title: Nurses' lifestyle behaviours, health priorities and barriers to living a healthy lifestyle: a qualitative descriptive study.
abstract: BACKGROUND
  Nurses have an increased risk for non-communicable diseases (NCDs), along with a high prevalence of obesity, poor eating habits and insufficient physical activity. The aim of this study was to determine the health concerns, health priorities and barriers to living a healthy lifestyle among nurses and hospital management staff from public hospitals in the Western Cape Metropole, South Africa.
  
  
  METHODS
  Participants were purposively sampled (n = 103), and included management personnel (n = 9), night shift (n = 57) and day-shift nurses (n = 36). Twelve focus groups (FGDs) were conducted with nursing staff to obtain insight into nurses' health concerns, lifestyle behaviours and worksite health promotion programmes (WHPPs). Seven key informant interviews (KII) were conducted with management personnel, to gain their perspective on health promotion in the worksite. Thematic analysis was used to analyse the data with the assistance of Atlas.ti Qualitative Data Analysis Software.
  
  
  RESULTS
  Night shift nurses frequently identified weight gain and living with NCDs such as hypertension as their main health concerns. Being overweight was perceived to have a negative impact on work performance. All nurses identified backache and exposure to tuberculosis (TB) as occupation-related health concerns, and both management and nurses frequently reported a stressful working environment. Nurses frequently mentioned lack of time to prepare healthy meals due to long working hours and being overtired from work. The hospital environment was perceived to have a negative influence on the nurses' lifestyle behaviours, including food service that offered predominantly unhealthy foods. The most commonly delivered WHPPs included independent counselling services, an online employee wellness programme offered by the Department of Health and wellness days in which clinical measures, such as blood glucose were measured. Nurses identified a preference for WHPPs that provided access to fitness facilities or support groups.
  
  
  CONCLUSIONS
  Public hospitals are a stressful work environment and shift work places an additional strain on nurses. The risk of NCDs and exposure to infectious disease remains a concern in this working population. Our findings highlight the need for WHPPs that support nurses in managing stress and transforming the work environment to facilitate healthy lifestyles.
authors.affiliation: UCT/MRC Research Unit for Exercise Science and Sports Science, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Lindokuhle P
authors.initials: LP
authors.lastname: Phiri
authors.affiliation: UCT/MRC Research Unit for Exercise Science and Sports Science, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Draper
authors.affiliation: UCT/MRC Research Unit for Exercise Science and Sports Science, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Estelle V
authors.initials: EV
authors.lastname: Lambert
authors.affiliation: UCT/MRC Research Unit for Exercise Science and Sports Science, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa ; Centre for Research on Exercise, Physical Activity and Health; School of Human Movement Studies, University of Queensland, Queensland, Australia.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Kolbe-Alexander
keywords: Lifestyle behaviours; Nurses’ health; Perceptions; Shift workers