Abstract
BackgroundUnhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population. The present study used a theoretical framework which summarises the many possible determinants of different health behaviours (the Theoretical Domains Framework; TDF) to systematically explore the most salient determinants of unhealthy eating and physical activity behaviour in hospital-based nurses.MethodsSemi-structured qualitative interviews based on the TDF were conducted with nurses (n = 16) to explore factors that behavioural theories suggest may influence nurses’ eating and physical activity behaviour. Important determinants of the target behaviours were identified using both inductive coding (of categories emerging from the data) and deductive coding (of categories derived from the TDF) of the qualitative data.ResultsThirteen of the fourteen domains in the TDF were found to influence nurses’ eating and physical activity behaviour. Within these domains, important barriers to engaging in healthy eating and physical activity behaviour were shift work, fatigue, stress, beliefs about negative consequences, the behaviours of family and friends and lack of planning. Important factors reported to enable engagement with healthy eating and physical activity behaviours were beliefs about benefits, the use of self-monitoring strategies, support from work colleagues, confidence, shift work, awareness of useful guidelines and strategies, good mood, future holidays and receiving compliments.ConclusionsThis study used a theory-informed approach by applying the TDF to identify the key perceived determinants of nurses’ eating and physical activity behaviour. The findings suggest that future efforts to change nurses’ eating and physical activity behaviours should consider targeting a broad range of environmental, interpersonal and intrapersonal level factors, consistent with a socio-ecological perspective.
Highlights
Unhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population
Reporting of the study follows the relevant sections of the consolidated criteria for reporting qualitative research (COREQ) [26]
Six Theoretical Domains Framework’ (TDF) domains were perceived as important barriers to eating and physical activity behaviour: “Environmental context and resources”, “memory, attention and decision processes”, “emotion”, “beliefs about consequences”, “behavioural regulation” and “social influences”
Summary
Unhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population. The present study used a theoretical framework which summarises the many possible determinants of different health behaviours (the Theoretical Domains Framework; TDF) to systematically explore the most salient determinants of unhealthy eating and physical activity behaviour in hospital-based nurses. To develop a theory-based intervention, the targets for intervention, that is the major determinants of the behaviours in question, must be identified. Determinants are factors that affect the nature or expression of a behaviour and can hinder or enable behaviour change. They are frequently referred to as barriers and enablers [17]. Possible barriers and enablers of weight-related behaviours in nurses are identified through systematic application of the TDF. In a study of 394 Icelandic nurses, exhaustion and lack of time were reported as barriers to nurses’ physical activity [20]
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