Health behaviour and health status of nursing staff--a review of the literature

Presently around 1.1 million nurses are employed in the German health care system. Due to increased workload and staff reduction, studies on the health behaviour and health condition of nursing staff are increasingly important. Hence we reviewed the literature on health behaviour and health condition of nursing staff. Articles available in Medline and Embase from 1978 to 2000 were included, focussing on smoking, alcohol consumption, substance abuse, eating habits, body-mass index, dental health status, risk behaviour in traffic, workload, burnout syndrome, sports and recreation, job satisfaction, subjective health status, subjective complaints, vaccinations and quality of life. Health behaviour was divided in unhealthy and healthy behaviour. It became obvious that most of the studies focussed on investigation of unhealthy behaviour, such as smoking, alcohol consumption, substance abuse and poor eating habits. Health promotion was mainly seen as avoiding these unhealthy habits. Only in current studies definitions of health promoting behaviour were developed as a part of a comprehensive life-style.     

Contribution of socioeconomic status to the association between hostility and cardiovascular risk behaviors: a prospective cohort study

The authors examined the contribution of childhood and early adulthood socioeconomic status (SES) to the association between adulthood cynical hostility and cardiovascular risk behaviors. Participants from the population-based, prospective Cardiovascular Risk in Young Finns Study were 531 males and 688 females, aged 12-21 years at the baseline in 1983 and 21-30 years at the follow-up in 1992. Cardiovascular risk behaviors comprised the number of cigarettes smoked per day, physical inactivity, the type of fat used in the diet, and the frequency of alcohol consumption. The general linear models showed socioeconomic variation in cynical hostility, butter use in the diet, and smoking. In regression analyses, hostility was positively associated with smoking in men and women (beta coefficients = 0.16 and 0.09; p values = 0.000 and 0.019, respectively) and with frequency of alcohol use (beta coefficients = 0.10 and 0.03; p values = 0.024 and 0.03, respectively). Adding parents' and participants' SES to the model marginally attenuated these associations. The authors conclude that the association of cynical hostility with smoking and alcohol use seems to be independent of intergenerational social mobility and childhood and adulthood SES.     

胶东半岛男性中小学体育教师健康状况及健康需求

目的了解中小学体育教师的健康状况、相关的行为及对健康促进的需求,为改善教师健康状况,提高教学质量提供依据。方法采用分层整群抽样方法,对胶东半岛160所中小学35岁以上的男性体育教师312人进行问卷调查。结果耐力水平感觉良好率仅为47.8%,39.4%的人患有1种或几种慢性疾病。中小学体育教师的不良行为发生率较高,吸烟、饮酒、心理压力、课时量等因素均与慢性病存在统计学联系。体育教师对健康促进的需求较高。结论应关注体育教师的健康状况,改善其工作条件,积极开展体育教师的健康促进工作。     

Neighborhood context and youth cardiovascular health behaviors

OBJECTIVES: This study sought to determine the relationships between race/ethnicity, socioeconomic status (SES), and cardiovascular health behaviors among youths and whether neighborhood characteristics are associated with such behaviors independently of individual characteristics. METHODS: Linear models determined the effects of individual and neighborhood characteristics (SES, social disorganization, racial/ethnic minority concentration, urbanization) on dietary habits, physical activity, and smoking among 8165 youths aged 12 to 21 years. RESULTS: Low SES was associated with poorer dietary habits, less physical activity, and higher odds of smoking. After adjustment for SES, Black race was associated with poorer dietary habits and lower odds of smoking. Hispanic ethnicity was associated with healthier dietary habits, lower levels of physical activity, and lower odds of smoking than non-Hispanic ethnicity. Low neighborhood SES and high neighborhood social disorganization were independently associated with poorer dietary habits, while high neighborhood Hispanic concentration and urbanicity were associated with healthier dietary habits. Neighborhood characteristics were not associated with physical activity or smoking. CONCLUSIONS: Changes in neighborhood social structures and policies that reduce social inequalities may enhance cardiovascular health behaviors.     

