About Us

We are a group of Year 2 Occupational Therapy students conducting our statistics project on the relationship between frequency of physical exercise and emotional well-being. Physical well-being has shown to improve the physiological aspects of an individual. However, there is limited research with regards to physical exercise influencing one's emotional well-being. Furthermore, we believe that emotional well-being is an essential aspect of a person especially in this time and age where a large number of individuals are experiencing an increased amount of stress. Hence, hope our research would provide you guys with insight in relation to our topic.

Principal Investigators

Amelia Lim

Jacqueline Sajita Fernandez

Neo Yun

Vivian Siew

Review of Literature

#1 Title: Effects of physical activity on emotional well-being among older Australian women: cross-sectional and longitudinal analyses.

Author: Christina Lee and Annie Russel
Published: Journal Of Psychosomatic Research, Volume 54, Issue 2
Retrieved from: http://www.sciencedirect.com/science/article/pii/S0022399902004142

Synopsis:

The objective of the study is to explore relationships between physical activity and mental health cross-sectionally and longitudinally in a large cohort of older Australian women (aged 70-78).
Cross-sectional data were analyzed for 10,063 women and longitudinal data for 6472 who participated in the Australian Longitudinal Study on Women's Health responded in 1996 and 1999. Self-reports were used to categorize women into four categories of physical activity at each time point as well as to define four physical activity transition categories across the 3-year period. Outcome variables for the cross-sectional analyses were the mental health component score (MCS) and mental health subscales of the Medical Outcomes Study Short Form (SF-36). The longitudinal analyses focused on changes in these variables. Confounders included the physical health component scale (PCS) of the SF-36, marital status, body mass index (BMI) and life events.

Physical activity is associated with emotional well-being among a population cohort of older women both cross-sectionally and longitudinally, supporting the need for the promotion of appropriate physical activity in this age group.

How is this relevant to us
The study shows that physical activity is associated with emotional well-being. The research shows that there is an association between physical activity and mental health. However, this study is done on Australian women who are in their 70s. It remains to be seen whether the results can be generalised to our OT students who are younger. Also this study was done in Australia, and the results of the study may not be generalisable to a Singapore context. Also we feel that the SF-36 is not a suitable scale to be used as it focuses on multiple areas, and only has a few questions on each area compared to other scales which are more focused on measuring emotional well-being.

#2
Title: Physical fitness, health behaviour and health among nursing students: A descriptive correlational study
Author:
Piyanee Klainin-Yobas,  Hong-Gu He,  Ying Lau  (2015)
Published: Nurse Education Today, Volume 35, Issue 12
Source: http://ac.els-cdn.com.libproxy.nyp.edu.sg/S026069171500266X/1-s2.0-S026069171500266X-main.pdf?_tid=40b117da-3108-11e6-a937-00000aab0f6b&acdnat=1465782399_9499b2aab71d1b91fbedd8814d7368d9


Synopsis:
This study aims to examine the relationships among health behaviour, personal variables, physical fitness, perceived physical health and psychological health. A cross-sectional descriptive correlational study was done on 335 nursing students who were enrolled in a university in Thailand. Data were collected by self-administered questionnaires and physical fitness tests. Independent variables were personal variables and health behaviour. Outcome variables included physical fitness, perceived physical health and psychological health.

Students who exercised regularly tended to have better physical fitness, perceived physical health and psychological health.

How this is relevant to us
Students of nursing in Thai and students of Occupational Therapy in NYP experience very different stressors in life, hence there are too many extraneous variables in this study to be generalised to the OT cohort in NYP.

In addition, the Thai-version General Health Questionnaire is used to identify minor psychiatric disorder, which is not really what we want to measure. A person with low emotional well-being does not mean that he/she has a psychiatric disorder hence the general health questionnaire might not be sensitive enough to detect low emotional well-being.

However, this article provides us with the hypothesis that there might be a relationship between exercise and emotional well-being as even though the variables may differ there can be some similarities such as the frequency of physical activity and psychological health which consists components of emotion.

