obesity among nurses final paper!!!

Running head: OBESITY AMONG NIGHT SHIFT NURSES Nursing 1

Obesity Among Night Shift Nurses

Olivia J. Kashuba

Keystone College


Introduction

Obesity is a growing epidemic in the United States raising public health concerns among

third shift workers in the workplace. Employers face new concerns and problems as the rate of

obesity increases. Not only is healthcare a concern employer’s face, absentees and productivity

are also being directly impacted by obesity. According to recent studies the rate of obesity

doubled since 1970 to more than 30% of Americans suffering from being overweight or obese

(Hammond, Levine, 2010).

Recently the American society has changed its work patterns. Society has shifted from a

9-5-work schedule to a 24-hour active society. The American work schedule reflects this shift

and its effects are being felt by this population of workers (Heath, Roach, Dorrian, Ferguson,

Darwent, Sargent, 2012). Working the night shift can be defined as a work schedule between

midnight and five in the morning before the continuation of the day shift. Work now extends to

working hours, which are disruptive to the bodies’ normal diurnal biological rhythm. Obesity,

among other serious health problems, are associated with working the night shift. Several

researchers reported shift workers displaying unhealthy behavioral patterns, are more

overweight, and suffer from other chronic health related problems related with obesity then

compared to those who work the day shift (Atkinson, Fullick, Grindly, Maclaren, Waterhouse,

2008).

Factors

Some factors contributing to the increase of obesity among night shift workers are

unnatural sleep patterns (sleeping during the day), eating habits, and physical activity. Shift

workers tend to develop sleep patterns, which are disruptive to the body’s normal circadian


rhythm. Circadian rhythm is the body’s internal clock. This cycle helps regulate the body’s

hormonal production as well as the body’s metabolism (CNS Drugs, 2001). Circadian rhythm is

prompted by the onset of light or darkness and is coordinated around a 24-hour time period.

Without the pattern of circadian rhythm an individual will have trouble sleeping, which in

essence, will cause a lack of sleep. Shift-related insomnia is a sleep restrictions often faced by

third shift workers (Flo, Pallensen, Akerstedt, Mageroy, Moen, Gronli, Nordhus, Bjorvatn,

2013). Insomnia is the variation in the amount of sleep an individual receives from night to night.

When suffering from insomnia the quality and quantity of sleep may be very minimal’ causing

an individual to have a lack of energy and focus throughout the day (Australian Psychological

Society date). Higher rates of night shift insomnia were recorded compared to those working

during the day shift (Flo, et. al., 2013).

Studies show third shift nurses tend to gravitate toward eating foods that are high in sugar

in order to surpass the feeling of tiredness. Unhealthy food choices were often chosen over

healthy food choices due to easy access. Studies also show night shift workers tend to develop

poor eating habits. These habits include nibbling rather than eating three complete meals, eating

only a few small meals per day and gravitating to quick microwave meals or fast food items.

(Elberly, Feldman, 2010).

One significant cause of obesity in night shift workers is physical activity. According to

Eberly and Feldman, night shift workers can develop vicious cycles of not partaking in physical

activity. Night shift workers often deal with the effects of insomnia and sleeping problems (Flo

et al., 2013). The absence of sleep causes workers to be unmotivated and lack energy to

participate in extra physical activity. This cycle can be difficult to stop if it is not quickly

addressed.


Obesity is often measured by Body mass index (BMI). BMI is the conceptual term used

to determine weight status among individuals. According to the 2012 North American

Association for the Study of Obesity BMI, even with its limitations for higher muscle mass

resulting in a higher BMI, is a commonly used indicator of adiposity. The Nurses’ Health Study

observed 79,000 U.S. female nurses and revealed a trend of nurses who worked the night shift

for a long duration, 1-15 years, and increase in their BMI (Eberly, Fieldman, 2012).

This study seeks to discover whether working the night shift increases BMI,

measurement, and obesity between LPN and RN nurses in the NEPA. A quantitative survey will

be conducted along with research to determine if the height and weight, BMI, of night shift

nurses compared to day shift nurses differs and to see if this difference can be attributed to

higher BMI.

