Metabolic Syndrome Among Primary Health Care Nursing Professionals: A Cross-Sectional Population-Based Study

Diagnosis of metabolic syndrome in nursing professionals: An accuracy study

Metabolic Syndrome (MetS) represents a group of cardiovascular risk factors. This article aims to evaluate the accuracy of the tools of MetS diagnosis in Nursing professionals from Primary Health Care (PHC) in Bahia, Brazil. A cross-sectional study with a random sample selected according to essential health information for the diagnostic of MetS. For MetS diagnostic, we used EGIR, NCEP-ATPIII, AACE, IDF, Barbosa et al. (2006), and IDF/AHA/NHLBI (defined as gold standard) definition. Sensitivity, specificity, predictive values, and likelihood ratio were estimated for each diagnostic tool and compared with the gold standard. Kappa statistic was used to determine the agreement between the diagnostic methods. One thousand one hundred and eleven nursing professionals were included in this study. Sensitivity varied from 15% to 95.1%, and specificity varied between 99.5% and 100%. IDF and Barbosa et al. (2006) definitions were more sensitive (95.1% and 92.8%, respectively), and EGIR, NCEP, ATP III, and IDF showed 100% specificity. IDF and Barbosa et al. (2006) use suitable metabolic syndrome identification and confirmation criteria. The highest agreement was found in the definition of the IDF, Barbosa et al. (2006) and the NCEP ATP III. Defining metabolic syndrome with a higher diagnostic accuracy could contribute to the screening and the early identification of nursing professionals with cardiovascular disease risk factors, which provide opportunities for appropriate prevention and treatment.

Sex differences in risk factors for metabolic syndrome in middle-aged and senior hospital employees: a population-based cohort study

BACKGROUND

Several cross-sectional studies have reported risk factors for metabolic syndrome (MetS). However, these studies did not focus on sex differences in middle-aged and senior populations or employ a longitudinal design. These study design differences are important, as there are sex differences in lifestyle habits associated with MetS, and middle-aged and senior individuals have increased MetS susceptibility. Therefore, the purpose of this study was to examine whether sex differences influenced MetS risk over a ten-year follow-up period among middle-aged and senior hospital employees.

METHODS

This population-based and prospective cohort study enrolled 565 participants who did not have MetS in 2012 for a ten-year repeated-measurement analysis. Data were retrieved from the hospital's Health Management Information System. Analyses included Student's t tests, χ² tests and Cox regression. P < 0.05 indicated statistical significance.

RESULTS

Male middle-aged and senior hospital employees had an elevated MetS risk (hazard ratio (HR) = 1.936, p < 0.001). Men with more than four family history risk factors had an increased risk of MetS (HR = 1.969, p = 0.010). Women who worked shift duty (HR = 1.326, p = 0.020), had more than two chronic diseases (HR = 1.513, p = 0.012), had three family history risk factors (HR = 1.623, p = 0.010), or chewed betel nuts (HR = 9.710, p = 0.002) had an increased risk of MetS.

CONCLUSIONS

The longitudinal design of our study improves the understanding of sex differences in MetS risk factors in middle-aged and senior adults. A significantly elevated risk of MetS over the ten-year follow-up period was associated with male sex, shift work, the number of chronic diseases, the number of family history risk factors, and betel nut chewing. Women who chewed betel nuts had an especially increased risk of MetS. Our study indicates that population-specific studies are important for the identification of subgroups susceptible to MetS and for the implementation of hospital-based strategies.

Association between burnout syndrome and obesity: A cross-sectional population-based study

