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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.

X-TIMESTAMP-MAP:LOCAL=00:00:00.000,MPEGTS=900000

00:00.000 --> 00:04.365
Shift workers in general have a bit of a, a bums here.

00:04.565 --> 00:06.805
I should probably not say that in a, in interview,

00:06.865 --> 00:08.805
but shift workers have the short end

00:08.805 --> 00:10.285
of the stick in a lot of ways.

00:10.465 --> 00:11.845
So it is really difficult.

00:12.225 --> 00:14.685
We are essentially primed to be awake

00:14.685 --> 00:16.165
during the day and asleep at night.

00:16.545 --> 00:19.005
And when you try to switch that your body has a lot

00:19.285 --> 00:21.965
of issues with it and basically sends you a lot of messages

00:21.985 --> 00:24.765
to say that that's not what you are supposed to be doing.

00:26.385 --> 00:29.125
So we see that shift workers as a consequence of that,

00:29.155 --> 00:32.325
have a lot of issues with mood regulation,

00:32.325 --> 00:33.765
emotion regulation in general

00:33.825 --> 00:35.125
and also a lot of health issues.

00:35.185 --> 00:37.845
And particularly when we're talking about health issues,

00:38.585 --> 00:42.045
the consequences of poor food intake come up a lot.

00:42.705 --> 00:44.725
Um, part of the reason for that is

00:44.725 --> 00:46.525
because shift workers generally,

00:46.525 --> 00:49.565
especially when they're working at night, will be trying

00:49.665 --> 00:52.685
to consume food at a time when their body is telling 'em

00:52.685 --> 00:54.205
that they shouldn't be consuming food.

00:54.825 --> 00:57.085
And so there are a lot of consequences of that in terms

00:57.205 --> 00:59.765
of type two diabetes, in particular,

00:59.825 --> 01:01.325
but a whole bunch of other issues as well.

01:01.325 --> 01:03.725
Obesity and all of the issues that come with that too.

01:04.755 --> 01:07.045
Another issue for shift workers,

01:07.185 --> 01:09.965
and particularly those who work night shift, is

01:10.075 --> 01:13.645
that their access to food is typically not

01:13.645 --> 01:16.245
what you would expect from working day shift.

01:16.355 --> 01:19.045
Most of us who work day shifts, you can go to the cafe,

01:19.265 --> 01:21.365
you can go somewhere healthy, lots of things are open,

01:21.425 --> 01:23.565
you have a lot of options, you know, even you can go

01:23.565 --> 01:25.005
to the supermarket and things like that.

01:25.675 --> 01:29.325
When you work night shift, the majority of things are closed

01:29.585 --> 01:31.165
and so your options are severely limited.

01:31.425 --> 01:33.445
You might just be able to go to the vending machine

01:33.505 --> 01:34.885
and typically, as we know,

01:35.195 --> 01:36.925
vending machines don't have healthy options.

01:37.145 --> 01:41.365
So not only are they eating at times when their bodies are

01:41.365 --> 01:42.725
telling them that they shouldn't be eating,

01:42.865 --> 01:45.485
but they're also generally eating less healthy foods

01:45.545 --> 01:47.125
and probably more food as well,

01:47.125 --> 01:48.325
because when you are really tired,

01:48.325 --> 01:50.805
your body sends you signals that you want

01:50.905 --> 01:53.925
to be consuming more food and more unhealthy food.

01:54.305 --> 01:56.485
And so there are a whole bunch of consequences in terms

01:56.485 --> 01:58.205
of health and wellbeing that come with that.

01:59.215 --> 02:01.795
So basically what we wanted to do

02:01.795 --> 02:03.355
with this study was have a look

02:03.415 --> 02:06.195
to see whether there were really any links

02:06.195 --> 02:08.835
between the coping mechanisms that people use

02:08.835 --> 02:11.275
because we know that in general shift work,

02:11.535 --> 02:13.275
can be really difficult to deal with.

02:13.735 --> 02:16.115
But also this was a study where we looked at nurses

02:16.215 --> 02:18.675
and midwives so they can also be dealing with a lot

02:18.675 --> 02:21.915
of stress and you know, concerns around their,

02:22.025 --> 02:23.195
work in general.

02:23.975 --> 02:28.915
Um, and so we wanted to see whether we could relate any kind

02:28.915 --> 02:32.835
of coping mechanisms that they were using to their diet

02:33.015 --> 02:34.315
and see whether they were related.

02:34.635 --> 02:37.115
I think where we kind of sat in

02:37.135 --> 02:39.555
and came to do something a little bit new

02:40.255 --> 02:41.635
was looking at those relationships

02:41.635 --> 02:43.995
between the coping mechanisms and shift work.

