Correlations of Physical Activity, Body Mass Index, Shift Duty, and Selected Eating Habits among Nurses in Riyadh, Saudi Arabia

Enhancing the quality of life for physical therapists: insights from a cross-sectional study

Background

Physical Therapy profession is known for its demanding physical requirements. This increases the risk of attrition and work-related accidents and disorders that affect physical therapists' quality of life and work performance. This study aimed to evaluate the effect of physical activity level and other contributing factors on quality of life of physical therapists.

Methods

A cross-sectional study was conducted among practicing physical therapists (n = 258). The International Physical Activity Questionnaires-Short Form was used to measure physical activity levels and the World Health Organization Quality of Life Questionnaire short form was used to measure the quality of life among physical therapists. Data was collected through a self-administered online survey using Microsoft Forms.

Results

The eligible participants were 258 out of 297. The highest percentage of physical therapists had a moderate physical activity level (45.35%) and the median for overall quality of life score was 63.27(52.73-73.59). There was a significant positive correlation between physical activity and age with overall quality of life score (rs = 0.41, p < 0.001; rs = 0.13, p < 0.036) respectively and a significant negative correlation between body mass index and overall quality of life score (rs = -0.13, p < 0.04).

Conclusion

The results obtained revealed that physical therapists mostly have moderate physical activity level and relatively good perceived quality of Life. Furthermore, our study identified significant correlations between physical activity, age, body mass index, and the overall quality of life among practicing physical therapists.

Nurses' occupational physical activity and workload in a perioperative intensive care unit in Slovenia

The field of nursing includes heavy occupational physical demands, including walking and standing for longer periods of time, in addition to moving and lifting. As such, in the context of a typical work shift, many nurses generally achieve the World Health Organization's recommended 10,000 steps per day. This study aimed at estimating the daily physical activity and workload of nurses in a perioperative intensive care unit. The data sources for this study included data from the hospital information system on various procedures and interventions, and the Silva Ex3 Plus pedometers for measuring steps, kilometers, calories, and activity time across various shifts in a perioperative intensive care unit. Twenty nurses from Slovenia volunteered to participate in this observational study. Over 13 weeks, a nurse working an 8-hour shift walked an average of 5,938 steps (4.4 km). However, nurses who worked a 12-hour weekend day shift came very close to the World Health Organization's recommendation with an average of 9,003 steps (6.5 km). A total of 227 patients were admitted and an average of 80 nursing interventions were performed per day and there was a positive relationship between physical activity, workload, and patient admissions in the perioperative intensive care unit (p = 0.001). Results of this study could help managers better understand nurses' physical activity and workload during various shifts in the perioperative intensive care unit.

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.

The Relationship between Sociodemographic, Professional, and Incentive Factors and Self-Reported Level of Physical Activity in the Nurse Population: A Cross-Sectional Study

Research indicates that while nurses are aware of the benefits of physical activity (PA), their adherence to PA is low. The results of workplace interventions that increase PA are inconsistent. The study aim was identification the sociodemographic, professional, and incentive factors influencing nurses’ PA and investigation its relationship with the level of PA that they report. This study was based on observational cross-sectional research conducted among professionally active nurses working in a clinical setting (n = 350). The self-reported questionnaire was used to collect sociodemographic and employment data and motivators and barriers of participating in PA. The level of PA was assessed using International Physical Activity Questionnaire. The analysis revealed significant differences in the Total Physical Activity Score (TPAS) depending on the variables related to professional activity (working in a management position: p = 0.015; workplace: p = 0.01; shift type: p ≤ 0.002). Cluster analysis revealed that the most important statement in the group division about motivation was fear of the pain occurring after exercise. Nurses who were more motivated to be active showed a higher level of leisure-time PA than less motivated nurses. The recommendation of PA in the nursing population should be focused on increasing the leisure time PA, ensuring the appropriate time to recovery, and compliance with the principles of work ergonomics to prevent musculoskeletal disorders.

