The health and health behaviours of Australian metropolitan nurses: an exploratory study

How a critical care environment influences nurses' health and working capacity: a scoping review

BACKGROUND

Internationally, the nursing workforce is ageing. Chronic conditions are becoming more prevalent amongst the ageing nursing workforce. With an increase in chronic conditions and an ageing nursing workforce, understanding environmental influences on nurses' health and work capacity is vital to supporting this workforce.

AIM

A scoping review was conducted to explore the influence of a critical care environment on nurses' health and work capacity.

DESIGN

A scoping review was conducted according to PRISMA-ScR guidelines.

METHODS

Database extraction occurred in June 2023 and included MEDLINE Complete, PubMed, Scopus, CINAHL, and Embase.

RESULTS

Eight studies met the inclusion criteria. Studies were conducted internationally with sample sizes from 20 to 500 critical care nurses (CCNs).

CONCLUSIONS

Findings identified the critical care environment had an impact on nurses' health and working capacity. Many CCNs self-reported having a chronic condition that influenced their nursing practice. Further research is needed to explore how to mitigate the influence of a chronic condition to support this valuable workforce.

The Effect of Shift Working on Dietary Patterns of Healthcare Practitioners during the COVID-19 Pandemic: A Cross-Sectional Study

Background and Objectives: Health professionals' working schedules often do not allow them to follow a balanced way of life, and the nature of their work can affect their weight and eating habits. The aim of the present study is to shed some light on the impact of night shift working on the dietary practices of healthcare practitioners in Greece. Materials and Methods: This was a cross-sectional study. With the use of an administered questionnaire several parameters were assessed, including anthropometric characteristics, weight history, as well as nutritional habits of the same group of participants during night shifts and when at regular working hours. Moreover, nutritional beliefs of the subjects were recorded, as well as the level of adherence to the Mediterranean diet. Results: It was observed that in all food groups, including water, used to compare the nutritional patterns of the participants during night shifts and when working regular hours, statistical differences were noted (p = 0.001). Furthermore, the participants who reported a higher adherence to the Mediterranean diet and self-reported healthier nutritional habits, had a statistically lower weight compared to the participants that rarely followed the specific model or reported unhealthier eating routine (p = 0.010 and p = 0.015, respectively). Conclusions: We conclude that shift-working healthcare professionals are associated with disturbed eating behaviours leading to the high consumption of unhealthy food. The implementation of interventions that will concentrate on educating health workers on balanced nutrition and improving physical environment (i.e., food availability, healthier food choices) seems to be of great importance.

Benefits of Mediterranean and Japanese Diets among Nurses: A Scoping Literature Review

INTRODUCTION

The present study aimed at all the benefits induced by taking the Mediterranean or Japanese diet among nurses and whether any beneficial differences in intakes between the two diets were considered.

METHODS

The author searched PubMed and Embase databases for medical subheadings terms and free full text referring to "Diet," "Mediterranean," "Japanese," and "Nurses" before 31st December 2022.

RESULTS

A total of 14 studies were included in this scoping review, which better underlined all the benefits implicated in the Mediterranean or Japanese diets assumption and also if there were any differences between the two diets. These eating behaviors were exclusively investigated among nurses.

CONCLUSION

The nursing profession has always been considered the most stressful healthcare activity. However, some important concerns in the regular lifestyle, such as eating and physical activity, might help to live better.

Levels of actigraphy-derived physical activity among Polish nurses: factors associated with the prevalence of selected metabolic disorders

Numerous studies demonstrate a relationship between physical activity and the development of non-communicable diseases. Nurses play a crucial role in the healthcare system, and their demanding work can have an impact on their health. The objective of this cross-sectional study was to assess physical activity in relation to factors predisposing to the occurrence of specific metabolic disorders among Polish nurses. The measurements included physical activity level using ActiGraph GT3X, body weight composition using Tanita MC-980, body mass index, waist circumference, blood pressure using Welch Allyn 4200B, lipid profile, and fasting blood glucose using CardioChek PA. The results indicate that nearly one-third (31.75%) of the total sample of studied nurses do not meet the criteria for the minimum amount of physical activity of at least moderate intensity. Furthermore, over half of the surveyed nurses (55.5%) were classified as overweight or obese based on BMI, and almost half (42.86%) had abdominal obesity. The regression model, employing linear regression, revealed that factors predisposing to selected metabolic disorders were age, engaging in multiple jobs, and the number of steps per day. There is a pressing need to implement comprehensive and supportive initiatives to improve the overall health condition of nurses in Poland through increased physical activity. Activating and supporting this professional group is an investment that benefits not only the nurses themselves but also the healthcare system and the entire nation.

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.

Health and Sedentary Behaviors within Polish Nurses: A Cross-Sectional Study

Health behaviors play a pivotal role in improving and strengthening health. Nurses, who constitute the vast majority of employees in the health sector, play a crucial role not only in treating disease but also in promoting and maintaining optimal health for themselves and society. The purpose of the study was to assess the level of health and sedentary behavior and the factors influencing them among nurses. A survey, cross-sectional study was conducted among 587 nurses. Standardized questionnaires evaluating health and sedentary behavior were used. The study utilized both single-factor and multifactor analyses, employing the linear regression method and Spearman correlation coefficient. The results showed that the health behaviors of the survey nurses were at an average level. Sedentary time (in hours) was an average of 5.62 h (SD = 1.77) and correlates significantly (p < 0.05) and negatively (r < 0) with health behaviors in terms of the positive mental attitude subscale; the longer the sitting time, the lower the intensity of this type of health behaviors. The efficient functioning of the healthcare system is greatly dependent on nursing staff. To improve health behaviors among nurses, systemic solutions such as workplace wellness programs, incentives for healthy behaviors, and education on the benefits of a healthy lifestyle are needed.

Enablers and barriers to healthy eating among hospital nurses: A systematic review

BACKGROUND

Nurses are the largest health professional body globally. Despite the significant role they play in healthcare, nurses exhibit poor dietary habits and have high rates of chronic diseases. Understanding the factors underlying healthy eating for nurses in the workplace is important to implement effective interventions.

OBJECTIVE

To identify enablers and barriers related to healthy eating among nurses employed in a hospital setting.

