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The relationships between coping styles and food intake in shift working nurses and midwives: a pilot study

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Shift Workers are more likely to suffer from gastrointestinal disease and Type 2 Diabetes than the general population, likely due to their altered dietary intakes. Previous research has suggested that coping strategies and health behaviours may be linked, however, questions remain regarding these relationships in shift working populations.

Image courtesy of interviewee. September 10, 2024

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This video discusses the challenges faced by shift workers, particularly nurses and midwives, regarding their dietary habits and coping mechanisms. It highlights that shift workers often struggle with mood and health issues due to the disruption of their natural circadian rhythms. When working night shifts, their eating patterns are negatively affected, as they tend to consume food when their bodies are not primed for it. This video leads to higher risks of health issues such as type 2 diabetes and obesity.

In a study involving 27 shift workers from two South Australian hospitals, the researchers aimed to explore the relationship between coping mechanisms and dietary habits. They found that shift workers generally had unhealthy diets, consuming more fats, sugars, and sodium than recommended. Importantly, the study revealed that those who employed engaged coping mechanisms—a healthier approach—tended to have better dietary habits, consuming less unhealthy food compared to those using disengaged coping strategies.

The findings emphasize the need for greater awareness and education on healthy coping strategies for shift workers. However, the study's limitations include its small sample size and the fact that it only captures data at a single point in time, making it difficult to generalize the results or determine causal relationships between coping mechanisms and dietary patterns. This video concludes by calling for larger, more longitudinal studies to better understand these aspects.

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Here are some articles that explore similar themes regarding the challenges faced by shift workers, particularly in relation to their dietary habits, health issues, and coping mechanisms:

1. **"The Impact of Shift Work on Health: A Review"**
This article examines how irregular working hours disrupt sleep and eating patterns, leading to health complications such as obesity and metabolic syndrome among shift workers.

2. **"Dietary Patterns and Coping Strategies Among Shift Workers: A Cross-Sectional Study"**
This study focuses on the dietary habits and coping strategies of shift workers, highlighting the association between specific coping mechanisms and healthier eating patterns.

3. **"Circadian Rhythms and Nutritional Challenges for Shift Workers"**
This review discusses how alterations in circadian rhythms affect the physiological processes related to metabolism and appetite regulation, and provides suggestions for optimizing nutrition among shift workers.

4. **"A Qualitative Study on Health and Well-Being of Night Shift Nurses"**
This research investigates the experiences of night shift nurses, focusing on their eating habits, health issues, and the coping strategies they adopt to manage work-life balance.

5. **"Managing Shift Work: Dietary Recommendations for Nurses and Midwives"**
This article provides guidelines and dietary recommendations specifically targeted towards shift-working nurses and midwives, aiming to mitigate the health risks associated with their work schedules.

6. **"Long-term Effects of Shift Work on Diet and Health: A Systematic Review"**
This systematic review analyzes multiple studies on shift working, diet, and health outcomes, emphasizing the importance of longitudinal research in advancing our understanding of these issues.

7. **"Coping Mechanisms and Their Impact on Dietary Habits in Healthcare Workers"**
This article explores various coping strategies utilized by healthcare workers and their effects on dietary choices and health outcomes, underlining the importance of positive coping mechanisms.

These articles collectively highlight the intricate relationship between shift work, dietary habits, health outcomes, and coping strategies, similar to the themes presented in your video.

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Shift workers in general have a bit of a, a bums here.

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I should probably not say that in a, in interview,

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but shift workers have the short end

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of the stick in a lot of ways.

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So it is really difficult.

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We are essentially primed to be awake

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during the day and asleep at night.

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And when you try to switch that your body has a lot

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of issues with it and basically sends you a lot of messages

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to say that that's not what you are supposed to be doing.

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So we see that shift workers as a consequence of that,

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have a lot of issues with mood regulation,

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emotion regulation in general

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and also a lot of health issues.

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And particularly when we're talking about health issues,

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the consequences of poor food intake come up a lot.

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Um, part of the reason for that is

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because shift workers generally,

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especially when they're working at night, will be trying

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to consume food at a time when their body is telling 'em

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that they shouldn't be consuming food.

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And so there are a lot of consequences of that in terms

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of type two diabetes, in particular,

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but a whole bunch of other issues as well.

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Obesity and all of the issues that come with that too.

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Another issue for shift workers,

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and particularly those who work night shift, is

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that their access to food is typically not

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what you would expect from working day shift.

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Most of us who work day shifts, you can go to the cafe,

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you can go somewhere healthy, lots of things are open,

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you have a lot of options, you know, even you can go

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to the supermarket and things like that.

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When you work night shift, the majority of things are closed

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and so your options are severely limited.

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You might just be able to go to the vending machine

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and typically, as we know,

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vending machines don't have healthy options.

