Meta-analysis based on work shifts.

BackgroundNurses as the largest group of health workers have a very stressful job which can cause number of diseases specially increase cardiovascular risk factors. This study aims to investigate the overall epidemiology of cardiovascular disease (CVD) risk factors among nurses.MethodWe searched all four main databases such as Scopus, PubMed, Embase and Web of Sciences from the beginning of 2000 to March 2022 with appropriate Mesh Terms. We also searched Google scholar. Then we applied inclusion and exclusion criteria and after selection the studies the Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of included studies. Comprehensive Meta-analysis and R software was used for analysis.ResultsFinally, 22 articles with a total number of 117922 nurses were included. Among all risk factors, sedentary lifestyle and lack of regular physical activity with a prevalence of 46.3% (CI 95%, 26.6–67.2) was regarded as the main prevalent risk factor among nurses. The mean systolic blood pressure (SBP) measured in the study population was 121.31 (CI 95%, 114.73–127.90) and the mean diastolic blood pressure (DBP) was 78.08 (CI 95%, 74.90–81.25). Also family history of cardiovascular disease (41.9%; 95% IC: 29.8–55.1%), being overweight (33.3%; 95% IC: 24.7–43.2%), and alcohol consumption (24.6%; 95% IC: 16.4–35.2%) was found among the participants.ConclusionStudy results revealed that sedentary lifestyle was the main prevalent CVD risk factor among nurses followed by family history of cardiovascular disease, being overweight and alcohol consumption. Furthermore, among nurses with shift works almost all risk factors got higher score representing the worse condition in comparison with day workers’ nurses. This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors.1. What was already known?In general, many studies have emphasized the impact of the nursing profession on the incidence of some cardiovascular patients. Also, different shifts of nurses can have a double effect.2. What are the new findings?In this study, the mean for sedentary lifestyle was reported to be 46.3% which represented the most prevalent risk factor for cardiovascular risk factors among study population.3. What is their significance?This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors. This information can comprise essential tools for health human resource management contributing to advance nursing.

背景 护理人员作为规模最大的医疗卫生工作群体，其工作负荷极高且压力巨大，可引发多种健康问题，尤其是会增加心血管疾病（Cardiovascular Disease, CVD）相关风险因素的暴露风险。本研究旨在调查护理人群中心血管疾病风险因素的整体流行病学特征。
方法 本研究检索了2000年初至2022年3月期间Scopus、PubMed、Embase、Web of Science四大核心数据库，辅以恰当的医学主题词（Mesh Terms），同时检索了Google Scholar。随后根据纳入与排除标准筛选文献，并采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale, NOS）对纳入研究的方法学质量进行评价。数据分析采用综合荟萃分析（Comprehensive Meta-analysis）软件与R软件完成。
结果 最终共纳入22项相关研究，涉及117922名护理人员。在所有心血管疾病风险因素中，久坐不动的生活方式与缺乏规律体育活动的患病率为46.3%（95%置信区间[CI]：26.6%~67.2%），是护理人群中最主要的流行风险因素。研究人群的平均收缩压（Systolic Blood Pressure, SBP）为121.31（95%CI：114.73~127.90），平均舒张压（Diastolic Blood Pressure, DBP）为78.08（95%CI：74.90~81.25）。此外，研究对象中存在心血管疾病家族史者占比41.9%（95%CI：29.8%~55.1%），超重者占比33.3%（95%CI：24.7%~43.2%），饮酒者占比24.6%（95%CI：16.4%~35.2%）。
结论 本研究结果显示，久坐不动的生活方式是护理人群中最主要的心血管疾病风险因素，其次分别为心血管疾病家族史、超重与饮酒行为。此外，相较于白班护理人员，轮班护理人员几乎所有心血管疾病风险因素的暴露水平均更高，健康状况更差。本研究明确了护理人群中心血管疾病相关风险因素的分布特征，可为制定干预方案提供依据，以降低护理人员尤其是轮班护理人员的心血管疾病风险因素暴露水平。
1. 现有研究基础 总体而言，既往多项研究已证实护理职业与部分心血管疾病发病风险之间存在关联，同时护士的不同排班模式也会对健康产生双向影响。
2. 本研究的新发现 本研究报道久坐不动生活方式的患病率达46.3%，是本研究人群中最主要的心血管疾病风险因素。
3. 本研究的研究意义 本研究明确了护理人群中心血管疾病相关风险因素的分布特征，可为制定干预方案提供依据，以降低护理人员尤其是轮班护理人员的心血管疾病风险因素暴露水平。该研究成果可作为卫生人力资源管理的重要工具，助力护理学领域的发展与进步。