of propelling oneself through water using the limbs.
3. Biking- a good cardio workout which burns a good amount of calories.
 4. Pilates- an arrangement of exercises utilizing different mechanical apparatus,
intended to improve physical quality, flexibility, and stance, and upgrade mental
awareness.
5. Tai-chi- cultivates the qi or life vitality inside us to stream easily and capably all
throughout the body.
6. Dancing- the movement of the body in a rhythmic way, usually to music and
within a given space, for the purpose of expressing an idea or emotion or
releasing energy.

iii. Benefits
According to the World Health Organization (2006), regular physical activity has
appeared to improve various parts of human life as far as metabolically
and physiologically. Physical activity can:
● Improve cardiovascular function and endurance:
1. Physical activity lowers down cholesterol and blood
pressure & strengthens heart muscles.
● Boost our immunity to any diseases:
Doing physical exercise improves overall fitness, thus
boosting immunity.
● Improves mental health:
Doing exercise does not only affect the physical aspect of
our body but also it can make us feel better mentally. With
exercise habitually comes fewer depressive thoughts, less anxiety,
improved self-confidence, and expanded mental sharpness.

iv. Challenges in attaining and maintaining physical wellness

Attaining and maintaining physical wellness has a wide array of benefits, but it also has
certain challenges which oftentimes stand as a barrier. Some perceived barriers include:
1. Lack of time:
In line with a study by Arzu, Tuzun, & Eker (2006), time is reported to be the
greatest barrier coming between the individual and physical wellness. This may be due to
school work, social and family activities.
2. Lack of motivation:
Individuals may feel unmotivated to maintain physical wellness, simply because
they are uninterested.
3. Lack of confidence:
The lack of confidence can greatly affect an individual's attitude towards physical
exercise. The individual may feel that they are neither fit enough nor capable for such.
4. Fatigue:
Extreme tiredness resulting from mental or physical stress from school work and
activities etc may cause a student or any individual to feel lazy about doing a physical
exercise.
b. Intellectual Wellness
i. Definition
Intellectual wellness is a state of positive cognitivity of an individual
(student). It is more than the absence of any intellectual or mental illness. Being
intellectually well means that your mind is in order and functioning in your best
interest. You are able to think, feel and act in ways that create a positive impact
on your physical and social well-being.

ii. Practices
Giving your brain a boost helps existing neurons form new
connections. studies show that mental exercise along with physical
exercise supports the growth of neurons.
The following are things you can do to increase intellectual well-
being.
● Reinforcement of knowledge - visit local libraries, universities, or
museums. Try learning a foreign language, a musical instrument or
a new craft or skill. learn to acquire new knowledge.
● Playing games - engaging oneself in strategic games helps improve
mind and memory. Trying a new sport can promote intellectual
wellness.
● Explore - Go to a concert, watch a movie or travel. Even taking a
different route can stimulate your mind.
● Adequate Sleep - Our brain needs time to rest and repair. So,
having an adequate sleep promotes intellectual wellness.
● Refrain from multitasking - Focus intensely on one task at a time,
it makes you more productive and efficient.
● Read - Spend 10 minutes at the start of each day reading a book
about positive thinking. This exercise is good, especially for a
student brain, health, elevation of mood, and protection of mind
against negativity.
● Practice mindfulness - Being mindful, makes one to be focused
and aware of the present moment. One way to do this is to focus on
your breathing; concentrate on the air moving in and out of your
body. Acknowledge thoughts as they arise and then let them go
without exploring anxieties about the future or regrets about the
past.
● Change your routine - Any time you step out of your normal
routine, your brain has to work a little harder as it adjusts,
processes new information and finds creative solutions and new
stimuli.

iii. Benefits
Evidence shows that novelty can boost your memory. “If
something novel grabs your attention you are more likely to remember
things that happened night before or after the event”, explains science
writer Tianna Hecklic, PhD. To prevent mental decline as you age,
 combining intellectual growth and relaxing mindfulness can boost your
brain’s health. (Melnyk, 2018)
iv. Challenges in attaining/maintaining a healthy lifestyle
● Lack of engagement in cognitive activities
According to a study by Parisi et. al., it was mentioned that
activities that involve cognitive stimulation, such as watching television,
have been related to an increased risk of cognitive impairment. Thus, lack
of engagement in cognitive activities hinders intellectual wellness.