Exploring Female University Students' Participation in Physical Activity in Saudi Arabia: A Mixed-Methods Study

Background

The importance of physical activity in improving physical and mental health has been emphasized in many studies. Researchers in Saudi Arabia have reported an increase in physical inactivity among Saudis, especially among University female population. Current efforts in the field in Saudi Arabia have yet to explore barriers and facilitators that influence female University student's participation in physical activity. This study aims to provide an assessment of the situation regarding physical activity among female University students in Saudi Arabia.

Methods

This mixed method study preceded a participatory action research initiative. The first part of the mixed method consisted of a cross-sectional survey of 375 female University students in Saudi Arabia who completed the short form of the International Physical Activity Questionnaire. The second part consisted of semi-structured, in-depth interviews with 14 female University students and 16 female exercise trainers.

Results

Results showed that most participants (91%) spent more time in walking activity compared to moderate (66%) and vigorous activity (57%) for at least 10 min at a time over a period of 7 days. Results showed that 70% of participants did not meet the WHO recommendation of 150 min per week of moderate activity, while around 62% of participants did not meet the WHO recommendation of 75 min per week of vigorous activity. Barriers to participation included limited facilities for physical activities, academic workload, gender role, and the need to adhere to cultural standards. Facilitators included valuing positive results, general health concerns, and family support.

Conclusion

Knowledge gained from this study might support organizations and public health authorities to develop physical activity interventions that better address Saudi women's perceived needs. These findings are an important contribution to current knowledge in light of recent advances in women's rights in Saudi Arabia.

Barriers and Facilitators Associated with Physical Activity in the Middle East and North Africa Region: A Systematic Overview

Increasing physical inactivity levels in the Middle East and North Africa (MENA) region is a public health concern. We aimed to synthesize barriers and facilitators to physical activity and make appropriate recommendations to address physical inactivity. We conducted an overview of systematic reviews on physical activity barriers and facilitators in 20 MENA countries by systematically searching MEDLINE/PubMed and Google Scholar for systematic reviews published between 2008 and 2020. Our overview included four systematic reviews and 119 primary studies with data from 17 MENA countries. Lack of suitable sports facilities, time, social support and motivation, gender and cultural norms, harsh weather, and hot climate were the most commonly reported barriers to physical activity. Socio-demographic factors negatively associated with physical activity participation include advanced age, being female, less educated, and being married. Motivation to gain health benefits, losing/maintaining weight, being male, dietary habits, recreation, and increased Body Mass Index are positively associated with increased levels of physical activity. Interventions promoting physical activity in MENA should target schoolchildren, women and girls, working parents, and the elderly. Country-specific sociocultural and environmental factors influencing physical activity should be considered in the design of interventions. Current and future policies and national interventions must be consistently evaluated for effectiveness and desired outcomes.

Relationship between shift-work and life-style behaviors among emergency department nurses in Jordan

Shift-work can alter the nurses' lifestyle behaviors, which negatively influence health. This study is purposed to assess the relationship between shift-work and selected lifestyle behaviors including, dietary habits, physical activity, and nicotine dependence among Jordanian nurses who work at the emergency department. A cross-sectional, descriptive correlational design was used. A total of 275 Jordanian nurses from the emergency department of Jordanian hospitals participated in the questionnaire. The results showed that 50.2% of the nurses suffered from poor dietary habits, 81.8% of them were physically inactive, and 65.1% had nicotine dependence. There was a positive correlation between shift-work, dietary habits, physical activity, and nicotine dependence. Therefore, the effects of shift-work should be considered when planning and developing interventional programs to enhance nurses' health and promote healthy behaviors among nurses workforce during shift-work.

Discriminating Metabolic Health Status in a Cohort of Nursing Students: Protocol for a Cross-Sectional Study

BACKGROUND

Obesity is currently a worldwide health crisis. Nurses are integral members of the primary health care team and have an important role in managing obesity and administering physical activity (PA) for patients. However, research shows that nurses tend to be overweight or obese, have poor metabolic health, and do not meet PA recommendations. This is problematic because PA is linked to both physiological and psychological well-being and may also influence how nurses counsel their patients. Nursing students are the next generation of nurses; however, there is limited research examining PA (among other lifestyle factors) and metabolic health in nursing students.

