High prevalence of obesity among nursing personnel working in tertiary care hospital

Prevalence of overweight and obesity among nurses in Bahrain: A cross-sectional study

AIM

This study aims to estimate the prevalence of overweight and obesity among nurses in Bahrain.

DESIGN

A cross-sectional design.

METHODS

A secondary data from a convenience sample of 550 nurses working in three hospitals in the Kingdom of Bahrain. The prevalence of overweight and obesity was determined by calculating the percentages of BMI using the World Health Organization classification.

RESULTS

Most participants were females (n = 488, 89.1%), ages 31 to 40 (n = 239, 43.8%). The mean BMI was 26.9 (±4.4). The prevalence of overweight and obesity was 43.2% and 21.4%, respectively. The prevalence of overweight and obesity is associated with nationality and shift work. We used BMI to estimate the prevalence of overweight and obesity. However, BMI does not consider muscle mass, bone density, body composition, and racial and sex differences. Therefore, in future studies, body fat proportion and muscle mass need to be measured to estimate the prevalence and predict risks.

The global prevalence of overweight and obesity among nurses: A systematic review and meta-analyses

BACKGROUND

Several studies have reported the prevalence of overweight and obesity in various countries but the global prevalence of nurses with overweight and obesity remains unclear. A consolidation of figures globally can help stakeholders worldwide improve workforce development and healthcare service delivery.

OBJECTIVE

To investigate the global prevalence of overweight and obesity among nurses.

DESIGN

Systematic review with meta-analysis.

SETTING

29 different countries across the WHO-classified geographical region.

PARTICIPANTS

Nurses.

METHODS

Eight electronic databases were searched for articles published from inception to January 2023. Two independent reviewers performed the article screening, methodological appraisal and data extraction. Methodological appraisal was conducted using Newcastle-Ottawa Scale (NOS). Inter-rater agreement was measured using Cohen's Kappa. Meta-analyses were conducted to pool the effect sizes on overweight, obesity and waist circumference using random effects model and adjusted using generalised linear mixed models and Hartung-Knapp method. Logit transformation was employed to stabilise the prevalence variance. Subgroup analyses were performed based on methodological quality and geographical regions. Heterogeneity was assessed using the I2 statistic.

RESULTS

Among 10,587 studies, 83 studies representing 158,775 nurses across 29 countries were included. Based on BMI, the global prevalence of overweight and obesity were 31.2% (n = 55, 95% CI: 29%-33.5%; p < .01) and 16.3% (n = 76, 95% CI: 13.7%-19.3%, p < .01), respectively. Subgroup analyses indicated that the highest prevalence of overweight was in Eastern Mediterranean (n = 9, 37.2%, 95% CI: 33.1%-41.4%) and that of obesity was in South-East Asia (n = 5, 26.4%, 95% CI: 5.3%-69.9%). NOS classification, NOS scores, sample size and the year of data collected were not significant moderators.

CONCLUSIONS

This review indicated the global prevalence of overweight and obesity among nurses along with the differences between regions. Healthcare organisations and policymakers should appreciate this increased risk and improve working conditions and environments for nurses to better maintain their metabolic health.

PATIENT OR PUBLIC CONTRIBUTION

Not applicable as this is a systematic review.

REGISTRATION

PROSPERO (ref: CRD42023403785) https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=403785.

TWEETABLE ABSTRACT

High prevalence of overweight and obesity among nurses worldwide.

Lifestyle behaviors and stress are risk factors for overweight and obesity in healthcare workers: a cross-sectional survey

BACKGROUND

Overweight and obesity have become major public health concerns worldwide. Persistent stress can activate the human hypothalamic‒pituitary‒adrenal axis (HPA) and increase the intake of "self-rewarding food", thereby raising the incidence of obesity. Health care workers (HCWs) experience higher workloads and mental stress than workers in many other industries, which may put them at increased risk for overweight/obesity. However, few studies have been carried out on overweight and obesity among HCWs in China, and the overall scenario and behind-the-scenes factors of their overweight and obesity are unknown. The aim of this study is to understand the epidemic of overweight and obesity and risk factors among Chinese HCWs.