DESIGN

A systematic literature review of qualitative, quantitative, and mixed methods research (PROSPERO ID: CRD42021290913).

DATA SOURCES

A comprehensive systematic search was conducted across PubMed, CINAHL, Embase, Web of Science and ProQuest databases for papers published after January 2015.

METHODS

Two authors independently screened titles and abstracts of 4139 deduplicated studies, performed critical appraisals on eligible studies using the Mixed Methods Appraisal Tool and extracted data relevant to the research question. This review includes papers that examined nurses' eating behaviours specifically, were conducted in a hospital setting and distinguished healthy eating from other behaviours. Data synthesis was conducted through descriptive summarisation of studies and enablers and barriers were classified according to the socio-ecological model.

RESULTS

A total of 29 studies were identified with 8024 participants. 8 studies were qualitative, 18 quantitative, and 3 were mixed method design. At an environmental level, barriers were high accessibility and availability of unhealthy foods, high cost and low availability of healthy foods and lack of storage and preparation facilities, while an enabler was close proximity to healthy options. Novel organisational enablers were considered roster planning which allowed for established routines around meals, and structured workplace programs that encouraged improvement in health behaviours, while barriers were shift work, inconsistent rosters and high work demands. An interpersonal enabler was supportive networks while barriers were work culture, social norms of celebrations and gifts of food from patients. Finally, intrapersonal barriers were stress and fatigue, personal values, beliefs, attitudes, and individual characteristics, with the latter two also acting as enablers.

CONCLUSIONS

This review identifies the complexity and interconnectedness of enablers and barriers to healthy eating across four domains of the socio-ecological model. Multi-faceted strategies which address factors across several domains are recommended for healthcare organisations to facilitate healthy eating among nurses. Further research is needed to assess these strategies and understand the extent to which eating behaviours can be improved.

Tackling change in mental health service delivery: A qualitative evaluation of a lifestyle program targeting mental health staff - Keeping our Staff in Mind (KoSiM)

ISSUES ADDRESSED

People with severe mental illness have adverse health outcomes compared to the general population. Lifestyle interventions are effective in improving health outcomes in this population. Current cultural processes in mental health services do not generally incorporate physical health care practices. Innovative education is required to improve knowledge and confidence of staff in the delivery of preventative health measures.

METHODS

The Keeping our Staff in Mind (KoSiM) program delivered a brief lifestyle intervention to mental health staff. A qualitative analysis following the Standards for Reporting Qualitative Research was undertaken. Semi-structured interviews designed to elicit information about the acceptability of the program and the impact of the intervention on participants' personal and professional lives. The interviews were analysed using thematic analysis, with coding independently developed and reviewed by three authors.

RESULTS

Of the 103 eligible participants, 75 were interviewed. Responses revealed four main themes: (i) positive changes in clinician's approach to physical health care, (ii) improvements in attitudes to self-care and family wellbeing, (iii) positive changes in workplace culture associated with physical health care delivery and (iv) high levels of acceptability of the program.

CONCLUSION

The KoSiM model may be useful in other settings as a means of changing the culture of mental health services to better integrate physical health care as a core part of mental health service provision. SO WHAT?: A novel approach using staff focussed lifestyle interventions model may cut through the resistance that is encountered when implementing proven methods of clinical intervention where cultural barriers exist.

Factors Involved in Nurses' Health-Seeking Behaviors: A Qualitative Study

This study aimed to explore the factors involved in Iranian nurses' health-seeking behavior. In this qualitative exploratory descriptive study, 15 nurses from hospitals affiliated to Iran and Qazvin University of Medical Sciences were interviewed from April to March 2020. Data were collected via purposive sampling by unstructured in-depth interviews and analyzed using thematic analysis. Findings identified 5 main themes, "fear," "trust/distrust," "excuse," "accessibility," and "support" that were involved in nurses' health-seeking behavior. The findings of this study may contribute to a deeper understanding of the factors involved in nurses' health-seeking behavior and pave the way for further research and policy making regarding nursing workforce health.

Sociodemographic Aspects and Healthy Behaviors Associated With Perceived Life Satisfaction in Health Professionals

BACKGROUND

Life satisfaction is a determining factor for the improvement of mental and physical health. Health care workers are a vulnerable population to suffer alterations in the factors that affect life satisfaction. Determining the influence of these factors on quality of life is important for their proper management.

OBJECTIVE

To examine sociodemographic factors and healthy behaviors influencing life satisfaction in Peruvian professionals.

METHODS

A cross-sectional study was conducted with 506 health care workers, who had a mean age of 40.34 years (SD = 10.39). A sociodemographic questionnaire, sleep quality, physical activity, eating habits, and life satisfaction were used. A regression model was fitted with the life satisfaction variable as the dependent variable.

RESULTS

In multivariable analysis, age (β = -.938, P < .01) and perception of poor health status (β = -4.743, P < .001) were found to be associated with lower life satisfaction. On the other hand, higher university education level (β = 1.667, P < .001), absence of smoking (β = 3.202, P < .01), absence of depressive symptoms (β = 3.390, P < .001), interest in daily activities (β = 3.503, P < .05), good sleep quality (β = 1.027, P < .01), a high frequency of physical activity (β = 1.056, P < .01), and healthy eating are variables associated with higher life satisfaction.

CONCLUSION

Sociodemographic aspects such as age and the perception of poor health are associated with lower life satisfaction. On the other hand, healthy behaviors such as absence of smoking, absence of depressive symptoms, interest in daily activities, good quality of sleep, high frequency of physical activity, and a healthy diet were associated with higher life satisfaction.

Managing an ageing healthcare workforce: a systematic literature review

PURPOSE

The aim of this paper is to review research conducted on managing the ageing healthcare workforce and identify gaps for further research.

DESIGN/METHODOLOGY/APPROACH

A systematic literature search of studies in the English language was carried out in Scopus and Web of Science databases.

FINDINGS

The study consists of an analysis of 75 published articles. The majority of the papers were published in recent years, indicating a growing interest in the field. The authors specified the following inclusion criteria: all years, articles/reviews, English language and full text in the Web of Science and Scopus databases. The authors of the paper illustrated seven major categories with different topics that were suggested for future research. It included: challenges of labor market in the healthcare field, age-related changes and their influence on work ability, training opportunities and lifelong learning among ageing health workforce, motives of early retirement, ageing and its relationship to Occupational Health and Safety. Longitudinal studies and case study strategy with mixed-methods approaches were suggested for future research by the authors.