Thus, the difference in variables and target population prompts us to carry out the topic we have selected. Furthermore, there are limited research with regards to the topic in Singapore and amongst NYP OT students.


#3
Title: Physical activity and quality of life among university students: exploring self-efficacy, self-esteem, and affect as potential mediators
Author: Rodney P. Joseph, Kathryn E. Royse, Tanya J. Benitez, Dorothy W. Pekmezi
Published: Quality of Life Research, Volume 23, Issue 2


Source http://link.springer.com/article/10.1007/s11136-013-0492-8


Synopsis:
Physical activity (PA) has been shown to enhance quality of life (QOL) in older adults. Findings from these studies indicate that the relationship between PA and QOL is indirect and likely mediated by variables such as physical self-esteem, exercise self-efficacy, and affect. As PA varies greatly by age, the purpose of the current study is to extend this area of research to young adults and explore the complex relationship between PA and QOL in this target population.Several studies have indicated positive relationships between physical activity (PA) and exercise self-efficacy, physical self-esteem, and affect in this population however, few studies have examined the influence of these variables on overall satisfaction with life. 604 participants were recruited from undergraduate classes. The data collection questionnaire was comprised of five demographic variables (age, sex, race, height, and weight), and 42 items taken from previously published scales representing the constructs in our hypothesized model. A description of each of the measures is provided below.

- Physical activity was measured by the Godin Leisure Time Exercise Questionnaire, a 4-item scale that assesses episodes, intensity, and duration of PA during a typical 7-day period.
Quality of life

- Bradburn Affect Balance Scale (ABS) was used to assess both positive and negative affects. The scale, which consists 10 items, lists a number of feeling states and asks respondent to indicate using a ‘‘yes/no’’ format if they have experienced certain feelings over the past few weeks.

- The 5-item Satisfaction with Life Scale (SWLS) was used to assess QOL.

- Physical self-esteem was measured by the 6-item Physical Self-Worth Scale (PSWS) from Fox and Corbin’s Physical Self-Perception Profile.

- Self-efficacy was assessed using the Exercise Self-Efficacy Scale

Results indicated that PA was only weakly related to positive and negative affects. These findings were somewhat surprising given the body of research that supports the relationship between PA and positive affective outcomes. A possible explanation for these discrepant findings could be measurement issues (e.g., the low reliability estimates demonstrated by the Affect Balance Scale).


How is it relevant to us:

The main aim of the study investigated the relationship between the level of physical activity (PA) and quality of life (QOL). Relationships between PA and positive and negative affect was also analysed. The study made use of the mediation model proposed by Elavsky et al. that can be seen above which proposes positive correlations between PA and measurements of affect. While the study results showed weak relations between PA and both positive and negative affect and does not support previous theoretical findings, the discrepancy was attributed to the use of the Affect Balance Scale which has low reliabilities. We have to take this into account in our choice of assessment to measure emotional wellbeing.

Introduction to Study

Project Title

A study on the relationship between frequency of physical exercise and emotional well-being

Need for study

OT students are constantly experiencing high levels of stress due to the intensive curriculum. By finding out if exercising increases emotional well-being, it serves as an outlet to relieve their stress levels and ensures emotional regulation. At the same time, it targets physical health as well.

OT students are an important part of the future healthcare workforce. Poor health behavior is linked to physical and psychological problems that may result in an increasing number of students quitting the course resulting in a further shortage of occupational therapists who are in high demand at this period of time.

