Should nurses be role models for healthy lifestyles? Results from a modified Delphi study

Factors associated with dietary behaviour change support in patients: A qualitative study among community nurses

AIM

To explore which factors, influencing dietary behaviour change support among patients by Dutch community nurses (CNs; nurses), are key focal points in training programmes.

BACKGROUND

Nurses have an important role in counselling patients towards healthier dietary behaviour to prevent or delay long-term complications from chronic lifestyle-related diseases. Most nurses do not incorporate dietary behaviour change support in their routines to the fullest potential.

DESIGN

A qualitative descriptive study.

METHODS

Data were collected in the Netherlands in 2018-2019 via semi-structured face-to-face interviews with 18 nurses. Interview guide themes were informed by the COM-B model, using validated descriptions in Dutch. Data were recorded, transcribed and analysed using inductive thematic analysis.

RESULTS

Factors that affected dietary behaviour change support were linked to (1) the nurse (role identity, dietary knowledge and competences such as methodical approach, behaviour change techniques and communication techniques), (2) nurse-patient encounter (building a relationship with a patient, supporting patient autonomy and tailoring the approach) and (3) cooperation and organizational context.

CONCLUSION

It is of utmost importance to pay attention to nurses' role identity regarding dietary behaviour change support, as this underlies professional behaviour. This should be accompanied by improving competences on dietary behaviour change support. Focus on competences regarding the application of behaviour change technique is crucial. Furthermore, having a relationship of trust with a patient was important for discussing sensitive topics such as diet.

IMPACT

The promotion of a healthy diet provides opportunities to contribute to patient autonomy and self-management. Well-fitted training offers for (senior) nurses will lead to improved professional practice of nurses, leading to healthier dietary behaviour of patients.

PATIENT OR PUBLIC CONTRIBUTION

A nurse provided feedback on the interview guide.

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.

Associations between compassion fatigue, burnout and secondary traumatic stress with lifestyle factors in mental health nurses: A multicenter study from Uganda

PURPOSE

This cross-sectional study aimed (a) to explore levels of compassion satisfaction, secondary traumatic stress, and symptoms of burnout among Ugandan mental health nurses working in regional referral hospitals in Uganda during the Covid-19 pandemic, and (b) to investigate associations between compassion satisfaction, secondary traumatic stress, and symptoms of burnout and sedentary levels, physical activity (PA) levels, sleep quality, and harmful drinking.

MATERIAL AND METHODS

In total 108 mental health nurses from 8 regional referral hospitals across Uganda (age = 34.8 ± 10.0 years; 55.6 % female) completed the Professional Quality of Life Scale-5, (PQoLS-5), the Simple Physical Activity Questionnaire (SIMPAQ), Physical Activity Vital Sign (PAVS), Pittsburgh Sleep Quality Index (PSQI), and Alcohol Use Disorder Identification Test - Concise (AUDIT-C). Spearman Rho correlations and Mann-Whitney U tests were applied.

RESULTS

ProQOL-5 compassion satisfaction correlated significantly with SIMPAQ walking, PSQI and AUDIT-C, ProQOL-5 burnout with SIMPAQ exercise and PSQI and ProQOL-5 traumatic with SIMPAQ walking and PSQI. Mental health nurses meeting PA guidelines reported higher ProQOL-5 compassion satisfaction and lower ProQOL-5 burnout and traumatic stress than those who did not. Those who reported a poor sleep quality reported significantly less ProQOL-5 compassion satisfaction and higher ProQOL-5 burnout than those who did not. Those who reported harmful drinking patterns reported a significantly lower compassion satisfaction versus those who did not.

DISCUSSION

In mental health nurses, a lower professional quality of life is associated with an unhealthy lifestyle. The effectiveness and efficacy of resilience and self-care programs for mental health nurses focusing on unhealthy lifestyle patterns should be explored.

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.

