Stress, shift duty, and eating behavior among nurses in Central Saudi Arabia

Workplace barriers and facilitators to nurses' healthy eating behaviours: a qualitative systematic review

BACKGROUND

Globally, nurses and midwives have a higher rate of being overweight/obese than the general population, influenced by workplace environments that impact dietary habits.

OBJECTIVE

This systematic review aimed to identify barriers/facilitators to healthy eating among nurses in clinical settings.

DESIGN

This systematic review followed Joanna Briggs Institute's guidelines for qualitative systematic reviews.

METHODS

Eight electronic databases: PROQUEST CENTRAL, SCIENCEDIRECT, MEDLINE, CINAHL, PsycINFO, WEB SCIENCE, PUB MED, and SCOPUS were searched. Articles were screened using JBI SUMARI®, and quality assessment was done using the JBI critical appraisal checklist. Data were extracted using the JBI data extraction tool.

RESULTS

Nine qualitative studies were reviewed, involving 488 nurses, concluding 37 distinct findings. Two synthesised findings emerged: barriers, and facilitators to healthy eating, related to organisational (shift work/long working hours), personal, physical workplace environment, and social factors.

CONCLUSIONS

The review emphasises the necessity of promoting attainable healthy eating practices at organisational, personal, environmental, and social levels within the workplace.

REGISTRATION

PROSPERO International prospective register of systematic reviews, ID: CRD42022309259.

Newly qualified graduate nurses' experiences of workplace incivility in healthcare settings: An integrative review

AIM

To explore, identify and integrate the existing knowledge to categorise the characteristics, likelihood, and consequences of workplace incivility among newly qualified graduate registered nurses. A particular focus of this review is on the experiences of new nurses related to these negative workplace behaviours and the strategies employed by these nurses and their organisations to manage workplace incivility.

BACKGROUND

Workplace incivility has been widely recognised as a global problem in healthcare settings and is known to affect nurses in all facets of their professional and personal life. This might be particularly harmful for newly qualified graduate nurses, as they are unprepared to deal with this uncivil culture.

DESIGN

An integrative review of the global literature, conducted according to the Whittemore and Knafl framework.

METHODS

Database searches (CINAHL, OVID Medline, PubMed, Scopus, Ovid Emcare and PsycINFO), and manual searching generated an aggregate of 1904 articles, which were further screened based on inclusion criteria and eligibility using the Mixed Methods Appraisal Tool (MMAT). Peer-reviewed empirical studies that explored the workplace incivility experiences of new graduate nurses were included in this review. Extracted data were grouped to develop themes and sub-themes.

RESULTS

This review included 14 studies in total with seven quantitative and seven qualitative studies. The data collected from these studies were categorised according to the research questions into a) expectations of civility, b) experiences and exposure to workplace incivility, c) forms and characteristics of incivility, d) sources of incivility, e) consequences of incivility, and f) managing and coping with incivility. Across studies, graduate nurses' views about the prestige and power of the nursing profession are conflicted due to experiences of incivility in clinical practice. New graduate nurses experienced a high but variable prevalence of incivility from their co-workers (25.6-87 %), with manifestations of incivility varying greatly, including eye rolling, yelling, exclusion and sexual harassment. Included studies primarily focused on professional and organisational effects and their outcomes relative to the physical and psychological effects on new nurses.

CONCLUSION

Findings from the literature demonstrate that incivility directed toward newly qualified graduate nurses is prevalent and can have significant negative impact on their self-esteem and confidence, which may ultimately impact on their workforce participation decisions and the quality of patient care. Supportive and empowering work environments are vital not only for improved nurse health and well-being, but also to retain new graduate nurses. The current nursing shortage emphasises the need for such conditions.

Level of Fruit and Vegetable Intake and Its Relationship with Risk for Malnutrition in China’s Adult Labor Force: China Nutrition and Health Surveillance, 2015–2017

The purpose of this study was to analyze the fruit and vegetable intake status and examine both potential risk and protective action factors in the Chinese labor force population, while investigating the association between fruit and vegetable intake and malnutrition in this population. Data were derived from a population-based cross-sectional survey, the China Nutrition and Health Surveillance, 2015–2017. Sociodemographic information, physical measurements, and dietary intake data were collected. A total of 45,459 survey respondents aged 18–64 years old were included in the analysis. Fruit and vegetable consumption data were assessed by a food frequency questionnaire (FFQ), and the average daily intake was calculated. In 2015, the daily intake of fresh fruits, fresh vegetables, and combined fruits and vegetables among the Chinese labor force was 64.3 g, 210.0 g, and 330.0 g (median), respectively. Compared with the Dietary Guidelines for Chinese Residents (2022), 79.9% and 53.0% were at risk of inadequate fruit and vegetable intake, while 55.2% were at risk of inadequate intake of combined fruits and vegetables compared with the WHO recommendation. Multivariate logistic regression analysis showed that female gender, higher educational level, and higher income were protective factors for adequate fruit intake, while increasing age and living in the southern region were protective factors for adequate vegetable intake. The results confirmed that increasing vegetable intake helped urban labor force maintain normal BMI and control overweight. Increased fruit consumption may reduce the risk of underweight, but no clear negative association with overweight and obesity was observed. In conclusion, the consumption of fresh fruits and vegetables by the Chinese labor force was inadequate, especially for fruits. Interventions are needed to promote the daily intake of fruits and vegetables in this population. In addition, further in-depth studies in this area are recommended in populations with different health status.

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.

Dietary Patterns, Occupational Stressors and Body Composition of Hospital Workers: A Longitudinal Study Comparing before and during the COVID-19 Pandemic

This longitudinal study aimed to evaluate the association between dietary patterns and the body composition of hospital workers subjected to occupational stressors before and during the COVID-19 pandemic. Data on sociodemographic, occupational, lifestyle, anthropometric, food consumption and occupational stress were collected before and during the COVID-19 pandemic. A total of 218 workers from a private hospital in Santo Antônio de Jesus, Bahia, Brazil were included in the study. After evaluating the normality of the data, parametric or non-parametric tests were used to characterize the sample. Dietary pattern was defined with Exploratory Factor Analysis and Structural Equation Modeling was used to test the desired association. During the pandemic, work per shift increased by 8.2% (p = 0.004) and working hours > 40 h/week increased by 9.2% (p = 0.006). Despite the higher prevalence of low occupational stress (85.8% vs. 72.1%), high stress increased by 13.7% from 2019 to 2020 (p < 0.001) and 30.3% reported a positive mediating effect on the variables of body composition, body mass index (b = 0.478; p < 0.001), waist circumference (b = 0.395; p = 0.001), fat-free mass (b = 0.440; p = 0.001) and fat mass (b = -0.104; p = 0.292). Therefore, a dietary pattern containing high-calorie foods was associated with changes in the body composition of hospital workers, including occupational stressors as mediators of this relationship.