Health risk behaviors, health status self-assessment and stress perception among industrial workers]

OBJECTIVE: To identify the prevalence and association among health risk behaviors, stress perception, and health status self-assessment among industrial workers. METHODS: A cross-sectional study was performed using a questionnaire previously tested in a pilot study in the State of Santa Catarina, Brazil. Data on smoking, alcohol consumption, fruit and vegetables intake, physical activity, stress perception, and self-assessment of health status were available for 4,225 workers (67.5% males and 32.5% females). Subjects were selected using a 3-stage cluster sampling (5% error margin). Statistical analysis was performed using Chi-square, and logistic regression analysis (p<0.05). RESULTS: The mean age was 29.7 years old (SD=8.6). The prevalence of smokers was 20.6%, higher among males (23.1%) than females (15.6%). The proportion of heavy drinkers was high (57.2% among males and 18.8% among females). Almost half of the subjects (46.2%) reported no leisure-time physical activity (67% females and 34.8% males). Approximately 14% of subjects reported high levels of stress and difficulty to cope with daily tasks. About 15% of the workers perceived their health status as regular or poor. Gender, age, marital status, number of children, educational level and economic status were significantly associated with the prevalence of health risk behaviors. CONCLUSIONS: Despite the limitations of cross-sectional studies, based on self-report assessments, the study results suggest a high prevalence of alcohol consumption and physical inactivity during leisure time. The observed association between gender and health risk behavior suggests that both sexes engage in risk behaviors: for men these behaviors are direct or active (smoking, alcohol consumption) and for women, they are more indirect or passive (physical inactivity, stress).     

健康危险因素对健康状况影响效应分析

目的量化分析健康危险因素对健康状况的影响效应。方法采用多元多水平方法(MVML)探索4 926名参加体检人员不同时间(2008—2010年)在体质指数(BMI)、吸烟、饮酒、体育锻炼和蔬菜、水果摄入等可控因素上的变化对脂蛋白、甘油三酯(TG)、总胆固醇(TC)等多个相关测量指标变化的影响。结果随着BMI增加,TG、TC、低密度脂蛋白(LDL)明显增加,而高密度脂蛋白(HDL)明显降低;男性组BMI平均每增加1 kg/m²,TG增加10.14 mg/dL,TC增加1.72 mg/dL,LDL增加1.91 mg/dL,而HDL则降低1.01 mg/dL;女性组,BMI平均每增加1 kg/m²,TG增加8.50 mg/dL,TC增加0.93 mg/dL,LDL增加1.40 mg/dL,而HDL则降低1.27 mg/dL;参加体育锻炼能明显降低TC、TG和LDL;经常吸烟、饮酒的男性的TC、TG和LDL明显升高;男性组蔬菜、水果摄入不足者的TC、TG水平较高。结论健康危险因素对健康状况有影响,可通过选择性干预措施有效改善我国居民健康状态。     

Gesundheitskompetenztraining für Menschen in Langzeitarbeitslosigkeit

Among the long-term unemployed ill health is often a hindrance to successful reintegration in the job market. In a quasi-experimental controlled study we examined the effects of a health promotion intervention program tailored to the specific needs of the long-term unemployed combining individual sessions based on motivational interviewing and participatory group sessions including physical activity. Over a period of 3 months the participants of the intervention group (n?=?179) showed more improvement compared to the control group (n?=?108) in terms of motivation for lifestyle changes towards more physical activity and healthier nutrition. Participants of the intervention group developed an intention to act significantly more often (active lifestyle: odds ratio 4.44; 95% CI: 2.00-9.83; healthy nutrition: odds ratio 3.94; 95% CI: 1.55-10.00) and actually implemented a behavior change significantly more often (active lifestyle: odds ratio 2.77; 95% CI: 1.35-5.71; healthy nutrition: odds ratio 4.34; 95% CI: 1.92-9.78). In terms of smoking and alcohol consumption no significant intervention effects were detected. The results of the study show the effectiveness of the described health promotion program regarding a lifestyle change towards more healthy nutrition and more physical activity.     

Relationships among children's health-related behaviors: a multivariate, developmental perspective

Considerable evidence documents the aggregation of cardiovascular risk factors in children; yet, very little is known about the covariation of children's health practices. Accordingly, using a multivariate and developmental perspective, the present research examines the interrelationships among multiple health behaviors (i.e., physical activity, eating habits, smoking, alcohol use, and stress-related behaviors) in 1,092 predominantly low-socioeconomic status, rural schoolchildren (ages 11-18, grades 6-12). Our data provide support for a multidimensional view of children's health habits and suggest that patterns of interrelationships may vary at different developmental levels. Implications of these results are discussed and directions for future research are highlighted.     