OBJECTIVE

The goal of this research is to examine multiple lifestyle factors (including PA, nutrition, sleep, and stress) and determine whether these factors are associated with metabolic health in full-time undergraduate nursing students.

METHODS

An estimated 320 nursing students (18 years of age and older) will be assessed for their metabolic health. Metabolic status will be determined by measuring body mass index (BMI), waist-to-hip ratio (WHR), body fat percentage [skinfold measures (FitSystems Inc)], resting blood pressure [automated oscillatory (Omron Healthcare Inc)], and fasting blood glucose (glucometer). Lifestyle factors will also be measured, including PA and sleep [the International Physical Activity Questionnaire (IPAQ) and 7-day accelerometry (wGT3X-BT, Actigraph LLC)], nutrition [3-day diet log (Nutritionist Pro, Axxya Systems)], and stress [the Depression Anxiety Stress Scale, heart rate variability assessments, and salivary cortisol (ELISA, Eagle Biosciences)]. The association between metabolic status and PA, sleep quantity and quality, nutrition, and stress will be examined by linear regression analyses. Differences by year of study in metabolic health status, PA, sleep, nutrition, and stress will be examined by 1-way analyses of variance (ANOVAs). To determine the ability of PA, sleep, nutrition, and stress to discriminate prevalent overweight and obesity or poor metabolic status, logistic regression and receiver operating characteristic (ROC) curves will be constructed. Statistical analyses will be performed in Stata (version 16.1, StataCorp LLC).

RESULTS

Based on pilot data, we believe senior nursing students will have worse metabolic health (ie, higher BMI and WHR, increased body fat percentage, higher blood pressure, and increased fasting blood glucose) compared to first-year students. We hypothesize that poor PA participation, poor sleep quantity and quality, increased food intake, poor nutrition, and increased stress will be associated with worse metabolic health in full-time nursing students. The study received funding in February 2020. Due to the coronavirus disease 2019 (COVID-19) pandemic, work on this study has been delayed. We are currently completing our application for institutional research ethics approval. Data collection is projected to begin in January 2021, with data collection and analyses expected to be completed by May 2022.

CONCLUSIONS

This study will be the first published research to examine the relationship between lifestyle choices and metabolic status in nursing students attending a Canadian institution. More importantly, the results of this study will support the development of an informed intervention that will target the identified lifestyle factors, improving the physiological and mental health and well-being of nursing students.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/21342.

Association between shift work and obesity among nurses: A systematic review and meta-analysis

BACKGROUND

The association of shiftwork and the risk of obesity in nurses has been inconsistent in the literature.

OBJECTIVES

We therefore conducted a systematic review and meta-analysis to quantitatively summarize this association in nurses.

METHODS

We systematically searched PubMed, Ovid MEDLINE, Cochrane Library, EMBASE and Web of Science from inception until April 2020 for studies that examined the relationship between shift work and obesity in nurses. Pooled odds ratio (OR) was calculated using a fixed- or random-effect model. The quality of each study was evaluated by using the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool. Two researchers independently assessed eligibility and extracted data. The whole process followed the PRISMA statement.

RESULTS

We included 11 eligible studies with a total of 74,651 nurses in this study. All of the studies were found to be low or moderate risk of bias according to the ROBINS-I tool. The pooled estimate of the risk of obesity in shift work nurses as compared to non-shift work nurses did not achieve statistical significance (OR = 1.05, 95% CI = 0.97-1.14). However, the risk of obesity was significantly higher in the sub-analysis of night-only shift work nurses (OR = 1.12, 95% CI = 1.03-1.21). In a sub-analysis limited only to the studies of female nurses, the obesity risk was found not to be statistically significant (OR = 1.09, 95% CI = 0.84-1.35). For different regions of study population, shift work was associated with a 36% increased risk of obesity in America (OR = 1.36, 95% CI = 1.30-1.42) and 1% increased risk in Europe and Australia (OR = 1.01, 95% CI = 1.00-1.03). The BMI cut-off for obesity varied in the included studies. When using a cut-off of BMI ≥ 30 kg/m² for obesity, our subgroup analysis shows a positive relationship between obesity and nurse shift work (OR = 1.12, 95% CI = 1.03-1.20).

