Healing the Healer: Exploring UK-based doctors’ and nurses’ nutrition and dietary behaviours within the workplace
Creators: name: Sum, Kiu
Publisher: name: 1 University of Westminster
Year: 2024

description: Medical doctors and nurses (DNs) play a crucial role in the National Health Service (NHS), but their occupational demands can negatively affect their health. Shift work, common in the medical field, has been linked to various health issues for DNs, including sleep disturbances, weight gain, cognitive performance decline, and cardiovascular health concerns. Nutrition has been identified as a key factor in managing these risks. However, limited research has been conducted on the dietary intake and nutritional behaviour of DNs during shift work. This thesis aims to address this gap by exploring the current diet and nutritional practices and the impact of shift work on DNs’ food consumption and dietary behaviours using a mixed-method approach.

The qualitative study, conducted between 2020 – 2021, involved online semistructured interviews with practising DNs undertaking shift work (n=16) from various occupational grades and specialities across the UK. Thematic analysis was performed on the collected data. The findings demonstrate the detrimental impacts of shift work on DNs’ poor nutrition and health and wellbeing. Factors influencing DNs' diet during shifts are complex, with clinical responsibilities often being prioritised and at the forefront, thus often missing eating opportunities. Consequently, DNs frequently eat on the go. Hence, food accessibility and availability are significant in DNs’ dietary decisions. Caffeine consumption is common among DNs to sustain energy during shifts due to its easy accessibility and availability. Night shifts pose challenges for maintaining a healthy diet and often lead to DNs making unhealthy food choices. Despite these challenges, DNs highly value their meals after their shifts as their main meal of the day. Workplace culture, staff shortages, and limited access to food facilities outside standard hours are additional barriers to good workplace nutrition.

Building on the qualitative findings, a quantitative analysis using the UK Biobank dataset (n=5,777) was conducted to compare the differences in dietary intake among UK DNs with different shift work patterns. The results indicate limited consumption of fruits, vegetables, fish, and dietary fibre, while all DN shift workers have a high intake of meat, tea, coffee, and alcohol. The data reported a significant difference between doctors and nurses, with doctors consuming more than nurses in unprocessed red meat portions per week (2.176 ± 1.429 vs 2.053 ± 1.443) (p&lt;0.001), cups of coffee per day (1.57 ± 3.859 vs 1.30 ± 3.60) (p&lt;0.001), and overall alcohol intake per week (63.146g ± 48.570 vs 40.261g ± 48.242) (p&lt;0.001). Meanwhile, nurses had a higher average consumption than doctors in portions of fruit (2.840 ± 2.489 vs 2.657 ± 2.796) and vegetables (2.415 ± 2.036 vs 2.349 ± 2.104) (p&lt;0.001), cups of tea (3.14 ± 3.560 vs 2.18 ± 3.972) and water (2.60 ± 3.568 vs 1.40 ± 4.229) (p=0.000). Various shift work factors influence dietary intake, such as working hours, night shift length and frequency, and consecutive night shifts. Longer working hours and more night shifts were associated with poorer dietary behaviour, including reduced vegetable and meat intake but increased tea and coffee consumption. Between doctors and nurses, doctors consumed less fruit when working over 30 hours per week (p=0.037) and on consecutive (p=0.020) and night shifts (p=0.048). In other types of food, doctors consumed more than nurses in vegetables, meat, fish, milk, and coffee across different shift patterns. Whereas nurses consumed more water than doctors (p&lt;0.001) and when measured against the average length of night and consecutive night shifts (p=0.002)

This thesis provides novel and valuable insights into the dietary intake and nutritional behaviours of DNs during shift work. Findings underscore the need for DNs to prioritise good nutrition, particularly highlighting the importance of considering workplace factors, such as regulations and cultures, in improving workplace nutrition during shifts. Further research is warranted to explore effective strategies for supporting and promoting DNs' workplace nutrition through changes in the healthcare setting. But also explore how other confounding factors, such as sociodemographic factors and other health behaviours, may influence DNs’ dietary habits at work.