Hypothesis

Null Hypothesis
There is no relation between frequency of physical exercise and emotional well-being

Alternate Hypothesis

There is a positive relationship between frequency of physical exercise and emotional well-being. (i.e an increase in frequency of exercise would lead to better emotional well-being)

Constructs

Independent variable: Frequency of physical exercise (measured by Godin Leisure Time Scale)

Dependent variable: Emotional Well-being (measured by the Warwick-Edinburgh Mental Wellbeing Scale)

Extraneous variable: Age, Gender, Stressful Events in past 2 weeks

Defining Variables

Physical exercise: Physical activity in daily life can be categorized into occupational, sports, conditioning, household, or other activities. Exercise is a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness. (Caspersen, Powell & Christenson, 1985)

Emotional well-being: A positive sense of wellbeing which enables an individual to be able to function in society and meet the demands of everyday life. (Mental Health Foundation, 2016)

References

Caspersen, C. J., K. L. Powell, and G. M. Christenson. "Physical Activity, Exercise, and Physical Fitness: Definitions and Distinctions for Health-related Research." Physical Activity, Exercise, and Physical Fitness: Definitions and Distinctions for Health-related Research. (1985): 126-31.

Mental Health Foundation. (2016). About Mental Health. Retrieved June 13, 2016 from https://www.mentalhealth.org.uk/your-mental-health/about-mental-health

Operationalization: Selecting our measuring instruments

We have chosen to use the Godin Leisure-Time Exercise Questionnaire and the Warwick-Edinburgh Mental Wellbeing Scale as tools to measure our independent variable and dependent variable respectively.

Godin Leisure Time Questionnaire (GLTEQ)

The Godin Leisure Time Questionnaire (GLTEQ) is a self-report measure of the frequency of light-intensity, moderate-intensity, and vigorous-intensity leisure-time physical activity. Weekly MET values can be estimated by following the Godin and Shepard (1997) calculations.

• Target population: Adults; 18 to 65 years
• Burden: 4 questions; 7-day recall of leisure-time physical activity
• Validity: Construct validity is supported via predictive, concurrent, and convergent validity evidence.
• Reliability: Acceptable to strong test re-test reliability (1 week)

We have chosen to use the Godin Leisure-Time Exercise Questionnaire as it has been used in previous studies investigating similar relationships between physical exercise and emotional well-being. In addition, good test–retest reliability has been found in past studies with coefficients ranging between .74 and .80 (Joseph, Royse, Benitez & Pekmezi, 2013). This measure has also been validated with objective measures of physical activity such as accelerometers as well as other subjective physical activity measures such as the 7-day physical activity recall.

Figure 1: Godin Leisure-Time Exercise Questionnaire

Scoring of the Godin Leisure Time Questionnaire

For each category of exercise (Strenuous, Moderate, Light), the number of times it is done is multiplied by 9, 6 and 3 respectively. These scores are then added up to obtain a weekly leisure activity score. An example of the scoring can be seen in Figure 2.

Figure 2: Scoring of the Godin Leisure Time Questionnaire

Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)

The Warwick-Edinburgh Mental Well-being scale was developed to enable the monitoring of mental wellbeing in the general population and the evaluation of projects, programmes and policies which aim to improve mental wellbeing. WEMWBS is a 14 item scale with 5 response categories, summed to provide a single score ranging from 14-70. The items are all worded positively and cover both feeling and functioning aspects of mental wellbeing.

Though previous studies found used various assessments, some of these tools were not selected due to their low reliability and variation in the constructs measured. In addition the Warwick-Edinburgh Mental Well-being scale has robust psychometric properties are robust and it is sensitive to the changes that occur in well-being promotion projects (Brown, 2012)

Various studies have shown that WEMWBS is normally distributed in the general population (although there is often a slight tail at the lower end) and hence can be used in parametric analyses. All the validation studies have shown WEMWBS to be easy to complete, and to capture concepts of wellbeing familiar to general and minority populations

Figure 3: Warwick-Edinburgh Mental Wellbeing Scale

Scoring of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS)

Each of the 14 item responses in WEMWBS are scored from 1 (none of the time) to 5 (all of the time) and a total scale score is calculated by summing the 14 individual item scores . The minimum score is 14 and the maximum is 70.  