Association between health risk behaviors in parents and adolescents in a rural area in southern Brazil

This article aimed to assess the association between health risk behaviors in parents and adolescents in a rural area. The sample included 377 schoolchildren 10 to 18 years of age and 338 parents. The following variables were analyzed: level of leisure-time and commuting physical activity, inadequate eating habits, overweight/obesity, smoking, and alcohol consumption. Prevalence rates for smoking and alcohol consumption by adolescents in the previous 30 days were 6.7% and 27%, respectively. Forty-five percent of adolescents failed to reach the target physical activity score. Adherence to steps to healthy eating was low. Physical activity in adolescents was positively associated with that of parents, and adolescent drinking was associated with maternal alcohol consumption. There was no significant association for other behaviors. In the analysis stratified by gender, level of physical exercise in female adolescents was associated with that of fathers. Parental health risk behaviors were associated with the behaviors in the adolescent children in this rural area.     

Risk of death by health habit index from a cohort study among the residents of a rural area in Aichi, Japan

To clarify the validity of the health habit index, we evaluated risk of death by health habit index in residents in Aichi Prefecture. Subjects were 7,662 residents aged 40-79 years living in a rural area of Aichi Prefecture who responded to a questionnaire in 1988, that included 12 health habit items on diet, physical activity, rest, mental health, smoking, drinking and regular health check. Data on death and migration in this cohort group was collected from 1990 to 1997. The risk ratios (RRs) of death for all causes, cancer and cardiovascular diseases were estimated by Cox's proportional hazard model. The number of all causes of death, cancer and cardiovascular diseases was 650, 240 and 197, respectively. Proper health habits of adequate but not over eating, regular physical activity, properly managing stress, non-smoking or smoking cessation for one year or more and regular health examinations in men and regular physical activity and non-smoking in women related to lower age-adjusted RR of death for all causes, while smoking cessation of less than one year in men with increased RR. Lower RR of cancer was observed for non-smoking men, and for women who occasionally have enough sleep. Proper health habits on adequate but not overeating, enjoying mealtime, regular physical activity, properly managing stress, moderate drinking (< 2 "go"/day) or occasional heavy drinking and regular health examinations related to lower RR of cardiovascular diseases in men, while regular physical activity related to lower RR in women. Multivariate analysis for the RR of death for all causes showed similar results, except higher RR in the men who avoided excess salt consumption, and decreased RR in the women who occasionally have enough sleep. In conclusion, the present study suggested that regular physical activity is associated with decreased risk from death for all causes, especially for cardiovascular diseases. Health habit index in the present study included various items with or without association to risk for death. It is important to apply this index to health promotion on the basis of its specific characteristic.     

Tobacco and alcohol consumption: impact on other cardiovascular and cancer risk factors in a southern European Mediterranean population

Tobacco and alcohol consumption are strongly related to other cardiovascular and cancer risk factors. The aim of the present study was to analyse the association of nutrient intake, blood lipid variables and leisure-time physical activity with tobacco and alcohol consumption status. Participants were recruited in a cross-sectional population-based survey, including cardiovascular risk factor measurements and evaluation of physical activity and diet intake in a Mediterranean population (n 1748). Multiple linear regression analysis, adjusted for several confounders, showed a direct association of saturated fatty acids (g and % total energy intake), dietary cholesterol intakes and serum triacylglycerol with smoking. An inverse association was observed for smoking and unsaturated fatty acids (% energy intake), vitamin C, alpha-tocopherol and beta-carotene intakes, leisure-time physical activity and HDL-cholesterol. These associations were not observed for alcohol drinking. After adjusting for the confounders earlier mentioned, low dietary intakes of vitamin C and dietary fibre were more likely in heavy-smokers as compared with non-smokers (odds ratio 1.74 (95 % CI 1.07, 2.73) and 1.94 (95 % CI 1.29, 2.92) of low vitamin C (<60 mg/d) and dietary fibre intakes (<10 g/d) respectively). Alcohol consumption was directly associated with HDL-cholesterol and triacylglycerol, and attenuated the effects of smoking on HDL-cholesterol. These results suggest that the dietary intake of fibre and several antioxidant components of the Mediterranean diet is reduced in smokers, who also show an adverse lipid profile. However, the worst triacylglycerol levels are associated with the combination of heavy smoking and heavy alcohol drinking. Moderate alcohol consumption was not associated with an unhealthy diet pattern or adverse lipid profile. The health benefits of the Mediterranean diet appear to be strongly counteracted by smoking.     

