School of Nursing, Chengdu University, Chengdu, China.
Department of Nursing, The Second People's Hospital of Neijiang City, Neijiang, China.
Sci Rep. 2024 Jul 23;14(1):16911. doi: 10.1038/s41598-024-67644-z.
This study aimed to explore the relationship between shift-working nurses' social jetlag and body mass index (BMI) and provide a theoretical basis for nursing managers to develop appropriate health interventions. Shift work is unavoidable in nursing and is associated with circadian rhythm disorders. Social jetlag is prevalent in shift-working nurses and is associated with adverse health outcomes (particularly metabolism-related indicators). BMI is a significant metabolic indicator, and research has demonstrated its effectiveness in predicting the formation of metabolic syndrome. The relationship between social jetlag and BMI can be explained by considering physiological, psychological, and behavioral factors. However, most studies on social jetlag and health status are focused on non-shift nurse populations, with fewer studies on shift workers. Five tertiary hospitals located at similar latitudes in Southwest China were selected for the study. We surveyed 429 shift-working nurses using sociodemographic data, the Munich Chronotype Questionnaire for Shift Workers, and BMI. The restricted cubic spline model was used to analyze the relationship between social jetlag and BMI among shift-working nurses, and segmented linear regression was performed around the inflection point using multiple linear regression analysis. The results revealed that social jetlag (82.0 [85.0] min) was experienced by 64.6% of the shift-working nurses. After controlling for confounding variables, the model with seven knots had the lowest accepted Akaike information criterion value, and there was a U-shaped relationship between shift-working nurses' BMI and social jetlag in this model; its inflection (lowest) point of 20.7 was considered the cut-off point. Segmented regression showed that for BMI < 20.7, BMI was significantly negative with standardized social jetlag; whereas with BMI > 20.7, BMI was significantly positive with standardized social jetlag. BMI has a U-shaped relationship with social jetlag, and attention should be paid to overweight or underweight shift-working nurses to detect early circadian rhythm disorder. Shift-working nurses with high social jetlag tended to have higher/lower BMI, which should be further investigated in the future, to minimize metabolic diseases among them.
本研究旨在探讨轮班护士社会时差与体重指数（BMI）之间的关系，为护理管理者制定适当的健康干预措施提供理论依据。护理工作中不可避免地需要轮班，这与昼夜节律紊乱有关。社会时差在轮班护士中很常见，与不良健康结果（特别是与代谢相关的指标）有关。BMI 是一个重要的代谢指标，研究表明其在预测代谢综合征的形成方面具有有效性。社会时差与 BMI 之间的关系可以通过考虑生理、心理和行为因素来解释。然而，大多数关于社会时差与健康状况的研究都集中在非轮班护士人群，而对轮班工人的研究较少。本研究在中国西南部纬度相似的五家三级医院选择了 429 名轮班护士，使用社会人口统计学数据、慕尼黑轮班工人昼夜类型问卷和 BMI 进行了调查。采用限制立方样条模型分析轮班护士社会时差与 BMI 的关系，并用多元线性回归分析在拐点处进行分段线性回归。结果显示，64.6%的轮班护士存在社会时差（82.0[85.0]分钟）。在控制混杂因素后，具有七个结的模型具有最低的可接受的赤池信息量标准值，并且在该模型中轮班护士的 BMI 与社会时差之间存在 U 型关系；其拐点（最低）值为 20.7，被认为是临界点。分段回归显示，对于 BMI<20.7，BMI 与标准化社会时差呈显著负相关；而对于 BMI>20.7，BMI 与标准化社会时差呈显著正相关。BMI 与社会时差呈 U 型关系，应注意超重或体重不足的轮班护士，以检测早期的昼夜节律紊乱。社会时差大的轮班护士往往有较高/较低的 BMI，这需要在未来进一步研究，以尽量减少他们的代谢疾病。