c. Emotional Wellness
i. Definition
Emotions are expressions of our feelings about an event. These
emotions can be intense and can evoke a strong response. It is important to
have a balance between our thought processes and emotion we are feeling;
otherwise, disharmony occurs.
Emotional intelligence is the ability to recognize your own feelings
and the feelings of those around you and manage your emotions in a
positive manner. It requires a mix of practice and skill. Emotional
intelligence includes these five basic emotional and social competencies:
(Kelly, 2012)
● Self-awareness
● Self-regulation
● Motivation
● Empathy
● Social skills
i. Practices
Nurses are well versed in the phases of grief-shock, anger, denial,
and acceptance. Part of understanding these phases is the knowledge that
they are not linear, but rather may cycle back and forth. An understanding
of grieving in all its dimensions is crucial for effectively working with
grieving patients or family members. Identifying emotions correctly is also
important for collegial and team relationships (American Nurse, 2012).
Nurses are taught to care, and often fundamentally see themselves
as altruistic, supportive individuals. According to Melnyk & Neale (2018)
here are coping strategies and some ways to relieve stress and feel better:

1. Meditate
Meditation can calm your mind and ease anxious, negative
thoughts. Even a few minutes of visualizing a calm environment
can release tension.

2. Start a journal
Keep track of stress symptoms you’re experiencing daily,
such as anxiety, irritability, trouble sleeping or concentrating, or
habits like nail biting or overeating. Make a list of what might be
 causing you the most stress. Some of these stressors will be
unavoidable, but others may be avoided or reduced. List ways you
can remove these stressors from your day, including creative
solutions. Setting aside a little extra time to avoid stress triggers is
worth it. Journaling is a good way to express and release your
emotions, too.

3. Go outside
Enjoying nature can be a great way to relax, shed stress,
and elevate your mood. If you’re stuck indoors for a while, use
screen savers with calming outdoor images or listen to recordings
of nature sounds in your car.

4. Get Help
If you’re feeling overwhelmed and it’s interfering with
your functioning, get help. Don’t feel ashamed if you need to see a
mental health professional to help you strengthen your coping
skills.

5. Think positive
Read a book about being positive (such as How
Successful People Think: Change Your Thinking, Change Your
Life by John C. Maxwell, The Power of Positive Thinking by
Norman Vincent Peale, and How to Stop Worrying and Start
Living: The Tested Methods for Conquering Worry by Dale
Carnegie) for 5 to 10 minutes every morning to start your day off
right and shield yourself from negativity during the day.

6. Engage in regular physical activity

Any activity helps to reduce cortisol buildup. (Cortisol has
many negative effects on the brain and body.) If you’re short on
time, stretch your muscles with a resistance band for a few
minutes, go for a short walk, or learn a few simple yoga postures
you can do anywhere. Remember, 30 minutes of physical activity 5
days a week is the evidence-based recommendation.

7. Get at least 7 hours of sleep each night

Sufficient sleep refreshes your mind and allows your body
to repair and heal itself. Anything less than 7 hours results in
increased cortisol production, and evidence shows a link between
 sleep and depression; an inability to fall asleep or stay asleep is
one of the signs of depression.

8. Use abdominal breathing exercises

These exercises can help slow your heart rate and decrease
your blood pressure. Try this: Breathe in through your nose for a
slow count of five while your abdomen expands, then out through
your mouth for a slow count of five and pull your abdomen in. On
the breath in, think “I am calm”; on the breath out, think “I am
blowing all stress out.” Just a few minutes of deep breathing can
calm you down. You can work this into your meal break.

9. Stay in the present moment

Worrying about the future and guilt about events in the past can
cause stress. Learn how to stay in the present moment; for example, chew
a piece of gum and count the number of chews it takes before the gum
runs out of flavor.