BACKGROUND: Burnout Syndrome (BS) is a response of organism against long-lasting exposure to occupational stressors. Those affected usually have comorbidities, as well as cardiovascular and metabolic problems. OBJECTIVE: Estimating the association between BS and obesity in primary health care nurses of in the state of Bahia, Brazil. METHODS: Population-analytical, cross-confirmatory, integrated and multicenter study, conducted with a random sample of primary health care nursing professionals in 43 municipalities from 07 mesoregions of Bahia, Brazil. This study was funded by the Brazilian Board for Scientific and Technological Development. The independent variable (BS) was evaluated by using the Maslach Burnout Inventory (MBI) scale, and the dependent one (obesity) was based on the Body Mass Index (BMI)≥30. Effect modification and confounding factors were verified by crude, stratified, and multivariate analysis. RESULTS: The prevalence of BS and obesity was 17.7% and 12.7%, respectively. BS was statistically associated with obesity, even after adjustment (RPa: 1.85; CI 95% 1.11–3.06) per gender, age, physical activity, healthy eating, satisfaction with occupation, another job, night shift, primary health care (PHC) time, and working conditions. Effect-modifying variables were not identified. CONCLUSIONS: The specialized literature points out a path to the association identified here. New studies on the subject are relevant and should have more robust methodologies so that the path of causality is better clarified. In addition, occupational health programs become an alternative to control stress and, therefore, its complications, such as burnout and other health aggravations.

Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study

BACKGROUND

Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness.

OBJECTIVE

Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil.

METHOD

Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described.

RESULTS

MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS.

CONCLUSION

The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.

Association between Metabolic Syndrome and professional category: a cross-sectional study with Nursing professionals

OBJECTIVE

to evaluate the association of Metabolic Syndrome and its components among Primary Health Care Nursing professionals in the state of Bahia, Brazil, according to professional category.

METHOD

a cross-sectional, population-based and multicenter study conducted with 1,125 Nursing professionals. The independent variable was the professional category, dichotomized into technical and higher education levels. The outcome was Metabolic Syndrome following criteria from the National Cholesterol Education Program Adult Treatment Panel III based on anthropometric measurements and blood samples. The statistical analysis was performed by calculating the prevalence ratios and using Pearson's Chi-square test.

RESULTS

the prevalence of Metabolic Syndrome was higher in the technical level category (PR=1.64; CI=1.29 - 2.06; p≤0.01). When compared to Nurses, these professionals were older, had lower incomes, worked more on duty and performed less physical activity on a regular basis. Among the Nurses, the most prevalent component was altered cholesterol (40.5%) and among the Nursing Technicians/Assistants, it was abdominal obesity (47.3%).

CONCLUSION

the association between the Nursing category and Metabolic Syndrome was evident, with higher occurrence among technical level professionals.

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.

Age, Sex, and Profession Difference Among Health Care Workers With Burnout and Metabolic Syndrome in Taiwan Tertiary Hospital-A Cross-Section Study

Background

This cross-sectional study aimed to analyze the association between burnout, work-related factors and metabolic syndrome (MetS) among various health-care workers (HCWs) at a tertiary hospital in Taiwan.

Methods

Relevant demographic data were obtained through written questionnaires. Information about psychosocial and work conditions, including assigned department, working hours, shifts, and sleep condition, was obtained. Burnout was evaluated according to the Chinese version of Maslach Burnout Inventory-Health Services Survey. MetS was analyzed according to the criteria of the National Cholesterol Education Program of Taiwan-Treatment Panel for Adults III.

Results

A total of 1,055 non-doctor/nurse and 2,078 doctor/nurse staff with a median age of 45.2 and 36.1 years participated in this study. The incidence of burnout was nearly 6.42 and 6.68% and that of MetS was 31.4 and 13.5% in non-doctor/nurse and doctor/nurse staff, respectively. The results showed that burnout induced a higher Odds ratio (OR) of MetS in the doctor/nurse group (OR = 1.96, p = 0.01). Other factors, such as night shift and seniority (>10 years), led to a higher OR of MetS, but a decreased risk was observed based on seniority (2-4 years). Further, young female participants and young doctors/nurses with burnout had a higher OR of MetS compare to other groups (OR = 2.43 and 2.32, p < 0.05).

Conclusion

The study results suggested positive relationship between burnout and MetS in young female staffs and young doctors/nurses. For doctor/nurse staff with higher seniority or more night shifts, strategies are needed to prevent burnout and MetS.

