Medico-sociological study of the role of primary care nurses in motivating community residents for a healthy lifestyle

Abstract

Purpose: Despite the positive outcomes of the primary health care (PHC) reform in Ukraine and the growing implementation of a family-oriented model of service delivery, the level of adherence to healthy lifestyle (HLS) practices among adults remains insufficient.Only one-third of the population regularly follows key HLS principles. This study aimed to assess the contribution of primary care nurses to promoting adherence to HLS and to identify key barriers and motivators influencing health-related behaviors in two typical communities in central Ukraine: Lokhvytsia (Poltava region) and Stanyshivska (Zhytomyr region).Materials and methods: A cross-sectional medical-sociological survey was conducted in March 2025 among 330 respondents aged 18 to 69 years (mean age: 42.4 ± 0.6 years; 58,0% women) using a standardized 36-item questionnaire based on the WHO STEPS instrument, adapted for the Ukrainian context. The sample included 180 participants from Lokhvytsia and 150 from Stanyshivska. Data were processed using SPSS v29, including descriptive statistics, 95,0% confidence intervals (CI), relative errors (δ), and correlation analysis. The differences in the studied criteria were insignificant and did not affect the overall conclusions, so the results were summarized, which allowed for a combined interpretation of the materials. Additionally, qualitative insights were obtained through two focus group discussions with practicing primary care nurses from both regions to contextualize survey findings and capture practical experiences.Results: Over half of respondents (55.2%; 95,0%; CI: 49.7–60.6%) recognized adherence to HLS as the primary factor for improving health. However, only 42.1% (95,0%; CI: 36.9–47.5%) rated their own health status as «good», and 52.1% (95,0%; CI: 46.6–57.5%) admitted that they do not pay sufficient attention to their health. Chronic fatigue was reported by 66.1% of respondents and showed a significant correlation with low physical activity (r = 0.41; p < 0.01). Inadequate diet and insufficient physical activity were reported by 37.9% and 36.1% of participants, respectively. Respondents with obesity (BMI > 30 kg/m²) were three times more likely to suffer from chronic pain (OR = 3.2; 95,0%; CI: 1.7–5.9), which limited their ability to engage in preventive behaviors.Motivational factors for adopting HLS included physician advice or symptom exacerbation (32,0%), maintaining physical fitness (25,0%), desire for a fulfilling life and sustained work capacity (21,0%), saving on treatment costs (18,0%), and gaining knowledge and skills for health preservation (17,0%). Key barriers included chronic fatigue, lack of time, limited access to sports infrastructure, and an overload of conflicting health information. These factors often undermined respondents’ confidence in making informed decisions.Focus group results confirmed that nurses play a pivotal role in individual counseling, early risk detection, and tailoring educational efforts to patients’ psychological readiness for change.Conclusions: This study highlights the critical importance of integrating behavioral prevention strategies into routine PHC practices. Empowering nursing staff through continuous professional development and promoting intersectoral partnerships could significantly enhance the effectiveness of health promotion at the community level. Importantly, 85,0% of respondents expressed willingness to receive regular health tips and personalized content via mobile applications linked to their family clinics. These findings support the scaling-up of digital tools and nurse-led interventions to improve health behaviors. A follow-up study is planned for 2026 to evaluate long-term changes in individual practices and community-level health outcomes.