CONCLUSIONS

This is the first systematic review and meta-analysis confirming that shiftwork may play a significant role in the development of obesity among nurses, especially in America, Europe and Australia. This was found to be particularly true for night only shift work nurses. Implementation of health policies and a better night shift schedule are needed in the hospital's management to effectively protect nurses from obesity, and the health risks associated with it.

Obesity and Cardiovascular Risk in the Arab Gulf States

Purpose of Review

Rapid economic growth in the Gulf Cooperation Council (GCC) states over the last half-century has been associated with a rise in obesity and cardiovascular morbidity and mortality. In this review, we shed some light on the factors driving the obesity epidemic, promising interventions to overcome this public health crisis, and challenges precluding a successful public health impact.

Recent Findings

Overweight and obesity rates have nearly tripled in the GCC countries over the past four decades. Cardiovascular morbidity and mortality have been rising in parallel. Several sociodemographic, environmental, and behavioral factors have been correlated with sedentary lifestyle and unhealthy diet habits, and ultimately the rise in overweight and obesity rates. Numerous studies have documented factors unique to the population of the Arab Gulf states, but high-quality data is scarce. Despite the growing awareness of the extent of the problem, several barriers to weight loss and physical activity need to be addressed. A few interventions to combat obesity at different levels have been reported with some promising outcomes. Using the social-ecological model (SEM), we review recently published interventions and discuss some challenges to overcome in order to make progress in fighting the obesity epidemic in the GCC.

Summary

Obesity prevalence has been mounting worldwide, and the Arab Gulf states are no exception. This public health crisis is drawing the attention of policymakers and several stakeholders. However, a lot needs to be done to reduce the burden of obesity and improve cardiovascular risks in the Arab Gulf states.

Emergency nurses' activity levels across rotating shifts

BACKGROUND

Emergency nurses work consecutive, rotating shift patterns. However, how their occupational physical activity levels are associated between these shifts is unknown. This study aimed to examine the associations between emergency nurses' time spent in different activity levels across one shift and the following day's shift.

METHODS

Fifty emergency nurses (45 female, five male) wore an ActiGraph accelerometer and completed work and sleep diaries across four weeks in 2018. A sub-sample (n = 42) also wore an activPAL inclinometer. Time spent sedentary, physically active, and in postural positions was determined. Multi-level analyses examined associations between one shift and the following day's shift.

RESULTS

Additional time spent sedentary and in light-intensity physical activity during the first shift was associated with more time spent being physically active in the following day's shift for all rotations except back-to-back night shifts. However, additional time spent engaged in moderate- to vigorous-intensity physical activity during the first shift was associated with less time spent physically active in the following day's shift for afternoon-morning and morning-afternoon rotations.

CONCLUSION

These findings demonstrate that shift sequences may impact emergency nurses' physical activity across shifts. Future research should identify the strategies emergency nurses use to maintain activity levels between shifts.

Overweight and obesity among adults in the Gulf States: A systematic literature review of correlates of weight, weight-related behaviours, and interventions

Obesity has increased to an epidemic level in the Gulf States. This systematic review is the first to explore the scientific evidence on correlates and interventions for overweight (body mass index [BMI] ≥ 25) or weight-related behaviours in the region. A systematic search of peer-reviewed articles was conducted using PubMed and PsycINFO. Ninety-one studies were eligible for this review including 84 correlate studies and seven intervention studies. Correlate studies of overweight focused on sociodemographic factors, physical activity, and dietary habits. Low physical activity, sedentary behaviour, and unhealthy dietary habits were associated with overweight. The most-reported sociodemographic correlates of overweight were increased age, being married, low education, urban residence, and unemployment. Correlate studies of physical activity and dietary behaviours mostly focused on sociodemographic variables. Being female and increased age (the latter less consistently) were associated with low physical activity. Interventions were very heterogeneous with respect to the target group, intensity, and behavioural strategies used. The effectiveness of interventions was difficult to evaluate because of the chosen study design or outcome measure, the small sample size, or high attrition rate. Few studies have investigated sociocognitive and environmental determinants of weight-related behaviours. Such information is crucial to developing health promotion initiatives that target those weight-related behaviours.

