BARRIERS AND FACILITATORS TO ENGAGING IN HEALTH PROMOTING BEHAVIORS AMONG NURSES IN AN URBAN SETTING: A MIXED-METHOD STUDY
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ABSTRACT The purpose of this study was to assess the prevalence of health-promoting behaviors among nurses and to examine the barriers and facilitators to engaging in health-promoting behaviors. Health-promoting behaviors were defined as 1) having quit smoking or never having smoked; 2) engaging in at least 30 minutes of exercise 5 days a week; 3) consuming at least 5 servings of fruits and vegetables daily; and 4) maintaining their Body Mass Index (BMI) within healthy range. The independent variables, including barriers (work-related stress, shift work), facilitators (social support, hardiness), and other factors (self-efficacy, intention, planning and individual characteristics), were identified from the conceptual framework, Health Action Plan Approach (HAPA), and measured in a survey filled out by 236 bedside nurses (8.7% response rate) at a urban hospital setting. The independent variables were examined in their relationship with the dependent variables listed above and tested by using chi-squares, correlations, and a series of multiple logistical regression analyses. In addition, this study conducted 4 focus groups, where the participants were invited only from the survey participants who agreed to be contacted for further study. With a total N of 14 (12.7% response rate), content analysis was utilized on the transcribed focus group interviews and categories emerged to illustrate nurses’ view on nurses engaging in health promoting behaviors. There were statistically significant positive associations seen with some of the antecedent variables (self-efficacy, planning, social support, hardiness) and health-promoting behaviors. From the focus group interviews, 12 hour shifts and work-related stress are two of the themes that emerged as being barriers to nurses engaging in health-promoting behaviors. From the findings, workplace programs along with social support found at work may be successful in helping nurses lose weight or stop smoking. Future research may explore the concept of hardiness and other possible unique traits that nurses may have as a protective factor to healthy lifestyle.