The Health of Health Care Professionals

Physical Activity Patterns and Lifestyle Habits Among Primary Healthcare Workers: A Cross-Sectional Study

BACKGROUND

Primary healthcare workers (PHCWs) serve as critical contributors to public health, yet their physical activity (PA) patterns and lifestyle habits often reflect the very challenges they address in their patients. The aim of this study is to determine the PA patterns and lifestyle habits among PHCWs in the Lepelle-Nkumpi sub-district of Limpopo Province, South Africa.

METHODOLOGY

A quantitative, cross-sectional design with stratified random sampling (n = 174) was used. A validated, closed-ended questionnaire assessed demographic data and occupational and leisure-time physical activity. Data were analysed using SPSS version 28, with descriptive statistics summarising characteristics. Chi-square tests identified significant associations (p < 0.05) between lifestyle scores (poor, good, excellent) and demographic factors.

RESULTS

The majority of the participants (53%) reported engaging in shorter walking durations during work, with only 7.5% of the participating engaging in moderate physical activity and 39.7% achieving 30 min or more of activity. Additionally, 59.8% do not use walking or cycling for transportation, while only 27% do so for at least 30 min daily. During leisure time, 33.9% of the participants engage in moderate-to-vigorous physical activities, with 37.9% spending 30 min or more on such activities daily. Nearly two-thirds of the participants (65.5%) had poor lifestyle scores (0-50%), while 23.6% achieved excellent scores (81-100%). Significant associations were found between gender and lifestyle scores (p = 0.022).

CONCLUSION

This study reveals critical gaps in the physical activity levels of PHCWs, with low engagement in moderate activity during work and limited active commuting. This study underscores the need for workplace wellness interventions, such as walking meetings and fitness facilities, to boost physical activity among healthcare workers, enhancing their health, resilience, and the quality of care they provide.

Exploring care quality in midwifery clinical practice settings in Ghana - a qualitative study

BACKGROUND

High-quality care is a significant factor in reducing maternal and neonatal mortality. There are known barriers affecting midwives' ability to provide quality care in low- and middle-income countries. The presence of qualified and competent midwives, coupled with the elimination of barriers, is essential for enhancing care quality, especially in education program clinical practice settings.

AIM

To explore factors that affect Ghanaian midwifery students' provision of high-quality care while on clinical rotation.

METHOD

Six focus-group discussions were conducted with a total of 36 midwifery students in Accra, Ghana. Data were analyzed using deductive content analysis applying a conceptual framework identifying social, economic and professional factors influencing the provision of high-quality care.

RESULTS

Social factors identified patient resistance to student midwives, class-based discrimination, traditional practices being preferred over evidence-based care, communication barriers, and poor security. Economic factors were unexpected expenses and inadequate compensation. Professional factors were lack of necessary materials, insufficient number of staff, and a theory-practice gap between classroom learning and hands-on experiences.

CONCLUSION

Factors impacting Ghanaian midwifery students' ability to provide high-quality care in clinical settings were summarized, highlighting social, economic, and professional challenges. Key issues include patient resistance, class-based discrimination, inadequate compensation, theory-practice gaps, and lack of materials. The findings emphasize the need for improved support, resources, and quality clinical learning environments. There needs to be investment in infrastructure and prioritization of pedagogy in clinical settings to enhance midwifery education and care quality in Ghana and more broadly in low- and middle-income countries.

CLINICAL TRIAL NUMBER

Not applicable.

Understanding Cardiovascular Health and Lifestyle Choices Among Healthcare Professionals in Medically Underserved Regions in Illinois

This study assesses the prevalence of cardiovascular risk factors, such as diabetes, obesity, high blood pressure, and stress, as related to healthy lifestyle behaviors among healthcare professionals (HCPs), including medical doctors, nurses, pharmacists, laboratory scientists, and radiologists, in medically underserved regions (MURs). Using a cross-sectional study design, an online survey was administered to HCPs in MURs of West Central Illinois. A total of 316 HCPs completed the survey. The study population was predominantly White, female, and aged 55 or older. The findings of this research imply that HCPs in medically underserved regions (MURs) with high cholesterol generally do not engage in physical activity. The study showed a correlation between HCP age, high blood pressure, Type 2 diabetes, and high cholesterol, implying that as HCPs age like every other individual, the likelihood of developing these conditions increases. This study emphasizes the role of time constraints and a lack of motivation in limiting HCPs' participation in physical activity in rural areas. Additionally, the study suggests that inadequate access to nutritious food and exercise facilities in rural regions contributes to lower rates of healthy eating and physical activity. Findings demonstrate how essential it is for healthcare professionals to remain vigilant about cardiovascular disease risk factors.

