ABSTRACT
The role of good nutrition in ensuring good quality of life among health care professionals cannot be over-emphasized. Good nutrition, in addition to ensuring health promotion and disease prevention, it improves workers’ performance and productivity and it is an antidote against nutritional related health problems such as eating disorders, obesity, high blood pressure, and cancer. This study aims to determine the dietary patterns, other lifestyles and anthropometric status of nurses in Federal Medical Centre, Owo, Ondo state and general hospital, Owo. It was descriptive cross-sectional study which involved 283 nurses who were randomly selected. Information on socio-demographic characteristics and lifestyle history of the respondents was obtained using a semi-structured, self-administered questionnaire. Obesity was assessed using Body mass index (BMI), Waist –Hip Ratio (WHR) and Waist Circumference (WC), Waist-Height ratio (WHtR) and bioelectrical impedance analysis. Data were analyzed by using Statistical Package for Social Science (SPSS) version 20.0 to find descriptive statistics and association of the variables through chi-square. Level of statistical significance was set at p <0.05. The mean age of the respondents was 36.72 ±9.47years. More than half (64.3%) of them were within the age of 30-49 years. More (68%) female nurses participated in the study than male nurses (32%). Only (7.1%) of the respondents drink alcohol, 2.5% smoke cigarette, 65% did not engage in physical exercise. Large number (81.3%) of the respondents always adds vegetables to their diet and 83.3% took fruit regularly. About 21.3% and 47.7% eat 4times and 3times respectively. 22.5% skipped meal of which 9.6% skipped breakfast while 19.1% were snacking. The mean heights of the female participants were shorter than the male counterpart 1.6254+0.0646 vs.1.65+0.0673 respectively. Although there was no significant difference between the height of the participants at (p<0.05), similarly with their weight and BMI (67.854+10.628 vs 66.88+11.079 and 25.778+4.350 vs. 24.50+3.909), but a significant difference was observed in their waist circumference. Female participants have more visceral fat than their male counterpart (p<0.05). Prevalence of Overweight/Obesity as determined by abnormal values for BMI, WC and WHR were 48.9%, 31.1%, and 43.1% respectively. Prevalence of chronic diseases was 18.4% of which 8.4% where hypertensive. Significant difference was found in age and marital status across the gender (p<0.05). This study observed prevalence obesity and central obesity among the nurses in the Hospitals.
TABLE OF CONTENTS
Title page i
Certification ii
Dedication iii
Acknowledgments iv
Table of Contents v
List of Tables ix
Abstract x
CHAPTER 1
INTRODUCTION
1.1 Statement of problem 3
1.2 Objectives of the Study 4
1.3 Significance of the Study 4
CHAPTER 2
LITERATURE REVIEW
2.1 Nurses and Their Lifestyles 6
2.1.1 Nurses 6
2.1.2 Lifestyles of Nurses 6
2.1.2.1 Consistent Nutrient Intake 7
2.1.2.2 Portion Control 7
2.1.2.3 Other Lifestyles of Nurses 8
2.2. Workplace Stress 9
2.2.1. Work Place Stress 9
2.3 Anthropometry 10
2.3.1 Meaning of Anthropometry
2.3.2 Importance of Anthropometric Data 11
2.3.3 Various Anthropometric Measurements 11
2.3.3.1 Weight 11
2.3.3.2 Height 11
2.3.3.3 Waist Circumference 12
2.3.3.4 Hip Circumferences 12
2.3.3.5 Waist to Hip Ratio (WHR) 12
2.3.3.6 Body Mass Index 13
2.4 Definition and Classification of Obesity 13
2.4.1 Definition of obesity and overweight 13
2.4.2 Classification of overweight and obesity 14
2.4.3 Obesity Prevalence and its Health Implication 15
2.4.4 Risk Factors of Obesity 16
2.4.4.1 Genetic Factor 16
2.4.4.2 Eating habits and other Lifestyle Factors 17
2.4.4.3 Age and Sex 19
2.4.4.4 Environmental and social factors 21
2.4.4.5 Physical activity 22
2.4.4.6 Endocrine and trauma factor 23
2.4.4.7 Prosperity and civilization 23
CHAPTER 3
MATERIALS AND METHODS 24
3.1 Study Design 24
3.2 Study Area 24
3.3 Study Population 24
3.4 Sampling and Sampling Technique 25
3.4.1 Sample Size Determination 25
3.4.2 Sampling Procedure 25
3.5 Preliminary activities 26
3.5.1 Training of research assistants 26
3.5.2 Informed consent 26
3.6 Data Collection 26
3.6.1 Questionnaire Administration 26
3.6.2 Interview 27
3.6.3 Anthropometric measurements 27
3.6.3.1 Weight 27
3.6.3.2 Height 27
3.6.3.3 Waist circumference 28
3.6.3.4 Hip Circumference 28
3.6.4 Dietary habits 28
3.6.5 Lifestyles habit 28
3.7 Data analysis 28
3.8 Statistical analysis 29
CHAPTER 4
RESULTS AND DISCUSSION 30
4.1 Socio- demographic characteristics of the nurses 30
4.2 Socio-Economic status of the nurses 32
4.3 Dietary Habits of the nurses 34
4.5 Lifestyle History of the nurses 38
4.6 Mean anthropometric parameters and blood pressure of nurses 42
4.7 Nutritional status of the nurses 44
