Impact of Shift Work and Job Category on Lifestyle Factors and Readiness to Change Among Hospital Workers: A Case-Control Study.

BACKGROUND

Shift work is essential in health care because of the need for 24-hour services but it is associated with adverse health outcomes, including disrupted circadian rhythms, poor sleep, unhealthy dietary habits, and increased stress. These effects may differ across job categories, such as nursing officers and hospital support staff, owing to varying physical and psychological demands. Limited research exists on how shift work impacts these groups differently, particularly regarding readiness to change unhealthy lifestyle behaviors.

OBJECTIVES

This study aims to assess and compare lifestyle factors across six domains - nutrition, physical activity, sleep, stress, social relationships, and addictions - between hospital support staff and nursing officers with rotating shifts versus fixed daytime duties. It also aims to evaluate the association between readiness to change lifestyle patterns and work type and determine the influence of job category and shift type on lifestyle parameters after adjusting for confounders such as demographics and body composition.

METHODOLOGY

A case-control study was conducted at All India Institute of Medical Sciences (AIIMS) Nagpur from December 2023 to June 2024. The study involved 327 participants (165 cases and 162 controls) comprising nurses and hospital support staff, aged 21-45 years. The case group included 83 nurses and 84 hospital support staff working rotating shifts for at least three years, while the control group consisted of 81 nurses and 81 staff members with fixed daytime schedules. General assessments, including demographics, body composition (InBody 770), and lifestyle assessments across nutrition, physical activity, sleep (Pittsburgh Sleep Quality Index; PSQI), stress (Perceived Stress Scale; PSS-10), social connectivity (Social Support Questionnaire), and alcohol use (a modified version of the 10-item Alcohol Use Disorders Identification Test (AUDIT-C)) were performed. Readiness to change lifestyle behaviors was assessed using the stages of the change model.

RESULTS

Shift workers had a significantly higher body weight (p = 0.030), larger waist circumference (p = 0.029), and higher calorie intake (p = 0.043) than non-shift workers. They also exhibited lower cardiovascular fitness (p = 0.021) and reduced water intake (p = 0.043). Among the nursing officers, shift workers had significantly poorer sleep quality (p = 0.003) and higher calorie intake (p = 0.046). Stress levels were paradoxically lower among shift nurses (p = 0.025) but not among support staff. Readiness to change lifestyle behaviors did not differ significantly between shift and non-shift workers across all domains. Logistic regression showed that sleep quality was significantly associated with shift work among nursing officers (odds ratio (OR): 6.503, p = 0.038), while no significant associations were found for other lifestyle parameters.

CONCLUSION

This study highlights the adverse effects of shift work on body composition, calorie intake, cardiovascular fitness, and sleep quality among hospital workers, particularly nursing officers. Despite these health risks, readiness to change lifestyle behaviors was similar between shift and non-shift workers, suggesting that shift work may not directly influence the motivation for lifestyle changes. These findings underscore the need for tailored interventions targeting specific health challenges of shift workers to improve their overall well-being and productivity.