Work-Related Fear-Avoidance Beliefs and Risk of Low-Back Pain: Prospective Cohort Study Among Healthcare Workers

PURPOSE

Low-back pain (LBP) is a prevalent condition among healthcare workers, negatively affecting well-being and work ability. Research has identified fear-avoidance beliefs, i.e., the belief that physical activities worsen or prolong pain, as a key psychological factor in LBP. Given the physical demands of healthcare work, understanding the link between fear-avoidance and LBP is crucial for effective prevention and management strategies. This study investigated the prospective association between fear-avoidance beliefs and risk of increased LBP intensity and duration in hospital workers.

METHODS

Fear-avoidance beliefs and LBP were assessed in 1933 healthcare workers from 389 departments at 19 hospitals at baseline and 1-year follow-up. Associations between baseline work-related fear-avoidance beliefs (FABW) and LBP intensity and duration at follow-up were analyzed using cumulative logistic regression, adjusting for various factors including age, sex, baseline LBP, education, seniority, patient transfers, psychosocial work environment, and lifestyle.

RESULTS

Moderate and high FABW was associated with higher odds of increased pain intensity (OR: 1.37 [95% CI 1.09-1.73] and 1.85 [95% CI 1.18-2.88], respectively) and prolonged pain duration (OR: 1.37 [95% CI 1.05-1.78] and 2.27 [95% CI 1.50-3.44], respectively). A sensitivity analysis including only female nurses showed similar results, with the high FABW group having significantly higher odds of increased pain intensity (OR 2.95, 95% CI 1.84-4.72) and duration (OR 2.64, 95% CI 1.55-4.49).

CONCLUSIONS

Fear-avoidance beliefs increase the risk of LBP intensity and duration among healthcare workers, emphasizing the need for interventions dealing with psychological aspects of LBP.

Well-being of undergraduate dental students: Questionnaire design, findings and future directions

INTRODUCTION

The recent pandemic has highlighted the importance of addressing well-being in the overall health of students. There is a need for support systems within dental schools to help students demonstrate resilience, adapt to learning environments and thrive in their professional careers.

OBJECTIVES

The main aim of the study was to evaluate Bachelor of Dental Surgery (BDS) students' understanding and experience of well-being. The objectives were to create a suitable survey to assess students' well-being, investigate the factors affecting dental students' well-being and develop a student well-being action plan based on the analysis of the survey.

METHODS

A literature review was conducted to identify and critically assess existing measures of well-being in dental students. Four domains of well-being (emotional, physical, social, intellectual) relevant to dental students were identified. Through a comprehensive iterative process, a two-part survey was developed and tested, which measured individual experiences of well-being across the four domains and collected feedback on proposed initiatives to support student well-being. The survey was disseminated to all 452 dental students from Years 1 through 6, of which 71% (321) responded.

RESULTS

The survey revealed low levels of overall well-being among the dental student population, which worsened with increasing years of clinical study. Fear of failing exams presented the biggest challenge with regard to emotional well-being, while sleep deprivation and occupational health hazards most affected the physical well-being domain. Intellectual well-being was compromised by insufficient free time to pursue extracurricular interests and concerns about achieving the required skills. Despite a majority experiencing positive relationships with their peers and tutors, less than a fifth agreed that the Faculty of Dentistry 'supported my well-being as a dental student'.

CONCLUSION

As the first investigation of the well-being of dental students in Hong Kong, the key stressors identified were examinations, long schedules and the physical burden of dental work, which are consistent with international literature. The findings reveal students' needs and preferences for well-being initiatives which will be optimized in the implementation of student-centred curricular activities.