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So not only are they eating at times when their bodies are

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telling them that they shouldn't be eating,

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but they're also generally eating less healthy foods

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and probably more food as well,

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because when you are really tired,

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your body sends you signals that you want

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to be consuming more food and more unhealthy food.

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And so there are a whole bunch of consequences in terms

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of health and wellbeing that come with that.

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So basically what we wanted to do

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with this study was have a look

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to see whether there were really any links

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between the coping mechanisms that people use

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because we know that in general shift work,

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can be really difficult to deal with.

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But also this was a study where we looked at nurses

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and midwives so they can also be dealing with a lot

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of stress and you know, concerns around their,

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work in general.

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Um, and so we wanted to see whether we could relate any kind

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of coping mechanisms that they were using to their diet

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and see whether they were related.

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I think where we kind of sat in

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and came to do something a little bit new

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was looking at those relationships

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between the coping mechanisms and shift work.

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So there's been stuff done,

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previously in coping mechanisms

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and stuff done previously in the, dietary,

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patterns in shift workers,

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but kind of linking them together was a little bit more new.

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We had 27,

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Uh, shift workers, nurses

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and midwives from two South Australian hospitals.

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Everybody was working forward rotating shifts, so a mix

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of different types of shifts.

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They did the standard shift work index,

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which asked them a whole bunch of questions.

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It's quite a long, questionnaire.

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What we were really interested in from the standard shift

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work index was the coping, questionnaire.

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So I asked them a bunch of questions.

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There are eight coping mechanisms, so four

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of them are engaged coping mechanisms,

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which are considered healthier,

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and four of them are disengaged coping mechanisms,

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which are considered less healthy generally.

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Um, and they rated to what extent they used them.

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The other thing that they did was fill out a,

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a food frequency questionnaire, which asks them,

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what they kind of ate over the past 12 months

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and in what portions, which allowed us

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to have a look at the, dietary profile

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of these, shift workers.

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We weren't surprised to find out that our shift workers

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consumed more fat, more saturated fat in particular,

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more protein, more sugar,

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more sodium than the Australian guidelines,

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so what they were supposed to eat.

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So that did support all of the previous literature

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to suggest that shift workers in general have pretty

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unhealthy diets.

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Um, but the kind of more interesting thing for us was

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that when you looked at the relationship between the engaged

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and the disengaged coping mechanisms

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and food intake overall, the engaged,

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or people who used greater engaged coping mechanisms

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had a healthier diet.

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So they consumed less energy overall.

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Um, less total fat, less cholesterol,

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and less sugar, which is obviously really good,

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especially when we're talking about

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unhealthy diets in general.

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So overall, greater engaged coping styles are related

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to healthier diets

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and greater disengaged coping styles are related

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to less healthy diets.

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I think it's a matter of, extent here as well

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because what we see in the general population is that most

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of the time we do consume a lot of the things

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that we're not supposed to consume,

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in higher levels than we should be.

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But when it comes to shift work,

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it's even more than the general population.

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Um, in terms of coping styles,

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we didn't pull them apart into different specific styles,

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in the study, but

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what we did do is look at the engaged versus the

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disengaged coping styles.

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So things like engaged coping styles are generally

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considered to be healthier.

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Um, so things like actually looking for a solution

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to the problem or doing some cognitive restructuring

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to change the way that you're thinking about it.

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Whereas with the disengaged coping styles,

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people do things like just switch off

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and they won't think about it

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or they'll kind of hide from the problem,

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which obviously might give you a little bit

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of a break from the problem and can be used sometimes,

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but is not a solution.

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And when they're used kind of exclusively

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or for a long period of time, then it just kind

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of makes everything way worse.

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I would love to see from this study is

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A greater focus on keeping yourself healthy

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before you go into the workplace.

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So we know that being a shift worker is really difficult.

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We know that being a nurse or a midwife

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or a doctor is really difficult

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and you see a lot of really difficult things.

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Um, but a lot of the people

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who go into this workplace are not kind

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of prepared effectively throughout their university degree

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for these kinds of issues.

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So personally what I would love

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to see is more a greater focus on coping styles

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and making sure that they're keeping themselves healthy

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and all of those health behaviors that we would love to see,

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you know, to prepare them

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for when they go into the workplace.

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The two kind of major limitations that we have

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for the study are that we only had two.

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Um, there's a small sample,

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they're only from two hospitals in South Australia,

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which obviously means

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that the findings are not generalizable across the world

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or even to, you know, wider Australia.

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So I would love to see that done on a, a greater scale

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to actually see whether that holds up across

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kind of the broader scale.

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Um, the other, major limitation that we have is that

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because it's single time point data,

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we don't know whether it's the dietary strategies that are

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forming or contributing to the coping mechanisms

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or the coping mechanisms that are contributing

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to the dietary styles or whether

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it's a combination of the two.

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So I guess the other thing that I would really like to see

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is that pulled apart

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and done over a longer time period so

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that you can see which contributes to which

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and to what extent.

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