ATTITUDE AND PRACTICE OF MENTAL HEALTH PROMOTION AMONG STUDENT NURSES IN EZEALA COLLEGE OF NURSING SCIENCES, OKWUDOR

TOPIC IS SUITABLE FOR:
1-Department of Nursing Science
2-Department of Public Health
3-Department of Psychology

TOPIC:  ATTITUDE AND PRACTICE OF MENTAL HEALTH PROMOTION AMONG STUDENT NURSES IN EZEALA COLLEGE OF NURSING SCIENCES, OKWUDOR

TABLE OF CONTENT
Abstract
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study
1.2 Statement of the Problem
1.3 Objectives of the Study
1.4 Research Questions
1.5 Research Hypothesis
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Operational Definition of Terms
CHAPTER TWO: LITERATURE REVIEW
2.1 Conceptual Review
2.2 Theoretical Review
2.3 Empirical Review
2.4 Summary of Literature Review
CHAPTER THREE: METHODOLOGY
3.1 Research Design
3.2 Research Setting
3.3 Target Population
3.4 Sample Size
3.5 Sampling Technique
3.6 Instrument for Data Collection
3.7 Validity and Reliability of Instrument
3.8 Pilot Study
3.9 Method of Data Collection
3.10 Method of Data Analysis
CHAPTER FOUR: DATA PRESENTATION, ANALYSIS AND INTERPRETATION
4.1 Data Presentation
4.2 Analysis
4.3 Test of Hypothesis
CHAPTER FIVE: DISCUSSION OF FINDINGS, CONCLUSION AND RECOMMENDATIONS
5.1 Discussion of Findings
5.2 Implications of Findings to Nursing
5.3 Limitations of the Study
5.4 Summary of the Study
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies
References
Appendix

ABSTRACT
This study was carried out to assess the attitude and practice of mental health promotion among student nurses in Ezeala College of Nursing Sciences, Okwudor. The study was specifically carried out to assess the attitude of student nurses towards mental health promotion in Ezeala College of Nursing Sciences, determine the level of practice of mental health promotion among student nurses in Ezeala College of Nursing Sciences, examine the mental health promotion activities commonly practiced by student nurses in Ezeala College of Nursing Sciences, and examine the factors influencing the practice of mental health promotion among student nurses in Ezeala College of Nursing Sciences. The study employed the descriptive survey research design. The study population comprised 420 student nurses enrolled at Ezeala College of Nursing Sciences, Okwudor, while a total of 205 respondents were selected as sample size using the Taro Yamane formula. Out of the 205 questionnaires distributed, 195 were returned and 195 were validated for analysis. The questionnaire was used for data collection, while the data collected were analyzed using frequency tables, percentages, and Pearson Product Moment Correlation (PPMC) with the aid of SPSS version 25. From the responses obtained and analyzed, the findings revealed that student nurses demonstrated positive attitudes toward mental health promotion as the majority agreed that mental health promotion is an important aspect of nursing practice, should be integrated into healthcare services, and contributes to improved wellbeing and stigma reduction. The study also showed that the level of practice of mental health promotion among student nurses was high, as respondents reported active participation in emotional wellbeing activities, stress management practices, healthy lifestyle behaviours, mental health information sharing, peer support, and awareness programmes. Likewise, participation in mental health awareness campaigns, physical exercise, attendance at seminars and workshops, peer support activities, relaxation and stress reduction activities, and seeking professional guidance were identified as the major mental health promotion activities commonly practiced by student nurses. The study further revealed that adequate knowledge of mental health promotion, availability of mental health education programmes, support from lecturers and clinical instructors, availability of mental health resources, academic workload, and institutional support significantly influence the practice of mental health promotion among student nurses. Furthermore, the hypothesis tested revealed that there is a significant relationship between attitude and practice of mental health promotion among student nurses at r = 0.68, t = 12.63, P = .000. The study concluded that student nurses in Ezeala College of Nursing Sciences possess positive attitudes toward mental health promotion and actively engage in mental health promotion practices. The study therefore recommends that nursing institutions should strengthen mental health education within the curriculum, provide regular mental health awareness programmes and counselling services, establish accessible support systems and mental health resources, and implement strategies that promote psychological wellbeing and reduce excessive academic pressure among student nurses.
Keywords: Mental Health Promotion, Attitude, Practice, Student Nurses, Mental Wellbeing, Nursing Education.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background of the Study
Mental health is an essential part of health and well-being, and it affects how people think, feel, interact with others, and cope with life's challenges. Mental health has become a growing focus in the education sector around the world as it is recognized as a key factor in student success, social engagement, and overall development. Modern health care systems focus on prevention and promotion, helping to build psychological resilience and emotional stability, not just on treatment. Carvalho et al. (2024) found that awareness of mental health is a critical factor for fostering positive attitudes towards mental health and healthy behavioral decisions among students. In the same vein, Duraku et al. (2024) reported that awareness campaigns in school settings foster a more open attitude towards mental health issues and reinforce positive attitudes towards emotional well-being. The increasing focus on mental health promotion has thus become a key component in the promotion of public health, educational development and the development of healthier populations. This has made mental health promotion an important element of modern health care education and practice.
The growing awareness of mental health as an integral part of health care has broadened the role of the nurse from the care of physical disease to psychological care. Nursing education thus gives significant attention to developing competence in skills that facilitate comprehensive care. Bakare et al. (2021) reported that mental health related training creates positive attitudes towards mental illness and enhances preparedness of nursing students for the workplace. Additionally, according to Valentim et al. (2023), nursing undergraduates are more aware of the importance of mental health promotion in professional practice and community engagement. Educational interventions have also proven effective in promoting positive attitudes towards mental health problems among nursing students (Juliá-Sanchís et al., 2024). The attitudes of nursing students are more relevant as they learn professional values and clinical skills, as attitudes can affect the future caregiving behaviors, interpersonal relationship with patients, and involvement in health promoting activities in health care contexts.
Positive attitudes towards mental health promotion are a natural progression towards the actual delivery of mental health promoting activities. The practices of mental health promotion among nursing students involve a wide range of behaviors, such as stress management, peer support, health education, self-care behaviors, activities involving resilience, and participation in awareness campaigns. According to Martinez et al. (2025), activities that foster resilience contribute to enhanced mental well-being among nursing students. Similarly, Russell et al. (2025) emphasized the significance of mental health promotion interventions, particularly those facilitated by nurses, in educational settings. Patterson et al. (2024) and Moxham et al. (2024) found evidence that experiential learning experiences and clinical exposures can influence behavioral orientations towards mental health-related practices. Moreover, Al-Najdi et al. (2025) highlighted that healthcare students often employ different strategies to sustain their psychological well-being and facilitate emotional functioning. Overall, these activities highlight the importance of mental health promotion in nursing education and reinforce the practical aspects of mental health promotion.
Attitudes and practices remain a key focus in mental health promotion and it has become more common to explore these attributes within the context of student nurses in particular educational institutions. Educational experiences, personal beliefs, professional socialization, and involvement in mental health-related activities can all have an impact on the effectiveness of mental health promotion. Farooq et al., (2021) highlighted that attitude towards mental health can influence the behavioral tendencies towards mental health engagement among nursing students. Favorable dispositions towards mental well-being among students pursuing health-related disciplines were also pointed out by Anosike et al. (2022). Individual and environmental factors in educational contexts have also been linked to mental health promotion (Bibire, 2024). Muda and Raphaie (2025) and Khan et al. (2026) also noted that personal and social factors might affect mental health-related behaviors among university students. In this context, it is appropriate to study the attitude of student nurses towards mental health promotion, level of practice, the most common mental health promotion activities practiced and the factors that affect the practice of mental health promotion among the students of Ezeala College of Nursing Sciences, Okwudor.

