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工作场所对身体活动和心血管代谢健康的影响:多中心横断面尚普兰护士研究的结果。

Influence of the workplace on physical activity and cardiometabolic health: Results of the multi-centre cross-sectional Champlain Nurses' study.

机构信息

Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada.

Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada.

出版信息

Int J Nurs Stud. 2018 May;81:49-60. doi: 10.1016/j.ijnurstu.2018.02.001. Epub 2018 Feb 13.

Abstract

BACKGROUND

Nurses are the largest professional group within the health care workforce, and their work is perceived as being physically demanding. Regular physical activity helps to prevent or ameliorate cardiometabolic conditions (e.g. cardiovascular disease, diabetes). It is not known whether Canadian nurses are meeting current physical activity guidelines.

OBJECTIVE

To assess the influence of the workplace on the physical activity and cardiometabolic health of nurses from hospitals in the Champlain region of Ontario, Canada.

DESIGN

A multi-centre, cross-sectional study.

SETTING

Hospitals in the Champlain Local Health Integration Network of Ontario.

METHODS

Nurses wore an ActiGraph accelerometer to objectively assess levels of moderate-to-vigorous intensity physical activity measured in minutes/day in bouts ≥10 min. All completed the Perceived Workplace Environment (PWE) scale and International Physical Activity Questionnaire (IPAQ). Height, body mass, waist circumference, blood pressure and heart rate were measured, and body mass index (BMI) was determined. Each nurse's 5-year cardiovascular risk was calculated using the Harvard Score.

FINDINGS

A total of 410 nurses (94% female; mean ± SD: age = 43 ± 12 years) from 14 hospitals participated. Nurses spent an average of 96 ± 100 min/week in bouts ≥10 min of moderate-to-vigorous intensity physical activity; 23% of nurses met recommended physical activity guidelines. Nurses working 8- vs. 12-h shifts (16 ± 16 vs. 10 ± 11 min/day, p = 0.026), fixed vs. rotating shifts (15 ± 15 vs. 12 ± 13 min/day, p = 0.012) and casual vs. full-time (29 ± 17 vs. 13 ± 15 min/day, p < 0.001) or vs. part-time (29 ± 17 vs. 13 ± 12 min/day, p = 0.001) accumulated more moderate-to-vigorous intensity physical activity in bouts ≥10 min. The average PWE score was 2.4 ± 0.9, with no association between PWE scores and moderate-to-vigorous intensity physical activity in bouts ≥10 min (p > 0.05). Nurses working 8-h shifts, fixed shifts and in urban hospitals reported better PWE scores (p < 0.05). Nurses working fixed vs. rotating shifts had higher systolic blood pressure (median: 114 vs. 112 mmHg, p = 0.043), and nurses working in rural vs. urban hospitals had higher BMI (median: 27.8 vs. 25.6 kg/m, p = 0.007) and waist circumference (median: 82.3 vs. 78.6 cm, p = 0.015).

CONCLUSIONS

Nurses are not meeting current physical activity guidelines (150 min of moderate-to-vigorous intensity physical activity per week in 10-min bouts), yet exceeded these recommendations when examining their continuous (i.e. non bouts) physical activity levels. No association between the PWE and moderate-to-vigorous intensity physical activity was observed. Rotating vs. fixed shifts, 12- vs. 8-h shifts, and/or full-time or part-time vs. casual hours may impede nurses' ability to meet recommended physical activity levels. The low physical activity levels and poor cardiometabolic health of Canadian nurses warrant attention.

摘要

背景

护士是医疗保健劳动力中最大的专业群体,他们的工作被认为是体力要求高的。有规律的身体活动有助于预防或改善心血管代谢状况(如心血管疾病、糖尿病)。目前尚不清楚加拿大护士是否符合当前的身体活动指南。

目的

评估工作场所对安大略省尚普兰地区医院护士身体活动和心血管代谢健康的影响。

设计

一项多中心、横断面研究。

地点

安大略省尚普兰地方卫生整合网络的医院。

方法

护士佩戴 ActiGraph 加速度计,客观测量中等至剧烈强度身体活动的分钟数/天,以 10 分钟以上的时间进行测量。所有护士都完成了感知工作环境(PWE)量表和国际体力活动问卷(IPAQ)。测量身高、体重、腰围、血压和心率,并确定体重指数(BMI)。使用哈佛评分计算每位护士的 5 年心血管风险。

结果

共有 410 名护士(94%为女性;平均年龄为 43±12 岁)参加了来自 14 家医院的研究。护士平均每周进行 96±100 分钟/周的 10 分钟以上的中等至剧烈强度身体活动;23%的护士符合推荐的身体活动指南。与 12 小时轮班相比,8 小时轮班(16±16 与 10±11 分钟/天,p=0.026)、固定轮班与轮转轮班(15±15 与 12±13 分钟/天,p=0.012)以及全职或兼职(29±17 与 13±15 分钟/天,p<0.001)或兼职与兼职(29±17 与 13±12 分钟/天,p=0.001)的护士积累了更多的 10 分钟以上的中等至剧烈强度身体活动。平均 PWE 评分为 2.4±0.9,PWE 评分与 10 分钟以上的中等至剧烈强度身体活动之间无相关性(p>0.05)。8 小时轮班、固定轮班和在城市医院工作的护士报告的 PWE 评分更好(p<0.05)。与轮转轮班相比,固定轮班的护士收缩压更高(中位数:114 与 112mmHg,p=0.043),与在城市医院工作的护士相比,在农村医院工作的护士 BMI(中位数:27.8 与 25.6kg/m,p=0.007)和腰围(中位数:82.3 与 78.6cm,p=0.015)更高。

结论

护士不符合当前的身体活动指南(每周进行 10 分钟的中等至剧烈强度身体活动 150 分钟),但当检查他们的连续(即非组块)身体活动水平时,他们超过了这些建议。感知工作环境与中等至剧烈强度身体活动之间没有关联。轮班与固定班、12 小时与 8 小时班次、全职或兼职与兼职班次可能会阻碍护士达到推荐的身体活动水平。加拿大护士的身体活动水平低和心血管代谢健康状况不佳值得关注。

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