Aim
Associations between sleep duration and obesity and between obesity and chronic illness are established. Current rates of obesity for all Australian people are rising. Recent reports indicate ...that high body mass index (BMI) is a leading contributor to overall burden of disease for Indigenous Australians. Understanding the factors that contribute to higher rates of obesity in Indigenous people is critical to developing effective interventions for reducing morbidity and premature mortality in this population. To explore the effect of sleep duration on the relationship between Indigenous status and BMI in Australian children.
Methods
716 non‐Indigenous and 186 Indigenous children aged 5–12 years in the Australian Health Survey 2011–2013. Primary carers were interviewed regarding children's sleep times; BMI was derived from measurement.
Results
Analysis of covariance revealed that regardless of a number of demographic and socio‐economic status markers, sleep duration and Indigenous status were independent predictors of BMI. However when both predictors were considered together, only sleep duration remained predictive of BMI.
Conclusions
Sleep duration plays an important mediating role in the relationship between Indigenous status and BMI in this Australian sample. Modification of sleep duration for Indigenous children may lead to longer‐term positive health outcomes.
Objectives
To explore if there are differences in shift patterns and work‐related factors between metropolitan and regional/rural healthcare shift workers and their risk of poor sleep and mental ...health. Furthermore, explore whether these factors impact on medical errors, workplace and car/near car accidents.
Design
A cross‐sectional study.
Setting
An anonymous online survey of healthcare shift workers in Australia.
Participants
A total of 403 nurses, midwives and paramedics completed the survey.
Main outcome measures
Sample characteristics, employment location, shift work‐related features, sleep and mental health measurements, workplace accidents, medical errors and car/near car accident post shift.
Results
Regional/rural healthcare shift workers were significantly older, had more years' experience, worked more nights, on‐call and hours per week. Those in metropolitan areas took significantly longer (minutes) to travel to work, had higher levels of anxiety, increased risk of shift work disorder, reported significantly more workplace accidents and were more likely to have a car/near car accident when commuting home post shift. Both groups reported ~25% having a medical error in the past year. Workplace accidents were related to more on‐call shifts and poor sleep quality. Medical errors were associated with fewer years' experience, more evening shifts and increased stress. Car accidents were associated with metropolitan location and increased depression.
Conclusion
Differences in work‐related factors between metropolitan and regional/rural healthcare shift workers were observed. Some of these factors contributed to occupational health and safety risks. Further exploration is needed to understand how to reduce occupational health and safety risks, and improve employee and patient safety both in both regional/rural and metropolitan areas.
Abstract
Background
Associations between high BMI and sleep duration and chronic illness are recognised. Short sleep is an accepted predictor of high BMI for children, including Indigenous Australian ...children. Short sleep has also been associated with high BMI in Australian adults, although not specifically in Indigenous Australian adults. This study aims to determine whether the relationship between sleep duration and BMI observed in non-Indigenous adults holds for Indigenous adults.
Methods
Data collected from 5204 non-Indigenous and 646 Indigenous participants aged over 18 years in a nationally representative Australian Health Survey 2011–2013 were analysed. Sleep duration was self-reported as the time between going to bed and time waking up; BMI was derived from measurement and categorised into normal weight (BMI = 18.5–24.9) and overweight/obese (BMI ≥ 25). Logistic regression was performed for the non-Indigenous and Indigenous groups separately to examine the association between sleep duration and BMI in each group.
Results
Proportionally more Indigenous people were classified as overweight/obese than non-Indigenous (χ
2
= 21.81,
p
< 0.001). Short sleep was reported by similar proportions in both groups (Indigenous 15% vs non-Indigenous 17%) whereas long sleep of > 9 h was reported by proportionally more Indigenous than non-Indigenous people (41% vs 26%). Without accounting for possible confounders, the association between sleep duration and BMI for the Indigenous group was not significant but a possible dose-response relationship was evident, with the odds of overweight/obesity being greatest for those who typically slept < 7 h (OR = 1.77, 95% CI 0.38–3.94) and < 6 h (OR = 1.55, 95%CI = 0.58–4.14). The same model for the non-Indigenous group was significant, with the odds of overweight/obesity being greatest for those who typically slept < 6 h (OR = 1.67, 95%CI 1.25–2.25). The risk of overweight/obesity diminished for both groups with sleep > 7 h. Accounting for a range of socioeconomic and personal confounders attenuated the strength of these relationships marginally.
