Complexity of work environment limits nurses from achieving a healthy lifestyle

Changing multiple behaviors is difficult in high stress occupations with demanding schedules such as nursing, according to a new study published in the Journal of Nutrition Education and Behavior

Research among nurses reports fewer than 10 percent meet physical activity guidelines and eat a healthy diet. The American Nurses Association underscored this issue by declaring 2017 as the Year of the Healthy Nurse. A new study published in the Journal of Nutrition Education and Behavior found that despite providing pedometers, a smartphone app, and access to a Facebook group, study participants were unable to change their diet and physical activity levels at the same time.

"The complexity of nurses' working environment limits the number of workplace programs to help them achieve and maintain a healthy lifestyle," said lead author Luciana Torquati, PhD, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia. "This study's aim was to evaluate and understand key factors to overcome the barriers to creating programs to help them change unhealthy behaviors."

This study recruited 47 nurses working directly in emergency rooms, intensive care units, or inpatient facilities at two metropolitan hospitals in Australia. The majority were female and working full time, and more than half were working at least one overnight shift. An initial assessment of participants included body measurements and questionnaires about self-rated health, interest in adopting healthier behaviors, and available social support. Participants were requested to wear an accelerometer for seven consecutive days. The nurses were asked to set realistic health goals, focusing on small and sustainable changes to their diet and physical activity levels.

To support their goals during the three-month intervention, a variety of tools were provided including a pedometer, smartphone app, and Facebook group. At the end of three months participants completed questionnaires, measurements were taken, and they were again asked to wear an accelerometer to track duration and intensity of physical activity. Similar data were gathered after six months to determine if any progress had been sustained.

After the intervention, fruit and vegetable intake significantly increased, while physical activity slightly decreased. The feedback indicated it was easier to change diet than to become more physically active. The tools to facilitate change were only partially used by the nurses participating with very few posts made to the Facebook group or shared in the app. This resulted in social support among participants being lower than expected with minimal encouragement among colleagues.

Some of the reasons given for not participating included lack of time, the material provided was not appealing, or they preferred an alternate weight loss program. Other feedback included having meal plans available and adding individual consultations to monitor progress. Nurses did feel that participation in the study increased their awareness of their eating habits and lack of physical activity.

"There was a discrepancy between what nurses said they wanted during the study and what they were prepared to do," said Dr. Torquati. "Future studies should take into consideration a person's primary motivation plus readiness to change when creating strategies."