Anxiety and dyslipidemia among primary health care professionals: A Cross-sectional study

BACKGROUND: Cross-sectional studies point out important evidence between anxiety and dyslipdemic disorders in health workers. OBJECTIVE: Our main objective was to estimate the association between anxiety and dyslipidemia in Primary Health Care (PHC) nursing professionals in Feira de Santana, Bahia, Brazil. METHODS: A confirmatory cross-sectional study involving 376 PHC nursing professionals. Data collection occurred through the application of a questionnaire containing sociodemographic, labor and lifestyle issues, and the Beck Inventory for anxiety; to evaluate the lipid profile, the HDL-c, LDL-c, and triglycerides markers were evaluated. Descriptive, bivariate analysis and Logistic Regression were performed. RESULTS: The estimated prevalence of moderate/severe anxiety corresponded to 26.1% and dyslipidemia was 54.8%, with a statistically significant association between both of variables stratified by physical activity (PR = 2.69; 95% CI = 1.87–3.85) and (PR = 1.87; 95% CI = 1.53–2.28). CONCLUSIONS: There is a positive association between anxiety and dyslipidemia in Primary Health Care nursing professionals.

Focus on Polish nurses' health condition: a cross-sectional study

Background

The nursing profession carries with it many negative factors and a high risk of developing chronic diseases, including overweight and obesity. According to statistics, the health condition of this professional group is much worse than that of the average population of the same age. As the largest and most trusted professional group in the world, nurses are critical to the health of any nation. The aim of the study was to assess the Polish nurse's health condition based on real measurements of parameters important for the occurrence of metabolic diseases.

Methods

This is the cross-sectional, conducted among two age groups of Polish nurses (<50 years and ≥50 years). Study included the measurements with DXA, the assessment of glucose concentration and lipid profile, the measurement of blood pressure and socio-demographic data of the surveyed nurses.

Results

The majority of respondents above 50 years old were nurses with elevated total cholesterol (79.3%), elevated LDL cholesterol (72.8%), 42.4% of studied nurses had hypertension.

Conclusion

Individual, local and national measures to prevent and support the health of this professional group are needed.

Interaction between Work and Metabolic Syndrome: A Population-Based Cross-Sectional Study

Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among primary health care (PHC) nursing professionals in the state of Bahia, Brazil. A sectional multicentered study carried out in 43 municipalities in Bahia, whose study population consisted of nursing professionals. The exposure variables were occupation, professional exhaustion, and working time, and the outcome variable was MS. Interaction measures based on the additivity criteria were verified by calculating the excess risks due to the interactions and according to the proportion of cases attributed to the interactions and the synergy index. The global MS prevalence is 24.4%. There was a greater magnitude in the exposure group regarding the three investigated factors (average level occupation, professional exhaustion, and working time in PHC for more than 5 years), reaching an occurrence of 44.9% when compared to the prevalence of 13.1% in the non-exposure group (academic education, without professional burnout, and working time in PHC for up to 5 years). The study's findings showed a synergistic interaction of work aspects for MS occurrence among PHC nursing professionals.

Asociación entre síndrome metabólico y categoría profesional: estudio transversal con profesionales de enfermería

Resumen Objetivo: evaluar la asociación que hay entre el Síndrome Metabólico y sus componentes y los profesionales de Enfermería de la Atención Primaria de Salud en el estado de Bahía, Brasil, según la categoría profesional. Método: estudio transversal, de base poblacional y multicéntrico realizado con 1.125 profesionales de Enfermería. La variable independiente fue la categoría profesional, dicotomizada en niveles de educación técnica y superior. El resultado fue Síndrome Metabólico siguiendo los criterios del National Cholesterol Education Program Adult Treatment Panel III a partir de mediciones antropométricas y muestras de sangre. El análisis estadístico se realizó calculando las razones de prevalencia y utilizando la prueba de Chi-cuadrado de Pearson. Resultados: la prevalencia de Síndrome Metabólico fue mayor en la categoría de nivel técnico (RP=1,64; IC 1,29 - 2,06; p≤0,01). Dichos profesionales tenían mayor edad, menor ingreso, más guardias y realizaban menos actividad física de forma regular que los Enfermeros. En los Enfermeros, el componente más prevalente fue el colesterol alterado (40,5%); en los Técnicos en Enfermería/Auxiliares fue la obesidad abdominal (47,3%). Conclusión: fue evidente la asociación entre la categoría de Enfermería y el Síndrome Metabólico, fue mayor en los profesionales de nivel técnico.