Rationale

Organizations and industries are affected by the dramatic leap the American society is

currently taking toward obesity. Obesity in employees not only affects health care cost but also

decreases productivity, and raises absenteeism in the workplace. Obesity is becoming

detrimental not only to individuals, but also to the companies that they are working for. Studies

show the annual cost of obesity among full-time employees, $73.1 billion in 1998, increased to

$147 billion in 2008. This total accounts for almost 10% of all medical spending. Medicare

spending would decrease by 8.5% and Medicaid by 11.8% in the absence of obesity (Hammond,

Levine, 2010). Employees with a body mass index over 35 represent 37% of the obese

population but are responsible for 61% of excess costs (Finkelstein, Di Bonaventura, Burgess,

and Hale, 2010).


In addition to medical cost, productivity is also affected by obesity. Productivity is

defined as the relationship between output and input in a company or organization (Stefan,

2002). According to Hammond and Levine, obese individuals tend to be less productive because

of their physical and mental conditions and have a greater loss of productive time - LPT. The

estimated loss of productivity in obese workers is $11.7 billion per year. Studies estimate the

correlation between absenteeism - not working your scheduled shift - and obesity make up the

largest area of productivity lost. Obese employees also use more paid off time from work than

employees who are a healthy weight (Hammond, Levine, 2010).

Obesity not only affects an individual’s work life but also their general quality of life.

Many risk factors included with obesity are metabolic syndrome, cardio vascular disease, type 2

diabetes, high levels of triglycerides, low levels of HDL cholesterol, high blood pressure, and

high fasting blood glucose levels (Arheart, Mrtinez, Christ6, Clark III, Clarke, Davila, 2010).

These ailments continue with the person even after they leave the job. These irreversible health

consequences need to be addressed for the greater good of the American workforce.

Nurses play a crucial part in serving our healthcare system. The increase of obesity,

which increases both productivity and increases absenteeism, may be directly affecting the care

and quality nurses are giving to their patients (Narbro, Jonsson, Larrson, Waaler, Wedel,

Sjostrom, 1996). The results of this study will help further the Social Cognitive Theory (SCT)

and conclude whether working the night shift increases BMI among nurses.


Theoretical Framework

Social Cognitive Theory (SCT)

The theoretical model supporting the research is the Social Cognitive Theory. The Social

Cognitive Theory (SCT) describes the influence of personal, environmental, and human

behaviors all have on one another. SCT is composed of three main factors: including self-

efficiency, goals set by an individual, and the expectations of the individual. If an individual is

confident and exercises self-efficiently he or she is able to change harmful behaviors even when

faced with difficult problems. In contrast, when an individual feels as though he or she is unable

to exercise control over their health behavior they will become unmotivated and potentially

create more difficulty when faced with challenges (National Institutes of Health). According to

the U.S. Department of Health and Human Services, SCT was derived from the Social Learning

Theory- SLT. SLT states, individuals not only learn from their own actions and experiences, but

also from observing others and the benefits they receive from their actions.

SCT and Obesity

In order to apply the Social Cognitive Theory to this research, obesity must be recognized

as both a physical and psychological problem. The underlying cause of obesity consists of an

individual’s psychosocial environment and their biological attributes. Individuals who have

difficulty controlling their food consumption and participating in physical activity may be

suffering from distress and anxiety. Obese individuals tend to use food as a coping mechanism to

relieve their anxiety and stress. This perpetual cycle of eating, when in distress, often leads to

overeating and obesity. Distress, which is mental strain or suffering, is inevitable for individuals

working in a high-stress workplace (Collins, Bentz, 2009).


Night eating, a coping mechanism for overeating, is a factor contributing to significant

weight gain. Night eating usually consists of easily accessible foods, which are high in calories.

Individuals tend to snack throughout the night, mindless eating, in replacement of normal meals.

Eating at night also disrupts an individual’s natural circadian rhythm. This disruption causes a

delay of appetite in the morning, which causes an individual to overeat during the night (Collins,

Bentz, 2009). .

Obesity does not only hurt the individual physically but also mentally. Society often

views obese individuals as having a “weak will” and being “unmotivated”. These negative

beliefs may cause feeling of frustration and anxiety. Also, individuals suffering from obesity are

often discriminated at work and have a low self-esteem (Collins, Bentz, 2009).

Behavior and SCT

Obese nurses need to become more cognizant of the behaviors in order to improve their

health and overall quality of life. By adopting the social cognitive theory individuals can

improve their behavior health by taking control of their thoughts and behaviors and exercising

their own self-efficiency or by observing the beneficial actions taken by others. Both methods

will be difficult for the individual, but the end result should overall improve the quality of their

behavior health.

