Long Shifts May Raise Some Nurses' Odds for Obesity

Job Stress and Work Schedules in Relation to Nurse Obesity


Objectives: This study aimed to examine the relationship between job stress/work schedules (JS/WS) and obesity among nurses.

Conclusions: Findings suggest interventions to limit adverse work schedules. Access to healthy food and optimal meal breaks should be investigated.

The obesity epidemic in the United States is a widely recognized major national health threat as obesity increases the risk of many health conditions and psychological impairments.   Annual medical costs associated with obesity are expected to double every decade to $861 to $960 billion by 2030, or 16% to 18% of the total US healthcare costs. In workplaces, obese employees have more fatigue, sleepiness, and physical limitations, which lead to higher risks of occupational injury than among nonobese employees. Nurses' obesity and related health problems may be related to high absenteeism, retention, and high healthcare costs.


A socioepidemiologic approach suggests that certain work characteristics and conditions may cause negative health behaviors and outcomes among employees. According to the Demand-Control-Support model, job strain occurs because of high psychological demands, combined with low control/decision latitude and lack of social support on the job. In this context, job strain is exhibited as job stress that may affect eating behavior and food choices, for example, a tendency to eat more sweet and energy-dense foods. In nursing, high workload, low staffing levels, and shorter work breaks have all been reported as barriers to nurses' healthy eating. Disordered eating was more prevalent among nurses with high job stress, and the relationship between disordered eating (ie, binging) and obesity was exacerbated by psychological stress. Moreover, Lallukka et al found job stress related to decreased physical activity and unhealthy diet habits (eg, low vegetable or fruit consumption, not choosing whole grains).


Work schedules also may influence nurses' health by causing job strain or altering health behaviors. Adverse work schedules could lead to obesity among nurses; for instance, shift work and long work hours disrupt normal eating times and reduce access to healthy food. Because of a lack of available food service, nightshift workers tend to eat unhealthy food (eg, high salt, sugar) from vending machines or prepackaged foods. Nightshift nurses reported that their work schedules affected their stamina, frequency of exercise, and social and family life more than those working other shifts. However, few nurses' obesity studies have incorporated work schedule variables.


There is also lack of knowledge about the prevalence of nurses' obesity and of the potential relationship between nurses' work and obesity. The prevalence of nurse overweight/obesity was 55% in 1 study, slightly lower than for the US population (65%). Another study found that 65% of hospital nurses were overweight/obese (OW/OB). However, low response rates and oversampling of minority and male nurses hamper generalization of these estimates.


The purposes of this article were to (a) describe overweight/obesity rates among a more representative sample of nurses and (b) examine the relationship between job stress/work schedules and nurse obesity. Demographic and work characteristics, mental/emotional distress, health behaviors, and home demands were also examined in these analyses. Study findings can provide evidence of working conditions related to obesity and could support recommendations to reduce nurses' obesity and improve their health. 


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Source: The Journal of Nursing Adminstration