10. Disconnect to socially connect

Technology can be overwhelming, so regularly disconnect from
the TV, phone, computer, and social media to stay connected with family
and friends and to cultivate new relationships whenever possible. Talk to
someone you trust about how you feel.

11. Use proprioceptive (body awareness) techniques

Try leaning against a wall or simply pressing your palms together.
These moves give your mind a reassuring sense of where your body is
positioned in space, which can be calming, and are easy to do even during
a busy workday.

12. Psychotherapy
The treatment of mental disorder by psychological rather than medical
means.

iii. Benefits of having a healthy lifestyle

1. Enables us to settle on better choices, and approach life with hope and
confidence.
2. You become increasingly productive, draw nearer to your objectives and
feel great in yourself.
3. Empowers us to appreciate all the more satisfying associations with our
loved ones, and interface with.
 4. It can positively affect our physical health.

iv. Challenges in attaining/maintaining a healthy lifestyle

According to Ingebretsen & Sagbakken (2016), nurses experience
large amounts of complex emotional exposures. Moreover, four themes
were identified as part of the emotional challenges encountered by nurses:

1. Emotionally Touched
Being emotionally touched was frequently related to “witnessing
suffering”. “Witnessing” or “partaking” in suffering was often associated
with a distinction of doing something “for” patients, versus being “with”
patients and their caregivers. A nurse’s perceived presence was
emotionally challenging when he/she felt he/she could not do anything
“for” the patient and relatives.
Being “with” patients, but not having the ability to change the patients’
life situation, was underlined as an emotional challenge.

2. Identifying and Distancing

Balancing identifying and distancing can be understood as a
dilemma in the nurse’s interaction with the patient. Nurses both identified
themselves with or strived to make a distance from the dying and their
relatives. When talking about experiences related to distancing and
identifying themselves, a dynamic connection between these terms was
revealed, as distancing was sometimes explained as a reaction to their
identification with the suffering person. Whilst distancing could be
described as a consequence of nurses not being able to absorb more
suffering, distancing was also described as helpful in a prolonged process
of relating to the suffering.

3. Person and Profession

Nurses require a balance between their personal and professional
dimensions. The ideal of keeping the personal and professional aspects
apart emerged from expectations of their primary understanding of what
constituted being a professional. The expectations involve a risk about
being too anxious about completing the role as “professional”, hence the
nurse might forget that he or she is also a human who sometimes makes
mistakes and does not know what to say.

4. Closeness to death
 Closeness to death and the dying led to increased awareness of the
nurse's own mortality and awareness to life. Noticing that one can be
touched on a deeper level that made it intense and challenging.

In general, emotional challenges were related to dynamic

movements between both enriching and draining experiences (Ingebretsen
& Sagbakken, 2016).

d. Spiritual Wellness
i. Definition
According to Kelly (2012), spirituality can mean different things to
different people. Although it is often viewed in a religious manner,
spirituality does not merely focus on religion alone (Anspaugh, Hamrick, &
Rosato, 2001). Some would say that it is an essence of being, or one’s
relationship with a higher being, with others and with the surroundings.
Maville & Huerta (2008) added that “it leads to the total positive
functioning of a person within the domains that constitutes a healthy state,
leads to a fulfilling life and results in the homeostasis within the body.”
Furthermore, spiritual health or spiritual wellness or well-being is
thought to not occur by chance, but by choice (Berman, Snyder, &
Frandsen, 2016). Spiritual health results when individuals intentionally seek
to strengthen their spiritual muscles, as it were, through various disciplines
(e.g. prayer, meditation, service, fellowship with similar believers, learning
from a spiritual mentor, worship, study fasting)