ORIGINALITY/VALUE

The paper summarizes knowledge related to the management of ageing health workforce, describes topics researched and as a result, presents findings on and conclusions about the most important future implications of the ageing workforce for management in the healthcare field providing lines for further research. To the authors' knowledge, no holistic systematic literature reviews have been published in academic journals targeted specifically to ageing healthcare workers.

Nurses' Quality of Life and Healthy Behaviors

Quality of life (QoL) is closely linked to the health status of the individual. In turn, health status strongly depends on lifestyle. Health behavior, which is defined as the actions and attitudes of a person that affect their physical and mental health, is one of many lifestyle components. The nursing community, which is exposed to a range of dangers associated with the job position and responsibilities of the nursing profession, has to contend with several negative impacts. This results in a decreased quality of life among the nursing staff and reduced effectiveness in providing care services to patients.

METHODS

This study was conducted using an online Google questionnaire, which was completed by 312 nurses nationwide. The questionnaire included questions about the respondents' socio-demographic survey and included the Health Behavior Inventory (HBI) by Juczyński and the WHOQoL-BREF questionnaire.

RESULTS

The mean QoL reported by respondents was 3.65 points (SD = 0.67), meaning that QoL ranked between good and average results. The respondents' mean rating of their own health was 3.58 points (SD = 0.79), indicating that they rated their health status between satisfactory and average. Low health-behavior prevalence was reported by 139 of the 312 survey participants (44.55%), while 111 respondents (35.58%) had average health-behavior prevalence and 62 (19.87%) had high health-behavior prevalence. Each of the QoL domains correlated significantly (p ˂ 0.05) and positively (r ˃ 0) with the total HBI score and all its subscales.

CONCLUSIONS

Higher quality of life improves the level of health behavior by nursing staff. Obesity lowers the quality of life in physical, psychological, and social domains. The psychological sphere was the best-rated quality of life domain by nurses. A good material situation for nurses has a positive effect on their quality of life.

The effects of nurses' perceived stress and life satisfaction on their emotional eating behaviors

PURPOSE

To examine the effects of the nurses' perceived stress and life satisfaction on their emotional eating behaviors.

DESIGN AND METHODS

A cross-sectional study was conducted among a random sample of 297 nurses in a research hospital.

FINDINGS

There is a negative correlation between nurses' emotional eating and life satisfaction (β = -0.192, p < 0.001), and a positive correlation between emotional eating and perceived stress (β = 0.392, p < 0.001). Perceived stress, life satisfaction, and marital status constituted 24% of the factors affecting emotional eating behaviors.

PRACTICE IMPLICATIONS

Psychiatric nurses would benefit from developing effective training programs that support nurses in making healthy lifestyle choices.

Influence of Sleep Characteristic Changes on Nurses' Quality of Life during Their Transition to Practice: A Prospective Cohort Study

Aim: To explore the effect of changes in sleep characteristics on changes in quality of life during the transition period of new graduate nurses. Background: Sleep problems among nurses are associated with negative physical and psychological consequences. Methods: This prospective cohort study was conducted at a tertiary hospital in South Korea. Participants included 88 newly graduated nurses. Data were collected twice, prior to shift work and after 4 months of working as a nurse, via online structured self-report questionnaires created using Survey Monkey from March 2018 to February 2020. A generalized linear mixed model was used to analyze the influence of changes in sleep characteristics on quality of life. Results: A generalized linear mixed model showed that changes in the subjective quality of sleep, subjective health perception, and daytime dysfunction influenced quality of life changes during the transition. This implies that deterioration already existed. From their undergraduate period to four months after they began working as nurses, a significant decrease was observed in the quality of sleep. Participants’ quality of life significantly decreased. Conclusions: Changes in the quality of life of new graduate nurses may show deterioration with a significant drop in subjective sleep quality. Institutions should improve existing work adaptation programs provided during new graduate nurses’ transition to practice by including information on changes in nurses’ health caused by changes in sleep characteristics and sleep quality.

Cancer Prevention Behaviors in Workers of a Referral Cancer Center in Mexico City: A Pilot Study on Early Detection Awareness for Cancer

BACKGROUND

Prevention strategies for cancer are necessary. Health workers who often serve as role models bear responsibility for prevention counseling and programs. However, whether their habits and behaviors reflect prevention goals are unknown. We describe the prevalence of cancer risk factors and prevention behaviors in health workers of a referral cancer center in Mexico City.

METHODS

Cross-sectional study in which workers of the National Cancer Institute were invited to participate in a prevention program, risk factor survey, and nutrition, psychological, and genetic counseling were included. The likelihood of cancer was calculated based on the presence of risk factors. Factors associated with prevention behaviors were identified by logistic regression.

RESULTS

We recruited 301 workers; 77% were women. The median self-reported BMI was 26.4 kg/m2, 9.97% smoked, 78% drank alcohol, and 89% did not get at least 150 min/week of physical activity. In women, age (OR = 1.3 95%CI 1.01-1.06) and physical activity of 150 min/week (OR = 2.52 95% CI 1.28-4.96) were associated with cancer prevention behaviors. No risk factors were associated with healthy behaviors among men.

CONCLUSION

Health workers may have unhealthy lifestyles and behaviors, is essential to create supportive environments to promote cancer prevention counseling and programs effectively.

Workplace Health Promotion and COVID-19 Support Measures in Outpatient Care Services in Germany: A Quantitative Study

Working conditions in the care sector, especially under the increased strain during COVID-19, make it difficult for outpatient caregivers to adhere to health-promoting behaviours. Research on workplace health promotion (WHP) and COVID-19 support measures in outpatient care services is limited. The aim of this pilot study was to characterise the current situation of WHP and COVID-19 support measures in outpatient care services and to explore how to offer WHP support measures targeted for a specific group. A web-based cross-sectional survey was conducted with outpatient caregivers (N = 171) in northern Germany. The results showed that 60.2% of the study participants were offered WHP support measures, with significantly higher work engagement when WHP support measures were available (Z = 4279.50, p < 0.01) and that 77.2% received specific support from their employer during the COVID-19 pandemic. Although spending a break in a break room was significantly associated with longer breaks as compared with being in a car (Z = 39.10, padj. = 0.01), a break room was neither available in all outpatient care services, nor did it appear to be feasible. Overall, WHP in outpatient care services is insufficiently covered. In order to be able to offer WHP support measures that are targeted to outpatient caregivers, cooperation among local care services, feasibility, and digital measures should be examined.