Association between Metabolic Syndrome and professional category: a cross-sectional study with Nursing professionals

Objective:

to evaluate the association of Metabolic Syndrome and its components among Primary Health Care Nursing professionals in the state of Bahia, Brazil, according to professional category.

Method:

a cross-sectional, population-based and multicenter study conducted with 1,125 Nursing professionals. The independent variable was the professional category, dichotomized into technical and higher education levels. The outcome was Metabolic Syndrome following criteria from the National Cholesterol Education Program Adult Treatment Panel III based on anthropometric measurements and blood samples. The statistical analysis was performed by calculating the prevalence ratios and using Pearson’s Chi-square test.

Results:

the prevalence of Metabolic Syndrome was higher in the technical level category (PR=1.64; CI=1.29 - 2.06; p≤0.01). When compared to Nurses, these professionals were older, had lower incomes, worked more on duty and performed less physical activity on a regular basis. Among the Nurses, the most prevalent component was altered cholesterol (40.5%) and among the Nursing Technicians/Assistants, it was abdominal obesity (47.3%).

Conclusion:

the association between the Nursing category and Metabolic Syndrome was evident, with higher occurrence among technical level professionals.

Incorporating a Microlearning Wellness Intervention Into Nursing Student Curricula

BACKGROUND

Cultivating healthy lifestyle beliefs (HLBs) can result in positive health outcomes for students during their nursing program.

PURPOSE

The purpose of the study was to determine the effectiveness of short wellness interventions (microlearning) in nursing courses on reducing stress and anxiety and enhancing HLB.

METHODS

Microlearning wellness interventions were offered to graduate and undergraduate nursing students in this cluster randomized intervention study. The Perceived Stress Scale 4, Generalized Anxiety Disorder 7, and Healthy Lifestyle Beliefs Scales were administered. Student perceptions were evaluated using a short answer narrative.

RESULTS

The intervention group reported higher HLB (P = .15), lower anxiety (P = .06), and lower stress (P = .06) compared with the control group after adjusting for baseline differences. Student comments were favorable and included enjoying the activities, weight loss success, and mindfulness strategies.

CONCLUSIONS

Incorporating wellness interventions into nursing curricula demonstrates a positive trend toward reducing anxiety and stress and improving HLB.

Risk Factors of Metabolic Syndrome among Polish Nurses

The metabolic syndrome, also known as syndrome X or the insulin resistance, is defined by the World Health Organization as a pathologic condition characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. Both all over the world and in Poland, there is a shortage of nurses; most of those employed are in the pre-retirement age. However, the requirements in this profession and the patient’s right to care at the highest level remain unchanged and do not take into account the poor condition or age of working nurses, so special attention should be paid to the state of health in this professional group. There is an emphasis on the importance of the adopted attitude toward health and the resulting behaviors, such as regular weight control, following dietary recommendations, regular physical activity and participation in preventive examinations. The aim of the study was to assess the frequency of the occurrence of the metabolic syndrome, its individual components and determining the factors influencing its development in Polish nurses. The research conducted among the nurses in question included DXA (Dual Energy X-ray Absorptiometry) measurements, assessment of glucose concentration, lipid profile, blood pressure and a questionnaire survey. Almost half of the surveyed nurses have metabolic syndrome, which significantly increases the risk of developing cardiovascular diseases or diabetes. After multivariate analysis, it was found that being overweight and obesity were significant factors influenced the MS (metabolic syndrome) occurrence among Polish nurses. Being overweight increases the chances of MS occurrence 8.58 times in relation to BMI (Body Mass Index) <25, obesity increases the chances of MS occurrence 8.085 times in relation to BMI <25, and obesity class II/III increases the chances of MS occurrence 16.505 times in relation to BMI <25. Preventive and supportive measures for this professional group are needed.