References

Godin, G., Shephard, R. J.. (1997) Godin Leisure-Time Exercise Questionnaire. Medicine and Science in Sports and Exercise. 29 June Supplement: S36-S38.

Joseph, R. P., Royse, K. E., Benitez, T. J., & Pekmezi, D. W. (2013). Physical activity and quality of life among university students: Exploring self-efficacy, self-esteem, and affect as potential mediators. Qual Life Res Quality of Life Research, 23(2), 659-667. doi:10.1007/s11136-013-0492-8

Stewart-Brown, S. (2012). The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS): Performance in Different Cultural and Geographical Groups. Mental Well-Being, 133-150. doi:10.1007/978-94-007-5195-8_7  

Methodology

Sampling

Due to time constraints of the study, we chose to do accidental/convenience sampling. Our targeted population involved 54 Nanyang Polytechnic Students who are currently pursuing their Second Year in Diploma in Occupational Therapy here in Singapore.

Such a choice of target group allowed us to get efficient responses and results, allowing us to quickly analyse our results and to focus on more crucial aspects of our study.

Target population: Year 2 OT students in NYP

Population size: 54

The reasons for choosing Year 2 OT students in NYP is due to easy access. Also choosing Year 2 OT students would eliminate as many extraneous variables as possible. As stress may affect emotional well being, Year 2 students would likely experience similar stressful events as they are undergoing the same course and modules.

Data Collection

We disseminated the questionnaire and made a brief introduction regarding the purpose of our study. 2 questionnaires were sent out to the Year 2 OT cohort via email where they were expected to complete the questionnaire once. The 2 questionnaires are the Godin Leisure-Time Exercise Questionnaire and the Warwick-Edinburgh Mental Wellbeing Scale.

Valid responses:

Although we sent out the surveys via email to all 54 Year 2 Occupational Therapy Students, only 35 targeted respondents completed the survey, all the responses were accepted.

Analysis of data

We checked for normality of for  Weekly Leisure Activity Score (refer to figure 1) and Well-being (refer to figure 2) through the skewness of data. Looking at the data for Weekly Leisure Activity Score and well-being, we found that the skewness value lies within 2 standard deviations from the standard error of skewness. Hence, both of the variables are normally distributed.

Figure 1: Skewness of Weekly Leisure Activity Score data

Figure 2: Skewness of Well-being data

To double confirm the normality, we ran the Q-Q plots for both variables and found that most of the points close to or on the line (refer to figure 3 and 4).

Figure 3: Q-Q plot for Weekly Leisure Activity Score data

Figure 4: Q-Q plot for Well-being data

The scatter plot for Weekly Leisure Activity Score vs Well-being is ran and a weak positive relationship was found between the two variables (refer to figure 5).

Figure 5: Scatter plot for weekly Leisure Activity Score vs Well-being

Since our research question is a correlation question, and both our variables are continuous data, Pearson’s R was chosen to be the statistical test.

Running the Pearson's R, we found that the Pearson's R value is 0.113 (refer to figure 6). As the value is < 0.2, there is a very weak relationship. Looking at the R² value of 0.013, the data points are not well-fitted to the regression line. Together with scatter plot, there is a very weak positive relationship between the frequency of exercise and emotional well-being.

Looking at the P-value (refer to figure 6), the P-value is 0.524. Since P-value > 0.05, we will not reject H0 and conclude that there is no relationship between frequency of exercise and emotional well-being.  

Figure 6: Pearson's R value & P-value

Evaluation

Limitations

The construct of emotional well-being that we have addressed in our study is broad and hence, we have to be more specific with regards to what component we are exactly measuring to ensure the right assessment has been chosen. We used the Warwick-Edinburgh Mental Wellbeing Scale (WEMWS) in our study as in article 3 of our literature review, it is mentioned that the Bradburn Affect Balance Scale (ABS) might not have been a good measure for their experiment. However we failed to take into consideration that the constructs measured in the WEMWS might be different from the scales used in the other literature reviews, and there might not have been a correlation between the constructs as the questionnaire used would not have measured the specific components of emotional well-being we wanted.