The Health Behaviour of German Outpatient Caregivers in Relation to the COVID-19 Pandemic: A Mixed-Methods Study

The COVID-19 pandemic has affected outpatient caregivers in a particular way. While the German population becomes increasingly older, the number of people in need of care has also increased. The health and, thus, the health behaviour of employees in the outpatient care become relevant to maintain working capacity and performance in the long term. The aims of the study were (1) to examine the health behaviour and (2) to explore pandemic-related perceived change of health behaviour among outpatient caregivers during the COVID-19 pandemic. In a mixed-methods study, 15 problem-centred interviews and a web-based cross-sectional survey (N = 171) were conducted with outpatient caregivers working in Northern Germany. Interviewees reported partially poorer eating behaviour, higher coffee consumption, lower physical activity, skipping breaks more often and less sleep duration and quality during the pandemic. Some quantitative findings indicate the same tendencies. A majority of participants were smokers and reported higher stress perception due to the pandemic. Preventive behaviour, such as wearing PPE or hand hygiene, was increased among interviewees compared to the pre-pandemic period. Our findings indicate that the COVID-19 pandemic could negatively affect outpatient caregivers' health behaviour, e.g., eating/drinking behaviour and physical activity. Therefore, employers in outpatient care should develop workplace health promotion measures to support their employees in conducting more health-promoting behaviours during the COVID-19 pandemic.

The Health Behaviour of German Outpatient Caregivers in Relation to Their Working Conditions: A Qualitative Study

Ongoing demographic change is leading to an increasingly older society and a rising proportion of people in need of care in the German population. Therefore, the professional group of outpatient caregivers is highly relevant. Their work is characterised not only by interacting with patients in a mobile setting but also by working in shifts. Health behaviour under these specific working conditions is crucial for ensuring long-term work ability and performance. Little is known about the health behaviour of German outpatient caregivers and its potential impact on their work. The aims of the study were (1) to examine health behavioural patterns (nutrition, exercise, smoking, regeneration) of outpatient caregivers, (2) to illuminate their personal health-promoting behaviours, and (3) to identify potential work-related factors influencing their health behaviour. Fifteen problem-centred interviews were conducted with outpatient caregivers working in Northern Germany in the period January-April 2020. Interviews were analysed by using qualitative content analysis. Outpatient caregivers reported improvable nutrition and hydration, with simultaneous high coffee consumption, low physical activity, poor regeneration (breaks and sleep quality), and good personal health-promoting behaviour (e.g., back-friendly habits), although the majority were smokers. Barriers to the implementation of health-promoting behaviours were a high perception of stress due to increased workload and time pressure, while aids to better health-promoting behaviour were described as being social support and personal resources. The respondents perceived their working conditions as potentially influencing their health behaviour. On the basis of their descriptions, various practice-relevant strategies were derived. The data explore a potential need for outpatient care services to develop interventions on behavioural and structural levels that can help create healthier working conditions for their employees so these caregivers can adopt better health behaviours.

Associations between health-related quality of life and health behaviors in Australian nursing students

Health-related quality of life (HRQoL) is being increasingly studied as an indicator of wellbeing. This study evaluated the HRQoL of nursing students and relationships between lifestyle behaviors including smoking, diet, alcohol intake and physical activity. A cross-sectional study was conducted in 2018 using the Short-Form 12V2 to measure the HRQoL of 475 students from both regional and metropolitan universities in Queensland, Australia. z-scores were aggregated into a Physical Composite Score (PCS) and a Mental Composite Score (MCS). Multivariate linear regression was used to explore the associations. Nursing students (94.5% female) had lower HRQoL scores relative to the general Australian population. Students enrolled at the regional university, with higher income; higher intakes of vitamin A, calcium, and iodine; and more physical activity had a higher Mental Composite Score, but those with health conditions and high intakes of meat, fat, carbohydrates, and sugar reported lower Physical Composite Score compared to their counterparts. Skipping breakfast, physical inactivity, and alcohol score were inversely associated with HRQoL. This study highlights the need for strategies to address the poor lifestyle and HRQoL in nursing students to support their physical and mental health.

Mindful Self-Care Practice of Nurses in Acute Care: A Multisite Cross-Sectional Survey

Consistent mindful self-care practices mitigate professional burnout and improve resilience to enable nurses provide safe and effective patient care. This study determined the levels and the influencing factors of mindful self-care of nurses in acute care settings. Data were collected from a convenience sample of 258 nurses from seven acute care hospitals using the 36-item Mindful Self-Care Scale. Data were analyzed using descriptive and correlation analyses. Nurses' mindful self-care scores were low, and female nurses had higher levels of mindful self-care than male nurses. Statistically significant negative correlations were found between nurses' mindful self-care levels and their age and clinical experience. Nurses' engagement in mindful self-care is low which may negatively affect their interactions with and care of patients and their families. Therefore, a need exists to develop and evaluate more clinical-based personal and organizational strategies to enhance the mindful self-care practices of nurses.

Promoting healthy eating in nurses

Across the world obesity rates in the general population have been increasing in recent years, a trend that has also been seen among nurses. Alongside the negative health effects of obesity such as type 2 diabetes mellitus and cardiovascular disease, the condition affects an individual's ability to work and results in increasing rates of absenteeism. However, the nature of nursing shift patterns and the healthcare workplace itself can influence a nurse's ability to eat healthily. This article discusses how obesity and healthy eating can affect the nursing role, as well as examining leadership and management practices that can support healthy eating in the workplace. The article is aimed at supporting nurse managers to reflect on their own lifestyle behaviour, which in turn will enable them to engage more with the topic of healthy eating among staff.