CHAPTER 5
CONCLUSION, RECOMMENDATION AND REFERENCES 49
5.1 Conclusion 49
5.2 Recommendation 49
References 50
Appendix 58
LISTS OF TABLES
Table Title Page Number
4.1 Personal characteristics of the nurses 31
4.2 socio economic status of the nurses 33
4.3 Dietary habit of the nurses 36
4.4 Lifestyles history of the nurses 40
4.5 Mean Anthropometric parameters 43
4.6 Nutritional status of the nurses 48
CHAPTER 1
INTRODUCTION
The role of good nutrition in ensuring good quality of life among health care professionals cannot be over-emphasized. Good nutrition, in addition to ensuring health promotion and disease prevention (Britt, 2012 and Hussung, 2014). Improves workers’ performance and productivity and it is an antidote against nutritional related health problems such as eating disorders, obesity, high blood pressure, and cancer (Benarroch et al., 2011). The practice of good eating habit among health care professionals could go a long way in making them effective advocates of healthy eating.
Nurses are health care professionals that work with a lot of other people to help make sick people better (Penn Nursing Science, 2016). They perform their roles either through provision of direct care for patients, helping patients to learn or acquire new knowledge (Shriver Scott-Stiles, 2015) and encouraging compliance with prescribed therapy (Penn Nursing Science, 2106). In addition, nurses also play important roles in preventive health care. Through public health education, nurses help to inspire a large number of people to engage in healthy lifestyle thereby helping them to live longer lives (Penn Nursing Science, 2106). One of the ways by which nurses can prepare to effectively perform their role, is for them to personally initiate a healthy lifestyle at the early stage of their career. A submission by (Shriver and Scott-Stiles, (2015) makes it clear that as our culture shifts from a sickness repair system to disease prevention and health promotion system, nurses need to take more responsibility for practicing health behaviours. This will prepare them to be effective advocates for health promotion and disease prevention. In addition, practicing health behaviours improves job performance of nurses and makes them effective role models of health promoting behaviours (Ogunjimi et al., 2010).
Healthy eating habit is one of the health promoting behaviours that could be role modeled and advocated by nurses. This is because most of the chronic diseases that are ravaging human health in our contemporary time are those that have their roots in unhealthy eating habits that were initiated early in life. Nurses spend more time with the patients hence their understanding of nutrition and their practice of good eating habit is highly essential (Britt, 2012). Many patients have high expectation of nurses and are more likely to listen to and follow the instructions of nurses who are modeling healthy lifestyles they need to adopt themselves (Kreimer, 2010).
The health sector is not left out and health personnel having the knowledge of implications of sedentary lifestyle are living such a lifestyle (Ogunjimi et al., 2010). Average health personnel are on the fat side and nobody is asking question(s) on why they are like that. Technological advancements in medical science have simplified life to the lowest term. But technological advancement, mechanization and automation demands a price for the benefits it brings and that price may be then care and cultivation of the mind and the body. In Nigeria, more than 80% of urban, professional Nigerian adults do not meet the World Health Organization (WHO) recommendations for physical activity (WHO, 2014). Recently, it seems some of the female health personnel in our health sector are becoming social cripples, ‘too tired’ to attend to emergency situation, ‘too tired’ to assist the patients that needs assistance, ‘too tried’ to go forward round and may be they are ‘too tired’ to even administer drugs. What they get in return is a disease condition known as obesity (Olanrewaju et al., 2018).
Overweight and obesity are as a result of energy imbalance over a period of time. Obesity can be said to be a global epidemic given the high prevalence in the world today. In fact, obesity is swiftly becoming a global epidemic, which is not restricted to the more “developed” countries. Currently, pacific islanders, especially women, are the fattest people in the world. For example 55% of Tonga women, 74% of Samoan women and women living in Nauru are obese (Galassie, 2014). Aldair (2016) also reported that obesity is now a major disease in Africa, along with HIV/AIDS and malnutrition. He further stated that in South Africa, one in every three men and more than half the female populations are obese, while in Morocco 40% of the population is obese (Aldair, 2016).