METHODS

Based on a cross-sectional web survey design, 23,234 HCWs from 100 health institutions in 5 provinces/autonomous regions/municipalities across China were sampled to answer a self-administered questionnaire that was purposely developed using a multi-staged clustered random-sampling method. Chi-square test and ANOVA were performed to compare variables between two or more groups. Univariate analyses were conducted to identify the influence of self-reported persistent stress and/or recurrent anxiety/depressed mood on lifestyle behaviors. A multivariate binary logistic regression model was used to analyse the risk factors of overweight/obesity.

RESULTS

Among the respondents, 34.26% were overweight, and 11.22% were obese. Most of the respondents had regular exercise habits (68.17%), had habitually stayed-up late (65.06%) and had been affected by persistent stress and/or recurrent anxiety/depressed mood (62.04%). A higher proportion of those with persistent stress and/or recurrent anxiety/depressed mood than those without habitually staying-up late (76.18%); consumed take-out food (54.92%), fried food (49.93%), snacks or desserts (50.51%); drank sugary drinks (46.57%); smoked (14.27%); and drank alcohol (23.34%). Gender (Female) (OR: 0.314, 95%CI: 0.292-0.336), age (OR: 1.742-2.334, 95%CI: 1.544-2.858), education (OR: 0.620-0.728, 95%CI: 0.445-0.973), living and working area (OR: 1.271, 95%CI: 1.192-1.355), breakfast (OR: 0.898, 95%CI: 0.839-0.960), fried food (OR: 1.133, 95%CI: 1.048-1.224), and alcohol consumption (OR: 1.111, 95%CI: 1.017-1.214) were factors for overweight/obesity. All of the aforementioned results were significant (P < 0.05).

CONCLUSIONS

The overweight/obesity rate of Chinese HCWs is rather high, which might be directly associated with lifestyle behaviors. However, these behaviors fundamentally originated from persistent stress and/or recurrent anxiety/depression, mediated by lifestyle behaviors. Substantial measures should be taken for stress reduction and mental health promotion for overweight/obesity prevention and control among HCWs.

Barriers and Facilitators of Diet, Physical Activity Levels, and Sleep Among Nursing Undergraduates and Early-Career Nurses: A Qualitative Descriptive Study

PURPOSE

Mechanisms leading to burnout, associated with high turnover in nursing, may start as early as in nursing school. Given health habits (e.g., diet, physical activity, and sleep) can exacerbate or lessen the impact of burnout, this study examined current barriers and facilitators to healthy diet, physical activity levels, and sleep among nursing undergraduates (UGs) and early-career nurses (ECNs).

RESEARCH DESIGN

Qualitative descriptive study.

SAMPLE

25 nursing UGs and 25 ECNs (within 3 years of graduation) from a Southeastern college of nursing.

DATA COLLECTION AND ANALYSIS

After development of theory-informed interview guides, participants conducted interviews either in-person or by phone, which were audio-recorded and transcribed. Braun and Clarke's six-step thematic analysis was used to analyze the transcripts.

RESULTS

All but one (aged 54) UG was in their early 20s and ECNs were in their early to mid-20s. Most participants were white, females. Time and stress were the strongest barriers among UGs and ECNs for adherence to healthy diet, physical activity, although stress did act as a facilitator for physical activity in a subset of both UGs and ECNs. Shiftwork was a common barrier to healthy behaviors among ECNs.

CONCLUSION

The fact that the more common and stronger barriers to healthier behaviors among UGs and ECNs were the same give credence to the idea that processes associated with burnout begin during or before nursing education and are persistent.

Effectiveness of Fit and Trimmed Staffs (FATS) program on weight management among the healthcare providers at Simpang Health Clinic, Perak: A pre-post interventional study

INTRODUCTION

Obesity is associated with an increased risk for non-communicable diseases. Local studies have shown that 33.1% of healthcare providers (HCPs) are overweight, while 21.1% are obese. Interventions that consist of diet, physical exercise and cognitive behavioural training have been shown to be successful in reducing weight.

METHOD

We designed a weight loss programme for our HCPs named the 'Fit and Trimmed Staff programme, which consisted of 3 months of group education on obesity-related health problems led by a doctor, a pharmacist, a nutritionist and an occupational therapist among HCPs. Monthly individual dietary counselling by a nutritionist was also provided for 6 months. We measured the body weight, body mass index, percentage of body fat, visceral fat and percentage of skeletal muscle of the HCPs before and after the intervention.

