Comparison of the Health-Promoting Lifestyle Dimensions between Students with Low and High Covid-19 Anxiety Levels

Document Type : Original Article


1 Department of Psychology, Faculty of Humanities, Arak University, Arak, Iran

2 Department of Psychology, Faculty of Humanities, Lorestan University, Lorestan, Iran



Introduction: Coronavirus pandemic and the resulting anxiety threatens the physical and mental health of individuals. This study aimed to compare the health-promoting lifestyle dimensions between two groups of students with severe and mild Coronavirus anxiety.
Method: Three hundred and Seventy undergraduate students of Arak University participated in this causal-comparative study in the academic year of 2020-2021. The participants were asked to complete two questionnaires of Coronavirus Anxiety and Health-Promoting Lifestyle Profile. Then, the two groups with mild (N = 37) and severe (N = 37) Coronavirus disease anxiety were selected through the screening and convenience sampling method. Finally, the two groups were compared in terms of health-promoting lifestyle dimensions using multivariate analysis of variance.
Results: The results concerning the analysis of the variance showed that there is a significant difference between the health-promoting lifestyle of the two groups with mild and severe Coronavirus anxiety. In addition, the group with mild Coronavirus anxiety reported higher spiritual growth compared to the group with severe Coronavirus anxiety.
Conclusion: According to the results, it seems that spiritual growth plays a significant role in the management and control of Coronavirus anxiety compared to the other dimensions of health-promoting styles.