Comparison of dietary and smoking habit changes in physical fitness improvers and nonimprovers

Changes in dietary, smoking, and alcohol intake habits of men who voluntarily increased their physical fitness level (n = 532) were compared with men who did not increase physical fitness (n = 390). These men were middle-aged (average age = 43 years), initially sedentary and free of disease, and had been examined twice at a preventive medicine clinic within a 1- to 6-year period. Subjects were retrospectively assigned to two fitness groups--improvers and nonimprovers--based on changes in treadmill performance between baseline and follow-up examinations. Fifteen lifestyle variables were assessed by questionnaire and evaluated for change. At baseline the two groups were similar in demographic variables and diet, differing significantly only in follow-up interval (P less than 0.001), treadmill time (P less than 0.001), whole milk consumption (P less than 0.003), and smoking (P less than 0.001). At follow-up, positive changes in health habits were seen for both groups. Statistically significant differences in health habit change between the groups were seen only for beef (P less than 0.003) and coffee (P less than 0.003) consumption (consumption of both decreasing in more improvers than nonimprovers). Smokers at baseline were less likely to improve their physical fitness. We concluded that individuals who voluntarily increased their physical fitness level were not more likely to change their dietary and alcohol habits than persons who maintained a more sedentary lifestyle.     

Lipoproteins as mediators for the effects of alcohol consumption and cigarette smoking on cardiovascular mortality: results form the Lipid Research Clinics Follow-up Study

Because alcohol consumption is associated with increased high density lipoprotein (HDL) cholesterol and decreased low density lipoprotein (LDL) cholesterol, and cigarette smoking is associated with lower HDL cholesterol and higher LDL cholesterol, there has been speculation that the protective effect of moderate alcohol consumption and/or the noxious effect of cigarette smoking for cardiovascular disease might be mediated in large part by a lipoprotein mechanism. The authors examined this question in a prospective study of 7,461 men and women in 10 North American populations initially seen in 1972-1976 and followed for an average of 8.5 years. Moderate alcohol consumption was weakly protective for cardiovascular disease, while cigarette smoking was strongly and significantly associated with cardiovascular disease mortality. As expected, LDL cholesterol was positively related and HDL cholesterol was inversely related to cardiovascular disease mortality. However, multivariable analysis of cardiovascular disease mortality alternately excluding and including HDL cholesterol and LDL cholesterol as covariates indicated that the effect of alcohol consumption on cardiovascular disease mortality was independent of an LDL cholesterol pathway and only partially mediated by an HDL cholesterol pathway, while the effect of cigarette smoking was independent of both the HDL cholesterol and LDL cholesterol pathways, suggesting alternative biologic mechanisms of action for both alcohol consumption and cigarette smoking on cardiovascular disease.     

我国体检人群不良生活方式与代谢指标异常的相关分析

目的了解我国体检人群不良生活方式和代谢指标异常之间的关系。方法收集全国65家体检机构2009年169251人次的体检数据,分析吸烟、运动、饮酒与空腹血糖和血脂异常之间的关系。结果体检人群的吸烟率、运动率、过量饮酒率分别为37．2％、42．8％、25．9％。吸烟、缺少运动、过量饮酒对体检人群空腹血糖和血脂的水平有明显影响,可增加或降低相应指标的异常率。比如男性体检人群吸烟组血糖正常检出率仅为85．1％,而不吸烟组血糖正常检出率为88．0％,两组差异有统计学意义。结论吸烟、缺少运动、过量饮酒等不良生活方式对我国体检人群空腹血糖和血脂水平有明显影响。戒烟、限酒、增加体力活动有利于体检人群控制空腹血糖和血脂水平,降低心血管疾病的发病风险。     