Burnout, Fat Intake, and Body Mass Index in Health Professionals Working in a Public Hospital: A Cross-Sectional Study

Burnout can have a negative influence on dietary intake, promoting unhealthy eating behaviors in health care workers. This study determined the association between burnout, saturated fat intake, and body mass index (BMI) in a group of health care workers. A cross-sectional study was conducted in 300 health professionals residing in Rioja, Department of San Martin, Peru. Data were collected through an online and face-to-face survey. Burnout was assessed using a scale adapted and validated in the Peruvian population. Additionally, a validated food frequency questionnaire (FFQ) was used to assess habitual fat intake. Both instruments were validated and adapted to the Peruvian population. Data were analyzed using Pearson correlation coefficients and multivariate logistic regression. Values of P < .05 were considered statistically significant. In the adjusted model, it was found that, for each extra point on intake scale, an average of 1.10 (95% CI, 0.57-1.62, P < .001) points increased burnout scale; these results persisted when compared by gender, 1.17 0.49 1.85, and 1.08 0.16 2.00, respectively female male genders. there no association between bmi (P > .05). Future programs and interventions should be considered to minimize the effects of burnout on unhealthy food intake in health care workers in Peru to ensure better medical care by health care professionals on behalf of patients.

Experiences, Perceptions, and Coping Patterns of Emergency Department Nurses with Occupational Stressors in Saudi Arabian Hospitals: Mixed-Method Study

Extended working hours, a complicated workplace environment, and engagement in numerous physical and psychological stressors have been associated with the stressful nature of the nursing profession. Only a few studies have provided some insight into workplace stress and coping strategies adopted by nurses in Saudi Arabia and neighboring countries. Therefore, this study utilized a mixed-method design to explore the numerous factors that lead to stress among emergency nurses, their experience and perception of stress, and the coping mechanisms they find useful. A survey containing four domains and 86 items was adapted, pilot tested, and validated. The quantitative phase recruited 296 nurses who returned completed questionnaires, and then 21 nurses were interviewed for the qualitative phase. In total, 89.5% (n = 265) of the participants were female, 51% (n = 151) were aged 20–29 years, 83% (n = 246) were non-Saudi nationals, 49% (n = 145) were married, and 82% (n = 245) had a bachelor’s degree. The most common causes of occupational stress were work overload, personnel shortages, and inadequate pay. The qualitative phase data revealed five primary themes, including increased workload, rising living costs despite equal compensation, and staff shortages as main stressors. In addition, the study found that praying and spending quality time with friends are the primary coping techniques among nurses. The study results contribute to a better understanding of nurses’ working conditions in the emergency department. Additionally, they may contribute to the development of policies and practice reforms to improve Saudi nurses’ well-being, health, and overall work experience.

Prevalence, correlates, and gender disparities related to eating disordered behaviors among health science students and healthcare practitioners in Lebanon: Findings of a national cross sectional study

Background

The raised prevalence of eating disorders (ED) amongst health science students and health professionals is of mounting concern. This study aims to determine the prevalence and correlates of eating disorders risk amongst a sample of Lebanese health science students and healthcare practitioners of both genders.

Methods

This cross-sectional study enrolled a convenient sample of 1,000 participants (mean age: 23 ± 5.4; females: 74.9%) from faculties of health sciences, clinics, pharmacies, and hospitals. The validated Eating Attitudes Test (EAT-26) was used to screen for eating disorders. Anthropometric data were self-reported by respondents to assess their nutritional status.

Results

The risk of eating disorders was prevalent in 22.5% of participants. Females were at higher risk of ED compared to males p = 0.03. Eating disorders risk did not differ between students and practitioners (p = 0.3). The highest proportion of high-risk participants were students studying nutrition and practitioners (40.9%), outracing their counterparts in nursing (18.7%), medicine (17.8%), pharmacy (17.7%), and midwifery (4.9%) sciences (p = 0.02). Most high-risk participants had normal body weight (60.4%), and 28.9% were overweight (p = 0.001). Female gender, nutrition profession, and dieting were associated with increasing the odd of ED. Particularly, dieting increased the risk around five times. Further, each 3 participants over 10 were facing binge eating behavior.

Conclusion

This study uncovers an undervalued profession-related-health-disorder in Lebanese health science students and healthcare practitioners. Specific attention should be given to EDs in professional educational programmes across healthcare disciplines.

Associations between Abnormal Eating Styles and Irritable Bowel Syndrome: A Cross-Sectional Study among Medical School Students

(1) Background: Few studies have investigated the association between eating styles and IBS. This study aimed to explore the association between abnormal eating styles and irritable bowel syndrome (IBS). (2) Methods: This cross-sectional study investigated students in China Medical University and Shenyang Medical College. Eating styles were evaluated by the Dutch Eating Behavior Questionnaire (DEBQ), and IBS was diagnosed according to Rome III criteria. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). (3) Results: A total of 335 students were diagnosed with IBS. Students with the total scores in tertile 2 and 3 had 1.29 times and 2.75 times higher risk of IBS than students with the total scores in tertile 1, respectively. Simultaneously, the risk of IBS in the tertile 3 of external eating, emotional eating, and restraint eating trends was 3.87 times, 2.71 times, and 3.82 times higher than that of tertile 1, respectively. (4) Conclusions: this study showed that a high score in both total eating styles and each eating style was associated with the odds of having IBS and suggested that the psychological factors behind eating styles may play a critical role in controlling the IBS.

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.

A Framework for Developing Translationally Relevant Animal Models of Stress-Induced Changes in Eating Behavior

Stress often affects eating behaviors, leading to increased eating in some individuals and decreased eating in others. Identifying physiological and psychological factors that determine the direction of eating responses to stress has been a major goal of epidemiological and clinical studies. However, challenges of standardizing the stress exposure in humans hinder efforts to uncover the underlying mechanisms. The issue of what determines the direction of stress-induced feeding responses has not been directly addressed in animal models, but assays that combine stress with a feeding-related task are commonly used as readouts of other behaviors, such as anxiety. Sex, estrous cyclicity, circadian cyclicity, caloric restriction, palatable diets, elevated body weight, and properties of the stressors similarly influence feeding behavior in humans and rodent models. Yet, most rodent studies do not use conditions that are most relevant for studying feeding behavior in humans. This review proposes a conceptual framework for incorporating these influences to develop reproducible and translationally relevant assays to study effects of stress on food intake. Such paradigms have the potential to uncover links between emotional eating and obesity as well as to the etiology of eating disorders.

Association Between Perceived Levels of Stress and Self-Reported Food Preferences Among Males and Females: A Stated Preference Approach Based on the China Health and Nutrition Survey

Objective

Stress is a major public health challenge and is associated with undesirable eating behavior. This cross-sectional study aimed to explore whether there is an association between perceived level of stress and food preference among Chinese adults.

