Lifestyle and Shiftwork: Designing and Testing a Model for Health Promotion of Iranian Nurses

Abstract

BACKGROUND: Lifestyle is one factor that forms the nurses’ health, particularly those who work in shiftwork schedules. AIMS: The aim of this study was to design and test a model for health promotion of Iranian nurses. In this model, nurses’ lifestyle was considered as the precedent, physical and mental health as the outcomes, and sleep disturbance and chronic fatigue as the mediators. METHODS: A cross-sectional study using structural equation modeling was conducted among 240 shiftworker nurses in Iran. The data collection was performed using the Persian versions of the Survey of Shiftworkers Questionnaire and Life Style Questionnaire. Bootstrap in Preacher and Hayes’ Macro program was used for testing mediation. RESULTS: Lifestyle had a weak significant direct effect on physical (β = 0.13, p < .04) and mental health (β = 0.12, p < .02), and it had a significant indirect effect on physical health via chronic fatigue (β = −0.11, p < .001) and sleep disturbance (β = −0.05, p < .01). This variable only had a significant indirect effect on mental health via chronic fatigue (β = −0.19, p < .001). The final model proposed a new significant path between sleep disturbances and chronic fatigue (β = 0.22, p < .001). CONCLUSIONS: Therefore, the hospital officials can enhance the nurses’ physical and mental well-being by providing interventions and training courses on aspects of healthy lifestyles, such as physical activity, avoidance of smoking, and maintenance of body weight.

Nurse Fatigue and Nurse, Patient Safety, and Organizational Outcomes: A Systematic Review

“…One cross-sectional study found a significant positive relationship between nurse fatigue and mental health problems (Bazazan et al, 2019; β = 0.36, p < 0.01). In addition, the study by Mokarami et al (2020) found that nurses’ higher level of chronic fatigue was significantly related to lower mental health status (β = -0.49, p = 0.01). Further, Mokarami et al (2020) found a significant negative association between nurses’ chronic fatigue and their physical health status (β = -0.32, p = 0.01).…”

“…In addition, the study by Mokarami et al (2020) found that nurses’ higher level of chronic fatigue was significantly related to lower mental health status (β = -0.49, p = 0.01). Further, Mokarami et al (2020) found a significant negative association between nurses’ chronic fatigue and their physical health status (β = -0.32, p = 0.01). Another cross-sectional study found that nurses’ musculoskeletal complaints were significantly related to their higher fatigue levels (Mehralizadeh et al, 2017; β = 0.22, p < 0.05).…”

“…In addition to performing routine tasks effectively, it is important for nurses to establish positive relationships with patients to provide quality nursing care (McCabe, 2004). Given that fatigue can negatively affect nurses’ mental health problems (Bazazan et al, 2019; Mokarami et al, 2020), further research on how nurse fatigue affects relational aspects of nurses’ role is needed.…”

The Impact of Social Jetlag on Sleep Quality among Nurses: A Cross-Sectional Survey

“…Shift work changes the awake and sleep time in a 24 h cycle [7] and it has an adverse impact on the amount and quality of sleep, as shift workers cannot avoid concerns about acute sleep loss during night and early morning shifts [2,8]. Adverse effects of poor sleep quality among nurses working shifts include daytime dysfunction, difficulty of recovery after sleep, poor sleep satisfaction, difficulty in sleep maintenance, difficulty with sleep initiation, and difficulty in waking up [9,10].…”

“…Despite the continued reports of the adverse impact of shift work on nurses' physical and mental health [8], shift work is inevitable for nurses because they must monitor patients, promptly respond to life-threatening situations, and continuously care for patients around the clock.…”