02:44.055 --> 02:46.075
So there's been stuff done,

02:46.555 --> 02:47.995
previously in coping mechanisms

02:48.055 --> 02:52.675
and stuff done previously in the, dietary,

02:52.915 --> 02:54.155
patterns in shift workers,

02:54.295 --> 02:56.835
but kind of linking them together was a little bit more new.

02:57.055 --> 02:58.195
We had 27,

02:58.735 --> 03:00.565
Uh, shift workers, nurses

03:00.665 --> 03:03.645
and midwives from two South Australian hospitals.

03:03.645 --> 03:06.525
Everybody was working forward rotating shifts, so a mix

03:06.545 --> 03:07.845
of different types of shifts.

03:08.475 --> 03:10.565
They did the standard shift work index,

03:10.565 --> 03:11.925
which asked them a whole bunch of questions.

03:11.925 --> 03:13.765
It's quite a long, questionnaire.

03:14.395 --> 03:17.645
What we were really interested in from the standard shift

03:17.645 --> 03:20.565
work index was the coping, questionnaire.

03:21.395 --> 03:22.895
So I asked them a bunch of questions.

03:22.905 --> 03:25.255
There are eight coping mechanisms, so four

03:25.255 --> 03:27.415
of them are engaged coping mechanisms,

03:27.415 --> 03:29.015
which are considered healthier,

03:29.355 --> 03:31.575
and four of them are disengaged coping mechanisms,

03:31.575 --> 03:33.175
which are considered less healthy generally.

03:33.715 --> 03:36.575
Um, and they rated to what extent they used them.

03:37.435 --> 03:39.935
The other thing that they did was fill out a,

03:39.975 --> 03:43.415
a food frequency questionnaire, which asks them,

03:44.825 --> 03:47.685
what they kind of ate over the past 12 months

03:47.685 --> 03:49.405
and in what portions, which allowed us

03:49.405 --> 03:52.245
to have a look at the, dietary profile

03:52.425 --> 03:53.925
of these, shift workers.

03:54.465 --> 03:58.765
We weren't surprised to find out that our shift workers

03:59.405 --> 04:03.125
consumed more fat, more saturated fat in particular,

04:03.395 --> 04:04.605
more protein, more sugar,

04:04.715 --> 04:07.445
more sodium than the Australian guidelines,

04:07.465 --> 04:08.645
so what they were supposed to eat.

04:08.645 --> 04:10.965
So that did support all of the previous literature

04:10.965 --> 04:13.645
to suggest that shift workers in general have pretty

04:13.645 --> 04:14.645
unhealthy diets.

04:15.425 --> 04:17.965
Um, but the kind of more interesting thing for us was

04:17.965 --> 04:21.205
that when you looked at the relationship between the engaged

04:21.225 --> 04:22.885
and the disengaged coping mechanisms

04:22.885 --> 04:27.125
and food intake overall, the engaged,

04:27.305 --> 04:30.365
or people who used greater engaged coping mechanisms

04:30.425 --> 04:31.445
had a healthier diet.

04:31.945 --> 04:34.205
So they consumed less energy overall.

04:34.625 --> 04:37.245
Um, less total fat, less cholesterol,

04:37.245 --> 04:39.445
and less sugar, which is obviously really good,

04:39.535 --> 04:41.045
especially when we're talking about

04:41.045 --> 04:42.285
unhealthy diets in general.

04:42.625 --> 04:46.685
So overall, greater engaged coping styles are related

04:46.705 --> 04:48.045
to healthier diets

04:48.305 --> 04:51.045
and greater disengaged coping styles are related

04:51.065 --> 04:52.205
to less healthy diets.

04:52.485 --> 04:56.725
I think it's a matter of, extent here as well

04:56.725 --> 05:00.525
because what we see in the general population is that most

05:00.525 --> 05:02.445
of the time we do consume a lot of the things

05:02.445 --> 05:04.645
that we're not supposed to consume,

05:04.905 --> 05:07.085
in higher levels than we should be.

05:07.665 --> 05:09.045
But when it comes to shift work,

05:09.285 --> 05:11.285
it's even more than the general population.

05:12.315 --> 05:13.935
Um, in terms of coping styles,

05:14.315 --> 05:17.775
we didn't pull them apart into different specific styles,

05:17.835 --> 05:19.215
in the study, but

05:19.215 --> 05:21.535
what we did do is look at the engaged versus the

05:21.535 --> 05:22.615
disengaged coping styles.

