Physical Activity of Nurse Clinical Practitioners and Managers

Hourly step recommendations to achieve daily goals for working and older adults

BACKGROUND

The widespread use of physical activity trackers enables the collection of high-resolution health data, such as hourly step counts, to evaluate health promotion programmes. We aim to investigate how participants meet their daily step goals.

METHODS

We used 24-h steps data from the National Steps ChallengeTM Season 3, wherein participants were rewarded with vouchers when achieving specified goals of 5000, 7500, and 10,000 steps per day. We extracted data from 3075 participants' including a total of 52,346 participant-days. We modelled the hourly step counts using a two-part model, in which the distribution for step counts was allowed to depend on the sum of step counts up to the previous hour and participant demographics.

RESULTS

Participants have a mean age of 44.2 years (standard deviation = 13.9), and 40.4% are males. We show that on weekdays, the hourly mean step counts among participants aged 60 and above are higher than participants aged 30 to 59 from the start of the day till 6 p.m. We also find that participants who accumulate at least 7000 steps by 7 p.m. are associated with higher success of achieving 10,000 steps.

CONCLUSIONS

We provide recommendations on the hourly targets to achieve daily goals, based on different participants' characteristics. Future studies could experimentally test if prompts and nudges at the recommended times of day could promote reaching step goals.

Leisure-time physical activity, occupational physical activity and the physical activity paradox in healthcare workers: A systematic overview of the literature

BACKGROUND

Physical activity positively influences cardiovascular health. Results from male-dominated physically active occupations suggest that a high level of occupational physical activity may be detrimental to cardiovascular health. This observation is referred to as the physical activity paradox. Whether this phenomenon can also be observed in female-dominated occupations remains unknown.

OBJECTIVE

We aimed to provide an overview of (1) leisure-time and occupational physical activity in healthcare workers. Therefore, we reviewed studies (2) to assess the relationship between the two physical activity domains and analyzed (3) their effects on cardiovascular health outcomes in relation to the paradox.

METHODS

Five databases (CINAHAL, PubMed, Scopus, Sportdiscus, Web of Science) were systematically searched. Both authors independently screened the titles, abstracts, and full texts and assessed the quality of the studies using the National Institutes of Health's quality assessment tool for observational cohort and cross-sectional studies. All studies that assessed leisure-time and occupational physical activity in healthcare workers were included. The two authors independently rated the risk of bias using the ROBINS-E tool. The body of evidence was evaluated using the GRADE approach.

RESULTS

The review included 17 studies that assessed the leisure-time and occupational physical activity of people working in healthcare, determined the relationship between the domains (n = 7) and/or examined their effects on the cardiovascular system (n = 5). Measurements for leisure-time and occupational physical activity varied between studies. Leisure-time physical activity typically ranged between low and high intensity, with a short duration (approx. 0.8-1.5 h). Occupational physical activity was typically performed at light to moderate intensity with a very long duration (approx. 0.5-3 h). Moreover, leisure-time and occupational physical activity were almost negatively related. The few studies investigating effects on cardiovascular parameters revealed a rather unfavorable effect of occupational physical activity, while leisure-time physical activity was beneficial. The study quality was rated as fair and the risk of bias was moderate to high. The body of evidence was low.

CONCLUSIONS

This review confirmed that leisure-time and occupational physical activity of healthcare workers are opposed in their duration and intensity. Moreover, leisure-time and occupational physical activity seem to be negatively related and should be analyzed according to their relation to each other in specific occupations. Furthermore, results support the relationship between the paradox and cardiovascular parameters.

REGISTRATION

Preregistered on PROSPERO (CRD42021254572). Date of registration on PROSPERO: 19 May 2021.

TWEETABLE ABSTRACT

Does occupational physical activity adversely affect the cardiovascular health of healthcare workers in comparison to leisure-time physical activity?

Nurses' steps, distance traveled, and perceived physical demands in a three-shift schedule

BACKGROUND

The physical job demands of hospital nurses are known to be very high. Although many studies have measured the physical activities of nurses subjectively using questionnaires, it remains necessary to quantify and measure nurses' physical activity at work using objective indicators. This study was conducted to address this gap in the literature by analyzing nurses' physical activity using both objective measurements and subjective perceptions. The number of steps, distance traveled, and actual work hours were measured during work, and the influence of related factors was analyzed.

METHODS

Using a cross-sectional design, survey and activity tracking data were collected from nurses who worked in three shifts in two tertiary hospitals located in the capital region of South Korea. The participants comprised 117 nurses working in four different units (medical ward, surgical ward, intensive care unit, emergency room), and data from 351 shifts were used in the final analysis. Between-group differences in the main variables were analyzed using the t-test, the Mann-Whitney test, analysis of variance, or the Kruskal-Wallis test, as appropriate. The relationships were examined through multiple linear regression analysis.

RESULTS

The average number of steps and distance traveled were greatest for nurses working in the emergency room, followed by the intensive care unit, surgical ward, and medical ward (in descending order). Younger nurses and those with shorter unit experience tended to have the greatest number of steps and distance traveled.