Study Design

Perceived level of stress was measured using the Chinese version of the 14-item Perceived Stress Scale, whereas self-reported food preferences were investigated by means of five food classification questions, including questions regarding the consumption of fast food, salty snacks, fruit, vegetables, and soft/sugary drinks.

Methods

The data were collected from the 2015 China Health and Nutrition Survey. Information of 8,216 adults (≥18 years) on perceived level of stress, self-reported food preferences, and other important covariates was available and analyzed.

Results

Perceived level of stress was negatively associated with a preference for fruit (β = −0.58, 95% CI: −0.81 to −0.34, p < 0.0001) and vegetables (β = −1.13, 95% CI: −1.41 to −0.85, p < 0.0001), while it was positively associated with a preference for fast food (β = 0.36, 95% CI: 0.08–0.64, p = 0.011) and soft/sugary drinks (β = 0.48, 95% CI: 0.30–0.66, p < 0.0001) after adjusting for potential confounders. No association between a preference for salty snacks and perceived level of stress was found in either men or women.

Conclusions

The present population-based study reported strong associations between perceived level of stress and self-reported food preferences among Chinese adults. Sex differences related to this association were also worthy of attention.

Occupational Fatigue and Associated Factors among Saudi Nurses Working 8-Hour Shifts at Public Hospitals

Introduction

Shift work and demanding work schedules contribute to occupational fatigue, negatively affecting patient safety and nurses’ well-being, consequently placing nurses and patients at risk for injury and adverse health outcomes. For preventing fatigue and minimizing its negative consequences, information about its characteristics and associated factors is required.

Objectives

This study aimed to assess occupational fatigue “acute fatigue, chronic fatigue, and inter-shift recovery” among Saudi nurses working 8-h shifts. Further, we explored factors associated with fatigue from nurses’ perspectives.

Methods

We conducted a mixed-method study with a convenience sample of Saudi nurses (N = 282) working in four public hospitals in Saudi Arabia. Data were collected using the nurses’ profile form; the occupational fatigue exhaustion recovery (OFER) scale, for relevant quantitative data; and open-ended questions for qualitative data. We used descriptive and inferential statistics for analysing the quantitative data and content analysis of the qualitative data.

Results

The results showed that Saudi nurses rated themselves moderately fatigued with working 8-h shifts. The inter-shift recovery subscale showed a negative correlation with chronic fatigue and acute fatigue (r = −0.518, r = −0.356, P < 0.001). Sleeping problems, meals per day, and frequency of exercise showed significant relations with chronic fatigue among nurses (p < 0.05). In addition, three categories were derived from the qualitative content analysis. Saudi nurses reported work-related, psychosocial, and individual factors as major contributors to fatigue and recovery.

Conclusion

Occupational fatigue is a multidimensional issue, and nurses and nurse managers are challenged with reducing its prevalence and negative impact on nurses and patients. Our quantitative and qualitative findings suggest the need for a comprehensive approach to fatigue management and mitigation, including organizational support, creative workforce planning, flexible work schedules, and psychosocial support. Fatigue reduction and prevention policies and educational programs are vital strategies to improve nurses’ well-being and inter-shift recovery.

The Negative Impact of Night Shifts on Diet in Emergency Healthcare Workers

Despite the consequences of night-shift work, the diet of night-shift workers has not been widely studied. To date, there are no studies related to food intake among emergency healthcare workers (HCWs). We performed a prospective observational study to assess the influence of night work on the diet of emergency HCWs. We monitored 24-h food intake during a day shift and the consecutive night, and during night work and the daytime beforehand. We analyzed 184 emergency HCWs' food intakes. Emergency HCWs had 14.7% lower (-206 kcal) of their 24-h energy intake during night shifts compared to their day-shift colleagues (1606.7 ± 748.2 vs. 1400.4 ± 708.3 kcal, p = 0.049) and a 16.7% decrease in water consumption (1451.4 ± 496.8 vs. 1208.3 ± 513.9 mL/day, p = 0.010). Compared to day shifts, night-shift had 8.7% lower carbohydrates, 17.6% proteins, and 18.7% lipids. During the night shift the proportion of emergency HCWs who did not drink for 4 h, 8 h and 12 h increased by 20.5%, 17.5%, and 9.1%, respectively. For those who did not eat for 4 h, 8 h and 12 h increased by 46.8%, 27.7%, and 17.7%, respectively. A night shift has a huge negative impact on both the amount and quality of nutrients consumed by emergency healthcare workers.

The lived experiences of frontline nurses during the coronavirus disease 2019 (COVID-19) pandemic in Qatar: A qualitative study

AIM

This study aims to explore the lived experiences of frontline nurses providing nursing care for COVID-19 patients in Qatar.

DESIGN

Qualitative, Phenomenological.

METHODS

Nurses were recruited from a designated COVID-19 facility using purposive and snowball sampling. The participants were interviewed face-to-face using semi-structured interview questions from 6 September-10 October 2020. The interviews were transcribed and analyzed using Colaizzi's phenomenological method.

RESULT

A total of 30 nurses were interviewed; (76.7%) were deployed for >6 months. Three major themes were drawn from the analysis: (a) Challenges of working in a COVID-19 facility (subthemes: working in a new context and new working environment, worn out by the workload, the struggle of wearing protective gear, fear of COVID-19, witnessing suffering); (b) Surviving COVID-19 (subthemes: keeping it safe with extra measures, change in eating habits, teamwork and camaraderie, social support); and (c) Resilience of Nurses (subthemes: a true calling, a sense of purpose).

Quality of Life, Sleep Quality, Depression, Anxiety, Stress, Eating Habits, and Social Bounds in Nurses during the Coronavirus Disease 2019 Pandemic in Qatar (The PROTECTOR Study): A Cross-Sectional, Comparative Study

There have been numerous concerns regarding the physical and mental health of nurses during the COVID-19 pandemic. Stress, sleep deprivation, anxiety, and depression potentiated nurses’ vulnerability to poor eating habits. Aims and Objectives: The purpose of this study was to explore the differences between nurses’ characteristics with COVID-19 facility designation, and sleep quality, depression, anxiety, stress, eating habits, social bonds, and quality of life. Design: A cross-sectional, comparative study. Methods: An online survey was sent using the corporation’s email to nurses working in three hospitals in Qatar from September to December 2020. One of them is a designated COVID-19 facility. The sleep quality, depression, eating habits, social bonds, and quality of life were measured using The Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale 21 (DASS-21), Emotional Eater Questionnaire (EEQ), Oslo Social Support Scale (OSSS-3), and the World Health Organization Quality of Life (WHOQOL-BREF), respectively. Results: A total of 200 nurses participated in the study (RR: 13.3%). No statistically significant association was found between designated facility (COVID-19 vs. not COVID-19) or nurses’ characteristics and ISI categories (OR 1.15; 95% CI 0.54, 2.44). Nurses working in COVID-19 facilities had increased odds of having higher EEQ categories by 2.62 times (95% CI 1.18, 5.83). Similarly, no statistically significant associations were found between any of the nurses’ characteristics and OSSS-3 categories. On the other hand, no statistically significant associations were found between any of the nurses’ characteristics and QOL domains except for the gender and social relationships’ domain. Conclusion: Overall, the quality of life of nurses in Qatar is on a positive level whether they are assigned to a COVID-19 facility or not. Although no significant difference was found with regard to the sleep quality, stress, anxiety, depression, and eating habits between nurses in a COVID-19 facility and in a non-COVID-19 facility, special interventions to diminish stressors need to be implemented and maintained.

