Healthy Eating and Physical Activity Behaviours in Nurses

Nurses are caregivers whose role in healthcare is essential to restoring health of the patient. This role is expected around the clock for as long as the patient is hospitalized or is unwell, sometimes long after being discharged from inpatient care. This therefore requires nurses to work long and variable hours, which affects their own lifestyle behaviors despite their knowledge of healthy eating and other healthful lifestyles.  

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Studies conducted on the factors related to healthy diet in physical activity in hospital based clinical nurses, demonstrated that majority of Nurses struggle to maintain healthy eating habits, only moderately eating healthy while many more are insufficiently active (Albert, Butler, & Sorrell, 2014). This research aims to identify the factors related to healthy diet and physical activity among hospital-based clinical nurses. Using a cross-sectional, correlational design survey, 278 sample size nurses were obtained who worked in units with 24 hours per day and 7 days per week responsibilities. Subjects were randomly sampled using convenience sampling method. They were included if they worked on a hospital based unit ( medical, surgical, Specialty Care or Critical Care)  that had 24 hours per day and 7 days per week responsibilities and had exposure to newsletter, email and website studies that communicated hospital-based lifestyle, dietary and physical activity and exercise programs.

Exclusion criteria eliminated nurses whose roles were primarily office or desk jobs or worked daytime business hours such as Educators, clinical nurse specialists, directors and case managers. Of the 278 nurses sampled, the median age was 31.5 years, 91% female, 91.2% were Caucasian and they had a median BMI of 25.5 (slightly overweight) (Albert, Butler, & Sorrell, 2014). Nurses as part of their role are required to provide nutrition assessment/or education to patients but also serve as role models. This role is poorly performed when Nurses do not see themselves as good role Models. Living healthful Lifestyles through proper diet and physical activity improves nurses own confidence of themselves which enables nurses to perform their role better. When asked about confidence in their outlook 36.1% responded as being non-confident, 43% were somewhat confident and only 20% responded as being confident. Generally, this research showed that nurses had an internal locus of control regarding their dietary habits but experienced difficulty overcoming many barriers affecting their ability to implement healthful dieting and lifestyle modifications (Albert, Butler, & Sorrell, 2014).

Another research conducted by Nicholls, Perry, Duffield, Gallagher, & Pierce, 2017 aimed to conduct an integrative systematic review to identify barriers and facilitators to healthy eating for working nurses. This review was designed using an integrated mixed method with sources from 5 electronic databases; CINAHL, MEDLINE, PROQUEST Health and medicine, ScienceDirect and PsycINFO.  A total of 26 research papers were included; 5 quantitative and 21 qualitative.  Inclusion criteria used standardized checklist of quality appraisal that examined workplace facilitators and constraints to healthy eating.  The qualitative studies were appraised using the critical appraisal skills program (CASP), while the quantitative studies where appraised using the Glasziou et al (2001) appraisal framework  (Nicholls, Perry, Duffield, Gallagher, & Pierce, 2017).  

Data abstractions were summarized into data tables containing methological data, participant roles, settings, study limitations and relevant text that referred to the research questions. Results of the review were synthesized by thematic synthesis of mixed methods which included; data reduction, data display (in tables) and drawing and verifying conclusions.  Review participants were either registered nurses, enrolled and/or nurse assistants, practice nurses, licensed practical nurses and health visitors primarily working in hospitals in middle or high-income countries (Nicholls et al., 2017).

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 Organizational barriers to nurses’ healthy eating were reported in majority of articles as due to long work hours, shift work, high workload, low staffing levels and short/few work breaks.  Personal barriers as reported by majority of studies reported that obese or overweight nurses did not perceive their weight as a health risk and therefore unlikely to be motivated to lose the weight. They also believed they were eating healthy and exercising regularly but were just not able to lose the weight. Few facilitators were reported, but overall studies found the workplace as a major negative influence on nurses’ dietary intake. Addressing such barriers by reorientation of the workplace will help promote healthy eating among nurses (Nicholls et al., 2017).

References

• Albert, N. M., Butler, R., Sorrell, J., (2014) “Factors Related to Healthy Diet and Physical Activity in Hospital-Based Clinical Nurses” OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 3, Manuscript 5.
• Glasziou P., Irwig L., Bain C. & Colditz G. (2001). Systematic Reviews in Health Care: A Practical Guide, Cambridge University Press, Cambridge, United Kingdom.
• Nicholls, R., Perry, L., Duffield, C., Gallagher, R., & Pierce, H. (2017). Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review. Journal of Advanced Nursing, 73(5), 1051–1065. https://doi.org/10.1111/jan.13185