05:22.615 --> 05:24.815
So things like engaged coping styles are generally

05:25.135 --> 05:26.135
considered to be healthier.

05:26.675 --> 05:30.615
Um, so things like actually looking for a solution

05:30.615 --> 05:33.015
to the problem or doing some cognitive restructuring

05:33.015 --> 05:34.655
to change the way that you're thinking about it.

05:34.885 --> 05:37.055
Whereas with the disengaged coping styles,

05:37.055 --> 05:38.695
people do things like just switch off

05:38.695 --> 05:39.735
and they won't think about it

05:39.835 --> 05:41.815
or they'll kind of hide from the problem,

05:42.185 --> 05:44.055
which obviously might give you a little bit

05:44.055 --> 05:47.135
of a break from the problem and can be used sometimes,

05:47.315 --> 05:48.455
but is not a solution.

05:48.515 --> 05:50.535
And when they're used kind of exclusively

05:50.635 --> 05:52.815
or for a long period of time, then it just kind

05:52.815 --> 05:54.335
of makes everything way worse.

05:54.655 --> 05:56.815
I would love to see from this study is

05:57.685 --> 06:00.485
A greater focus on keeping yourself healthy

06:00.705 --> 06:02.325
before you go into the workplace.

06:02.905 --> 06:05.885
So we know that being a shift worker is really difficult.

06:05.945 --> 06:07.725
We know that being a nurse or a midwife

06:07.725 --> 06:09.125
or a doctor is really difficult

06:09.125 --> 06:10.925
and you see a lot of really difficult things.

06:11.545 --> 06:12.765
Um, but a lot of the people

06:12.785 --> 06:15.245
who go into this workplace are not kind

06:15.405 --> 06:18.725
of prepared effectively throughout their university degree

06:19.385 --> 06:20.565
for these kinds of issues.

06:20.825 --> 06:23.095
So personally what I would love

06:23.095 --> 06:25.935
to see is more a greater focus on coping styles

06:25.935 --> 06:28.335
and making sure that they're keeping themselves healthy

06:28.395 --> 06:30.655
and all of those health behaviors that we would love to see,

06:31.275 --> 06:33.215
you know, to prepare them

06:33.235 --> 06:34.695
for when they go into the workplace.

06:35.075 --> 06:37.535
The two kind of major limitations that we have

06:37.555 --> 06:40.415
for the study are that we only had two.

06:41.035 --> 06:43.375
Um, there's a small sample,

06:43.405 --> 06:45.895
they're only from two hospitals in South Australia,

06:45.895 --> 06:46.895
which obviously means

06:46.895 --> 06:49.495
that the findings are not generalizable across the world

06:49.495 --> 06:51.815
or even to, you know, wider Australia.

06:52.475 --> 06:55.375
So I would love to see that done on a, a greater scale

06:55.395 --> 06:57.575
to actually see whether that holds up across

06:57.925 --> 06:59.055
kind of the broader scale.

06:59.675 --> 07:04.055
Um, the other, major limitation that we have is that

07:04.055 --> 07:05.655
because it's single time point data,

07:05.795 --> 07:10.055
we don't know whether it's the dietary strategies that are

07:10.575 --> 07:14.655
forming or contributing to the coping mechanisms

07:14.755 --> 07:16.695
or the coping mechanisms that are contributing

07:16.695 --> 07:17.975
to the dietary styles or whether

07:17.975 --> 07:19.135
it's a combination of the two.

07:20.215 --> 07:22.395
So I guess the other thing that I would really like to see

07:22.935 --> 07:24.595
is that pulled apart

07:24.615 --> 07:26.275
and done over a longer time period so

07:26.275 --> 07:28.115
that you can see which contributes to which

07:28.175 --> 07:29.035
and to what extent.

"The Challenges of Shift Work: Health Implications and Coping Mechanisms"

