Physical fitness and health-related quality of life in nursing students: a cross-sectional study with a gender perspective

Health-related quality of life (HRQoL) is a key indicator of well-being among university students, who are often exposed to stress and unhealthy lifestyles. Students enrolled in nursing programs represent a specific subgroup within the university population, characterized by high academic demands and early exposure to health-related knowledge and practices. Although higher physical fitness (PF) levels have been associated with better HRQoL, the contribution of specific PF components and potential gender differences has been insufficiently explored. This study aimed to examine the association between PF and HRQoL in nursing students, with a focus on gender differences and the role of individual PF components across HRQoL dimensions. A cross-sectional analysis of 637 nursing students from two Spanish universities was conducted. HRQoL was assessed using the WHOQOL-BREF questionnaire. Self-reported PF was assessed using the International Fitness Scale (IFIS) questionnaire. Body mass index and parental education level were included as covariates. Partial correlations, analysis of covariance (ANCOVA), and linear regression analyses were performed. Higher PF levels were associated with better HRQoL across all dimensions. General PF, cardiorespiratory fitness (CRF), muscular strength (MS), and speed-agility showed the strongest associations with HRQoL. Men reported higher PF levels, greater psychological well-being, and higher overall QoL compared to women. Flexibility showed statistically significant associations with physical and psychological well-being in women, and weaker associations with life satisfaction and overall QoL in the total sample. Stronger associations between PF and HRQoL were observed for general PF, CRF, and MS, especially in analyses conducted among men. Higher levels of general PF and its core components are closely associated with most dimensions of HRQoL among nursing students. From a gender perspective, the observed sex-related patterns suggest the potential value of gender-sensitive interventions to improve HRQoL through PF within this population.