Actions Speak Louder Than Words: Health Behaviours and the Literacy of Future Healthcare Professionals

Our everyday behaviours in life can positively and negatively impact our health, thus cumulatively shaping our lifestyles as more or less healthy. These behaviours are often determined by our knowledge, literacy, motivations and socioeconomic backgrounds. The authors aimed to assess health behaviours and explore variables that may affect persons studying to become future healthcare professionals in Poland. This study was conducted with a group of 275 undergraduate students attending the Poznan University of Medical Sciences representing six different majors of study. We used self-reported, cross-sectional survey conducted through the use of a questionnaire that consisted of one standardised scale (Juczyński’s Health Behaviour Inventory) as well as a self-developed health literacy measure. The students showed average to high levels of health-promoting behaviours (mean HBI = 82.04 ± 11.26). Medium to strong associations were found between these behaviours and high scores on the health literacy scale (p = 0.001, r = 0.45 between total scores of the two scales). Dietetics students and female respondents scored significantly better on both scales, which suggests that their self-reported behaviours and health literacy were higher than those of other participants. Exhibiting health-protective behaviours and high health literacy is likely to result in the better individual health of our respondents, but, more importantly, will also influence their future professions. As members of the healthcare workforce they will be responsible for the health of the population and it is crucial for them not only to provide care, education, and guidance, but also to act as role-models for their patients and society.

Actions Speak Louder Than Words: Health Behaviours and the Literacy of Future Healthcare Professionals

Our everyday behaviours in life can positively and negatively impact our health, thus cumulatively shaping our lifestyles as more or less healthy. These behaviours are often determined by our knowledge, literacy, motivations and socioeconomic backgrounds. The authors aimed to assess health behaviours and explore variables that may affect persons studying to become future healthcare professionals in Poland. This study was conducted with a group of 275 undergraduate students attending the Poznan University of Medical Sciences representing six different majors of study. We used self-reported, cross-sectional survey conducted through the use of a questionnaire that consisted of one standardised scale (Juczyński’s Health Behaviour Inventory) as well as a self-developed health literacy measure. The students showed average to high levels of health-promoting behaviours (mean HBI = 82.04 ± 11.26). Medium to strong associations were found between these behaviours and high scores on the health literacy scale (p = 0.001, r = 0.45 between total scores of the two scales). Dietetics students and female respondents scored significantly better on both scales, which suggests that their self-reported behaviours and health literacy were higher than those of other participants. Exhibiting health-protective behaviours and high health literacy is likely to result in the better individual health of our respondents, but, more importantly, will also influence their future professions. As members of the healthcare workforce they will be responsible for the health of the population and it is crucial for them not only to provide care, education, and guidance, but also to act as role-models for their patients and society.

The relationship between e-health literacy and health-promoting behaviors of Turkish hospital nurses

The increase in information technologies has made it easy to access much health information online. In this context, e-health literacy emerges as a skill for acquiring health information. Obtaining health information through information technology for health promotion requires e-health literacy. The aim of this study was to examine the e-health literacy and the health-promoting behaviors of Turkish hospital nurses directly involved in patient care. This descriptive and cross-sectional study was carried out with 451 nurses working in two large training and research hospitals in Izmir between June and August 2019. Data were collected using the Turkish version of the Healthy Lifestyle Behavior Scale II and the Turkish version of the e-Health Literacy Scale. Descriptive statistics and multiple linear regression analysis were used for data analysis. Nurses were found to have moderate levels of healthy lifestyle behaviors (130.56 ± 21.90) and e-health literacy (29.87 ± 5.39). There was significant relationship between the e-health literacy levels of the nurses and their overall health-promoting behaviors (R = .349; F = 12,381; p = 0.013), health responsibility (R = .326; F = 10,567; p = 0.014), spiritual development (R = .242; F = 5.276; p = 0.001) and interpersonal relations (R = .343; F = 9.896; p = 0.001) scores. The results of this study showed that the development of strategies to improve the e-health literacy of nurses may contribute to the maintenance of health-promoting behaviors of both nurses and their patients.

Factors influencing initiation of health behaviour conversations with patients: Cross-sectional study of nurses, midwives, and healthcare support workers in Wales

Aim

To identify factors influencing healthcare professionals’ engagement in health behaviour conversations with patients.