Development of a behaviour change workplace-based intervention to improve nurses' eating and physical activity

BACKGROUND

There is a critical need for an intervention to improve nurses' eating and physical activity behaviours. As nurses spend a substantial proportion of their waking hours at work, concerted efforts to deliver such interventions in the workplace is growing. This study formed part of a multiphase programme of research that aimed to systematically develop an evidence-based and theory-informed workplace intervention to promote changes in eating and physical activity among nurses.

METHODS

The intervention was developed iteratively, in line with Medical Research Council complex intervention guidelines. It involved four activities: (1) identifying the evidence base, (2) understanding the determinants of nurses' eating and physical activity behaviour change through theory-based qualitative interviews and survey, (3) identifying intervention options using the Behaviour Change Wheel, and (4) specifying intervention content and implementation options using a taxonomy of behaviour change techniques.

RESULTS

Data from 13 randomised controlled trials indicated that workplace-based behaviour change interventions targeted to this population are effective in changing behaviour. The evidence base was, however, limited in quantity and quality. Nurses' beliefs about important factors determining their eating and physical activity behaviour were identified across 16 qualitative interviews and 245 survey responses, and key determinants included environmental context and resources, behavioural regulation, emotion, beliefs about consequences, knowledge and optimism. Based on these findings, 22 behaviour change techniques suitable for targeting the identified determinants were identified and combined into a potential workplace intervention.

CONCLUSIONS

An evidence-based and theory-informed intervention tailored to the target population and setting has been explicitly conceptualised using a systematic approach. The proposed intervention addresses previous evidence gaps for the user population of nurses. Further to this, such an intervention, if implemented, has the potential to impact nurses' eating and physical activity behaviours and in turn, the health of nurses and the quality of healthcare delivery.

Risky Behaviour among Nurses in Poland: An Analysis of Nurses' Physical Condition, Mental Health, and Resilience

Background: Nursing is a profession where staff are exposed to chronic stress. Mental resilience plays a significant role in the process of coping with these challenges. The aim of this study was to assess nurses' mental and physical wellbeing, as well as resilience, by taking into account the occurrence of risky behaviour among nurses in Poland. Methods: A descriptive study was carried out between June 2017 and May 2018 among nurses (n = 1080) employed in primary healthcare or in training centres in Silesia, Poland. Data were obtained from a number of questionnaires. Results: Over half of the nurses (n = 735; 68%) had an average psychophysical mood level resulting from stress, and 179 (16.6%) nurses had a low psychophysical mood. Those with a lower psychophysical mood showed a greater tendency towards developing improper eating habits (r = -0.23; p < 0.001). Most nurses had an average (n = 649; 60.1%) or low (n = 255; 23.6%) level of resilience. Higher resilience levels were observed in nurses aged over 30 years (p = 0.004) and in those with additional employment (p = 0.008). High resilience was associated with a lower intensity of risky behaviour. Conclusion: Most nurses in Poland display average and low levels of resilience, which can have unfavourable consequences for their health.

Combined Effects of Physical Behavior Compositions and Psychosocial Resources on Perceived Exertion Among Eldercare Workers

Objectives

High perceived physical exertion is common in eldercare workers and a strong predictor for impaired health. However, little is known on how physical behaviors at work associate with physical exertion in this group. The aim of this study was to determine the extent to which the composition of physical behaviors at work is associated with perceived physical exertion in nursing home eldercare workers, and the extent to which these associations are modified by psychosocial resources.

Methods

Our population consisted of 399 female eldercare workers from 126 wards in 20 different nursing homes. We evaluated time spent in physical behaviors at work [sitting, standing still, light activities (LAs), and moderate to vigorous activities (MVAs)] using triaxial accelerometers worn, on average, for three working days. We accounted for inherent codependency between the behaviors using compositional data analysis. We used multilevel linear mixed regression models to determine associations between the behaviors and perceived exertion, measured on a numeric rating scale (0–10), and included interactions between each behavior and psychosocial resources (influence at work, social support, and quality of leadership) to determine a possible moderating effect of resources. Regression results were illustrated using isotemporal substitution.

Results

Sitting was negatively (β: −0.64; P < 0.01) while MVA was positively (β: 0.95; P = 0.02) associated with perceived exertion. According to isotemporal substitution, replacing 30 min of MVA by sitting would, for an average worker, be associated with a decrease in physical exertion by −0.14 on the 0–10 scale. Job resources marginally moderated the association between LA and exertion. Thus, among workers with low influence and low social support, we found a positive association between LA and exertion, while that was not found for workers with medium or high influence and support (interactions for influence and support: P = 0.08 and P = 0.10).

Conclusions

Our findings suggest that reallocating time from MVA to sitting can mitigate perceived physical exertion in eldercare workers. More time in LA increased physical exertion only for workers with low psychosocial resources, supporting a positive effect of a better psychosocial work environment in elderly care.

Calidad de la dieta del personal de salud de un hospital chileno según el índice de alimentación saludable

Introducción. Se ha reportado que los trabajadores hospitalarios tienen una alta probabilidad de presentar factores de riesgo modificables asociados al desarrollo de enfermedades crónicas no transmisibles, tales como mala alimentación, altos niveles de estrés y cambios de los patrones del sueño.Objetivo. Determinar la calidad de la dieta del personal de salud que usa los servicios del Casino de Funcionarios del Hospital Regional de Temuco de acuerdo a sistemas de turno, sexo y edad. Para la medición de la calidad de la dieta se utilizó el índice de alimentación saludable (IAS).Materiales y métodos. Estudio transversal realizado en 201 trabajadores (156 mujeres y 45 hombres), a quienes se les solicitó completar una encuesta sobre consumo de alimentos para evaluar sus IAS; el instrumento estuvo dividido por grupos de alimentos.Resultados. La edad promedio fue 34.8±10.7 años y el puntaje promedio de IAS fue 67.5±14.5. El 12.9% de los participantes tenía hábitos alimenticios poco saludables, el 65.2% requería cambios dietarios y el 21.9% presentaba una alimentación saludable. Se observaron diferencias estadísticamente significativas respecto al IAS según sexo (p=0.033) y edad (p=0.009), pero no entre puntaje IAS y el sistema de turnos (p=0.334). Conclusiones. La mayoría de participantes necesita modificar sus hábitos alimenticios, por lo que es necesario que en los hospitales, como lugar de trabajo, se implementen acciones que promuevan la adopción de hábitos alimenticios saludables por parte del personal de salud, en particular en el caso de los hombres, quienes tuvieron puntajes de IAS significativamente bajos en varios grupos de alimentos en comparación con las mujeres.