Associations of job strain and working overtime with adverse health behaviors and obesity: evidence from the Whitehall II Study, Helsinki Health Study, and the Japanese Civil Servants Study

Adverse health behaviors and obesity are key determinants of major chronic diseases. Evidence on work-related determinants of these behavioral risk factors is inconclusive, and comparative studies are especially lacking. We aimed to examine the associations between job strain, working overtime, adverse health behaviors, and obesity among 45-60-year-old white-collar employees of the Whitehall II Study from London (n=3,397), Helsinki Health Study (n=6,070), and the Japanese Civil Servants Study (n=2,213). Comparable data from all three cohorts were pooled, and logistic regression analysis was used, stratified by cohort and sex. Models were adjusted for age, occupational class, and marital status. Outcomes were unhealthy food habits, physical inactivity, heavy drinking, smoking, and obesity. In London, men reporting passive work were more likely to be physically inactive. A similar association was repeated among women in Helsinki. Additionally, high job strain was associated with physical inactivity among men in London and women in Helsinki. In London, women reporting passive work were less likely to be heavy drinkers and smokers. In Japan, men working overtime reported less smoking, whereas those with high job strain were more likely to smoke. Among men in Helsinki the association between working overtime and non-smoking was also suggested, but it reached statistical significance in the age-adjusted model only. Obesity was associated with working overtime among women in London. In conclusion, job strain and working overtime had some, albeit mostly weak and inconsistent, associations with adverse health behaviors and obesity in these middle-aged white-collar employee cohorts from Britain, Finland, and Japan.     

Life-style intervention at the worksite--reduction of cardiovascular risk factors in a randomized study

OBJECTIVES: This study tested a feasible method for screening for cardiovascular risk at the worksite and investigated the effects of a long-term comprehensive program of life-style intervention to prevent cardiovascular disease. METHODS: Employees in the public sector filled out a self-administered questionnaire with questions on social, medical, and work-related factors. The respondents numbered 454 (80%). A score sum for cardiovascular risk was calculated (range 1-20, median 7.0), and the 128 subjects with a sum above 8 were invited to a health examination including blood sampling. Thereafter the subjects were invited to participate, following randomization, in a comprehensive, 18-month, life-style intervention program to improve cardiovascular risk or in a control group. RESULTS: The intervention group significantly decreased body mass index, diastolic blood pressure, heart rate, low-density lipoprotein (LDL) cholesterol, and smoking habits during the intervention. The initially elevated serum cortisol, as a marker of stress reaction, normalized in the intervention group. In the control group LDL cholesterol also decreased, but the glucose and triglyceride levels increased, and smoking habits were unchanged. Sick days for a given period decreased after 1 year in the intervention group but not in the control group. CONCLUSIONS: Several cardiovascular risk factors can be improved and morning serum cortisol normalized during a long-term life-style intervention program with a randomized design using a worksite population of middle-aged subjects. The use of a 2-step screening program, with an initial questionnaire followed by a health check of subjects with elevated risk, is feasible for worksite settings.     

山东省农村居民健康行为及影响因素分析

目的 调查山东省农村居民健康行为并分析其影响因素。方法 采用分层随机抽样方法,对山东省3个县(县级市)≥25岁居民进行健康行为问卷调查。结果 本次共调查1600名农村居民,吸烟者占26.9%,饮酒者占27.9%,参加体育锻炼者占55.1%,饮食规律者占74.3%,定期健康体检者占92.3%;多因素logistic回归分析结果显示,性别是影响吸烟、饮酒和体育锻炼的主要因素,年龄是影响体育锻炼、合理饮食和健康体检的主要因素,人均月收入是影响合理饮食的主要因素。结论 山东省农村居民健康行为与性别、年龄、人均月收入有关,应针对影响因素采取相应措施,促使其形成正确的健康观念和健康行为。     

The effects of a health promotion program on physical, mental, and dietetic health status in climacteric women