Design

Cross‐sectional survey.

Methods

Between April and June 2019, an online survey of 1338 nurses, midwives and healthcare support workers was conducted. The survey assessed whether staff felt comfortable initiating health behaviour conversations with patients about five behaviours (reducing alcohol intake; stop smoking; being more active; reducing their weight; and improving their diet) and barriers to conversation initiation. Health professionals’ own health‐related behaviours, self‐rated health and mental wellbeing, and socio‐demographic characteristics were recorded. Logistic regression models were built to assess factors associated with feeling comfortable initiating health behaviour conversations for each topic.

Result

Less than 50% of respondents reported feeling comfortable initiating health behaviour conversations with patients. Female staff, young professionals (18 to 29 years), those in lower staff grades and those with poorer health and low mental wellbeing were less likely to report feeling comfortable having health behaviour conversations across all topics. Those who did not adhere to physical activity and dietary guidelines were less likely to initiate a conversation about being more active and having a healthy diet, respectively. Not having time to discuss the topic, suitable space to hold a conversation, and feeling worried about offending/upsetting patients were the main barriers reported.

Conclusion

Around 6 in 10 members of the nursing, midwifery and healthcare support workforce in Wales potentially do not feel comfortable to initiate a health behaviour conversation with patients about health and wellbeing. Feeling less comfortable to initiate a conversation was associated with staff demographics and organizational factors.

Impact

We identified those less likely to initiate health behaviour conversations as well as personal and organizational barriers to initiation. This will help to target and tailor interventions to ensure staff are equipped and enabled to hold health behaviour conversations with patients.

The effect of undergraduate nursing students' e-Health literacy on healthy lifestyle behaviour

e-Health literacy has become more important in promoting healthy lifestyles in recent years. The purpose of this study was to determine the effect of undergraduate nursing students' e-Health literacy on healthy lifestyle behaviours. This cross-sectional study was conducted during the 2016-2017 academic year at a Nursing Department in the Faculty of Health Sciences in Istanbul. The study population consisted of 232 undergraduate nursing students. The study sample was 205 students who volunteered to participate in the research. The data were collected using the Structured Questionnaire Form, the e-Health Literacy Scale in Adolescent and the Adolescent Lifestyle Profile Scale. The mean score of the e-Health Literacy Scale in Adolescent was 29.50 ± 5.02. The mean total score of the Adolescent Lifestyle Profile was 112.11 ± 14.66. There was a positive correlation between students' Internet attitudes and general health-promoting lifestyle (r = 0.273; p < 0.01), indicating the higher the students' e-Health literacy, the higher their levels of healthy lifestyle behaviours. The result showed that e-Health literacy is an important parameter in promoting healthy lifestyle behaviours of nursing students.

Delphi Technique in Health Sciences: A Map

Objectives: In health sciences, the Delphi technique is primarily used by researchers when the available knowledge is incomplete or subject to uncertainty and other methods that provide higher levels of evidence cannot be used. The aim is to collect expert-based judgments and often to use them to identify consensus. In this map, we provide an overview of the fields of application for Delphi techniques in health sciences in this map and discuss the processes used and the quality of the findings. We use systematic reviews of Delphi techniques for the map, summarize their findings and examine them from a methodological perspective.

Methods: Twelve systematic reviews of Delphi techniques from different sectors of the health sciences were identified and systematically analyzed.

Results: The 12 systematic reviews show, that Delphi studies are typically carried out in two to three rounds with a deliberately selected panel of experts. A large number of modifications to the Delphi technique have now been developed. Significant weaknesses exist in the quality of the reporting.

Conclusion: Based on the results, there is a need for clarification with regard to the methodological approaches of Delphi techniques, also with respect to any modification. Criteria for evaluating the quality of their execution and reporting also appear to be necessary. However, it should be noted that we cannot make any statements about the quality of execution of the Delphi studies but rather our results are exclusively based on the reported findings of the systematic reviews.