RESULTS

Forty-five (56.25%) HCPs at Simpang Health Clinic were either overweight or obese; the majority of them were drivers and administrative clerks (100%), followed by health attendants (69.2%) and medical assistants (63.6%). At 6 months post-intervention, there was a trend towards a non-significant reduction in the fat percentage (median=-0.8%, P=0.423). Approximately 42% (n=19) of the HCPs lost weight, while 58% gained weight. Weight loss was observed more commonly in the male HCPs (>50%) than in the female HCPs.

CONCLUSION

A weight loss programme solely consisting of health discussion and nutritional advice is inadequate to induce weight reductions. A multimodal approach may be considered in managing weight among HCPs.

Profile of Non-communicable disease risk factors among nurses in a tertiary care hospital in South India

PURPOSE

The work nature of nurses and the associated lifestyle changes put them at high risk of developing non-communicable diseases (NCDs). This study was conducted to estimate the prevalence of NCD risk factors among nurses working in a tertiary care hospital in Puducherry and to determine the associated factors among nurses.

METHODS

We conducted a cross-sectional study among all nurses (N=1217) in the tertiary care hospital aged between 21 and 60 from May 2019 to April 2020. We assessed NCDs behavioral, physical and biochemical risk factors using a self-administered questionnaire. The adjusted prevalence ratio was calculated using a generalized linear regression model to determine factors associated with NCD risk factors.

RESULTS

The response rate was 99% (1217/1229), and 77.5 % of the participants were women. Current tobacco use, and alcohol consumption were 1.5% (95% CI: 0.8-2.2) and 2.9% (95% CI: 2-3.9) respectively with significantly higher prevalence among men. Overweight or Obesity (BMI >23 kg/m2) was 77.7%, with a significantly higher prevalence among those aged ≥30 and married. Prevalence of hypertension was 14.4 % (95% CI: 12.5-16.4), and diabetes mellitus was 11.5 % (95% CI: 9.7-13.6) were significantly higher among those aged ≥50 years. One-third of nurses, 34.3% (95% CI: 31.6-37.1), had hypercholesterolemia, significantly higher among men.

CONCLUSION

We found a high prevalence of various NCD risk factors among the nurses. We highlight the urgent need for initiating health promotion interventions, especially to improve intake of healthy diet and physical activity among nurses aged ≥30 years.

The healthy/unhealthy dietary pattern is associated with resting metabolic rate status among women with overweight/obesity

BACKGROUND

Although various dietary patterns have been indicated to be associated with the resting metabolic rate [RMR], limited data are available in this field. This study was therefore focused on the association between dietary patterns and resting metabolic rate among participants with overweight and obesity.

METHODS

This cross-sectional study was conducted on 304 women with overweight or obesity (BMI ≥ 25 kg/m²), aged 18-50. Anthropometric assessments, physical activity and biochemical measurements were assessed. RMR was also measured by means of indirect calorimetry. Dietary intake of participants was evaluated by 147-item semi-quantitative food frequency questionnaire [FFQ].

RESULTS

There was a significant association between higher adherence to the healthy dietary pattern [HDP] and RMR (P = 0.05), intakes of protein (P = 0.003), minerals (P = 0.001) as well as fat free mass [FFM] (P = 0.002), bone mineral content (P = 0.001), skeletal muscle mass (P = 0.001), soft lean mass (P = 0.002) and visceral fat area (P = 0.05). Also, there was a considerable association between higher adherence to the unhealthy dietary pattern [UHDP] and fasting blood sugar [FBS] (P = 0.05). Using multinomial logistic regression has been shown that the medium adherence to the HDP was marginally significant with decreased resting metabolic rate [Dec. RMR] group in crude model (OR: 0.54; 95% CI: 0.28-1.05, P = 0.07). After controlling for various confounders such as age, FFM, physical activity, and energy intake, the association between Dec. RMR group and the lowest quartile of the HDP (OR: 0.36; 95% CI: 0.14-0.91, P = 0.03) became significant as well as the association between Dec. RMR group and medium adherence to the HDP (OR: 0.42; 95% CI: 0.18-0.97, P = 0.04). The medium adherence to the UHDP in crude model was also significant with increased resting metabolic rate [Inc. RMR] group (OR: 2.59; 95% CI: 1.01-6.65, P = 0.04).

CONCLUSIONS

Our study showed that there are significant associations between dietary patterns and RMR status.

Obesity among Health-Care Workers: Which Occupations Are at Higher Risk of Being Obese?

