Background

More than one quarter of US working adults are obese. Obesity increases risk for chronic disease and injury. Work-related factors contributing to obesity may be modified to assist in health promotion.

Objectives

This dissertation examines occupational stress and obesity among hospital-working female registered nurses (RNs). The objectives are to summarize the evidence to-date; to describe shift work, work hours, meal break practices, occupational stress, sleep quality, and obesity among female RNs; to develop and evaluate a conceptual model that occupational stress is associated with adiposity, and mediated by stress-induced eating behaviors.

Methods

A cross-sectional web survey collected data from members of the Academy of Medical/Surgical Nurses. Occupational stress was measured with the Effort Reward Imbalance (ERI) short form. An ERI >1 indicates high effort and low reward indicative of occupational stress. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Scores can range from 0-21, and >5 indicates poor sleep quality. Descriptive statistics summarized the results, and Pearson’s correlations tested associations between sleep quality, occupational stress, and body mass index (BMI). The associations between occupational stress, adiposity, and mediating pathways were assessed using structural equation modeling (SEM).

Results

A total of 256 participated. The RNs’ mean age was 46 (±11.9) years, the majority were White (76%). Over half (58%) of the RNs worked more than 40 hours per week, and one third (33%) were never able to take a meal break during their shifts. The majority (77%) reported high occupational stress with an ERI>1, poor sleep quality (78%), and over one-third (35%) were obese. Worse sleep quality correlated with higher BMI and higher occupational stress. SEM showed a significant indirect effect of occupational stress on adiposity mediated by eating behaviors (p<0.001). The direct effect of occupational stress on adiposity was negative, and non-significant.

Conclusions

These findings indicate that RNs are experiencing occupational stress and not getting adequate rest; interventions are needed to reduce occupational stress, improve rest, meal-breaks, and sleep. For individuals with stress-related eating behaviors, occupational stress may increase obesity risk. Interventions to reduce stress-related eating behaviors included in wellness programs need to be evaluated.