Promoting and supporting healthy eating among nurses

Maintaining a healthy diet is important for health and longevity. Many diets are recommended for their health-promotion properties. Despite their role in providing health education to patients, nurses do not always maintain healthy diets themselves. The literature shows that a significant number of nurses are overweight or obese. This article reviews the recommended healthy eating guidance and explores why nurses may not always eat healthily. It appears that several characteristics of the nursing role and workplace - notably shift work, fatigue, stress, and suboptimal facilities and availability of healthy foods - make it increasingly challenging for nurses to maintain healthy diets. The article also discusses strategies employers can use to adapt the work environment to support healthy eating.

A longitudinal study of multiple lifestyle health risk behaviours among nursing students and non-nursing peers

AIM

The aim of this paper is to compare the evolution of health risk behaviours between undergraduate nursing and social work students.

BACKGROUND

Nursing includes the promotion of health and the shaping of healthy behaviours. An important determinant for providing lifestyle advice is the lifestyle of nurses themselves.

DESIGN

Longitudinal comparative study.

MEASUREMENTS

We compared lifestyle risk behaviours (binge drinking, cannabis/hashish/marijuana use, smoking, oral hygiene/toothbrushing, breakfast/fruit/vegetable consumption, physical activity and screen time/sedentary behaviours) using a self-administered standardized questionnaire in nursing (n = 121) and social work (n = 140) students at the beginning (2012) and the end of their studies (2015). Adjusted multivariable logistic/Poisson regression models were performed.

RESULTS

There were no statistically significant differences between the departments in most risk factors in both assessments. However, in relation to their first year, both nursing and social work students displayed higher relative risk of engaging in more behavioural risk factors at the end of their studies (in delivery/junk food consumption, sunburns, hashish/marijuana use and multiple sexual partners). Social work students displayed better behaviours in physical activity and breakfast intake.

CONCLUSION

Nursing students share the patterns of their nonnursing peers in behavioural risk factors compromising their future health and health-promoting role. We need strategies to safeguard the professional nursing practice.

Perceived Facilitators and Barriers to Nigerian Nurses' Engagement in Health Promoting Behaviors: A Socio-Ecological Model Approach

Nurses make up the single largest healthcare professional group in the Nigerian healthcare system. As frontline healthcare providers, they promote healthy lifestyles to patients and families. However, the determinants of Nigerian nurses’ personal health promoting behaviors (HPBs) remain unknown. Utilizing the socio-ecological model (SEM) approach, this study aimed to explore the perceived facilitators and barriers to Nigerian nurses’ engagement in HPBs. HPBs were operationalized to comprise of healthy dietary behaviors, engagement in physical activity, low-risk alcohol consumption, and non-smoking behaviors. Our study was carried out in a large sub-urban tertiary health facility in Nigeria. Data collection was via face-to-face semi-structured interviews and participants were registered nurses (n = 18). Interview data were transcribed verbatim and analyzed thematically to produce nine themes that were mapped onto corresponding levels of influence on the SEM. Findings show that in Nigeria, nurses perceive there to be a lack of organizational and policy level initiatives and interventions to facilitate their engagement in HPBs. The determinants of Nigerian nurses’ HPBs span across all five levels of the SEM. Nurses perceived more barriers to healthy lifestyle behaviors than facilitators. Engagement in healthy behaviors was heavily influenced by: societal and organizational infrastructure and perceived value for public health; job-related factors such as occupational stress, high workload, lack of protected breaks, and shift-work; cultural and religious beliefs; financial issues; and health-related knowledge. Organizations should provide facilities and services to support healthy lifestyle choices in Nigeria nurses. Government policies should prioritize the promotion of health through the workplace setting, by advocating the development, implementation, regulation, and monitoring of healthy lifestyle policies.

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.

Exercise, fitness and musculoskeletal health of undergraduate nursing students: A cross-sectional study

AIMS

To describe the exercise, physical fitness and musculoskeletal health of nursing students.

BACKGROUND

Nursing students are prone to musculoskeletal disorders restricting work ability. Physical fitness and leisure-time exercise may affect responses to workplace exposures and risk for work-related musculoskeletal disorders.

DESIGN

A cross-sectional study.

METHOD

Between August 2013 and April 2015, a convenience sample of 111 nursing students performed submaximal exercise tests. Nursing work, exercise and musculoskeletal health were surveyed and analysed descriptively.

RESULTS

Students' mean age was 30.0 years, 89.2% were female and 20.0% worked in nursing while studying. Highest annual prevalence of musculoskeletal trouble was in low back (45.6%), neck (32.0%) and shoulder (18.5%) regions. Most exercised regularly but did not meet weekly cardiorespiratory, resistance, neuromotor and flexibility exercise recommendations and had poor to average fitness levels. Approximately 40% were overweight or obese; 26.1% had risk for obesity-related disease.

CONCLUSIONS

Interventions to improve nursing students' physical condition before entering the nursing workforce appear warranted.

IMPACT

Imbalance between physical work capacity and demanding workloads increases musculoskeletal disorder risk amongst undergraduate nursing students. A large proportion studied reported recent musculoskeletal trouble (particularly low back, neck and shoulder). They exhibited modifiable characteristics of overweight/obese, poor fitness and inadequate leisure-time exercise, predisposing them to work-related musculoskeletal disorders. Undergraduate preparation should raise nursing students' health literacy about physical fitness and ways to achieve it, for their musculoskeletal health and work capacity. Improving nursing students' fitness may enhance their work preparedness and help them achieve longevity in this physically demanding occupation.

How many calories do nurses burn at work? A real-time study of nurses' energy expenditure

Background

Nurses have high rates of overweight and obesity, and physical inactivity is one key determinant of weight gain.

Aims

The present study aims to quantify nurses' energy expenditure over a standard 12-hour shift to establish whether activity levels at work are too low to maintain a healthy body weight.