Burnout and metabolic syndrome among different departments of medical center nurses in Taiwan-Cross-sectional study and biomarker research

OBJECTIVES

The cross-sectional study aimed to analyze the association between burnout, work-related factors, and metabolic syndrome (Mets) in nurses from several departments of a tertiary hospital in Taiwan. Exploring biomarkers could provide for prevention.

METHODS

Demographic data were obtained through a written questionnaire and include the following information: gender, age, education level, psychosocial and work situations, such as departments, working hours, work shift, depression, and sleep time. Burnout was evaluated according to the Chinese Burnout inventory, Mets was evaluated according to the criteria of the National Cholesterol Education Program of Taiwan-Treatment Panel for Adults III (NCEP-ATP III).

RESULTS

A total of 1758 nurses participated with a median age of 35.2 years. The prevalence of burnout and Mets was 6.4% and 13.84%, respectively. The results showed that burnout induced higher risk of Mets, odds ratio (OR) 1.70 (95% confidence interval, 1.04-3.05). Other factors, such as out-patient nurses, seniority (4-10 and >10 years), working hours (51-59 h/wk), nigh shift, Brief Symptom Rating Scale-5 (score 10-14 and ≧15), poor self-rated health status, and inadequate sleep time, led to higher risk of Mets. Biomarkers research showed that Glycated hemoglobin (Hba1c) was significantly associated with burnout nurses (OR = 24.72, P < .001), but thyroid-stimulating hormone and free thyroxin were not.

CONCLUSIONS

Results suggested positive associations between burnout and Mets in nurses. For nurses with higher seniority, long hours of work, night shifts, poor physical and mental conditions, and poor lifestyle habits in different departments, strategies are needed to prevent burnout and Mets.

Burnout and metabolic syndrome among healthcare workers: Is subclinical hypothyroidism a mediator?

OBJECTIVES

Evidence suggests that subclinical hypothyroidism (SCH) is associated with burnout and metabolic syndrome (MetS). We examined the relationship between burnout and MetS among healthcare workers (HCWs) and investigated the potential mediation of SCH.

METHODS

This cross-sectional study included HCWs from a tertiary medical center; demographic data were obtained using a questionnaire. Burnout was evaluated according to the Chinese version of the Maslach Burnout Inventory-Health Services Survey (MBI-HSS). MetS and thyroid function data were obtained from a physical check-up. Logistic regression models were used to evaluate the adjusted odds ratio (aOR), and mediation analysis was employed to examine the mediation effect.

RESULTS

Among 945 non-doctor/nurse and 1868 doctor/nurse staff, MetS was 30% and 14%, respectively, and the prevalence of burnout was nearly 6.5%. The results showed that burnout induced higher aOR of MetS in the doctor/nurse group (1.27, 95% confidence interval [CI]: 1.05-3.62). Thyroid-stimulating hormone (TSH) showed a positive association factor of MetS in doctor/nurse group-adjusted burnout (aOR = 1.15, 95% CI: 1.01-4.19). A higher TSH level was associated with an increased odds of MetS in younger doctor/nurse staff with burnout syndrome (aOR = 1.74; 95% CI: 1.04-3.22). There was a borderline significant mediation effect of SCH in the association between burnout and MetS in doctor/nurse staff.

CONCLUSIONS

The results showed that higher TSH levels were positively associated with burnout and MetS in doctor/nurse professionals, especially in the young cohort. Burnout may rely on the borderline mediation effect of SCH, which is likely to affect MetS.

Association between metabolic syndrome and work: an integrative review of the literature

The aim of this study was to highlight the association between occupational aspects and the occurrence of metabolic syndrome among various occupational groups. This is an integrative review of the literature that included articles indexed in the following databases: LILACS, SciELO, PubMed, and CINAHL. We evaluated 32 articles, most of which were published in Englishlanguage medical journals and with level 4 scientific evidence. The occupational aspects most commonly reported as associated with metabolic syndrome were occupation, work shift, and occupational stress. Our results indicated that occupational aspects could negatively interfere with workers' health; more robust longitudinal studies should contribute to further uncovering the reported associations.