  1. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet respiratory medicine. 2020; 8(4):420-2. doi:10.1016/S2213-2600(20)30076-X.
  2. Hageman JR. The coronavirus disease 2019 (COVID-19). Slack Incorporated Thorofare, NJ; 2020.
  3. WHO. 2021.
  4. Ghebreyesus TA. Addressing mental health needs: an integral part of COVID‐19 response. World Psychiatry. 2020; 19(2):129.
  5. Ojiaku CM, Iorfa S, Mefoh PC, Ezeuzo O, Odinko IC. COVID-19-Induced Anxiety and Covid-19 Precautionary Measures as Predictors of Mental Wellbeing of Nigerians. International Journal of Behavioral Sciences. 2020; 14(3):149-54. doi: 10.30491/ijbs.2020.239210.1342.
  6. Bong C-L, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A. The COVID-19 pandemic: effects on low-and middle-income countries. Anesthesia and analgesia. 2020;131(1):86-92. doi:10.1213/ANE.0000000000004846
  7. Cénat JM. The vulnerability of low-and middle-income countries facing the COVID-19 pandemic: The case of Haiti. Travel medicine and infectious disease. 2020; 37:101684. doi:10.1016/j.tmaid.2020.101684.
  8. Asmundson GJ, Taylor S. How health anxiety influences responses to viral outbreaks like COVID-19: What all decision-makers, health authorities, and health care professionals need to know. Journal of anxiety disorders. 2020; 71:102211. doi:10.1016/j.janxdis.2020.102211.
  9. Bajema KL, Oster AM, McGovern OL, Lindstrom S, Stenger MR, Anderson TC, et al. Persons evaluated for 2019 novel coronavirus—United States, January 2020. Morbidity and mortality weekly report. 2020; 69(6):166-170.
  10. Jawhara S. How to boost the immune defence prior to respiratory virus infections with the special focus on coronavirus infections. Gut Pathogens. 2020; 12(1):1-6. doi:org/10.1186/s13099-020-00385-2.
  11. Basharpoor S, Heydarirad H, Atadokht A, Daryadel SJ, Nasiri-Razi R. The role of health beliefs and health promoting lifestyle in predicting pregnancy anxiety among pregnant women. Iranian Journal of Health Education and Health Promotion. 2015; 3(3):171-180.
  12. People H. The Surgeon General’s Report On Health Promotion and Disease Prevention. US Department of Health, Education, and Welfare. Public Health Service, Office of the Assistant Secretary for Health and Surgeon General Washington, DC: US Government Printing Office. 1979.
  13. Kelly MP. Health promotion in primary care: taking account of the patient's point of view. Journal of Advanced Nursing. 1992; 17(11):1291-1296.
  14. Mohammadi Zeidi I, Pakpour Hajiagha A, Mohammadi Zeidi B. Reliability and validity of Persian version of the health-promoting lifestyle profile. Journal of Mazandaran University of Medical Sciences. 2012; 21(1):102-113.
  15. Siboni FS, Alimoradi Z, Khatooni M, Atashi V. The role of health promotion behavior in controlling anxiety and stress in patients with hypertension. ARYA Atherosclerosis. 2012:208-211.
  16. Afsahi F, Kachooei M. Comparison of Health-Promoting Lifestyle and Health Locus of Control in Individuals with Hypertension and Healthy Individuals. International Journal of Behavioral Sciences. 2019; 13(3):111-116.
  17. Fadaei M. The relationship between lifestyle and the meaning of life in Alfred Adler’s thought. J Res Bull Lifestyle. 2016; 2(3):65-76.
  18. Ghanbari Sartang A, Dehghan H, Abbaspour Darbandi A. A review of health promotion lifestyle comparisons in shift and non-shift nurses. Journal of Rehabilitation in Nursing Research. 2015; 2(2):32-38.
  19. Najjarnasab S, Dashbozorg Z. The effect of motivational interviewing on health promoting lifestyles and blood pressure of women with eating disorders. Quarterly journal of health psychology. 2019; 8(31):103-118. doi: 10.30473/hpj.2019.40367.4005
  20. Singer JE. The need to measure life style. International Review of Applied Psychology. 1982.
  21. Hui W-HC. The health-promoting lifestyles of undergraduate nurses in Hong Kong. Journal of professional nursing. 2002; 18(2):101-111. doi:10.1053/jpnu.2002.32346
  22. Shaban M, Mehran A, Taghlili F. Relationship between perception of health concept and health promoting behaviors: A comparative study among Tehran university medical and non-medical Students. 2007 ; 13 (3) :27-36.
  23. Walker SN, Sechrist KR, Pender NJ. Health promotion model-instruments to measure health promoting lifestyle: Health-promoting lifestyle profile [HPLP II] (Adult version). 1995.
  24. Diaz-Godiño J, Fernández-Henriquez L, Peña-Pastor F, Alfaro-Flores P, Manrique-Borjas G, Mayta-Tovalino F. Lifestyles, depression, anxiety, and stress as risk factors in nursing apprentices: a logistic regression analysis of 1193 students in Lima, Peru. Journal of environmental and public health. 2019;7395784. doi:10.1155/2019/7395784
  25. Norouzinia R, Aghabarari M, Kohan M, Karimi M. Health promotion behaviors and its correlation with anxiety and some students’ demographic factors of Alborz University of Medical Sciences. Journal of health promotion management. 2013; 2(4):39-49.
  26. Atadokht A, Rahimi S, Valinejad S. The Role of Health Promoting Lifestyle and Religious Orientation in Predicting Quality of Life and Death Anxiety in Elders. Aging Psychology. 2018; 4(2):143-154.
  27. Fathi A, Sadeghi S, Maleki Rad A A, Rostami H, Abdolmohammadi K. Effect of Health-promoting Lifestyle and Psychological Well-being on Anxiety Induced by Coronavirus Disease 2019 in Non-medical Students. J Arak Uni Med Sci. 2020; 23 (5):698-709.
  28. Delavar A. Probability and applied statistics in psychology and educational sciences. Tehran: Roshd Publication. 2011.[persion]
  29. Walker SN, Kerr MJ, Pender NJ, Sechrist KR. A Spanish language version of the Health-Promoting Lifestyle Profile. Nursing research. 1990; 39(5):268-273.doi: 10.1097/00006199-199009000-00003.
  30. Shekari O, Tamizi N, Pour Shahriyar H, Abdollah Poor M, Akhavi Z, Lavaf H. Psychometric Properties Of Health-Promoting Life Profile-Ii Among University Students. Training Measurement. 2015; 6(21):41-60.
  31. Alipour A, Ghadami A, Alipour Z, Abdollahzadeh H. Preliminary validation of the Corona Disease Anxiety Scale (CDAS) in the Iranian sample. Quarterly Journal of Health Psychology. 2020; 8(32):163-75. doi: 10.30473/hpj.2020.52023.4756.
  32. Júnior JG, de Sales JP, Moreira MM, de Lima CKT, Neto MLR. Spiritual beliefs, mental health and the 2019 coronavirus (2019-nCoV) outbreak: what does literature have to tell us? Frontiers in Psychiatry. 2020; 11. 570439. doi:10.3389/fpsyt.2020.570439
  33. Hill PC, Pargament KI. Advances in the conceptualization and measurement of religion and spirituality: Implications for physical and mental health research. American psychologist. 2003; 58(1):64-74.doi:10.1037/0003-066x.58.1.64.
  34. Loewenthal KM. Mental health and religion: Chapman & Hall; 1995.
  35. Seybold KS, Hill PC. The role of religion and spirituality in mental and physical health. Current directions in psychological science. 2001; 10(1):21-24. doi:10.1111/1467-8721.00106
  36. De Freitas Melo C, Sampaio IS, de Abreu Souza DL, dos Santos Pinto N. Correlação entre religiosidade, espiritualidade e qualidade de vida: uma revisão de literatura. Estudos e Pesquisas em Psicologia. 2015; 15(2):447-464.