PURPOSES: The purpose of this study was to evaluate the effects of a six months health promotion program on physical and mental health status assessments in climacteric women. METHODS: Seventy-two women, with a mean (+/- SD) age of 51.3 (+/- 3.1 yr.), body weight of 51.5 (+/- 6.3 kg), and Body Mass Index of 22.4 (+/- 2.4 kg/m2), residing in Tokyo Metropolitan area, participated as subjects in a health promotion program, completing health status assessments. Health promotion was performed once a week, two hours per session, sixteen times. The lecture and exercise program, in the first half, included basic information on diet, exercise and relaxation, and prevention of life-style related disease, and instructions for walking exercise, dancing, and dumbbell exercise. In the latter half, they performed extended walking, stretching, and autogenic training for relaxation. Healthy foods were also supplied. Before and after the program, health status was assessed, with a general medical health check, a questionnaire regarding nutrition, exercise and relaxation activities, and determination of dietary intake based on food records, eating behavior, complaints (CMI, Nichidai stress score) and physical activity levels. RESULTS: After the six months of the program: 1) Total cholesterol levels had decreased significantly, along with both systolic and diastolic blood pressure, body weight and BMI; 2) Major nutrient intake, density of nutrients and eating behavior were improved, with decrease in daily salt intake, and increase significant in daily energy expenditure; 3) Stress scores by the Nichidai stress check were decreased significantly, subjects with higher stress scores at the beginning of programs having marked change, and neurotic tendencies were decreased in CMI categories II-IV. CONCLUSION: These results suggest that, in order to maintain and/or improve the QOL of climacteric women, good dietary habits and physical activities, such as walking, and psychological support are essential. Further long-term investigations of larger populations (middle-aged to elderly) are now necessary.     

Race/ethnic differences in adult mortality: the role of perceived stress and health behaviors

We examine the role of perceived stress and health behaviors (i.e., cigarette smoking, alcohol consumption, physical inactivity, sleep duration) in shaping differential mortality among whites, blacks, and Hispanics. We use data from the 1990 National Health Interview Survey (N = 38,891), a nationally representative sample of United States adults, to model prospective mortality through 2006. Our first aim examines whether unhealthy behaviors and perceived stress mediate race/ethnic disparities in mortality. The black disadvantage in mortality, relative to whites, closes after adjusting for socioeconomic status (SES), but re-emerges after adjusting for the lower smoking levels among blacks. After adjusting for SES, Hispanics have slightly lower mortality than whites; that advantage increases after adjusting for the greater physical inactivity among Hispanics, but closes after adjusting for their lower smoking levels. Perceived stress, sleep duration, and alcohol consumption do not mediate race/ethnic disparities in mortality. Our second aim tests competing hypotheses about race/ethnic differences in the relationships among unhealthy behaviors, perceived stress, and mortality. The social vulnerability hypothesis predicts that unhealthy behaviors and high stress levels will be more harmful for race/ethnic minorities. In contrast, the Blaxter (1990) hypothesis predicts that unhealthy lifestyles will be less harmful for disadvantaged groups. Consistent with the social vulnerability perspective, smoking is more harmful for blacks than for whites. But consistent with the Blaxter hypothesis, compared to whites, current smoking has a weaker relationship with mortality for Hispanics, and low or high levels of alcohol consumption, high levels of physical inactivity, and short or long sleep hours have weaker relationships with mortality for blacks.     

北京市丰台区老年人运动健身现状及相关因素分析

[目的]了解北京市丰台区老年人群的人口学状况、健康状况和生活习惯,并分析影响老年人群运动健身行为的因素,为指导老年人科学健身提供参考。[方法]采用《中国国民运动健身指导系统的研究与应用》的调查问卷,内容主要包括自然情况、健康状况、运动习惯、生活习惯和饮食习惯等5部分。[结果]145名受试对象中,均表现患有多种疾病的征象,老年男性的脂代谢异常、高血压病、骨关节病和肝病的发病情况与老年女性存在明显差异,并在睡眠时间、食欲状况和吸烟状况上存在显著差异。老年男性和女性体育人口所占比例分别为88.9%和85.7%。运动中有控制心率的男性与女性比例分别为27.6%和26.9%,有专业人员指导的男性与女性比例为10.3%和7.5%。经相关分析发现职业、文化程度和月人均生活费与体育锻炼行为存在紧密联系。[结论]北京丰台区老年人慢性病的发病率较高,参与健身锻炼的比率较高,以有氧运动为主,但缺少力量性练习,运动中缺乏科学指导。