ii. Practices
Nurses are able to gain insight into their own spirituality by
exploring ways to nurture themselves through ritual, rest, play and
expressions of creativity. Older adults who are religiously active (based on
church attendance) are more physically fit and live longer than those who
are less religious. Those who are more religious or spiritual have a greater
chance of adjusting to life and maintaining good health. (Kelly, 2012)
Spiritual health occurs when individuals would readily want to
improve and strengthen their spirituality through different disciplines such
as prayer, meditation, service, fellowship with similar believers, learning
from a spiritual mentor, worship, study and fasting (Berman, Snyder, &
Frandsen, 2016).
According to Anspaugh, Hamrick, & Rosato (2001), The National
Institutes of Health (NIH) suggests the following spiritual practices:
1. Support groups
Support groups help give patients consolation, instilling
hope.
2. Meditation
 Meditation, formerly considered to be a religious
practice, is self - controlled relaxation.
3. Yoga
Yoga is the disciplined practice that involves
meditation, breathing techniques, and exercises that improve health
and relaxes the mind.
4. Music therapy
Music therapy puts to good use the power of music
on the psyche.
5. Art therapy
Art therapy uses self-expression through art to
enhance healing.
6. Prayer
Prayer involves communication with some form of
higher power.

iii. Benefits
There are various physical, mental benefits of spiritual wellness as
highlighted by Life Med Well Care (2019):
1. Reduces stress and depression
Spiritual wellness can physiologically help individuals by
controlling the secretion of stress hormones. (fight or flight
response)
2. Reduce anxiety
Spiritual wellness also gives the individual an elated mood
of joy, happiness and wellness.
3. Lower blood pressure (and thereby reduce the risk of heart
diseases)
It improves blood supply, therefore, lowering blood
pressure.
4. Strengthen your immune system and lower blood sugar level
The body lowers down the production of glucose for
immediate energy.
5. Help sustain concentration, memory, and cognition
Spiritual wellness also improves brain wave function and
gives the feeling of calmness and relaxation.

iv. Challenges in attaining/maintaining a healthy lifestyle

C. IMPORTANCE OF HAVING AND MAINTAINING A HEALTHY LIFESTYLE

A person’s lifestyle is one of the major determinants of a person’s health status.

According to Kamakhya Kumar, Associate Professor & Head, Department of Yogic Science,
Living a healthy lifestyle is the total harmony in the mode of living of a person, with nature, and
the spiritual inheritance of life.
Living a healthy lifestyle, at first, is a great challenge to many in our society today,
especially studens. But despite the challenges that come with it, living a healthy lifestyle has a
wide array of benefits that encompasses the physical, intellectual, emotional and spiritual aspects
of health. These benefits constitute significant long-term and short-term effects, especially for
student nurses. The majority, of which, lead to an improvement in one’s physical appearance,
relationships, mental health, and overall happiness, according to Ng (2020).

Furthermore, having and maintaining a healthy lifestyle could bring people various
significant long-term and short-term effects, especially for students. According to the article
written by Florence Ng (2020), a lot of individuals were surprised that acquiring healthy
practices in one’s lifestyle (e.g. exercise and eating healthy food) could not only help improve
one’s physical appearance, but could also improve one’s mental health, relationships, and overall
happiness. It is proven to reduce stress, increase happiness, increase self-confidence, strengthen
mental health, encourage creativity, and decrease mental health problems (e.g. anxiety). It is also
mentioned in the article that implementing a healthy lifestyle could also help prevent individuals
from acquiring diseases (e.g. cardiovascular diseases, type II diabetes), increase good cholesterol
levels, strengthen immune system, and improve metabolism.
In addition, according to studies conducted by researchers at Duke, healthy living
improves the body’s ability to control blood glucose levels. Considering this, it causes an
improved blood circulation and helps reduce the risk of death from heart disease as regular
exercise enhances proper supply of blood from the blood vessels to the heart. It also helps one in
burning down unnecessary fats in the body.
Finally, according to the Foundation for Peripheral Neuropathy (2016), engaging in a
healthy lifestyle enables one to cope better in stressful situations. With this being said, it is
essential for individuals to acquire a healthy lifestyle in order to live a meaningful life.

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Ingebretsen, L.P., MSN & Sagbakken, M., PhD. (2016). Hospice nurses’ emotional challenges in
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