Barriers to healthy eating among nurses working in hospitals: A meta-synthesis

AIM

To explore the barriers to healthy eating among nurses working in hospitals.

DESIGN

Meta-synthesis.

DATA SOURCES

Published and unpublished papers were identified through electronic searches on PubMed, CINAHL, PsycINFO, Embase, Scopus, COCHRANE Library, Food Science and Technology Abstract, ProQuest Dissertations and Theses and OpenGrey from inception until 6 September 2020. English-language primary qualitative or mixed-method studies on barriers to healthy eating among hospital nurses were included. Mixed-method studies were eligible if their qualitative data were distinguishable. Studies on nursing assistants, enrolled nurses, nursing students, and patient-care assistants were excluded, as well as studies without full-texts, correlational studies, quantitative surveys, exploratory studies, conference abstracts and reviews.

METHODS

The studies were appraised using Critical Appraisal Skills Programme checklist. Qualitative data were extracted using Joanna Briggs Institute Qualitative Data Extraction Tool. Data synthesis followed two stages, meta-summary and meta-synthesis, proposed by Sandelowski & Barroso.

RESULTS

Twelve studies published from 2008 to 2020 involving 618 hospital nurses were included. The meta-summary generated 10 themes, which were meta-synthesized into three interrelated themes: personal barriers (e.g. nonchalance towards unhealthy eating), interprofessional and patient-related barriers (e.g. sharing unhealthy food), and organizational barriers (e.g. overwhelming work demands).

CONCLUSION

Insufficient self-control and self-confidence, nonchalance and negligence towards healthy eating and cultural beliefs that oppose the practice of healthy eating (personal barriers), exposure of unhealthy food practices in wards (interprofessional and patient-related barriers) and hospital cafeterias, overwhelming work exigencies and institutional constraints (organizational barriers) hindered nurses to achieve wholesome healthy eating.

IMPACT

Many hospital nurses' encountered challenges in healthy eating, thereby potentially jeopardizing their health and work performance. The findings emphasized the need of a joint effort by hospital nurses, families and colleagues, and hospital institutions to overcome the barriers to healthy eating faced by the hospital nurses.

Depressive symptom trajectories and their relation to body mass index in women of child-bearing age: The Korea Nurses' Health Study

BACKGROUND

This study investigated the sub-trajectory groups of depressive symptoms in women of child-bearing age and the factors impacting latent class membership. Moreover, differences in body mass index (BMI) as an outcome variable were identified among the sub-trajectory groups.

METHODS

Data from the Korea Nurses' Health Study (KNHS) were analyzed, comprising that from 6,918 participants who filled out surveys during modules 1, 5, and 7. The growth mixture model with individually varying observation times was used to identify latent subgroups of depressive symptom trajectories.

RESULTS

Three classes of depressive symptom trajectories were identified: increasing over time, stable/low, and decreasing over time. Older participants had a higher probability of belonging to the stable/low class. Married participants were more likely to belong to the stable/low class than to the increasing over time class or decreasing over time class. Participants who worked shifts had a higher chance of belonging to the decreasing over time class than the stable/low class. There was a significant difference between mean BMI across latent classes in module 1 (χ²(df=2,N=6918)=155.16, p<0.001) and in module 7 (χ²(df=2,N=6918)=149.68, p<0.001).

LIMITATIONS

The findings of this study should not be generalized to all women of childbearing age, because the study population only included nurses.

CONCLUSIONS

The results suggest that interventions designed to manage depressive symptoms in women who are younger, unmarried, and who perform shift work may be beneficial. This study identified a relationship between increasing severity of depressive symptoms and increasing BMI.

Prediction model for abnormal eating behaviour among hospital nurses: A structural equation modelling approach

BACKGROUND

Nurses are at a high risk of developing abnormal eating behaviour. However, few studies have attempted to identify the factors that influence such behaviour.

AIM

This study identifies factors that can predict abnormal eating behaviour in hospital nurses.

DESIGN

This study adopted a cross-sectional, descriptive correlational research design.

METHODS

A literature review was used to establish a hypothetical model, comprising the eight factors of shift work, job stress, depression, sleep quality, fatigue, coping strategy (active coping and passive coping) and abnormal eating behaviour. A convenience sample of 298 nurses aged less than 45 was recruited from two university hospitals, and structured questionnaire was administered between March and April 2017. The hypothesized model was tested using structural equation modelling.

RESULTS

Sleep quality and passive coping directly affect abnormal eating behaviour, which implies that poor sleep quality and increased passive coping worsens the behaviour. Shift work and depression indirectly affect abnormal eating behaviours.

CONCLUSION

Nursing managers and health policy makers should adopt strategies such as improving the shift-work pattern, providing adequate rest time after a night shift and enabling coping strategies by providing educational programs for hospital nurses.

The linkage "Body Mass Index-Insomnia Levels-Eating Disorder Flexibility" in Italian nurses during the Covid-19 outbreak: a psychoendocrinological employment disease

AIM

To evaluate differences between insomnia condition and flexibility attitude to eating in Italian nurses directly involved in the care of patients affected by Covid-19 according to sex, Body Mass Index, shift working condition and incidence of new Covid-19 cases in the region of participants. Moreover, any correlations between the insomnia condition and the flexible attitude to eat have been investigated.

METHODS

An online questionnaire was administered in October 2020, including the socio-demographic section, the insomnia condition assessment, and the behavioral flexibility evaluation to develop an eating disorder.

RESULTS

341 Italian nurses answered the questionnaire. Regarding the insomnia condition levels, nurses belonging to regions with a higher incidence rate of the Covid-19 pandemic recorded higher levels of insomnia than others (p=.004). Females and nurses belonging to areas with lower Covid-19 incidence rate recorded a significantly higher total eating flexibility attitude (p=.003; p<.001), also, in the Food and Exercise flexibility (p=.007; p<.001). As regards the flexible attitude for weight and shape, significant differences were recorded among nurses according to their BMI values (p<.001) and to their incidence rate of the belonging region (p<.001). The insomnia condition levels significantly correlated with the eat flexibility attitude both in its total score (p=.010), in the general score (p=.010), and the weight and shape score (p<.001). All correlations between the insomnia conditions and the flexibility to eat were significantly inverse except for the food and exercise dimension. All the eat flexibility sub-dimensions significantly correlated among them (p<.001).