Conceptual Framework

The conceptual framework illustrates the relationship among the dependent variable and

the independent variables. At the core and the outcome of the problem lies BMI.


BMI

Physical Activity

Sleep Deprivation/Carcadian

Rhythm

Eating Habits


BMI

Obesity is becoming a serious health problem seen among 30% of the American

population (Heath et. al., 2012). Obesity is measured by an individual’s body mass index (BMI),

which is the core problem faced by nurses working the night shift. Several researchers have

observed a relationship between night shift workers and a higher occurrence of obesity compared

to those working the day shift. The most common differences seen among day shift and night

shift workers are sleep deprivation and changes in the circadian rhythm, eating habits and sleep

deprivation (Eberly, Feldman, 2010). .

SLEEP DISORDERS

Night shift nurses often disrupt the body’s natural circadian cycle, which often times

results in sleep deprivation, sleep disorders and insomnia. Circadian rhythm is the body’s clock

that resides in the brain that revolves around a 24 hours period (CNS Drugs, 2001). Research

shows the circadian rhythm has a direct impact on an individual’s energy and metabolism, which

is a plausible factor as to why many night shift nurses suffer from being overweight and obese

(Eberly,Feldman 2010). Also one of the many symptoms seen in insomniacs is a lack of energy

and motivation to enable them to engage in physical activity, thus resulting in an increase in

obesity(Flo et al., 2013).

EATING HABITS

Night shift nurses eat foods during the shift often high in sugar in order to overcome the

feeling of being tired. The desire and easy accessibility to sweets and junk food often override

the alternative choice of a healthy snack. Also, the timing of meals, rather than total caloric


intake, results are most affected by night shift nurses. Night shift nurses are more likely to snack

in place of whole meals, and eat meals and snacks later at night (Atkinson, et. al., 2008).

PHYSICAL ACTIVITY

Night shift nurses often suffer from insomnia and other sleep disorders, which leads to

the lack the energy to engage in physical activity. Physical activity is a major contributor to

weight gain in individuals who work the night shift. The precarious cycle of not getting the daily

amount of exercise because of low energy levels can become very difficult to break. Daily

exercise helps energize and strengthen the body. By not partaking in physical activity an

individual is taking away the body’s natural way of energizing and strengthening the body

(Eberly and Feldman, 2010).

Purpose

The purpose of this study is to find out if working the night shift negatively affects BMI

of Nurses in the Northeast Pennsylvania. The research will determine if working the night shift

impacts lifestyle habits, sleep deprivation and circadian rhythm, eating habits, physical activity,

and increases BMI.

Research Question

Does sleep restriction, lack of physical activity, and unhealthy eating habits increase the

BMI among night shift nurses?


Hypothesis

Based on the research in the literature review the following hypothesis is established:

Sleep restrictions, lack of physical activity, and unhealthy eating increase the BMI in night shift

nurses.

Null Hypothesis

The null hypothesis of the research is: Sleep restrictions, lack of physical activity,

and unhealthy eating do not increase the BMI in night shift nurses.

Limitations

Limitations in the study are restricted by: the geographical area in which the study is

done, and obtaining surveys from willing participants. Nurses working the night shift have little

time to concentrate and partake in external issues not pertaining to work. In order to gain

efficient responses, additional incentives might have to be made. Also, because the sample size

will be restricted to Northeast Pennsylvania, the study will have geographical constraints.

Significance of Study

According to Healthy People 2010, both physical activity and obesity were included in

the top ten leading health indicators. The two goals designed by the Healthy People 2010 are

increasing the quality and years of a healthy life and to try and diminish health disparities. By

gaining knowledge through this study, night shift nurses will discover how they can improve

their own quality of life, decreasing their BMI, and what steps they need to take to accomplish a

healthy lifestyle.

Literature Review


The purpose of this section is to recognize influences contributing to the growing rate of

obesity among third shift nurses. The literature of the influences will reveal how working the

night shift negatively impacts the quality of life among nurses compared to nurses who work

during the day.