Describing the health behaviours of future nurses: a cross-sectional study among Italian nursing students

Academic environments may influence the achievement of healthy behaviors in nursing students. However, the lifestyles among Italian nursing students have been poorly investigated. Therefore, the aim of this study was to describe the health behaviours of Italian undergraduate nursing students. A monocentric, cross-sectional, study design was performed. The study was conducted in an undergraduate nursing course in the north of Italy (University of Pavia). Data were collected through the list of freshmen in nursing in March 2018 (i.e. first years of the undergraduate program) using an online survey and a purposive sampling, where 134 nursing students were enrolled. The results highlighted that the nursing students observed a varied and balanced alimentation. The most problematic areas are referred to the physical activity and the smoking habits. Future research should frame the trajectory of the undergraduate nursing students over the overall education path, also promoting and testing strategies to address the observed issues, such as limited physical activities and smoking habits. (www.actabiomedica.it)

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.

The health of the nursing workforce. A survey of National Nurse Associations

AIM

This investigation explored the extent to which nurses' own health is a priority for global National Nursing Associations.

BACKGROUND

There is a growing body of evidence linking staff health and well-being and key dimensions of service quality, including patient safety, patient experience and the effectiveness of patient care.

INTRODUCTION

The International Council of Nurses is a federation of more than 130 National Nurses Associations, representing more than 20 million nurses worldwide. Representatives from these Associations attended a Congress in Singapore in 2019 at which a survey was conducted.

METHODS

A convenience sample of 37 leaders of National Nurse Associations from 33 countries and 61 nurse representatives took part in a survey.

RESULTS

The majority of nurse leaders and participants believed that nurses' own health should be a priority to be addressed, principally because a healthy nurse is better able to provide good patient care. All of the examples offered about how these Associations address nurses' own health were about actions to prompt individual health behaviour change.

DISCUSSION

The National Nurses Associations did not have a common terminology to talk about nurses' own health. Taking care of one's own health was included as part of the professional role and most nurse leaders thought that working conditions contributed to ill health.

CONCLUSIONS

There is widespread agreement that nurses' own health matters but for most National Nurses Associations it is not a current priority.

IMPLICATIONS FOR NURSING POLICY

Going forward nurse health and wellbeing should be a core principle for health services and professional associations, and additional research is needed that demonstrates if improving working environments contributes to nurse retention and recruitment.

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.

Preparing student nurses to be healthy role models: A qualitative study

There are national and international expectations for nurses to be healthy role models. This study aimed to investigate student nurses', nurse educators' and registered nurses' experiences and perceptions about being healthy role models and to explore whether nurse education prepares students to become healthy role models. The study used an exploratory qualitative design and was based in the south of England. Participants (n = 39) included student nurses, nurse lecturers and registered nurses. Data collection was conducted through focus groups and data were analysed using thematic analysis. The themes highlighted nurses' understanding of the key features of being a healthy role model, and perceptions that working as nurses does not support individuals to be healthy. Participants had varied views about whether they should be healthy role models or mirror society and share the same struggles with their health. Students and registered nurses reported inadequate understanding of health promotion and that there was a lack of healthy lifestyle content within undergraduate nurse education. Participants also considered that role modelling healthy behaviour would not in itself influence behaviour change. In conclusion, there needs to be preparation and support for student nurses to be healthy role models from the outset of nurse education.

To Role Model or Not? Nurses' Challenges in Promoting a Healthy Lifestyle

Nurses often struggle with maintaining a healthy lifestyle. While nurses are often assumed to have the knowledge to participate in health-promoting behaviors, this knowledge may not translate into sustainable change in behavior. The purpose of this descriptive study was to compare nurses' health behaviors with residents in the community where the nurses were employed. Participants (N = 166) completed the Health Promoting Lifestyle Profile-II survey (HPLP-II) along with a demographic survey. The HPLP-II consists of six dimensions of a health-promoting lifestyle: (a) spiritual growth, (b) health responsibility, (c) physical activity, (d) nutrition, (e) interpersonal relations, and (f) stress management. Both groups scored the highest in spirituality followed by interpersonal relations. However, scores for the other HPLP-II dimensions ranked differently between the two groups. Nurses scored higher in health responsibility while the community participants scored higher on nutrition. Both groups scored the lowest on stress management and physical activity. Significant differences between groups were found only on the health responsibility dimension of the HPLP-II survey with nurses scoring higher. While nurses overall did not do any better than the general population in participating in a healthy lifestyle, patient stakeholders feel strongly that nurses should role model healthy behaviors. Employers need to be better prepared to support nurses to participate in a healthy lifestyle. Success can come from even small incremental changes (e.g., walking groups, team challenges, taking stairs) within the work environment. Furthermore, evidence-based practice teams that include administration, management, and staff are positioned to contribute through education and development of innovative workplace wellness programs.