Conclusion
Adding to reports relating sleep duration and BMI for Australian adults, this study provides evidence for an inverse relationship in non-Indigenous adults and suggests a similar trend for Indigenous adults. This trend was non-significant but is consistent with previous results for Indigenous children.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
Associations between short sleep duration and obesity and the relationship between obesity and chronic illness are well documented. Obese children are likely to become obese adults. To date, ...there is a paucity of information regarding sleep duration and quality for Indigenous Australian people. It may be that poor‐quality, short sleep is contributing to the gap in health outcomes for Indigenous people compared with non‐Indigenous adults and children. This study sought to investigate the possibility that poor sleep quality may be contributing to health outcomes for Indigenous children by exploring associations between sleep duration and body mass index (BMI).
Methods
Participants included 1253 children aged 7–12 years in Wave 7 of the national Longitudinal Study of Indigenous Children survey. Interviewers asked primary carers about children's sleep times. BMI was derived from measurements of children made by researchers.
Results
Regardless of age, relative socio‐economic disadvantage and level of remoteness, unhealthy weight was associated with less sleep duration than healthy weight for Indigenous children.
Conclusion
The relationship between short sleep duration and BMI in Indigenous children has important implications for their future health outcomes. Both overweight conditions and short sleep are established modifiable risk factors for metabolic dysfunction and other chronic illnesses prominent in the Indigenous population. It is important to consider strategies to optimise both for Indigenous children in an attempt to help ‘close the gap’ in health outcomes and life expectancy between Indigenous and non‐Indigenous people.
Overweight/obesity is a well-defined risk factor for a variety of chronic cardiovascular and metabolic diseases. Sleep duration has been associated with overweight/obesity and other cardio metabolic ...and neurocognitive problems. Notably, overweight/obesity and many of the associated comorbidities are prevalent in Indigenous Australians. Generally, sleep duration has been associated with BMI for Australian adults but information about Australian Indigenous adults' sleep is scant. A recent report established that sleep is a weak predictor of obesity for Indigenous Australian adults.
To determine whether sleep remains a predictor of obesity when physical activity, diet and smoking status are accounted for; and to determine whether sleep duration plays a mediating role in the relationship between Indigenous status and BMI.
Statistical analyses of 5,886 Australian adults: 5236 non-Indigenous and 650 Indigenous people aged over 18 years who participated in the Australian Health Survey 2011-2013. Demographic and lifestyle characteristics were described by χ2 and t-tests. ANOVA was used to determine the variables that significantly predicted BMI and sleep duration. Stepwise regression analyses were performed to determine the strongest significant predictors of BMI. Sleep duration was self-reported; BMI was calculated from measurement.
The study revealed two main findings: (i) short sleep duration was an independent predictor of obesity (adjusted-R2 = 0.056, p <0.0001); and (ii) controlling for sleep duration and other possible confounders, Indigenous status was a significant predictor of BMI overweight/obesity. Sleep duration played a weak, partial mediator role in this relationship. Increased BMI was associated with lower socioeconomic status and level of disadvantage of household locality for non-remote Indigenous and non-Indigenous people.
Indigenous status strongly predicted increased BMI. The effect was not mediated by the socioeconomic indicators but was partially mediated by sleep duration.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aims
To understand the benefits and challenges of shift work, and the coping strategies used by nurses, midwives and paramedics to manage the impact of shift work on sleep and fatigue from shift ...work.
Design
A single case study with embedded units.
Methods
Twenty‐seven participants were interviewed exploring their shift work experiences, coping strategies used to improve sleep, and what their recommendations are for improving shift work management. Interviews were completed between November and December 2022.
Results
Participants enjoyed the lifestyle, flexibility and financial rewards offered by working shift work. However, fatigue and sleep deprivation undermined these benefits, as it impacted their ability to enjoy social and family events. There were also concerns of long‐term health consequences of shift work and delivery of care. Changes to rostering practices and sleep and shift work education were common recommendations.
Conclusion
This study provides insights on how healthcare professionals manage sleep and fatigue due to shift work and the inadequate support. There is absence of adequate policies, processes and training at an organizational, academic and personal level on how to best manage sleep and fatigue when working shift work. Future research is needed to explore how to equip healthcare shift workers with the skills to successfully manage their schedules to mitigate the negative impact that poor sleep and fatigue has on the health and safety of themselves and their patients.
Implications for the Profession and/or Patient Care
Understanding the specific challenges of shift work and how workers manage their shift work schedules is critical for improving the health and safety of themselves and their patients. This study identified that there is insufficient training regarding sleep and shift work management strategies, potentially leading to occupational health and safety concerns. Further education and training to equip staff with the necessary information, training and guidance to staff on how to reduce fatigue risk is required.
Patient or Public Contribution
This study involved healthcare shift workers in semi‐structured interviews. Data gathered from a previous survey that participants were involved in helped shape the interview topics and the study design.