CONCLUSION

Using activity trackers, this study derived physical activity measures such as number of steps and distance traveled, enabling an objective examination of physical activity during shifts. Nurses' level of physical activity differed depending on the type of nursing unit, nurses' age, and unit experience. These results suggest the need for support programs that are specific to the job demands of specific nursing units.

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.

An exploration of New Zealand mental health nurses' personal physical activities

This study assessed the physical activities of Mental Health Nurses (MHN) in New Zealand against the 2018 World Health Organization recommended minimum levels of moderate-to-vigorous physical activity. The research design was exploratory and descriptive as there were no previous studies about physical activity levels of MHNs in New Zealand. Quantitative and qualitative data were collected using the International Physical Activity Questionnaire (IPAQ, Long Version) which included options for free-text responses. Data were analysed using descriptive and inferential statistics. A total of 266 participants returned the survey, a response rate of 4%, and a limitation of the study. More than 50% of MHNs reported <150 min of moderate-to-vigorous exercise per week for each of the four physical activity domains. When individual physical activity domains were combined, only 10% spent <150 min on moderate-to-vigorous physical activity. Work-related physical activities were higher for those working in the inpatient area than in community settings. Transport-related physical activities were higher for those working in community settings. Participants registered from 6 to 20 years had more time sitting than other groups. Nurses aged 55 years and above showed the highest total physical activity levels. Moreover, healthcare organizations and nurse leaders need to promote physical activity and provide wellness intervention for their staff. Nurses who are physically active may be more effective in supporting their patients to increase their physical activity.

Work-related factors predict changes in physical activity among nurses participating in a web-based worksite intervention: A randomized controlled trial

Background

Despite the numerous benefits associated with physical activity (PA), most nurses are not active enough and few interventions have been developed to promote PA among nurses. A secondary analysis of raw data from a single-centre, three-arm parallel-group randomized controlled trial was conducted to assess whether work-related characteristics and general mood states predict changes in total weekly moderate-to-vigorous intensity PA (MVPA) and average daily step-count among nurses participating in a 6-week web-based worksite intervention.

Methods

Seventy nurses (mean_age: 46.1 ± 11.2 years) were randomized to an individual-, friend-, or team-based PA challenge. Participants completed questionnaires pre- and post-intervention assessing work-related characteristics (i.e., shift schedule and length, number of hours worked per week, work role) and general mood states (i.e., tension, depression, anger, confusion, fatigue, vigour). Participants received a PA monitor to wear before and during the 6-week PA challenge, which was used to assess total weekly MVPA minutes and average daily step-count. Data were analyzed descriptively and using multilevel modeling for repeated measures.

Results

Change in total weekly MVPA minutes, but not change in average daily step-count, was predicted by shift schedule (rotating vs. fixed) by time (estimate = − 17.43, SE = 6.18, p = .006), and work role (clinical-only vs. other) by time (estimate = 18.98, SE = 6.51, p = .005). General mood states did not predict change in MVPA or change in average daily step-count.

Conclusions

Given that nurses who work rotating shifts and perform clinical work showed smaller improvements in MVPA, it may be necessary to consider work-related factors/barriers (e.g., time constraints, fatigue) and collaborate with nurses when designing and implementing MVPA interventions in the workplace.

Trial registration

ClinicalTrials.gov: NCT04524572. August 24, 2020. This trial was registered retrospectively. This study adheres to the CONSORT 2010 statement guidelines.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00739-4.

Women's heart health: a focus on nurses' physical activity and sedentary behaviour

PURPOSE OF REVIEW

This review focuses on recent literature examining and targeting the physical activity and sedentary behaviour of nurses. The role of physical activity and sedentary behaviour in preventing and managing cardiovascular disease (CVD) in women is also discussed.

RECENT FINDINGS

Nurses (most of whom are women) represent the largest professional group within the health care workforce and many present with risk factors for CVD (e.g. physical inactivity, sedentary behaviour, overweight/obesity, hypertension, dyslipidemia, diabetes, smoking, depression, anxiety). Several studies have measured the physical activity and sedentary behaviour of nurses and found low levels of physical activity (i.e. most do not meet physical activity guidelines) and high levels of sedentary behaviour (50-60% of the day). Nurses working rotating shifts, 12-h shifts and/or working full-time or part-time (vs. casual) may be at greater risk of physical inactivity; however, the opposite has been observed for sedentary behaviour. Few interventions targeting nurses' physical activity levels have shown promise, but those that have used activity monitors with behavioural strategies; no studies, to date, have evaluated the impact of sedentary behaviour interventions in nurses.

SUMMARY

Improving the physical activity levels and reducing the sedentary behaviour of nurses is important for nurses' cardiovascular health. There is a need for interventions to address low physical activity and high sedentary behaviour among nurses.

Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis

BACKGROUND

With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups.

OBJECTIVE

To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation.

METHODS

Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses.

RESULTS

The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure.

CONCLUSION

This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017070448 .