Nurses' Working Conditions and Obesity

Abstract

Background: Job stress and shift work are known risk factors for obesity, yet comprehensive measures of job stress/work schedules (JS/WS) in relation to nurse obesity have been little investigated. Moreover, the effect of JS on obesity can vary with WS characteristics because WS comprehensively influence workers' lives. Nonetheless, there are knowledge gaps about differences in factors which are associated with nurse obesity by WS status. Purpose: This study aimed to 1) examine the proportion of overweight/obesity (OW/OB) among nurses, 2) investigate the relationship between JS/WS and nurse obesity, and 3) compare the relationship between JS and nurse obesity by WS status. Methods: The conceptual framework was based on the Demand-Control-Support model which assumes workers' health is affected by stress-producing factors in employment settings. This study was a cross-sectional secondary data analysis of 2,103 female nurses. Obesity was measured using body mass index estimates. To examine associations of JS/WS with nurse obesity, binomial logistic regression models for OW/OB incorporated independent components of JS/WS. To compare associations between JS and nurse obesity by WS status, binomial regression models were stratified by WS status (favorable WS and unfavorable WS). All models included demographics, depressive symptoms, and health and family related covariates. Results: The prevalence of OW/OB was 55%. In the overall nurse sample, longer work hours (OR=1.22, 95% CI=1.08-1.39) and jobs with lower physical exertion (OR=0.83, 95% CI=0.73-0.95) and more limited movement (OR=1.14, 95% CI=1.02-1.28) were significantly associated with OW/OB. When comparing associations between JS and nurse obesity by WS status, among nurses with favorable WS, OW/OB nurses reported significantly less supervisory support (OR=0.83, 95% CI=0.68-1.00). On the other hand, among those with unfavorable WS, no job stress components were significantly related to OW/OB. Only healthy behaviors (i.e., exercise and sleep) were significantly associated with decreased odds of OW/OB (OR=0.79, 95% CI=0.66-0.95). Conclusion: Organizational supports to limit adverse WS are needed. In particular, for nurses with unfavorable WS, educational interventions about sleep hygiene and other lifestyle modifications for adaptation to their WS may help improve health. For nurses with favorable WS, organizational supports for alleviating nurses' home/family responsibilities and stress are needed.