None listed
Conditions
Brief summary
Most nurses work shifts, and those who work night shifts have poorer lifestyle behaviours than those who work day shift only, placing them at increased risk of cardiovascular disease (CVD) and diabetes. There is strong evidence to show that shift workers have a 40% higher risk of CVD than non-shift workers. Regular physical activity (PA) is associated with reduced risk of CVD and has been shown to improve vascular function. However, shift workers have less opportunity to participate in leisure time PA and have poorer health seeking behaviours than non-shift workers. This research will investigate the impact of physical activity (PA) on intermediary vascular function and CVD outcomes in nurses who work night or rotational shifts. This will be achieved by: (1) measuring current PA patterns and vascular function, and comparing these in nurses who work night or rotating shifts with those who only work day shift; (2) conducting a feasibility trial of a PA intervention program for nurses who work night/rotational shifts. We hypothesise that participants in the intervention group will have increased levels of PA, significantly greater improvements in vascular function, and reduced risk of CVD compared with those in the control group. Intervention and comparison groups: Nurses who work night/rotational shifts and who participate in less than 150 minutes of physical activity per week, will be invited to participate in the intervention. The 8-week intervention will comprise a one-on-one information session during which a research assistant will provide participants with feedback for their baseline results and set physical activity goals. The nurses will also receive an educational leaflet and self-monitoring device (Fitbit Flex) to track physical activity. The shift workers in the control group will also meet with the research assistant (exercise physiologist) to receive feedback on their baseline results and receive the educational leaflet. These participants will not receive the Fitbit flex to monitor physical activity, and will not receive any encouragement to change their physical activity behaviour. Outcome Measures: The main outcome measure is a change in vascular function (assessed using ultrasound) and physical activity (assesed using acelerometers). Secondary outcomes include change in sedentary behaviour, cardiovascular disease risk score and Body Mass Index. These measurements will take place at baseline (Phase 1) and then at 2 (vascular function only) and 8 weeks in the intervention group. The comparison group will have measurements performed at baseline and 8 weeks.
Interventions
All nurses, irrespective of rank, will be eligible to participate. We are aiming to recruit 120 nurses (n= 60 day shift and n=60 night/rotating shift) for Phase 1, which is a cross-sectional study comparing vascular function, physical activity and risk for CVD in nurses who work day shift with those who work night / rotating shifts.
Phase 2 is a randomized control trial to assess the effectiveness of a physical activity intervention. Nurses who work night/rotational shifts and are inactive (<1
All nurses, irrespective of rank, will be eligible to participate. We are aiming to recruit 120 nurses (n= 60 day shift and n=60 night/rotating shift) for Phase 1, which is a cross-sectional study comparing vascular function, physical activity and risk for CVD in nurses who work day shift with those who work night / rotating shifts. Phase 2 is a randomized control trial to assess the effectiveness of a physical activity intervention. Nurses who work night/rotational shifts and are inactive (<150 minutes per week) will be invited to participate in Phase 2. Randomisation will take place at the ward level, to ensure that nurses in the same ward are allocated to the same group, either the intervention or control group, as this will prevent contamination between participants. Data obtained in Phase 1 will serve as the baseline or pre-intervention measures for the night shift nurses' intervention study. All participants (day and night/rotating shift workers) will have Baseline vascular function assessments the morning of a day shift (no night shift previous day). All other clinical measures and self-reported lifestyle data will also be collected during this first visit. Follow-up measurements of vascular function will be conducted only in the night/rotational shift nurses, and will take place the morning after a night shift after the 8 week intervention. Phase 2 is an 8-week intervention for night/rotational shift workers who are insufficiently physically active. Endothelial function will be re-assessed at 2 and 8 weeks following the start of the intervention. Physical activity, clinical measures and components of the survey will be repeated at 8 weeks. The primary outcome measure in this phase is changes in endothelial function (FMD). The secondary outcomes include changes in physical activity, sedentary behaviour, Body Mass Index, blood pressure and cardiovascular disease risk score. Measurements: Primary Outcome measure: Vascular Function Peripheral endothelial function: Nurses will rest in the supine position for 20 minutes after which a pneumatic cuff will be inflated for 5 minutes. Brachial artery diameters and flow measures will start 30 seconds prior to deflating the cuff, until 3 minutes after deflation. The time taken to reach maximum post-deflation diameter will also be recorded as ‘time to peak’. Secondary Outcome Measures: Objective measure of Physical Activity: Physical activity will be measured objectively using the Actigraph GT3X (ActiGraph, Shalimar, FL, USA) accelerometer. Clinical Measures: Blood pressure and a fasting blood sample will be taken to measure serum glucose concentration, HDL, LDL and triglycerides. Height and weight will be measured to calculate Body Mass Index, and waist circumference will be measured using standard protocols. Australian absolute cardiovascular disease risk score (AACDRS): The participants will be asked to complete a survey with questions about: demographic information (age, education, years working shifts), lifestyle behaviours (dietary habits and smoking status) and self-reported health status. These data, together with the clinical measures, will be used to calculate the AACDRS. Intervention: The 8-week multi-component intervention will comprise a one-on-one information session (10-15 minutes) during which a research assistant will provide participants with their baseline results and set physical activity goals. The nurses will also receive an educational booklet and self-monitoring physical activity device (Fitbit Flex) to track physical activity. The educational booklet will include information on the benefits of pf physical activity, the importance of sleep, and chronotype. They will be encouraged to wear the FitBit and engage in 30-60 minutes of moderate intensity physical activity every day and to log onto a website to track progress. The shift workers in the wait list control group will receive the educational booklet only, and will be offered the opportunity to participate in the intervention at the end of the 8 weeks. All nurses in the study will receive a certificate from LCCH/UQ endorsing their participation as eligible for their annual mandatory continuing professional development required by Australian Health Practitioner Regulating Authority (AHPRA).
Sponsors
University of Queensland
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
all nurses, irresepective of rank will be invited to participate in Phase 1. Only night shift nurses who have less than 150 minutes of physical activity per week, will be invited to participate in Phase 2.
Exclusion criteria
Nurses with known or uncontrolled cardiovascular and metabolic disease.
Outcome results
None listed