Obesity among health-care workers (HCWs) is an important issue as it can affect both their health condition and their professional capability. Although adult obesity is attributable to occupational factors, few reports are available on Malaysian health-care workers’ obesity and whether different health-care job categories are related to workers’ obesity. This study aimed to determine the prevalence of obesity among HCWs and the association between various HCW job categories and obesity. A cross-sectional study was conducted by analyzing secondary data from the 2019 annual cardiovascular health screening program, which included information regarding all government health-care workers in the east coast region of Peninsular Malaysia. The subject’s body mass index (BMI) was categorized according to WHO criteria. Only 43% of the subjects had a normal BMI, while 33.1% were categorized as overweight, and 21.1% were obese. Different HCWs’ job categories were shown to be significantly associated with their obesity status, with nurses apparently having a higher risk of being obese (Adj OR = 1.91, 95% CI 1.45, 2.53, p-value < 0.001). This study’s results require further exploration of HCWs’ working condition factors and for different job categories that contribute to obesity. Public health intervention programs to combat obesity should be implemented that primarily target HCW groups at the highest risk of obesity.

Nurses' physical activity exploratory study: Caring for you so you can care for others

BACKGROUND

Nurses report the greatest stress of all health care workers. Although physical activity (PA) is associated with health benefits among other populations, nurses have stressors that other occupations do not typically encounter. It is important for nurses to identify techniques for stress management since stressors negatively impact their health and patient care.

OBJECTIVE

We aimed to examine the relationship between PA levels and physical, mental, and occupational health among nurses.

METHODS

Nurses (N = 62) completed measures of anthropometrics, demographics, and domains of physical, mental, and occupational health. Pearson correlations determined the relationship between PA and measures health along with the relationship between PA and health among active versus inactive nurses.

RESULTS

Fatigue was significantly correlated with moderate-to-vigorous PA (r = -0.27, p < 0.05). Relationships were found between mental health and light and moderate intensity PA (r = 0.40, p < 0.001; r = 0.30, p < 0.05).

CONCLUSIONS

Stress is prevalent among nurses and negatively impacts a nurse's health along with patient care. Findings suggest health benefits associated with PA among nurses. PA interventions among nurses may be needed to fully see the effects of PA on physical, mental, and occupational health, and ultimately patient health and safety.

Shift work, and particularly permanent night shifts, promote dyslipidaemia: A systematic review and meta-analysis

BACKGROUND AND AIMS

Shift work is common worldwide and linked to deleterious cardiovascular effects that might be underlined by dyslipidemia. The aim of this systematic review and meta-analysis is to determine the impact of shiftwork on dyslipidemia.

METHODS

Searching in PubMed, Cochrane Library, Science Direct and Embase databases without language restriction on 15 February 2020, included studies that describe blood lipids levels or a risk measure in shift workers compared with fixed-day workers (controls). Differences by study-level characteristics were estimated using stratified meta-analysis by type of shift work, and meta-regression to examine relations between dyslipidemia and demographic, lifestyle and work characteristics. Estimates were pooled using random-effect meta-analysis.

RESULTS

We included a total of 66 articles, representing 197,063 workers. Shift work globally increased the levels of triglycerides (overall SMD = 0.09; 95CI 0.05 to 0.13; p < 0.001), and globally decreased the levels of c-HDL (-0.08; 95CI -0.12 to -0.03; p = 0.001). Permanent night shift workers were an at-risk type of shift for dyslipidemia with significantly higher blood levels of total cholesterol (0.22; 95CI 0.01 to 0.42; p = 0.043) and triglycerides (0.18; 0.03 to 0.33; p = 0.017), and significantly lower blood levels of c-HDL (-0.16; 95CI -0.32 to 0.00; p = 0.05). Permanent night shift workers were more at-risk for total cholesterol than rotating 3 × 8 shift workers (Coefficient 0.22; 95CI 0.01 to 0.42; p = 0.038) and rotating 2 × 12 shift workers (0.24; 0.02 to 0.46; p = 0.037), and more at-risk for triglycerides than rotating day shift workers (0.21; 95CI 0.03 to 0.38; p = 0.023). Results were non-significant for c-LDL, nor depending on type of shifts.

CONCLUSIONS

Shift work, and particularly permanent night shift, is associated with dyslipidaemia via elevated total cholesterol and triglycerides, and reduced HDL-cholesterol. Our current study provides a practical and valuable strengthening of the evidence-base required for preventive health initiatives and workplace reform.