Advancing Lifestyle Medicine in New York City's Public Health Care System

Chronic diseases are the leading cause of death and disability in the United States, and much of this burden can be attributed to lifestyle and behavioral risk factors. Lifestyle medicine is an approach to preventing and treating lifestyle-related chronic disease using evidence-based lifestyle modification as a primary modality. NYC Health + Hospitals, the largest municipal public health care system in the United States, is a national pioneer in incorporating lifestyle medicine systemwide. In 2019, a pilot lifestyle medicine program was launched at NYC Health + Hospitals/Bellevue to improve cardiometabolic health in high-risk patients through intensive support for evidence-based lifestyle changes. Analyses of program data collected from January 29, 2019 to February 26, 2020 demonstrated feasibility, high demand for services, high patient satisfaction, and clinically and statistically significant improvements in cardiometabolic risk factors. This pilot is being expanded to 6 new NYC Health + Hospitals sites spanning all 5 NYC boroughs. As part of the expansion, many changes have been implemented to enhance the original pilot model, scale services effectively, and generate more interest and incentives in lifestyle medicine for staff and patients across the health care system, including a plant-based default meal program for inpatients. This narrative review describes the pilot model and outcomes, the expansion process, and lessons learned to serve as a guide for other health systems.

Supporting health and wellbeing in health care employees: a documentary review of organizational policies, strategies and frameworks

Background

Health care workers are crucial for a productive and thriving health care system, yet the health and lifestyle behaviour of key groups within this workforce (for example nurses and healthcare assistants/support workers) is typically poor. The extent of health and wellbeing documents that guide action towards improving their health and wellbeing is unknown. Using one health care system, NHS Scotland, as an example, the aim of this study was to assess the number of NHS health boards with workplace documents focused on health and wellbeing of employees, the quality of these documents and the extent to which they reference lifestyle behaviours, namely physical activity.

Methods

Documentary analysis was undertaken on employee health and wellbeing policies (and wider documents). These were sourced through online searches on Google search engine and Freedom of Information Requests sent to all 14 Scottish NHS Health Boards. Titles and content were assessed for relevance to employee health and wellbeing. Content analysis was used to analyse the included documents against eight predefined codes.

Results

Thirteen documents were retrieved with 11 of the 14 Health Boards having at least one relevant document. The content varied greatly between documents with regards to how many reported the eight codes and the quality of content within these. Nine documents mentioned physical activity but mainly in relation to current activities rather than in the context of a future healthy workforce.

Conclusions

Despite the importance of a healthy, health care workforce, more work is needed to ensure high level documents are able to support these efforts, especially with reference to lifestyle behaviours.

A comprehensive analysis concerning eating behavior associated with chronic diseases among Romanian community nurses

Introduction

Lifestyle factors, including inadequate eating patterns, emerge as a critical determinant of chronic disease. Apart from caring for patients, nurses should also take an active role in monitoring and managing their own health. Understanding the intricate relationship between nurses' eating behavior and managing their own health is crucial for fostering a holistic approach to healthcare, therefore our study aimed to evaluate eating behavior and demographic factors influencing chronic disease prevalence in a sample of community nurses from Romania.

Methods

Between October-November 2023, 1920 community nurses were invited to answer an online survey, using an advertisement in their professional network. Of them, 788 responded. In the survey, which included a semi-quantitative food frequency questionnaire with 53 food items, the Intuitive Eating Survey 2 (IES-2), and demographic items were used.

Results

A multivariate model was built for the prediction of the association between eating behavior and other factors associated with chronic diseases. The majority of participants were females (95.1%), with the largest age group falling between 40 and 49.9 years (48.2%). Regarding the EFSA criteria for adequate carbohydrate and fat intake, 20.2% of the group have a high intake of carbohydrates, respectively, 43.4% of the group have a high intake of fat. Analysis of chronic diseases indicated that 24.9% of individuals reported at least one diagnosis by a physician. The presence of chronic disease was associated with a low level of perceived health status, with an OR = 3.388, 95%CI (1.684-6.814), compared to those reporting excellent or very good perceived health status. High stress had an OR = 1.483, 95%CI (1.033-2.129). BMI had an OR = 1.069, 95%CI (1.032-1.108), while low carbohydrate diet score had an OR = 0.956, 95%CI (0.920-0.992). Gender and IES-2 did not significantly contribute to the model, but their effect was controlled.