Methods

Ward-based nurses (n = 96, 90 female, mean age = 36 years, mean experience = 10 years, mean body mass index = 26.6) wore heart rate and physical activity monitors for the duration of one full working shift. Heart rate and activity data were used in combination with demographic information to estimate each nurse's energy expenditure over 12 hours.

Results

On average, nurses burned 2.12 kcals per minute while at work, equating to 1521 kcals/6364 kJ (SD = 403 kcals/1686 kJ) per 12-hour shift. Energy expenditure over 12 hours varied markedly between nurses (from 812 kcals/3397 kJ to 3005 kcals/12,573 kJ) but was sufficient in 72% of participants (assuming minimal resting levels of energy expenditure for the 12 hours not at work) to burn off a daily calorie intake of 2000 kcals.

Conclusions

Three-quarters of nurses expend more energy on working days than is required to maintain a healthy body weight if dietary intake does not exceed recommended levels.

Working Time Society consensus statements: Evidence-based effects of shift work on physical and mental health

Potential effects of shift work on health are probably related to the misalignment between the light-dark cycle and the human activity-rest cycle. Light exposure at night mediates these effects, including social misalignment and leads to an inversion of activity and rest, which, in turn, is linked to changes in behaviours. This article reviews the epidemiological evidence on the association between shift work and health, and possible mechanisms underlying this association. First, evidence from findings of the meta-analyses and systematic reviews published in the last 10 yr is presented. In addition, it reports the larger single-occupation studies and recent large population-based studies of the general workforce. Koch's postulates were used to evaluate the evidence related to the development of disease as a result of exposure to shift work. Finally, we discussed limitations of the multiple pathways that link shift work with specific disorders and the methodological challenges facing shift work research. We concluded that the clearest indications of shift work being the cause of a disease are given when there is a substantial body of evidence from high quality field studies showing an association and there is good evidence from laboratory studies supporting a causal explanation of the link.

Nutritional status of the student nurses of a tertiary health-care center - A mixed-method study

CONTEXT

Nursing students are the future role model of health; so critical evaluation of their nutritional status is imperative for effective functioning of health sector.

AIMS

The aim is to assess the nutritional status of nursing students using basal metabolic index and exploring the causes of malnutrition along with uncovering the causes behind these causes of malnutrition.

SETTING AND DESIGN

Nutritional status of student's nurses was assessed by mixed-method study design in tertiary care center of Mumbai, India.

MATERIALS AND METHODS

The method is to use the census method for sampling 280 nursing students of a tertiary care center interviewed using a semistructured interview schedule. Focus group discussions were held with student nurses, which were selected through purposive sampling technique to interpret the instigator causes behind causes of malnutrition.

STATISTICAL ANALYSIS

Descriptive statistics was applied on qualitative data. Conceptual model framed on themes and subthemes based upon the codes from qualitative data.

RESULTS

Students having BMI less than 18 and more than 24.9 were 189 and 11, respectively, out of 280 students. About 64.20% had acidity and 11.07% performed regular exercises evolving major themes: challenges, stress, attitude, knowledge, social barriers, and motivators.

CONCLUSION

About 67.5% of nursing students had BMI less than 18. Inappropriate dietary pattern, frequent ailments, and improper personal habits ensued their malnourished status. Lack of proper knowledge on balanced diet, work place stress, and challenges such as financial constrain, peer pressure, and health ailments along with improper perception of body image of the student nurses are major triggering factors behind the causes of malnutrition.

Unhealthy dietary patterns among healthcare professionals and students in Mexico

Background

While dietary patterns (DPs) enable the combination of foods that make up a person’s habitual diet to be known, little is known about the DPs of health sector professionals. The objective of this study was to describe the DPs of healthcare students and professionals and assess their association with sociodemographic, lifestyle, anthropometric and biochemical characteristics.

Methods

Cross-sectional design. A sample (n = 319) of healthcare students and professionals in apparent good health who studied or worked at the University of Guadalajara (Mexico) was selected. A semiquantitative food intake frequency questionnaire validated on a Mexican population was administered. Questions covering sociodemographic factors, smoking habits and physical activity were asked. Weight, height, waist circumference, blood pressure, triglycerides, glucose, HDL-cholesterol, LDL-cholesterol and total cholesterol were also measured. DPs were generated from a principal components analysis of 25 food groups, and associations were analyzed using logistic regression adjusted for age and sex.

Results

The majority of participants were younger than 29 years (84%), women (71.2%) and students (59.6%). Three DPs were identified: “Traditional Westernized”, “Healthy” and “Animal protein and alcoholic beverages”. After adjustment, the “Traditional Westernized” DP was positively associated with being younger than 22 years (OR: 2.15; 95%CI: 1.1–4.1); the “Healthy” DP was positively associated with having a daily energy expenditure from physical activity greater than 605 kcal (OR: 4.19; 95%CI: 2.3–7.5), and it was negatively associated with being younger than 22 years (OR: 0.48; 95%CI: 0.2–0.9); and the “Animal protein and alcoholic beverages” DP was positively associated with being male (OR: 3.07; 95%CI: 1.8–5.1) and a smoker (OR: 2.77; 95%CI: 1.2–6.3). No association was found between DPs and anthropometric and biochemical characteristics.

Conclusions

Among the participants evaluated, healthy DP was associated with being physically active while unhealthy DPs were associated with being younger than 22 years, male and a smoker. These data suggest that being knowledgeable about health does not ensure that individuals will engage in healthy behaviors. As is the case among the general population, training and individual efforts aimed at achieving healthy behaviors must be reinforced by initiatives undertaken by social groups, social institutions, the community at large as well as political and business leaders.

Supporting nurses to adopt healthy eating behaviours

Nurses have a central role in health education and promotion, particularly with regard to supporting individuals to optimise their nutritional intake and engage in healthy eating behaviours. However, high rates of obesity, unhealthy eating behaviours and low levels of physical activity have been found among nurses. Nursing is a challenging profession, and a high workload, a lack of resources and shift work may affect nurses' ability to adopt healthy lifestyles. Supporting nurses to improve aspects of their eating behaviours, such as the nutritional value, timing and frequency of meals, can have a positive effect on their health which, in turn, may enhance their ability to care for patients. Although there is much literature available on the benefits of healthy eating, there is a lack of practical guidance for nurses on how to enhance their nutritional intake. This article uses a case study to examine the occupational and personal factors that may affect nurses' ability to engage in healthy eating behaviours, and identifies how healthcare organisations and individual nurses can use a behavioural change approach to optimise nutritional intake.