Emotional well-being also proves to be a difficult construct to measure as extraneous variables such as stressful events play a role in influencing the results and these extraneous variables are hard to control.

In addition, as the 2 questionnaires have not been utilized in the same study before, the findings from other studies as presented in our literature review may not generalized to our study. Though the definition of the constructs might be similar, there might be discrepancies in terms of the questionnaires’ ability to measure these constructs. Hence, this might have affected the results of our study.

Improvements to be Made

Thus, to address the problem above we could have started off by comparing the questionnaires used in article 2 to those we were intending to use as a better gauge of whether they are measuring the same construct since the questionnaires in the article has evidence for providing the desired results.

Reflections

Group Reflection

Through this project, we have learned that statistics enable us to organize and evaluate data efficiently and effectively providing us with a comprehensive evaluation of results obtained. However, to be able to appreciate the benefits of statistics we had to stumble through some challenges. Firstly, as JC students we had a background to statistics, however what we learned currently had to be applied in a different context which proved to be slightly challenging for most of us. The first part of the project which involved carrying out the study was relatively easier as compared to entering and evaluating the data through the use of charts, graphs and tables obtained from the SPSS.

We also realized that it is not easy to reach out to our population through emails. Although we sent the questionnaires out by email twice, we only managed to get 35 replies out of 54 people in the population. This is probably due to the fact that those who did not respond might not have read what our study is about when it is sent through email or did not check their emails. In the future, when we require participants to take part in our studies, it might be a better idea to gather the sample or population together and brief them as listening to our study might actually pique their interest.

Usage of the SPSS was alright as we were able to follow the clear step-by-step instructions available in the Statistics book. However, we experienced difficulty in being able to select the appropriate test to evaluate the result and upon figuring out the test, analysis of results from the plots was a challenge as well. Fortunately, our supervising tutor guided us through which gave us a clearer understanding  and made the process of evaluation easier.

In general, as a group we were able to work well together where we tried our best to problem solve and provide suggestions whenever required to refine our study.

Individual Reflections

Jacqueline

Personally, I was a little demoralized at the start of the module, as I required more time to grasp the concept even with some background in JC. However, with time and coaching from my fellow group mates and classmates, the topics made more sense to me which enabled me to contribute more to my group especially with regards to the analysis of data. Hence, since my strength was not in evaluating data, I aided my group more in the research components of the study such as the literature review and questionnaire.

Neo Yun

Through this project, I got a sense of what it is like to carry out a project where we are in the shoes of the researchers whom we always relied on. It is not easy to think of a topic to carry out from scratch, review literature, gather participants and analyse the data but this project served as a taste of what to expect for our final year project. At first, the SPSS was very difficult to use but with more practice, I got to know of how useful it is to analyse data. I’m glad for our group members, who were encouraging and supported each other through difficult times during the project when we were unsure of our next course of action.

Amelia

I felt that the process of completing this project was a good learning experience and introduction to conducting a statistical study. Through the project, I was able to see a study, though small, from its conceptualization to the analysis of result. Along the way I have picked up more knowledge and insight about utilizing statistical tools such as the SPSS to analyze our research data. It has also helped me to appreciate the importance of in depth research especially during the conceptualization of our research hypothesis. Though challenging at times, I feel the project has further prepared me for the Final Year Project we will be doing in Year 3.

Vivian

Personally at the start, I was a little excited as I had always liked Statistics and Mathematics when I was in JC and Secondary School. However, when the project actually started, it turned out to be more difficulty than expected. Gathering data was already a challenge as we had to send out a second email as the first email has failed to garner sufficient responses. Keying in the results into SPSS was not that difficult but deciding which test to choose was at first a challenge. Also, things like running QQ plot to check for normality and checking r2 value for correlation were all very new to me. However, with the help of my group mates, I have managed to have a better understanding of Statistics which will be a great help for my FYP next year.