Associations Among Work and Family Health Climate, Health Behaviors, Work Schedule, and Body Weight

OBJECTIVES

Correctional employees exhibit elevated obesity rates. This study examines interrelations among health behaviors, health climate, body mass index (BMI), and work schedule.

METHODS

Using survey results from correctional supervisors (n = 157), mediation and moderated-mediation analyses were performed to examine how health behaviors explain relationships between obesity, work health climate (WHC) and family health climate (FHC), and work schedule.

RESULTS

Over 85% of the sample was overweight/obese (mean BMI = 30.20). Higher WHC and FHC were associated with lower BMI, mediated by nutrition, and physical activity. The interaction effect between health behavior and work schedule revealed a protective effect on BMI. Overtime shift work may share a relationship with BMI.

CONCLUSIONS

Findings may have implications for reexamining organizational policies on maximum weekly overtime in corrections. They provide direction for targeted obesity interventions that encourage a supportive FHC and promote healthy behaviors among supervisors working overtime.

Assessment of the environmental and genetic factors influencing prevalence of metabolic syndrome in Saudi Arabia

Metabolic syndrome (MS) is a combination of factors that increases the risk of cardiovascular atherosclerotic diseases including diabetes, obesity, dyslipidemia, and high blood pressure. Cardiovascular diseases are one of the leading causes of death in the adult Saudi population where the increase in cardiovascular-related mortality is augmented by the rise in the prevalence of MS. Metabolic syndrome is a multi-factorial disorder influenced by interactions between genetic and environmental components. This review aims to provide a comprehensive assessment of studied environmental and genetic factors explaining the prevalence of MS in the Kingdom of Saudi Arabia. Additionally, this review aims to illustrate factors related to the population genetics of Saudi Arabia, which might explain a proportion of the prevalence of MS.

A systematic review of physical activity and sedentary behaviour research in the oil-producing countries of the Arabian Peninsula

BACKGROUND

The dramatic rise in Noncommunicable Diseases (NCD) in the oil-producing countries of the Arabian Peninsula is driven in part by insufficient physical activity, one of the five main contributors to health risk in the region. The aim of this paper is to review the available evidence on physical activity and sedentary behaviour for this region. Based on the findings, we prioritize an agenda for research that could inform policy initiatives with regional relevance.

METHODS

We reviewed regional evidence on physical activity and sedentary behaviour to identify the needs for prevention and policy-related research. A literature search of peer-reviewed publications in the English language was conducted in May 2016 using PubMed, Web of Science and Google Scholar. 100 studies were identified and classified using the Behavioural Epidemiology Framework.

RESULTS

Review findings demonstrate that research relevant to NCD prevention is underdeveloped in the region. A majority of the studies were epidemiological in approach with few being large-scale population-based studies using standardised measures. Correlates demonstrated expected associations with health outcomes, low levels of physical activity (particularly among young people), high levels of sedentary behaviour (particularly among men and young people) and expected associations of known correlates (e.g. gender, age, education, time, self-motivation, social support, and access). Very few studies offered recommendations for translating research findings into practice.

CONCLUSIONS

Further research on the determinants of physical activity and sedentary behaviour in the Arabian Peninsula using standard assessment tools is urgently needed. Priority research includes examining these behaviours across the four domains (household, work, transport and leisure). Intervention research focusing on the sectors of education, health and sports sectors is recommended. Furthermore, adapting and testing international examples to the local context would help identify culturally relevant policy and programmatic interventions for the region.