Working the night shift shows much higher BMI’s ratings of obesity compared to day

shift nurses (Eberly, Feldman, 2010). Research shows working the night shift decreases the

opportunity for physical activity. The University Of Maryland School Of Nursing, in Baltimore,

studied 2103 nurses who worked the night shift. Among the nurses studied 55 percent were

recorded as being obese. The study revealed that the sedentary lifestyle of the nurses was the

main cause of increased BMI and obesity (Tarapchak, 2012). Working the night shift also

changes behavior-eating habits and often causes normal meals to be replaced by continual

snacking. Studies have shown that both dietary and timing of meals is most pretentious in night

shift workers (Atkinson, et. al., 2008). Around one-third of the U.S workforce has irregular shift

rotation schedules, which lead to the offset of the natural circadian rhythm. This disruption often

causes obesity and other health related problems when working the night shift (Flo et. al., 2013).

Obesity/BMI

The most commonly used method of measuring obesity is by calculating the

height and weight index of an individual, which is known as body mass index (BMI). According

to the North American Association for the Study of Obesity the formula used to calculate BMI is

BMI = weight (kg) / [height (m)2 (CDC, 2013). Individuals with a BMI in between 18.5 and 24.9

kg/m² are classified as having a normal weight. Whereas individuals with a BMI in between 25

and 29 kg/m² are said to be overweight, over 30 kg/m² are moderately obese, and anything


exceeding 40 kg/m² is considered morbidly obese (Feedman, Thornton, Pi-Snye, Heymsfield,

Wang, Pierson, Blanck, Gallagher, 2012).

Approximately 300 million people suffer from obesity around the world. Of these

300 million, obesity related deaths per year occur in the United States. The National Health

Examination and the National Health and Nutrition Examination conducted a survey on the

American population from 1960-2000. The survey conveyed the alarming growth rates obesity

has taken. The most astonishing of these surveys was during the years 1990-2000. During this

span of ten years, obesity rates tripled among the American population. These studies have

shown that obesity is now an epidemic affecting more than one-third of the American population

(Wiborn, Beckham, Campbell Harvey, Galbreath, Bounty, Nassar, Wismann, Kreider, 2005).

Along with suffering from obesity, an individual is also at risk for type 2 diabetes, hypertension,

coronary heart diseases, gallbladder disease, osteoarthritis, and many types of cancers.

The highest of these risk factors for those suffering from obesity is type 2 diabetes.

Approximately 85% of Americans are currently suffering from type 2 diabetes. Of the 85%, 70%

of these individuals are also suffering from a BMI of 30 or greater. Research shows the risk for

type 2 diabetes is 5 times greater in men and 8.3 times greater in women who suffer from obesity

compared to individuals who have a normal weight. Living a sedentary life, poor nutrition, and

obesity are all factors that greatly contribute increase risk of type 2 diabetes. In addition to being

at a high risk for type 2 diabetes, obese individuals are also at a high risk for cardiovascular

disease, coronary heart disease, hypertension, and congestive heart failure (Wiborn, et. al., 2005).

Not only is an individual at risk for many health factors when sufferings from obesity,

but also the economic costs of obesity have taken a dramatic increase. In 1999, research revealed


the total amount of obesity-related health care cost in the United States was nearly 24 billion

dollars. Research also revealed that obese individuals are 14% and morbidly obese individuals

are 25% more likely to visit their physician than a normal weight individual. Overall over weight

and obese individuals have a 38% higher doctor’s visit record than normal weight individuals.

By the year 2003 the obesity related health care cost sky rocketed to a staggering 75 billion

dollars (Wiborn, et. al., 2005). .

Nurses Working the Night Shift Compared to Day Shift

A study was done to compare the weight gain both day and night shift nurses. The

variables used in the questionnaire were directed to the individual’s weight, eating habits,

physical activity and sleep patterns. The study included a total 85 subjects. Of these subjects 36

worked the day shift and 49 worked the night shift. The mean weight gain of the night shift was

4.3 kg, and the mean weight gain for the day shift was 0.9 kg. Night shift workers reported eating

later and more during their scheduled shift. Many of the nurses also reported eating foods that

were high in sugar and calories in attempts to counteract the feeling of doziness and increase

energy (Eberly, Fieldman, 2012). The average night shift worker ate their last meal at 10:27pm

while the day shift worker ate theirs around 5:52pm. Eating later meals decreases the thermic

effect, which in result causes weight gain (Eberly, Fieldman, 2012). Night shift workers also

found it much more difficult to find time to exercise. Night shift workers were also prone to take

more naps and longer naps throughout the week than compared to the day shift nurses. The

combination of changes in eating habits, lack of physical activity, and the changes in sleep

patterns may have contributed to the rapid weight gain of the night shift workers (Geliebter,

Tanowitz, Aronoff, & Zammit, 2000).