CONCLUSION

There was a direct correlation among socio-demographic factors, BMI values, insomnia, and behavioral flexibility scores in Italian nurses. So, it could be assumed that the nursing profession is at risk of developing a metabolic syndrome condition. Therefore, it could be considered a psychoendocrinological employment disease during the Covid-19 outbreak.

"You Need to Get Over the Difficulties and Stand Up Again"-A Qualitative Inquiry into Young Nurses' Coping with Lateral Violence from the Feminist Perspective

Previous studies have reported lateral violence (LV) styles among nurses and the adverse impacts of LV on nurses and nursing. Young nurses, including nursing students and novice nurses, are often victims of LV. A large qualitative research study that contained three sub-studies exploring professional identity development in different professional stages was conducted by a research team in Macau, Special Administrative Region of China. Semi-structured interviews with nursing students and clinical nurses were carried out; among the 58 participants in the three sub-studies, 20 described some forms of LV and their ways of dealing with them. Framed by the feminist perspective, the researchers explored young nurses’ coping strategies in dealing with LV perpetrated by senior colleagues. Two themes were developed reflecting the coping strategies for LV: “making extra efforts” and “soothing emotional distress”. Three sub-themes were under the theme of “making extra efforts”: “catching up knowledge”, “making the most use of learning resources”, “adjusting communication manner”; another batch of sub-themes was under the theme of “soothing emotional distress”: “seeking support from schoolmates”, “living with family but crying alone”, and “adjusting lifestyle”. The study implied that young nurses exerted their agency in coping with LV in clinical practices. Nursing managers and educators should support young nurses’ efforts in overcoming power-based LV and incivility.

The impact of dayshifts and sleepover nightshifts on the eating and driving behaviours of residential support workers: An exploratory workplace study

BACKGROUND

Residential support workers (RSWs) provide 24-hour care to clients and many work overnight sleepover nightshifts. Although RSWs perform safety-critical tasks and are at high-risk of work stress and exhaustion, the health and safety of RSWs has not been investigated.

OBJECTIVE

This explorative workplace case study explored the impact of support work on the eating and driving behaviours of RSWs.

METHODS

Thirteen RSWs who had worked a dayshift (n = 6) or a sleepover nightshift (n = 7) completed questions on the timing of food intake during their shift, motivations for eating during the shift, subjective work performance, alertness and sleepiness post-shift, and driving performance post-shift.

RESULTS

RSWs reported snacking during the night on a sleepover nightshift. Time available was the biggest determinant for when RSWs ate during a day and sleepover nightshift. Ratings of subjective alertness and sleepiness after eating were not different between shift types, however participants reported an increase in work performance after eating during a dayshift. Driving events were more frequently reported post-sleepover nightshift, compared to post-dayshift.

CONCLUSIONS

Findings demonstrate an impact of shift type on eating and driving behaviours of RSWs and highlight the importance of further investigation of this under-researched group to identify appropriate strategies for improving health and safety.

Nutrition Habits of Polish Nurses: An Approach

BACKGROUND

Chronic stress, unlimited working time and the shift working system as well as sleep deficiency may lead to the occurrence of nutrition disorders among nurses.

AIM

The aim of the paper was an assessment of the nutrition habits of nurses. It was an observational study conducted from June 2017 to May 2018 among nurses (n = 1080) in Silesia in Poland. Data was obtained using a range of questionnaires.

RESULTS

Body mass index (BMI) of the analysed nurses demonstrated overweight/obesity in 490 (45.5%) of them. Nearly all the diets of the analysed nurses (n = 1021; 94.5%) required improvement. Younger nurses (<31 years old) demonstrated a greater tendency to indulge in habitual overeating, and those having additional employment demonstrated poorer nutrition habits compared to those without additional employment.

CONCLUSION

The analysed nurses made numerous dietary mistakes which, as a consequence, can lead to obesity. Emotional overeating was the dominant nutrition habit in the studied group of nurses. Nurses who were overweight/obese, nurses who had additional employment and younger nurses demonstrated tendencies toward improper nutrition choices, i.e., the tendency to overeat or restrain oneself from eating.

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.

Unhealthy Food and Psychological Stress: The Association between Ultra-Processed Food Consumption and Perceived Stress in Working-Class Young Adults

BACKGROUND

Ultra-processed foods are industrial formulations made from food extracts or constituents with little or no intact food and often containing additives that confer hyper-palatability. The consumption of these products increases the risk of chronic non-communicable diseases. Stressed people may engage in unhealthy eating as a way to cope. This study aimed to verify whether ultra-processed food consumption was associated with perceived stress levels in industrial and retail workers from Vitoria da Conquista, Brazil.

METHODS

This was a cross-sectional study carried out between July 2017 and August 2018. During the study period, 1270 participants completed a survey administered by an interviewer. Stress levels were assessed using the Perceived Stress Scale. Information regarding weekly ultra-processed food consumption was collected. Ultra-processed foods were classified into four groups: sugary drinks; sugary foods; fast foods; and canned foods, frozen foods, or processed meat. The Student's t-test or one-way analysis of variance was used to assess the differences in stress levels and ultra-processed food consumption. Ordinal regression was used to determine the association between the degrees of stress and ultra-processed food consumption levels.

RESULTS

Factors such as a young age, being unmarried, smoking, high-risk alcohol consumption, negative health perception, and high perceived stress level indicated higher rates of ultra-processed food consumption. Ordinal regression analysis showed that high stress levels were associated with increased odds of higher ultra-processed food consumption (odds ratio: 1.94; 95% CI: 1.54-2.45).

CONCLUSIONS

These findings could help identify appropriate target areas for interventions aimed at mental health promotion and healthier food consumption.

Mental health research studies in Saudi Arabia for the years 2009-2019; a systematic scoping review

BACKGROUND

An updated systematic scoping review and narrative analysis of all possible mental health studies done during the concerned immediate years clarifies its present condition and status for all professionals, and concerned researchers.

AIMS

To synthesize published mental health research studies in and for Saudi Arabia for the years 2009-2019 with the confidence to evaluate current situation, identify research gaps and limitations (if any), and assist in conceptualizing the forthcoming directions of future mental health research activities.

METHODS

Scoping systematic review and modified narrative analysis were the methods utilized to achieve the aim and objective set for this formal academic endeavor.

RESULTS

Of the 1006 published studies identified from chosen databases, a total of 241 papers were included and had passed the stringent criteria set for the scoping review process. Basic characteristics of the reviewed studies were quantitative survey type with about 101-500 size range of respondents, utilizing non-patients and adults for participants which were common and randomly chosen from selected population, and most research activities were self-funded. Four major research themes were found including a list of research limitations.

