Perceived Stress, Sleep Quality, and Healthy Lifestyle Behaviors Among Nursing Students: A Nutrition-Focused Cross-Sectional Study

This study examined how perceived stress and sleep quality related to healthy eating behaviors among nursing students and explored the extent to which these factors are statistically associated with health-promoting lifestyle behaviors. In this study adopting a cross-sectional and descriptive-correlational design, the Perceived Stress Scale (PSS-14), the Sleep Quality Scale (SQS-SVQ), and the Healthy Lifestyle Behavior Scale II (HLBS-II) were used. A total of 411 students (177 males and 234 females) participated in the study. Spearman correlations showed a weak but significant inverse association between perceived stress and health-promoting lifestyle behaviors (r=-0.241, p<0.001). Likewise, stress level was negatively linked with sleep quality (r=-0.317, p<0.001), whereas sleep quality was positively linked with health-promoting lifestyle behaviors (r=0.290, p<0.001). A modest negative association was also found between body mass index (BMI) and the nutrition subscale of health-promoting lifestyle behaviors (r=-0.235, p<0.001). Multiple linear regression indicated that nutrition behaviors were independently associated with better sleep quality (β=0.134, p=0.006), lower BMI (β=-0.161, p<0.001), older age (β=0.178, p<0.001), and physical activity (β=0.184, p<0.001) (adjusted R²=0.127, F(7, 403)=9.486, p<0.001). Although the effect sizes were in the weak range, the statistically significant associations observed in this study suggest that holistic strategies, including sleep hygiene and stress management, may support healthier eating and health-promoting lifestyle behaviors in nursing students and therefore warrant further evaluation in longitudinal intervention studies.