Eating Habits

Studies show that night shift nurses have different eating habits compared to

nurses who work during the day. Some ways in which night shift workers eating behaviors differ

from day shift nurses are: night shift nurses tend to have higher overall caloric intake, are more

likely to snack in place of whole meals, and eat meals and snacks later at night. Results have

revealed the timing of meals, rather than total caloric consumption, is most affected by night

shift (Atkinson, et. al., 2012).

A survey was administered to shift workers over a 5-day period. The survey included

morning afternoon and night shifts. Although the total amount of food ingested within a 24-hour

period did not differ between the three shifts the amount of food did differ during the individual

8-hour shift. The study showed that food intake was much higher for those who worked the

morning shift compared to those who worked the evening and night shift. Night shift workers

tend to have less of an appetite and have limited access to food (Atkinson, et. al., 2012).

The circadian rhythm directly affects an individual’s appetite because the human body is

not designed to intake and digests food during the night, but rather it is naturally designed to

sleep during the night. The body’s glucose tolerance decreases from the morning to the night and

increases cholesterol. This may put an individual at risk of cardiovascular disease (Atkinson, et.

al., 2012).

Night shift workers lean towards foods that are high-energy dense foods to counteract the

feeling of tiredness. These foods are high in calories and have very limited proteins, fat, and

carbohydrates. The differences in eating habits have resulted in lower meal frequency and poorer

meal quality among night shift workers (Atkinson, et. al., 2012).


Sleep Deprivation and Circadian Rhythm

Night shift workers often face the risk of insomnia and sleep deprivation due to

the fact that they are constantly upsetting the body’s natural circadian rhythm. Circadian rhythm

is the body’s clock that resides in the brain. It regulates the unique patterns and rhythms

experienced by every individual during both sleep and wakefulness. A person’s endogenous

clock is coordinated around a 24-hour period and is signaled by the day and night (CNS Drugs,

2001). Circadian rhythm not only regulates the body’s behaviors and awake-sleep cycle, it also

affects a person’s feeding behaviors.

Working the late shift has become s disservice to the human performing this work

schedule. Not only are they out of circadian rhythm but they are also affected by a number of

other maladies. They often deal with significant stressors and have few ways of coping with

them. The late shift can become detrimental to an individual's health especially over a prolonged

period of time. The malnutrition can assist in leading to a number of irreversible maladies.

Obesity most often deteriorates an individual's self-efficacy. This loss of drive not only affects

their psyche but also their behavior. The entire wellness of a person is not being addressed when

they work the late shift.

Research shows the circadian rhythm has a direct impact on an individual’s

energy metabolism, which is a plausible factor as to why many night shift nurses suffer from

being overweight and obese (Eberly, Feldman, 2010). Nurses working the night shift get an

average of 5 hours of sleep, which may be the cause of the adverse health effect of obesity.

A study to compare carbohydrate levels and hormone levels during sleep was

performed by Spiegel. Spiegel evaluated 11 men ages 18-27. The studies duration was 16 days


and only allowed the men to sleep four hours a night. The study was performed in a clinical

research center. After 16 days the participants seemed to suffer from both carbohydrate

intolerance and insufficient glucose effectiveness (related to an individual’s hormone levels) due

to lack of sleep, sleep deprivation. That in effect creates a cycle of maladaptive tendencies these

maladies then manifest itself in weight in the continuation of this cycle maladaptation’s become

maladies of the mind and body. The importance of the study was that impaired carbohydrate

metabolism and hormone imbalances can be directly associated with obesity (Eberly Feldman,

2010).

Night shift nurses are constantly defying the body’s natural circadian cycle, which often

times results in sleep deprivation, sleep disorders and insomnia. Insomnia is when an individual

has trouble falling asleep or staying asleep (Member Resource Team, 2013). There are many

types of insomnias, which include delayed sleep phase syndrome, advanced sleep phase

syndrome, irregular sleep-wake cycle, periodic insomnia, and temporary insomnia. Insomnia has

many lifestyle behaviors and risk, which includes both being overweight and diabetes (Sutton,

Moldofsky, Badley, 2001). Night shift nurses suffering from insomnia find it difficult to

overcome its harmful effects. One of the many symptoms seen in insomniacs is a lack of energy

and motivation to enable them to engage in physical activity (Flo et al., 2013).