CONCLUSIONS

This systematic scoping review identified a wide range of results characterizing the different studies that qualified using pre-determined inclusion-exclusion criteria. Though of increasing publication volume in the past decade, most researches done were quantitative survey type whose themes seemed to show no drastic difference or change from the previous years of output. More variety in research themes would further improve the over-all quality of mental health publications.

Work-Related Challenges among Primary Health Centers Workers during COVID-19 in Saudi Arabia

This study aimed to identify certain occupational risk factors for stress among healthcare workers (HCWs) during the COVID-19 pandemic. Using a multistage random sampling approach, an online questionnaire was applied to collect data on role conflict and ambiguity, self-esteem and social support from 1378 HCWs working in primary health centers (regular and fever clinics; clinics specialized in managing patients with COVID-19 symptoms) across Saudi Arabia. The results showed that stress correlated positively with role conflict and ambiguity and negatively with social support. HCWs in fever clinics exhibited significantly more stress and role conflict and ambiguity than those who were working in regular primary healthcare centers. In conclusion, role conflict and ambiguity and social support were determinants for stress among HCWs, especially those working in fever clinics.

Impact of night shift rotations on nursing performance and patient safety: A cross-sectional study

Aim

Hospitals operate on a 24‐hr basis, with shiftwork being unavoidable for most nurses. This study aims to explore the impact of night shiftwork rotations on nurses' physiological status, work performance and patient safety concerns among nurses in public hospitals.

Design

A descriptive predictive correlational design using a self‐administered questionnaire.

Methods

Electronic and printable survey questionnaires were distrusted among nurses working in public hospitals in multiple regions of Saudi Arabia. The study recruited 1,256 nurses from different nationalities, hospital work units and work experience.

Results

A large proportion of nurses on night shiftwork encountered patient safety issues (85.7%) and physiological consequences (93.6%). Counselling sessions and programmes to support at‐risk nurses are recommended.

The Relationship between Job Stress and Job Satisfaction among Saudi Nurses: A Cross-Sectional Study

Background: The productivity of nurses and patient healthcare is highly influenced by nurses’ stress-related factors and job satisfaction. Nursing is the least preferred career opportunities for Saudi residents as compared to other options. Nurses’ perceptions of intention to quit contributes to their shortage in Saudi health care institutions.Purpose: The study aimed to examine the relationship between work-related stress and job satisfaction among Saudi nurses working at a public hospital.Methods: The research used a cross-sectional design that collected data from samples of 297 nurses working at a specified public hospital and aged over than 20 years old. Convenient sampling was employed to recruit the samples. Data were collected using the Expanded Nursing Stress Scale (ENSS) and Job Satisfaction Scale (JSS). The Statistical Package for Social Sciences (SPSS) version 20.0 was applied, and Pearson’s correlation test was to identify the relationship between variables.Results: The results indicated that the nurses at the hospital where the study took place experienced low levels of stress with a mean value of 2.1995. Besides, the nature of work indicated maximum job satisfaction with a mean value of 15.666, whereas minimum job satisfaction levels (11.569), were related to benefits provided to nurses. A positive correlation was found between the level of stress and satisfaction with a p-value of 0.041.Conclusion: The stress factors were highly correlated with job satisfaction. The identification of stress factors is important as it may create a negative impact on patients’ care and their well-being. It is suggested that changes in managerial affairs and policies are essential for implementing beneficial strategies that may assist in resolving the issue.

Relationship between shift-work and life-style behaviors among emergency department nurses in Jordan

Shift-work can alter the nurses' lifestyle behaviors, which negatively influence health. This study is purposed to assess the relationship between shift-work and selected lifestyle behaviors including, dietary habits, physical activity, and nicotine dependence among Jordanian nurses who work at the emergency department. A cross-sectional, descriptive correlational design was used. A total of 275 Jordanian nurses from the emergency department of Jordanian hospitals participated in the questionnaire. The results showed that 50.2% of the nurses suffered from poor dietary habits, 81.8% of them were physically inactive, and 65.1% had nicotine dependence. There was a positive correlation between shift-work, dietary habits, physical activity, and nicotine dependence. Therefore, the effects of shift-work should be considered when planning and developing interventional programs to enhance nurses' health and promote healthy behaviors among nurses workforce during shift-work.

Association between Dietary Habits, Shift Work, and the Metabolic Syndrome: The Korea Nurses' Health Study

Metabolic syndrome (MetS) is an important public health problem, and unhealthy dietary habits and shift work are considered major factors that increase the prevalence of MetS. The purpose of this study was to examine whether dietary habits, alcohol drinking, and shift-working were associated with development of MetS in shift-working female nurses. This study analyzed cross-sectional survey data from the Korea Nurses’ Health Study (KNHS). Of the 1638 nurses, 403 participants were selected based on the propensity score matching method (PSM). These participants had either no or more than three MetS determinant factors. Analysis was conducted by using multivariable logistic regression to confirm the factors influencing MetS. The prevalence of MetS in this group (1638 participants) was 5.6% (92 participants). Consumption of over 50% of daily calorie intake after 7 p.m., consumption of carbonated drinks, family history of diabetes, and non-shift work were significant factors influencing MetS. Nurses are one of the at-risk groups for unhealthy dietary habits due to the nature of their work. Therefore, nurse managers should include regular dietary education for nurses and continue their policy efforts to resolve health problems that may arise in connection with nurses’ work.

Strategies to promote nurses' health: A qualitative study with student nurses

Developing strategies to support student nurses' health is a global priority for healthcare organisations and governments. This is because emerging international evidence indicates that improvements in student nurses' health are required to increase the longevity of careers and reduce the loss of time, skill and financial cost of sickness absence and workforce exit. However, we do not know what intervention strategies student nurses think would support their health. The study aim was to explore student nurses' views on factors that influence health-related behaviours and strategies that could improve health. Data were collected through participatory activities during focus groups with student nurses in Scotland. Analysis was theoretically informed and involved mapping to the Behaviour Change Wheel framework. Students identified several factors that influenced health-related behaviours. Four were ranked most important: knowledge, culture, time constraints, and stress. Strategies student nurses thought should be prioritised to improve nurses' health-related behaviours were: stimulating a health-promoting environment by reviewing shift work, improving workplace support, increasing staffing levels, subsidising and role-modelling of healthy food and exercise; and creating applied health-promoting curricula by integrating time and stress management training and lifestyle advice into nursing education. Educational and environmental interventions are needed to support student nurses' health.

Obesity and Cardiovascular Risk in the Arab Gulf States

Purpose of Review

Rapid economic growth in the Gulf Cooperation Council (GCC) states over the last half-century has been associated with a rise in obesity and cardiovascular morbidity and mortality. In this review, we shed some light on the factors driving the obesity epidemic, promising interventions to overcome this public health crisis, and challenges precluding a successful public health impact.