The complexities surrounding the health and wellbeing of rural and remote communities are often exacerbated by the limited access to healthcare resources and infrastructure compared with their urban ...counterparts.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Implementing appropriate shift work schedules can help mitigate the risk of sleep impairment and reduce fatigue of healthcare workers, reducing occupational health and safety risks. In Australia, the ...organisation has a responsibility to make sure all reasonable measures are taken to reduce fatigue of staff. Therefore, it is important to assess what the current rostering processes is for staff responsible for creating the rosters for nurses.
The aims of the project were to understand (1) who creates the rosters and what the process is, (2) what training and knowledge these staff have in establishing rostering schedules that optimise the sleep and wellbeing of staff, and (3) what the benefits and limitations are of current rostering practices.
Findings were generated through semi-structured interviews, using cluster coding to form categories. Twenty four nurses responsible for rostering staff were interviewed from three different sites in Victoria (one metropolitan and two regional/rural hospitals). Data was analysed using selected grounded theory methods with thematic analysis.
The common themes that came out of the interviews were that rostering staff were under prepared, unaware of fatigue and safety guidelines and polices from governing bodies and had not received any education or training before taking on the role. The most common rostering style was self-rostering, where staff could submit preferences. However, there were concerns about staff fatigue but were divided as to who should be responsible, with many saying it was up to staff to preference shifts that they could cope with. The final theme was cultural barriers to change.
While self-rostering resulted in staff having more freedom and flexibility, shift preferences may be influenced more so by a need to fit with lifestyle rather than to minimise fatigue and increase safety in the workplace. Greater consideration of the impact of shift work schedules on fatigue is required to ensure that the layers of clinical governance in health care organisations minimise the risk of occupation health and safety issues for employees delivering direct patient care.
Poor medication management may contribute to the increased morbidity and mortality of Aboriginal people in Australia. Yet while there is extensive literature about the perceptions of healthcare ...providers on this issue, there is limited information on the perceptions of Aboriginal people themselves.
To investigate the perceptions of a group of Aboriginal people attending a Victorian regional Aboriginal Health Service (AHS) with diagnosed medical conditions requiring medications, of their lifestyle, disease management and medication usage.
Data was collected through one to one in depth interviews using a semi-structured 'yarning' process. Twenty patients were invited to participate in the study and were interviewed by Aboriginal Health Workers in a culturally appropriate manner. The interviews were recorded and transcribed verbatim. The data were analysed using descriptive statistics.
Our results show that the majority of participants perceived that changes in lifestyle factors such as diet, exercise, and smoking cessation would help improve their health. Most patients reported having been counselled on their medicines, and while the majority reported adherence and acknowledgement of the efficacy of their medicines, there was a lack of clarity regarding long term maintenance on regimens. Finally, while the majority reported taking over the counter products, some did not see the need to inform their doctor about this, or chose not to.
Chronic illness was perceived as common in families and community. Patients relied mostly on their health care professionals as sources for their drug information. Patients may have benefited from further counselling in the area of complementary and other over the counter medicines, as well as on the necessity of maintenance of regimes for chronic disease management. Finally, lifestyle changes such as dietary improvements and smoking cessation were identified as areas that may assist in improving health outcomes.
Overweight/obesity is a well-defined risk factor for a variety of chronic cardiovascular and metabolic diseases. Sleep duration has been associated with overweight/obesity and other cardio metabolic ...and neurocognitive problems. Notably, overweight/obesity and many of the associated comorbidities are prevalent in Indigenous Australians. Generally, sleep duration has been associated with BMI for Australian adults but information about Australian Indigenous adults' sleep is scant. A recent report established that sleep is a weak predictor of obesity for Indigenous Australian adults. To determine whether sleep remains a predictor of obesity when physical activity, diet and smoking status are accounted for; and to determine whether sleep duration plays a mediating role in the relationship between Indigenous status and BMI. Statistical analyses of 5,886 Australian adults: 5236 non-Indigenous and 650 Indigenous people aged over 18 years who participated in the Australian Health Survey 2011-2013. Demographic and lifestyle characteristics were described by X.sup.2 and t-tests. ANOVA was used to determine the variables that significantly predicted BMI and sleep duration. Stepwise regression analyses were performed to determine the strongest significant predictors of BMI. Sleep duration was self-reported; BMI was calculated from measurement. The study revealed two main findings: (i) short sleep duration was an independent predictor of obesity (adjusted-R.sup.2 = 0.056, p <0.0001); and (ii) controlling for sleep duration and other possible confounders, Indigenous status was a significant predictor of BMI overweight/obesity. Sleep duration played a weak, partial mediator role in this relationship. Increased BMI was associated with lower socioeconomic status and level of disadvantage of household locality for non-remote Indigenous and non-Indigenous people. Indigenous status strongly predicted increased BMI. The effect was not mediated by the socioeconomic indicators but was partially mediated by sleep duration.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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