Physical Activity

According to Eberly and Feldman because nighttime nurses often suffer from insomnia

and other sleep disorders nurses often times lack the energy to engage in physical activity.

Physical activity is a major contributor to weight gain in individuals who work the night shift.

The precarious cycle of not getting the daily amount of exercise because of low energy levels can


become very difficult to break. Daily exercise helps energize and strengthen the body. By not

partaking in physical activity an individual is taking away the body’s natural way of energizing

and strengthening the body (Eberly and Feldman, 2010). A limitation to this study is the lack of

evidence concluding that physical activity is a direct factor in higher obesity ratings among night

shift workers.

An observation performed by Perssons stated many of the night shift nurses included in

the study reported often times choosing sleep over physical activity. The nurses felt as though no

time of the day seemed suitable to part take in physical activity. Many nurses used the time

before their night shift to spend time with family or rest and the time directly after work was

used for sleep. Rest always seemed to be the night shift nurse’s optimal choice when not

working. The lack of strenuous physical activity is one of the main logical factors contributing to

the increase of overweight and obesity seen among night shift nurses (Eberly and Feldman,

2010).

Summary

The literature review discussed the in-depth meaning and relation between

obesity, BMI, and nurses working the night shift. The research highly suggest that eating habits,

sleep deprivation and the circadian rhythm, and physical activity all contribute to the increase in

body mass index among night shift workers. Having a high BMI poses potential health risk

including type 2 diabetes, cardiovascular disease, coronary heart disease, hypertension, and

congestive heart failure. By understanding the effects of bad eating habits, inadequate sleep and

lack of physical activity have on the body the results of the surveys will be more focused and

applicable.


Methodology

Research Design

This research is a quantitative and non-experimental. This research reveals whether

working the night shift effects BMI among nurses. The predictors supporting the research are

eating habits, sleep deprivation, and the circadian rhythm and physical activity.

Sample

My sample will include male and female RN and LPN nurses from Lackawanna,

Wyoming, and Luzerne county hospitals. A consent and survey will be sent out to a total of 18

hospitals included in the three counties. A limitation to the study is the small sample size,

participation and geographical restrictions.

Instrumentation

According to the University of Wisconsin there are several collection methods used in

obtaining reliable research including experiments and clinical trials, observing and recording

events, finding relevant data, administering surveys, and questionnaires. The instruments used in

this research include the equation used to measure BMI and a questionnaire adapted from Nurse

Health Questionnaire and Stanford Disorders research Questionnaire. The Keystone College

Institutional Review Board (IRB) for use approved both questionnaires. The quantitative

questionnaire focuses on the health and measures the BMI of both night shift and day shift

nurses. BMI will be measured using the formula BMI = weight (kg) / [height (m)2 (CDC, 2013).

BMI BMI = weight (kg) / [height (m)2 (CDC, 2013)

Normal Healthy Weight 18.5- 24.9 kg/m²


Over Weight 25 - 29 kg/m²

Moderately Obese 30 -39 kg/m²

Morbidly Obese 40+ kg/m²

Feedman, Thornton, Pi-Snye, Heymsfield, Wang, Pierson, Blanck, Gallagher, 2012

Procedure

Approval from the Keystone College IRB will allow the research to be performed. First, a list of

certified male and female LPN and RN nurse information will be collected from hospitals included in

Lackawanna, Luzerne, and Wyoming counties. A letter including the information and the purpose of the

study along with a confidentiality form will be sent to all qualified individuals as well as their place of

employment. To confirm and encourage participants a follow up letter will be sent to each individual.

This letter will include the same information as the first time along with the website location of the

questionnaire. Two weeks after the second letter is mailed the individuals will receive a phone call

encouraging them to participate, the importance of the study, and the potential to win either a $125 dollar

gift certificate to Olive Garden or four day passes to Hershey Park. The survey will be located at

SurveyMonkey.com and listed under NEPA night shift nurses and obesity Keystone College Study. After

the survey is completed an e-mail will be sent confirming the participant is entered into the drawing to

win one of the two prizes listed above.

Analysis of Data

The rate of BMI among night shift nurses will be analyzed using the social cognitive theory and

life-style behaviors. The predictors eating habits sleep deprivation and circadian rhythm, and physical

activity will be analyzed and completed using the SPSS version 22.