In Nigeria, on a daily basis people are complaining about the sluggish attitude of the nurses in the health sector in reaction to emergency situations in particular and patient case in general. The nurses with the requisite education are equipped to promote health, prevent illness and also care for the sick as a member of the health team (Coulehan et al., 2016; O’lynn, 2013). Abnormal body weight, dietary concerns and unhealthy weight gain behaviors are increasingly being observed among health personnel (nurses) in Nigeria. This research therefore, derives it impetus from concern about the weight of health personnel and their health status. To ensure healthy eating lifestyle among nurses, it is important to initiate it early especially during the nursing career process. Healthy eating habits could be inculcated into the lifestyle of student nurses/midwives so as to prepare them for effective advocates of healthy eating in their profession. It has been commonly reported that lifestyle behaviours initiated early in life are likely to persist (Neumark-Sztainer, et al., 2017; Linde, et al., 2009). There is the need to critically examine the dietary habits, lifestyle and anthropometric status of nurses in Federal Medical Centre, Owo, Ondo State.
1.1 STATEMENT OF PROBLEM
Obesity, overweight and stress are the leading risk factors of hypertension which is a silent disease which can affect anyone (Ibekwe, 2015). The health workers have been known to have excessive weight gain which is risk factor of high blood pressure (Sandra et al., 2015). The prevalence of obesity is increasing worldwide and it has been identified as a major risk factor contributing to the overall burden of disease worldwide (Centre for Disease and Control, 2013; Halsam et al., 2016; Ladabaum, 2014; Ng et al., 2014). This trend of emerging obesity in Nigeria population is seen more not just in urban dwellers (Finucane 2011; Prentice, 2016), but also among health workers (Oladapo et al., 2017). Researchers have reported a high prevalence of obesity among health workers in Jos (Ojomu and Kuranga, 2013), Ido-Ekiti, (Busari et al., 2014), Enugu, (Aghaji, 2015), Benin, (Edo and Enofe, 2013), Ogbomosho (Owolabi et al., 2015), Ibadan (Adeoye, et al., 2015), Bayelsa (Egbi et al., 2015) and Lagos, Nigeria (Iwuala et al., 2015). Another study among health service providers in Lagos shows that (27.3%) health workers obese while 44.7% of them were overweight. Central obesity among them was 49.7% (with 12.9% males and 68.3% females) (Sandra et al., 2015).
In Nigeria, more than 80% of urban, professional Nigerian adults do not meet the World Health Organization (WHO) recommendations for physical activity (WHO, 2014). Another study among health service providers in Lagos shows that (27.3%) health workers obese while 44.7% of them were overweight due to poor dietary pattern and sedentary lifestyles (Sandra et al., 2015 and Olanrewaju et al. 2019), reported a high prevalence of alcohol consumption and cigarettes smoking among females health workers in Jos University of Teaching Hospital, Nigeria World Health Organization, (2014) and Black, (2014) stated that numerous calls for interventions to help employees improve their health or maintain good health. Time spent at work can be positive and contribute to good health and a good quality of life, or it can be negative and fail to support good physical and mental health. The general health of nurses can be a continuous issue, particularly since patients may see them as role models.
1.2 OBJECTIVES OF THE STUDY
The broad objective of the study is to determine the dietary patterns, other lifestyles and anthropometric status of nurses in Federal Medical Centre, Owo, Ondo state. The specific objectives are to;
i. Determine the Dietary patterns of the nurses.
ii. Assess the lifestyle patterns of the nurses.
iii. Determine the nutritional status of the respondents using anthropometric indices.
1.3 SIGNIFICANCE OF THE STUDY
The health condition of the health care providers such as the nurses needs to be examined from time-to-time if proper healthcare will be delivered through them to the clients or patients. Knowledge gain from this study will help in creating awareness about the state of health (especially their blood pressure, lifestyles pattern, dietary patterns and anthropometry status) of nurses in Nigeria so as to help the stakeholders in ministry of health in designing workplace programs which will prevent the risk of cardiovascular diseases and stress, and promote efficient healthcare delivery.
The outcome of the study can serve as an evidence base health information tools for Nurses and medical based practitioners and the management of federal medical centre, Owo to develop policy that will help the health workers most especially the nurses in reshaping their health for efficiency work delivery. It will serve as a guide for government and for planning health policies for their staff. It will increase the awareness among nurses and the general public about the health implication of obesity when the study is made available by publication.
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