Lifestyle Health Behaviors of Nurses and Midwives: The 'Fit for the Future' Study

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014–2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25–34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required.

The health of working nurses: Hypertension prevalence, awareness, treatment and control by medication

AIMS

To investigate hypertension awareness, prevalence and treatment in nurses.

BACKGROUND

Nurses are the largest health workforce group, currently facing an ageing demographic and the risk of chronic disease such as hypertension. Little is known about hypertension in nurses despite the potential impact on work productivity.

METHODS

A cross-sectional online survey was distributed to nurses and midwives via the professional association and nursing directors. Questions were taken from published longitudinal health studies for blood pressure, hypertension and key sociodemographic and health factors.

RESULTS

The participants' (n = 5,041) mean age was 47.99 (SD 11.46) years. The majority knew their blood pressure, more so if they were female, of higher body mass index and aged 45-64 years, but less so if they were smokers. Hypertension prevalence increased with age, peaking at the oldest ages and the majority were treated (anti-hypertensive medication), less so if aged <55 years. Many nurses treated for hypertension had poor blood pressure control, were most often aged 45-54 years and were smokers.

CONCLUSIONS

Hypertension prevalence is less in nurses than in the general population, however, once diagnosed treatment is not optimized.

IMPLICATIONS FOR NURSING MANAGEMENT

The potential impact of hypertension on older nurses' work productivity justifies work-based support for risk reduction behaviours.

The Impact of Web-Based Feedback on Physical Activity and Cardiovascular Health of Nurses Working in a Cardiovascular Setting: A Randomized Trial

A disconcerting proportion of Canadian nurses are physically inactive and report poor cardiovascular health. Web-based interventions incorporating feedback and group features may represent opportune, convenient, and cost-effective methods for encouraging physical activity (PA) in order to improve the levels of PA and cardiovascular health of nurses. The purpose of this parallel-group randomized trial was to examine the impact of an intervention providing participants with feedback from an activity monitor coupled with a web-based individual, friend or team PA challenge, on the PA and cardiovascular health of nurses working in a cardiovascular setting.

Methods: Nurses were randomly assigned in a 1:1:1 ratio to one of the following intervention “challenge” groups: (1) individual, (2) friend or (3) team. Nurses wore a Tractivity® activity monitor throughout a baseline week and 6-week intervention. Height, body mass, body fat percentage, waist circumference, resting blood pressure (BP) and heart rate were assessed, and body mass index (BMI) was calculated, during baseline and within 1 week post-intervention. Data were analyzed using descriptive statistics and general linear model procedures for repeated measures.

Results: 76 nurses (97% female; age: 46 ± 11 years) participated. Weekly moderate-to-vigorous intensity PA (MVPA) changed over time (F = 4.022, df = 4.827, p = 0.002, η² = 0.055), and was greater during intervention week 2 when compared to intervention week 6 (p = 0.011). Daily steps changed over time (F = 7.668, df = 3.910, p < 0.001, η² = 0.100), and were greater during baseline and intervention weeks 1, 2, 3, and 5 when compared to intervention week 6 (p < 0.05). No differences in weekly MVPA or daily steps were observed between groups (p > 0.05). No changes in body mass, BMI or waist circumference were observed within or between groups (p > 0.05). Decreases in body fat percentage (−0.8 ± 4.8%, p = 0.015) and resting systolic BP (−2.6 ± 8.8 mmHg, p = 0.019) were observed within groups, but not between groups (p > 0.05).

Conclusions: A web-based intervention providing feedback and a PA challenge initially impacted the PA, body fat percentage and resting systolic BP of nurses working in a cardiovascular setting, though increases in PA were short-lived. The nature of the PA challenge did not differentially impact outcomes. Alternative innovative strategies to improve and sustain nurses' PA should be developed and their effectiveness evaluated.

'Mental health day' sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics

AIM

To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as 'mental health days'.

BACKGROUND

The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a 'mental health day' as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence.

DESIGN

Online cross-sectional survey.

METHODS

Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. Sample characteristics were reported using descriptive statistics. Factors independently predictive of 'mental health day' reportage were determined using logistic regression.

RESULTS

Fifty-four percentage of the n = 5041 nurse and midwife respondents took 'mental health days'. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work; to report workplace abuse and plans to leave; having been admitted to hospital in previous 12 months; to be current smokers; to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use.

CONCLUSION

Specific characteristics of nurses and midwives who report taking 'mental health day' sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety.

Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review

AIM

The aim was to conduct an integrative systematic review to identify barriers and facilitators to healthy eating for working nurses.

BACKGROUND

There is growing recognition of the influence of the workplace environment on the eating habits of the workforce, which in turn may contribute to increased overweight and obesity. Overweight and obesity exact enormous costs in terms of reduced well-being, worker productivity and increased risk of non-communicable diseases. The workplace is an ideal place to intervene and support healthy behaviours. This review aimed to identify barriers and facilitators to nurses' healthy eating in the workplace.

DESIGN

Integrative mixed method review.

DATA SOURCES

Five electronic databases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO. Reference lists were searched. Included papers were published in English between 2000-2016. Of 26 included papers, 21 were qualitative and five quantitative.

REVIEW METHODS

An integrative literature review was undertaken. Quality appraisal of included studies used standardized checklists. A social-ecological framework was used to examine workplace facilitators and constraints to healthy eating, derived from the literature. Emergent themes were identified by thematic analysis.

RESULTS

Review participants were Registered, Enrolled and/or Nurse Assistants primarily working in hospitals in middle or high income countries. The majority of studies reported barriers to healthy eating related to adverse work schedules, individual barriers, aspects of the physical workplace environment and social eating practices at work. Few facilitators were reported. Overall, studies found the workplace exerts a considerable negative influence on nurses' dietary intake.

CONCLUSION

Reorientation of the workplace to promote healthy eating among nurses is required.