00:00:00 - Shift workers in general have a bit of a, a bums here. I should probably not say that in a, in interview, but shift workers have the short end of the stick in a lot of ways. So it is really difficult. We are essentially primed to be awake during the day and asleep at night. And when you try to switch that your body has a lot of issues with it and basically sends you a lot of messages to say that that's not what you are supposed to be doing. So we see that shift workers as a consequence of that, have a lot of issues with mood regulation, emotion regulation in general and also a lot of health issues. And particularly when we're talking about health issues, the consequences of poor food intake come up a lot. part of the reason for that is
00:00:46 - especially when they're working at night, will be trying to consume food at a time when their body is telling 'em that they shouldn't be consuming food. And so there are a lot of consequences of that in terms of type two diabetes, in particular, but a whole bunch of other issues as well. Obesity and all of the issues that come with that too. Another issue for shift workers, and particularly those who work night shift, is that their access to food is typically not what you would expect from working day shift. Most of us who work day shifts, you can go to the cafe, you can go somewhere healthy, lots of things are open, you have a lot of options, you know, even you can go to the supermarket and things like that.
00:01:29 - and so your options are severely limited. You might just be able to go to the vending machine and typically, as we know, vending machines don't have healthy options. So not only are they eating at times when their bodies are telling them that they shouldn't be eating, but they're also generally eating less healthy foods and probably more food as well, because when you are really tired, your body sends you signals that you want to be consuming more food and more unhealthy food. And so there are a whole bunch of consequences in terms of health and wellbeing that come with that. So basically what we wanted to do with this study was have a look to see whether there were really any links
00:02:08 - because we know that in general shift work, can be really difficult to deal with. But also this was a study where we looked at nurses and midwives so they can also be dealing with a lot of stress and you know, concerns around their, work in general. and so we wanted to see whether we could relate any kind of coping mechanisms that they were using to their diet and see whether they were related. I think where we kind of sat in and came to do something a little bit new was looking at those relationships between the coping mechanisms and shift work. So there's been stuff done,
00:02:48 - and stuff done previously in the, dietary, patterns in shift workers, but kind of linking them together was a little bit more new. We had 27, shift workers, nurses and midwives from two South Australian hospitals. Everybody was working forward rotating shifts, so a mix of different types of shifts. They did the standard shift work index, which asked them a whole bunch of questions. It's quite a long, questionnaire. What we were really interested in from the standard shift work index was the coping, questionnaire. So I asked them a bunch of questions. There are eight coping mechanisms, so four of them are engaged coping mechanisms,
00:03:29 - and four of them are disengaged coping mechanisms, which are considered less healthy generally. and they rated to what extent they used them. The other thing that they did was fill out a, a food frequency questionnaire, which asks them, what they kind of ate over the past 12 months and in what portions, which allowed us to have a look at the, dietary profile of these, shift workers. We weren't surprised to find out that our shift workers consumed more fat, more saturated fat in particular, more protein, more sugar, more sodium than the Australian guidelines,

"Exploring the Connection Between Coping Mechanisms and Dietary Choices Among Shift Workers"

00:04:08 - So that did support all of the previous literature to suggest that shift workers in general have pretty unhealthy diets. but the kind of more interesting thing for us was that when you looked at the relationship between the engaged and the disengaged coping mechanisms and food intake overall, the engaged, or people who used greater engaged coping mechanisms had a healthier diet. So they consumed less energy overall. less total fat, less cholesterol, and less sugar, which is obviously really good, especially when we're talking about unhealthy diets in general. So overall, greater engaged coping styles are related to healthier diets
00:04:51 - to less healthy diets. I think it's a matter of, extent here as well because what we see in the general population is that most of the time we do consume a lot of the things that we're not supposed to consume, in higher levels than we should be. But when it comes to shift work, it's even more than the general population. in terms of coping styles, we didn't pull them apart into different specific styles, in the study, but what we did do is look at the engaged versus the disengaged coping styles. So things like engaged coping styles are generally considered to be healthier. so things like actually looking for a solution
00:05:33 - to change the way that you're thinking about it. Whereas with the disengaged coping styles, people do things like just switch off and they won't think about it or they'll kind of hide from the problem, which obviously might give you a little bit of a break from the problem and can be used sometimes, but is not a solution. And when they're used kind of exclusively or for a long period of time, then it just kind of makes everything way worse. I would love to see from this study is A greater focus on keeping yourself healthy before you go into the workplace. So we know that being a shift worker is really difficult. We know that being a nurse or a midwife or a doctor is really difficult and you see a lot of really difficult things.
00:06:12 - who go into this workplace are not kind of prepared effectively throughout their university degree for these kinds of issues. So personally what I would love to see is more a greater focus on coping styles and making sure that they're keeping themselves healthy and all of those health behaviors that we would love to see, you know, to prepare them for when they go into the workplace. The two kind of major limitations that we have for the study are that we only had two. there's a small sample, they're only from two hospitals in South Australia, which obviously means that the findings are not generalizable across the world or even to, you know, wider Australia.
00:07:28 - to actually see whether that holds up across kind of the broader scale. the other, major limitation that we have is that because it's single time point data, we don't know whether it's the dietary strategies that are forming or contributing to the coping mechanisms or the coping mechanisms that are contributing to the dietary styles or whether it's a combination of the two. So I guess the other thing that I would really like to see is that pulled apart and done over a longer time period so that you can see which contributes to which and to what extent.

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