The association between shift duty and abnormal eating behavior among nurses working in a major hospital: a cross-sectional study

Background: Shift work induces stress, disturbs family life and interrupts regular meal schedules. Few studies have addressed the association between shift duties and abnormal eating behavior among hospital nurses.

Objectives and design: We tested the hypothesis that shift duties were independent predictors of abnormal eating. Self-administered surveys consisting of socio-demographic data, working pattern, Perceived Organizational Support (POS) questionnaire and the patterns of eating style identified by the Dutch Eating Behavior Questionnaires (DEBQ) were used.

Settings: One major acute hospital in one Territory of Hong Kong.

Participants: All 662 nurses who worked on a full-time basis in this hospital were invited to join the study and among them, 378 completed surveys were collected with a response rate of 57.1%. The average age was 37.2 years, and 91.5% were female. 67.3 were registered nurses, 17.9% enrolled nurses; and 14.5% were ranked nursing officers or above. 39.1% worked in acute settings (medical wards, intensive care units and emergency departments), and 62.1% of respondents had at least 11 years of clinical experience and 76.2% of respondents had shift duties with 81.9% having at least four shift duties per month. Only 66.7% of respondents had normal body mass index (BMI 18.5-22.9 kg/m2).

Methods: Three binary logistic regression analyses were conducted with abnormal emotional, external and restraint DEBQ as outcome variables, respectively. We controlled for age, gender, marital status, work setting (acute vs. non-acute), years of clinical experience, the frequency of shift duties, body mass index, perception of body weight changes in the past 6 months, self-perception of recent overeating and POS.

Results: The proportions of participants having abnormal emotional, external and restraint DEBQ scores were 66.4%, 61.4% and 64.0%, respectively. From multiple regression analysis, nurses having 4 or more shift duties per month were more likely to present with abnormal emotional (adjusted odds ratio aOR 2.91, 95% C.I. 1.57-5.42, p=0.001) and restraint (aOR 3.35, 95% C.I. 1.76-6.38, p<0.001) DEBS scores.

Conclusions: Shift duties were positively associated with abnormal eating behavior among nurses working in hospitals. More health promotional initiatives should be targeted towards hospital nurses whose duties require frequent night shifts to enhance healthy eating.