Recent Findings

Overweight and obesity rates have nearly tripled in the GCC countries over the past four decades. Cardiovascular morbidity and mortality have been rising in parallel. Several sociodemographic, environmental, and behavioral factors have been correlated with sedentary lifestyle and unhealthy diet habits, and ultimately the rise in overweight and obesity rates. Numerous studies have documented factors unique to the population of the Arab Gulf states, but high-quality data is scarce. Despite the growing awareness of the extent of the problem, several barriers to weight loss and physical activity need to be addressed. A few interventions to combat obesity at different levels have been reported with some promising outcomes. Using the social-ecological model (SEM), we review recently published interventions and discuss some challenges to overcome in order to make progress in fighting the obesity epidemic in the GCC.

Summary

Obesity prevalence has been mounting worldwide, and the Arab Gulf states are no exception. This public health crisis is drawing the attention of policymakers and several stakeholders. However, a lot needs to be done to reduce the burden of obesity and improve cardiovascular risks in the Arab Gulf states.

Relationship between night shift work, eating habits and BMI among nurses in Lebanon

Background

The objective of this cross-sectional study was to evaluate the relationships between night shift work, eating habits and body mass index (BMI) among Lebanese nurses.

Methods

A total of 307 nurses were randomly selected from five hospitals located in Beirut. Data about demographic and professional characteristics, anthropometric measures, dietary habits and intakes were collected through a validated questionnaire. To study the relationship between night shift work, eating habits and BMI, chi-square test, t-test and logistic regressions were used.

Results

The majority of nurses (78. 2%) had irregular meals timing with a significant decrease in the number of complete meals consumed during the day and an increase in the number of snacks consumed during night (p < 0. 05). The most consumed snacks during night shifts were sweets and potato chips. The findings highlighted that BMI and waist circumference significantly increased with the number of years of work (r = 0.175; p < 0.05) and the cumulative number of night shifts hours over the entire work history (r = 0.135/p < 0. 05).

Conclusion

Night shift work is positively associated with abnormal eating patterns and BMI among Lebanese nurses. However the increase in BMI is not related to eating habits.

Consequences of Circadian Disruption in Shift Workers on Chrononutrition and their Psychosocial Well-Being

The workers and employees in various institutions are subjected to different shifts and work schedules. The employees work not only at daytime but also during odd hours at night. The biological clock of an individual is often altered during night shifts. This affects the psychosocial well-being and circadian nutritional intake of the worker. Disturbance in circadian rhythm results in the development of metabolic disorders such as hypertension, dyslipidemia, dysglycemia, and abdominal obesity. In the present review, we discuss the nature of shift work, sleep/wake cycle of an individual, chrononutrition, dietary habits, and meal changes with regard to timing and frequency, related to shift work. We also discuss the relationship between nutritional intake and psychosocial well-being among shift workers. The review may be beneficial for prevention of metabolic disorders and maintaining sound psychological condition in shift workers.

The factors influencing the eating behaviour of shiftworkers: what, when, where and why

Shiftwork leads to altered eating patterns, with workers often eating foods at all times across the 24 h period. Strategies to reduce the burden of shiftwork on the workers should be prioritised and altering these eating patterns is an important area for change. This narrative review examines the current evidence on the individual and environmental factors influencing the eating behaviours of shiftworkers. A systematic search was conducted and yielded 62 articles. These were split into four themes that influence eating patterns; When shiftworkers eat, What type of foods shiftworkers eat, Where the food is sourced from, and Why shiftworkers choose to eat on shift. Irregular working hours was the biggest influence on when workers ate on shift, shift-type was the biggest influence on what workers ate, the majority of food was sourced from canteens and cafeterias, and socialising with colleagues was the biggest reason why workers chose to eat. While more research is needed to explore multiple industries and shift-types, and to investigate the ideal size, type and timing of food on shift, this review has highlighted that future research into shiftworker eating needs to adopt an integrative approach and consider the different individual and social contexts that influence eating patterns.

Exploring nurses' work-related stress in an acute care hospital in KSA

Objectives

This study aimed to assess the perceived work-related-stress of staff nurses and determine the relationship between work-related stress and demographic profile.

Methods

This study used a descriptive cross-sectional design and was conducted in a secondary public hospital (staff nurses = 178, bed capacity = 225) in Riyadh, KSA. The hospital provides medical and surgical services that are important to achieve optimum quality patient care and services. In total, 178 staff nurses were interviewed, but 15 responses were excluded because of missing data (response rate: 92.52%).

Results

Nurses reported a moderately stressful work environment. Nationality was found to be a significant predictor of nurses' stress levels. Indian nurses had higher stress levels compared with nurses of other nationalities. Working hours per week was another significant predictor of stress.

Conclusion

This study highlighted perceived work-related stress of staff nurses and determined the relationship between work-related stress and demographic profile. Most nurses were moderately stressed. Working hours were associated directly with stress level. The study findings can serve as a guide for establishing human resources policies aiming at reducing nurses' stress and, thereby, promoting improved health care and task force work performance.

Overweight and obesity among adults in the Gulf States: A systematic literature review of correlates of weight, weight-related behaviours, and interventions

Obesity has increased to an epidemic level in the Gulf States. This systematic review is the first to explore the scientific evidence on correlates and interventions for overweight (body mass index [BMI] ≥ 25) or weight-related behaviours in the region. A systematic search of peer-reviewed articles was conducted using PubMed and PsycINFO. Ninety-one studies were eligible for this review including 84 correlate studies and seven intervention studies. Correlate studies of overweight focused on sociodemographic factors, physical activity, and dietary habits. Low physical activity, sedentary behaviour, and unhealthy dietary habits were associated with overweight. The most-reported sociodemographic correlates of overweight were increased age, being married, low education, urban residence, and unemployment. Correlate studies of physical activity and dietary behaviours mostly focused on sociodemographic variables. Being female and increased age (the latter less consistently) were associated with low physical activity. Interventions were very heterogeneous with respect to the target group, intensity, and behavioural strategies used. The effectiveness of interventions was difficult to evaluate because of the chosen study design or outcome measure, the small sample size, or high attrition rate. Few studies have investigated sociocognitive and environmental determinants of weight-related behaviours. Such information is crucial to developing health promotion initiatives that target those weight-related behaviours.

Association of cumulative job dissatisfaction with depression, anxiety and stress among expatriate nurses in Saudi Arabia

AIMS

We aimed to (a) determine the prevalence of depression, anxiety and stress among expatriate nurses in Saudi Arabia, and (b) assess how dissatisfaction with salary, workload and teamwork, individually and in combination, was associated with those conditions.

BACKGROUND

Prevalence estimates for depression, anxiety and stress among nurses are higher than those in the general population. Available data on the mental health of expatriate nurses are limited.