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.

Obesity prevalence among healthcare professionals in England: a cross-sectional study using the Health Survey for England

OBJECTIVE

To estimate obesity prevalence among healthcare professionals in England and compare prevalence with those working outside of the health services.

DESIGN

Cross-sectional study based on data from 5 years (2008-2012) of the nationally representative Health Survey for England.

SETTING

England.

PARTICIPANTS

20 103 adults aged 17-65 years indicating they were economically active at the time of survey classified into four occupational groups: nurses (n=422), other healthcare professionals (n=412), unregistered care workers (n=736) and individuals employed in non-health-related occupations (n=18 533).

OUTCOME MEASURE

Prevalence of obesity defined as body mass index ≥30.0 with 95% CIs and weighted to reflect the population.

RESULTS

Obesity prevalence was high across all occupational groups including: among nurses (25.1%, 95% CI 20.9% to 29.4%); other healthcare professionals (14.4%, 95% CI 11.0% to 17.8%); non-health-related occupations (23.5%, 95% CI 22.9% to 24.1%); and unregistered care workers who had the highest prevalence of obesity (31.9%, 95% CI 28.4% to 35.3%). A logistic regression model adjusted for sociodemographic composition and survey year indicated that, compared with nurses, the odds of being obese were significantly lower for other healthcare professionals (adjusted OR (aOR) 0.52, 95% CI 0.37 to 0.75) and higher for unregistered care workers (aOR 1.46, 95% CI 1.11 to 1.93). There was no significant difference in obesity prevalence between nurses and people working in non-health-related occupations (aOR 0.94, 95% CI 0.74 to 1.18).

CONCLUSIONS

High obesity prevalence among nurses and unregistered care workers is concerning as it increases the risks of musculoskeletal conditions and mental health conditions that are the main causes of sickness absence in health services. Further research is required to better understand the reasons for high obesity prevalence among healthcare professionals in England to inform interventions to support individuals to achieve and maintain a healthy weight.

Health professionals' personal behaviours hindering health promotion: A study of nurses who smoke

AIM

To explore the views of current and ex-smoker nurses on their role in supporting patients to stop smoking.

BACKGROUND

Long-term conditions are closely linked to harmful lifestyle behaviours, including smoking and overeating. Health professionals have an important role to play in promoting healthier lifestyles. It has been described that nurses' health behaviours may be a barrier to their health promotion practice. There is a need to gain further understanding on why nurses' health promotion activity is influenced by their own health behaviour.

DESIGN

A secondary analysis of qualitative data gathered in 2010 in the context of a project that aimed to develop a smoking cessation intervention for nurses.

METHODS

Eleven transcripts of semi-structured interviews conducted with nurses (current and ex-smokers) working in one university hospital in Spain. Data were analysed using framework analysis.

FINDINGS

Nurses who smoked engaged in social justification in terms of social norms and work stress. Only nurses who had quit smoking were able to identify the negative feelings it generated and the effect that it had on their past health promotion practice. This was expressed by ex-smokers as an internal conflict that prevented them from supporting patients with their own habit.

CONCLUSION

Nurses who smoke may be inhibited as health promoters without being aware of it. Interventions that focus on helping these professionals deal with the challenges associated with these encounters are necessary if health promotion practices are to be enhanced. Targeting this conflict might also work to improve their lifestyle, which would expand the potential impact to professionals' own health.