Occupational and leisure-time physical activity and associated factors among shift-working registered nurses: A cross-sectional study

Int J Nurs Stud Adv. 2023 Oct 14:5:100157. doi: 10.1016/j.ijnsa.2023.100157. eCollection 2023 Dec.

Abstract

Background: Lifestyle behaviors, including physical activity, may help to mitigate the chronic disease and mental health consequences of shift work in nurses at the individual level. The physical activity levels of shift-working nurses and factors that predict physical activity in this population are unclear.

Objective: The primary aim of this study was to describe work and leisure-time physical activity behaviors in shift-working hospital nurses and determine behavioral, biological, or work-related factors that influence physical activity.

Design: Observational; cross-sectional.

Settings: Acute care hospital system.

Participants: Current registered nurses (N = 112) with a shift work schedule (rotating, mixed, or permanent night shift).

Methods: Online validated questionnaires were used to assess work and leisure physical activity levels (International Physical Activity Questionnaire); Theory of Planned Behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) related to physical activity; and morningness-eveningness. Work-related characteristics were also assessed. Structural equation models were examined for the Theory of Planned Behavior constructs.

Results: Shift-working nurses reported 227 (±265) minutes/week of leisure-time and 566 (±868) minutes/week of occupational moderate-to-vigorous physical activity. Attitude (standardized coefficient = 0.63; p < 0.05) was the strongest predictor of physical activity intention, and intention (standardized coefficient = 0.40; p < 0.05) was a significant predictor of leisure-time physical activity behavior. There were no statistically significant differences in physical activity type and amount between those who identified as "morning", "intermediate", or "evening" types. Clinical nurse leaders engaged in statistically significantly less leisure-time physical activity than direct care nurses (703 ± 1142 vs. 1202 ± 1372 MET-minutes/week) (p = 0.013).

Conclusions: Our findings suggest that on average, shift-working registered nurses report meeting national physical activity guidelines for leisure and occupational physical activity; however, there is considerable interindividual variability. Theory of Planned Behavior constructs, especially attitude and intention, were significantly associated with leisure-time physical activity but not occupational physical activity, emphasizing the importance of targeting them in interventions to increase physical activity levels among shift-working nurses.

Keywords: Hospital; Nursing staff; Observational research; Physical activity; Shift work.