Discussion

By unraveling the intricate interplay between nutrition, lifestyle, and health outcomes in this healthcare cohort, our findings contribute valuable insights for the development of targeted interventions and support programs tailored to enhance the well-being of community nurses and, by extension, the patients they support.

Acceptability and Feasibility of a Hospital-Based Herb and Vegetable Garden for Health Care Workers

OBJECTIVE

Evaluate the acceptability and feasibility and explore the potential health impacts of a hospital-based herb and vegetable garden.

METHODS

Mixed-method program evaluation assessed dietetic and food service staff health, well-being, and garden engagement. Surveys were administered at baseline and follow-up (6 months). Key informant interviews (n = 6) were conducted at 6 months to evaluate program feasibility.

RESULTS

There was good acceptance and engagement with the garden, with 18 participants volunteering to maintain the garden. Key informant interviews identified workforce, leadership, and garden design engagement factors. Participants also noted several psychosocial benefits.

CONCLUSION AND IMPLICATIONS

A hospital-based garden for staff is feasible if programmatic improvements are addressed. More robust evaluations considering challenges with measuring key outcomes with survey methodology and extended periods are warranted.

Metabolic Health Immersion for Medical Education: A Pilot Program with Continuous Glucose Monitors in Medical and Dental Students

Diet-related chronic diseases are increasing in prevalence and poised to dominate the future careers of current medical students. While the value of nutritionally-informed care and nutrition-based health interventions is increasingly recognized, nutrition education is inconsistently and often inadequately included in medical school curricula. One obstacle to incorporating nutrition into medical and dental school curricula is the density of existing coursework, with incorporation of new material necessitating removal of other material. One solution is to engage students outside the classroom in immersive education in nutrition and metabolism using health-wearables. We report the Metabolic Health Immersion for Medical Education pilot program, spearheaded and designed by Harvard Medical students centering on use of continuous glucose monitors (CGM). Students reported enjoyment with the study, felt encouraged to improve health behaviors, and shared that the experience enhanced their understanding of nutrition and metabolism, was valuable to their medical education, and would influence their future patient care. This study demonstrates proof-of-principle that metabolic health immersion opportunities for health care trainees provide a means of helping to address the current deficit in medical school nutrition education.

Healthcare Workers' Safety; A Necessity for a Robust Health System

It is a prevalent misconception that healthcare professionals are specialists and thus can effectively manage their health. This is probably true, but given recent pandemics and the rise in violence in medical settings, one is compelled to question whether their health and safety are sufficient for a robust healthcare system. This is important because protecting and promoting the health, safety, and well-being of health workers will improve the quality of patient care and increase the resilience of health services in the face of outbreaks and public health emergencies. We thus strive to answer this question and suggest potential remedies to this growing public health issue.

Bringing the "Joy of Healthy Eating" to Advanced Medical Students: Utilizing a Remote Learning Platform to Teach Culinary Medicine: Findings from the First Online Course Based on the ACLM's Whole-Food Plant-Based Culinary Medicine Curriculum

Over 80% of chronic disease is caused by lifestyle practices, including an unhealthy diet. Despite this, most medical students in the United States graduate having received minimal nutrition education, guidance towards improving their nutrition, or skills needed to coach patients to adopt a healthier diet. This study aimed to educate fourth-year medical students in evidence-based knowledge regarding a delicious, whole-food plant-based diet while introducing practical culinary skills and patient coaching skills. We adapted an open-source culinary medicine curriculum designed for in-person teaching of pre-clinical medical students to provide a novel 1-month online elective to fourth-year medical students. We used a 26-item pre/post questionnaire to assess change in evidence-based knowledge regarding nutrition, culinary skills, patient coaching skills, and attitudes toward a whole-food plant-based diet. In addition, we reviewed narrative comments by the student participants, course directors, and medical-school administrators. Scores in all 4 domains were tested, and for all individual questions, they showed statistically significant improvement following the course. Most narrative responses were positive, and areas for improvement were also identified. We successfully adapted an open-source whole-food plant-based culinary medicine curriculum for advanced medical students into a 1-month elective taught on a virtual platform. This course filled a need for training in nutrition and counseling for these students as they start their professional careers.