Conclusion


Obesity is a growing epidemic in the United States raising public health concerns among third

shift workers in the workplace. The research and completed surveys will confirm or deny if sleep

restrictions, circadian rhythm, physical activity, and eating habits increase the BMI of night shift nurses.

By validating the hypothesis of the research, precaution, preventatives, and solutions will be available in

order to improve the quality of health among night shift nurses with high BMI.

Obesity Rates Among Night Shift Nurses Questionnaire

1. What shift do you currently work? 1. Day 2. Night 3. Rotating

2. Average total hours of sleep per day?

3. How often do you exercise?

A. Sedentary (No Exercise)

B. Mild Exercise (play golf, climb stairs, go for a walk)

C. Occasional exercise (work out less then 4xs a week for 30min)

D. Regular vigorous exercise (more then 4x a week for 1 hour or more)

4. What is your gender? Male Female


5. What is your age?

6. What is your current weight?

7. What is your current height?

Are you dieting? Yes No

Are you on a Physician prescribed diet? Yes No

Do you use artificial sweetener? Yes No

Do you have breakfast everyday? Yes No

Do you eat all three meals a day? Yes No

Do you have problems with eating or your appetite? Yes No

Do you eat fried foods more then three times per week? Yes No

Do you take food from home to work? Yes No

Are you concerned about your weight? Yes No

Have you tried to lose weight? Yes No

8. What percentage of your meals are made at home?

9. What types of snacks do you most often eat at work?

10. Please list all medical problems that currently affect you, including narcolepsy and other sleep

disorders. Please indicate whether each condition has or has not been diagnosed by a physician.

_____________________________________________________________________

_________________________________________________________________________________

_____________________________________________________________________

11. Please list all medications and doses that you are currently taking, including those for narcolepsy

and other sleep disorders.


_________________________________________________________________________________

_________________________________________________________________________________

_______________________________________________________________

12. Please list all significant medical problems that you had in the past including narcolepsy and

other sleep disorders.

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________

13. At what time do you usually get into bed on a work night?

14. At what time do you usually get out of bed on a work morning?

15. How long, on average, does it take you to get out of bed?

16. Once you are out of bed on a work morning, how long does it take you to feel fully awake?

17. At what time do you usually get into bed on a non-work night? __________AM / PM

18. At what time do you usually get out of bed on a non-work morning __________AM / PM 19.

On a non-work morning, how long does it take you to get out of bed? _____ hr _____ min

20. Once you are out of bed on a non-work morning, how long does it take you to feel fully awake?

_____ hr _____ min -OR- Never feel fully awake

20. How many hours of sleep do you think you need to feel fully rested? _____ hr _____ min -OR-

Never feel fully rested

21. Do you consider yourself to be a morning person or an evening person? Morning person

Evening person No preference

22. At what time would you ideally like to go to sleep? __________AM / PM


23. What time would you ideally like to wake up? __________AM / PM

24. In general, do you sleep well at night? Yes No

25. How long does it usually take you to fall asleep after the lights are off? _____ hr _____ min

26. How often do you wake up too early in the morning and cannot get back to sleep?

Always Usually Rarely Never

27. How often do you feel refreshed after a typical night of sleep?

Always Usually) Rarely Never

28. How often do you sleep restlessly?

29 Always Usually Rarely Never

30. How often do you have difficulty falling asleep at night?


31. How often do you have difficulties maintaining sleep?


32. How often do you have difficulty falling asleep and maintaining sleep?


33. How often do you wake up during a typical night's sleep and have a difficult time falling back asleep? __________ times

34. If you have difficulties with sleeping well at night using a scale from 0 to 10 please rate how much this problem affects you (0 = no distress/impairment; 10 = severe distress/impairment):

A. In general, how much distress does sleep cause?

B. How much does it affect your social life/relationship with friends?

C. How much does it affect your relationship with your spouse/family members?

D. How much does it affect your relationships with your coworkers and employers?

35.How often do you have difficulty staying awake during the day?

Once, or more, per day Several times per week Once per month Once per year, or less

37. How often do you experience sudden sleep attacks (nightmares) that are so intense that you must stop

what you are doing? Once, or more, per day Several times per week Once per month Once per year, or

less

Thank you for you participation to help further this research


Questions were taken from a research document by Reham Abdulkkarim Halawani, and the Sleep

Disorder Research Questionnaire by Stanford University Center for Narcolepsy and Related Disorders.

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