1.2 Statement of the Problem
Promoting mental health is a critical part of the nursing curriculum as student nurses are expected to acquire the necessary skills to contribute to their personal health and overall care of the patient. While there is significant focus on psychological wellness and mental health awareness in nursing curricula, the evidence to date indicates that positive knowledge does not always lead to positive attitudes and regular mental health promotion practices in nursing students. Stigma related perceptions continue to affect attitudes towards mental health and help seeking among nursing students (Farooq et al., 2021). Likewise, Moxham et al. (2024) found that some nursing students have concerns about mental health engagement, and Valentim et al. (2023) found that undergraduate nursing students have a mixed perception of mental health problems. These differences highlight the need for concern about how much student nurses internalize as a professional and personal commitment to mental health promotion.
There is a growing interest in mental health awareness, stigma reduction, resilience development and psychological wellness of students in health-related disciplines in the current literature. Carvalho et al. (2024), Duraku et al. (2024), and Juliá-Sanchís et al. (2024) emphasized the importance of mental health promotion programs in educational settings. Moreover, Martinez et al. (2025) highlighted the significance of resilience-building activities for improving student mental well-being and Russell et al. (2025) discussed the efficacy of mental health promotion interventions in educational environments. However, the existing literature mostly focuses on awareness, stigma and outcomes of interventions, and little attention has been paid to the extent of mental health promotion activities that student nurses actually undertake, or to the activities being undertaken in their training institutions. This raises doubts about how far mental health promotion principles are transferred to everyday behaviours of nursing students.
The other topic that needs attention has to do with the factors affecting the practice of mental health promotion by student nurses. The current literature indicates that educational experiences, personal beliefs, social influences, and institutional environments can influence attitudes and behavioral patterns that are associated with mental health promotion (Bibire, 2024; Patterson et al., 2024). Al-Najdi et al. (2025) also reported that healthcare students face a variety of psychological and academic pressures which can impact their involvement in wellness-related activities. But the factors that can help or hinder mental health promotion practices among student nurses in many nursing institutions are not well documented. Thus, there is little empirical evidence on the interaction of these factors and their impact on students' engagement in mental health enhancing behaviors.
The need for this study thus becomes imperative in order to gather empirical data on attitude and practice of mental health promotion among the students nurses in Ezeala College of Nursing Sciences, Okwudor. In particular, this study aims to find out student attitudes towards mental health promotion, their level of practice, commonly practiced mental health promotion activities, and factors affecting the practice. The results of this study will yield institution-specific data that can be used to improve mental health promotion initiatives for student nurses and help inform the development of strategies to promote positive mental health behaviors in nursing education.
1.3 Objective of the Study
The aim of this objective is to examine the attitude and practice of mental health promotion among student nurses in Ezeala College Of Nursing Sciences, Okwudor
The specific objectives are: 
1.Assess the attitude of student nurses towards mental health promotion in Ezeala College of Nursing Sciences.
2.Determine the level of practice of mental health promotion among student nurses in Ezeala College of Nursing Sciences.
3.Examine the mental health promotion activities commonly practiced by student nurses in Ezeala College of Nursing Sciences.
4.Examine the factors influencing the practice of mental health promotion among student nurses in Ezeala College of Nursing Sciences.
OTHER PARTS OF CHAPTER ONE INCLUDE:
1.4 Research Questions
1.5 Research Hypotheses
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Operational Definition of Terms

CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of mental health, the concept of mental health promotion, attitudes towards mental health promotion, practices of mental health promotion, factors influencing mental health promotion, and mental health promotion among student nurses. The chapter covers the following subheadings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Research Design: The study adopted a descriptive survey research design.
Population of the Study: The population of the study comprises all 420 student nurses enrolled at Ezeala College of Nursing Sciences, Okwudor, Imo State.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 205 participants.
Sampling Technique: The study employed a stratified and purposive sampling technique to select the individual respondents.
Research Instrument: The study utilized a structured questionnaire as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies, percentages, means, and standard deviations to summarize and present the demographic characteristics of the respondents and their responses. Inferential statistics, specifically Pearson Product Moment Correlation (PPMC), were used to test the hypothesis.

CHAPTER FOUR; DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that student nurses in Ezeala College of Nursing Sciences, Okwudor, have a positive attitude toward mental health promotion, as evidenced by the majority of respondents (176) agreeing that mental health promotion is an important aspect of nursing practice, while 181 respondents agreed that knowledge of mental health promotion is essential for every nursing student. The findings indicate that student nurses recognize the importance of mental health promotion in nursing practice, healthcare delivery, and the reduction of stigma associated with mental illness.

ii. The study found that the level of practice of mental health promotion among student nurses in Ezeala College of Nursing Sciences is high, as evidenced by 168 respondents agreeing that participation in activities that support emotional well-being is common among student nurses, while 171 respondents agreed that student nurses encourage peers to seek help when experiencing emotional difficulties. The findings indicate that student nurses engage in stress management, healthy lifestyle practices, mental health information sharing, peer support, and mental health awareness programmes.

iii. The study found that mental health awareness campaigns, physical exercise, seminars and workshops, peer support activities, relaxation and stress reduction practices, and seeking professional guidance are the major mental health promotion activities commonly practiced by student nurses in Ezeala College of Nursing Sciences. This was evidenced by 171 respondents agreeing that participation in mental health awareness campaigns is common, while 170 respondents agreed that physical exercise and seeking professional guidance on mental health matters are commonly practiced or encouraged among student nurses.

iv. The study found that adequate knowledge, availability of mental health education programmes, support from lecturers and clinical instructors, availability of mental health resources, academic workload, and institutional support are major factors influencing the practice of mental health promotion among student nurses in Ezeala College of Nursing Sciences. This was evidenced by 176 respondents agreeing that adequate knowledge influences mental health promotion practices, while 175 respondents agreed that mental health education programmes, lecturers' support, available resources, and institutional support influence such practices.

v. The study found that a significant positive relationship exists between attitude and practice of mental health promotion among student nurses in Ezeala College of Nursing Sciences, as evidenced by a correlation coefficient (r) of 0.68, t-value of 12.63, and p-value of 0.000 (p < 0.05). The corresponding hypothesis test led to the rejection of the null hypothesis, indicating that positive attitudes toward mental health promotion are significantly associated with increased practice of mental health promotion activities among student nurses.

CHAPTER FIVE:DISCUSSION OF FINDINGS, CONCLUSION AND RECOMMENDATIONS
This chapter covers the following outline:
5.1 Discussion of Findings
5.2 Implications of Findings to Nursing
5.3 Limitations of the Study
5.4 Summary of the Study
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies

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