METHODS

Expatriate nurses (n = 977) from governmental hospitals completed an electronic survey on demography, lifestyle, job factors, depression, anxiety and stress (assessed with DASS-21 scale). Multinomial logistic regressions were used for analyses.

RESULTS

Dissatisfaction with workload and teamwork was significantly associated with both mild/moderate and severe depression in adjusted models. Dissatisfaction with workload was significantly associated with both anxiety and stress, but teamwork was not. There was a significant dose-response relationship between the number of domains of dissatisfaction and depression, anxiety and stress (p for trend was < 0.001).

CONCLUSIONS

Dissatisfaction with salary, workload and teamwork is associated with depression, anxiety and stress in expatriate nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital and nursing administrators should identify specific aspects related to workload and teamwork and offer solutions to reduce mental health distress among nurses.

Job insecurity, fear of litigation, and mental health among expatriate nurses

The objective was to assess whether job insecurity and fear of litigation were correlates of depression, anxiety, and stress among expatriate nurses in Saudi Arabia. The participants included 977 expatriate nurses working in Al-Qassim, Saudi Arabia who completed an online survey that assessed depression, anxiety, and stress (using DASS-21) as well as demography, lifestyle, and job characteristics. Mean age was 32 years and 60% of nurses were from India/Pakistan. Twenty-four percent of nurses reported job insecurity, and 18% reported a fear of litigation. Severe depression, anxiety, and stress were significantly higher among nurses who always felt insecure about their job (compared to never) and among those who always feared litigation (compared to never). We concluded that job insecurity and fear of litigation were significant correlates of severe depression, anxiety, and stress among expatriate nurses.

Does stress affect food preferences? - a randomized controlled trial investigating the effect of examination stress on measures of food preferences and obesogenic behavior

Lay summary: Human and animal studies have shown that chronic stress interfers with both homeostatic and hedonic appetite control. Here, we investigated the effect of chronic stress on food preferences and eating behavior in real life settings. In random order, fifty healthy students participated in two test periods of 4-5 days; a stressful period (one week prior to an examination) and a nonstressful period (four weeks after an examination). Food preferences were assessed by counting money spent on highly rewarding foods bought with gift certificates, and changes in eating behavior was further assessed by the Three Factor Eating Questionnaire. Cohen's Perceived Stress Scale, the Recovery-Stress Questionnaire, heart rate variability and Cortisol awakening response were used to evaluate the level of stress. Data on glycemic control, blood pressure, physical activity and sleep were also collected. Forty-four subjects had complete data on the primary outcome. Self-perceived stress was higher and recovery lower in the exam period (p ≤ .001). Subjects were less cognitively restrained (p = .037), less moderately-to-vigorously and lightly physically active (p ≤ .037) and were more sedentary (p = .009) in the examination period. However, no difference was found in money spent on high reward foods, disinhibition or hunger between the examination and control condition. Furthermore, no differences in the physiological markers of stress, glycemic measures and sleep were found. Data does not convincingly support the hypothesis that perceived stress increases the preference for highly palatable foods or leads to adverse effects on different markers of health. However, the stressor might have been to mild to induce obesogenic behaviors.

Dietary Differences in Male Workers among Smaller Occupational Groups within Large Occupational Categories: Findings from the Japan Environment and Children's Study (JECS)

Studies examining workers' diet according to smaller occupational groups within "large occupational categories" are sparse. The aim of this study was to examine the potential differences in workers' diets based on the classification of workers into smaller occupational groups that comprise "large occupational categories". The subjects of this study were working fathers who had participated in the Japan Environment and Children's Study (N = 38,656). Energy and nutrient intake were calculated based on data collected from the Food Frequency Questionnaire. Occupations were classified according to the Japanese Standard Occupational Classification. Logistic regression analyses were performed to examine the adherence to current dietary recommendations within smaller occupational groups. In particular, significant differences were observed among the categorical groups of "professional and engineering workers", "service workers", and "agricultural, forestry, and fishery workers". In "professional and engineering workers", teachers showed higher odds of adherence to calcium intake recommendations compared with nurses (OR, 2.54; 95% CI, 2.02⁻3.14; p < 0.001). In "agricultural, forestry, and fishery workers", agriculture workers showed higher odds of adherence to calcium (OR, 2.15; 95% CI, 1.46⁻3.15; p < 0.001) and vitamin C (OR 1.90, 95% CI 1.31⁻2.74, p = 0.001) intake recommendations compared with forestry and fishery workers. These findings may be beneficial from a research perspective as well as in the development of more effective techniques to improve workers' diet and health.

Binge eating disorder and depressive symptoms among females of child-bearing age: the Korea Nurses' Health Study

BACKGROUND

Most studies regarding the relationship between binge eating disorder (BED) and depression have targeted obese populations. However, nurses, particularly female nurses, are one of the vocations that face these issues due to various reasons including high stress and shift work. This study investigated the prevalence of BED and the correlation between BED and severity of self-reported depressive symptoms among female nurses in South Korea.

METHODS

Participants were 7,267 female nurses, of which 502 had symptoms of BED. Using the propensity score matching (PSM) technique, 502 nurses with BED and 502 without BED were included in the analyses. Data were analyzed using descriptive statistics, Spearman's correlation, and multivariable ordinal logistic regression analysis.

RESULTS

The proportion of binge eating disorder was 6.90% among the nurses, and 81.3% of nurses displayed some levels of depressive symptoms. Multivariable ordinal logistic regression analysis revealed that age (40 years old and older), alcohol consumption (frequent drinkers), self-rated health, sleep problems, and stress were associated with self-reported depression symptoms. Overall, after adjusting for confounders, nurses with BED had 1.80 times the risk (95% CI = [1.41-2.30]; p-value < 0.001) of experiencing a greater severity of self-reported depression symptoms.

CONCLUSIONS

Korean female nurse showed a higher prevalence of both binge eating disorder and depressive symptoms, and the association between the two factors was proven in the study. Therefore, hospital management and health policy makers should be alarmed and agreed on both examining nurses on such problems and providing organized and systematic assistance.

Nurses and Health-Promoting Behaviors: Knowledge May Not Translate Into Self-Care

Nurses are knowledgeable regarding the importance of health-promoting activities such as healthy eating, physical activity, stress management, sleep hygiene, and maintaining healthy relationships. However, this knowledge may not translate into nurses' own self-care. Nurses may not follow recommended guidelines for physical activity and proper nutrition. Long hours, work overload, and shift work associated with nursing practice can be stressful and contribute to job dissatisfaction, burnout, and health consequences such as obesity and sleep disturbances. The purpose of this article is to provide an overview of research examining nurses' participation in health-promoting behaviors, including intrinsic and extrinsic factors that may influence nurses' participation in these activities. This article also provides recommendations for perioperative nurse leaders regarding strategies to incorporate into the nursing workplace to improve the health of the staff nurses by increasing health-promoting behaviors.