Lifestyle health promotion interventions for the nursing workforce: a systematic review

Aims and objectives. Study aims were to identify the efficacy of lifestyle health promotion interventions intended to improve behavioural health risk factors and/or behavioural or clinical outcomes of working-age nurses. Background. Nurses constitute around half the health workforce but global shortages and an ageing profile challenge future supply. The occupational hazards and stresses of nursing are well known. Health promotion, possibly workplace-based, presents opportunities to safeguard the health of nurses. Design. This was a systematic review undertaken in line with guidance for reviews in health care. Methods. Seven electronic databases were searched from 20002011 and references of relevant papers. Two reviewers independently reviewed and critiqued retrieved papers and extracted data. Methodological features were described using the CONSORT checklists; risk of bias was assessed using the Cochrane Handbook classification. Results. With design inclusion criteria relaxed to include an uncontrolled trial, only three intervention studies were retrieved, from the United States, Canada and Taiwan. All had limitations and high risk of bias, but benefits were reported. Outcomes included fewer cigarettes smoked during the intervention period, down from mean (SD) 20 (8)12 (9) per day (p < 0.001); significantly reduced fat mass (0.68 vs. 0.07 kg; p = 0.028); and significant gains across a battery of fitness assessments. The paucity of work focused on nurses health behaviours was the important finding. Conclusion. The workplace is a potentially fruitful location for health promotion intervention but nurses have seldom been recognised as a target participant group. Given the international priority ascribed to nursing workforce retention, this is a missed opportunity for occupational health planning. Potential benefits to nurses welfare and well-being may accrue from well-designed intervention studies. Relevance to clinical practice. Nurse leaders have a key role in driving recognition, spearheading commitment and development of targeted, whole-organisation programmes to promote health profile improvement for the nursing workforce.