Overweight, Obesity and its Associated Factors among Nurses at Tertiary Care Hospitals Karachi

Overweight and obesity have been identi�ed as considerable health risks worldwide. Objective: To identify the prevalence of overweight, and obesity and its association with demographic variables among nurses. Methods: A cross-sectional analytical study was conducted at Dr. Ruth KM Pfau Civil Hospital and Dow University Hospital Karachi over a period of six months of periods from March to August 2019. A total of 299 subjects of both genders were approached by the non-probability convenient sampling method. Chi-square test was applied to identify the associated factors. P-value ≤ 0.05 counted as signi�cant. Results: Out of 299, half of the study nurses 149 (49.8%) were male. Among 299 participants, 75 (25.1%) of them were overweight or obese. While 13 (4.3%) were underweight and 211 (70.6%) were normal weight. Mean age, working experience, and BMI were found 29.52 ± 8.568, 7.35 ± 6.177, and 23.30 ± 3.148 respectively of the study nurses. Gender (p-value=0.003), educational status (p-value=0.002), and nature of the job (p-value=0.003) of the participants were found statistically signi�cant with BMI. Conclusions: Present study concluded that the majority of study participants had normal BMI and a small number of study subjects were found obese. However, a quarter of nurses are recognized as overweight. Moreover, a signi�cant association was established between BMI with gender, the nature of the job, and the education of nurses.

disclosed that nurses primarily female nurses who work in night shift tend to be overweight or obese [4].In Kenya, the rate of overweight and obesity among healthcare workers was 35% and 28.4% [5]. It is established that overeating, stress, anxiety, and inactivity can lead to obesity [6]. Obesity has been recognized as an emerging health issue in both developing and developed countries [7]. World Health Overweight, Obesity and its Associated Factors

I N T R O D U C T I O N
Overweight and obesity have been identi ed as considerable health risks worldwide. Objective: To identify the prevalence of overweight, and obesity and its association with demographic variables among nurses. Methods: A cross-sectional analytical study was conducted at Dr. Ruth KM Pfau Civil Hospital and Dow University Hospital Karachi over a period of six months of periods from March to August 2019. A total of 299 subjects of both genders were approached by the nonprobability convenient sampling method. Chi-square test was applied to identify the associated factors. P-value ≤ 0.05 counted as signi cant. Results: Out of 299, half of the study nurses 149 (49.8%) were male. Among 299 participants, 75 (25.1%) of them were overweight or obese. While 13 (4.3%) were underweight and 211 (70.6%) were normal weight. Mean age, working experience, and BMI were found 29.52 ± 8.568, 7.35 ± 6.177, and 23.30 ± 3.148 respectively of the study nurses. Gender (p-value=0.003), educational status (p-value=0.002), and nature of the job (p-value=0.003) of the participants were found statistically signi cant with BMI. Conclusions: Present study concluded that the majority of study participants had normal BMI and a small number of study subjects were found obese. However, a quarter of nurses are recognized as overweight. Moreover, a signi cant association was established between BMI with gender, the nature of the job, and the education of nurses.

M E T H O D S
Organization (WHO) predicted that non-communicable diseases will cause the greatest number of deaths in Southeast Asia and the Western Paci c Region by the year 2020 [8]. The prevalence of obesity was reported in 40.3% India [9]. In Bangladesh, 39% of participants were found th overweight [10]. Pakistan is the 9 most obese nation in the world. Moreover, it is documented that around 26% of women in Pakistan suffer from the trouble of obesity while just 19% of the men are obese [11]. For a nurse, it is very necessary to maintain the quality and quantity of healthy life to achieve life's main goal [12]. Therefore, this research was performed to de ne the prevalence of obesity and its associated factors amongst nurses at Tertiary Care Hospitals, in Karachi.
This Cross-sectional analytical study was carried out at Dr. Ruth KM Pfau Civil Hospital Karachi (CHK) and Dow University Hospital (DUH) Karachi. The study was accomplished in six months of periods from March to August 2019. OpenEpi version 3.0 was used to calculate the sample size with the proportion formula. It was calculated by taking 26.4% of the prevalence of overweight and obesity [13], a 95% level of signi cance, and a 5% margin of error. The calculated sample was 299 subjects of both genders. Subjects were approached by a non-probability convenience sampling method. Both gender male and female nurses, who were registered by Pakistan Nursing Council (PNC) and had one-year working experience were included in the study. Study protocols were approved by the Institutional Review Board of Dow University of Health Sciences, Karachi. Data were entered and analysed by using SPSS version 21.0. Quantitative variables like age, working experience, and BMI were presented with mean ± standard deviation. While, data of qualitative variables such as gender, marital status, religion, educational status, hospital, nature of the job, and shift duty were presented in frequency and percentages. Moreover, the Chi-square test was applied to determine an association between designation, gender, age, working experience, educational status, hospital, religion, marital status, duty shift, and nature of the job with the outcome variable. P-value ≤ 0.05 was considered as signi cant. Data Collection Tool: Adapted, validated tool was used for data collection. It was adapted from the previously published study conducted by Aryee et al.,in Ghana [13]. The written permission of using the questionnaire was granted.
nurses or team leaders of the duty shift. Approximately half of the study nurses 149 (49.8%) were male. Almost half 154 (51.5%) were unmarried. Three fourth 227 (75.9%) of the study subjects were Muslims. Two-thirds of 193 (64.9%) of the participants had an education or diploma in nursing. Out of 299 participants, 75 (25.1%) of them were overweight or obese. While 13 (4.3%) were underweight, and 211 (70.6%), were normal weight. Mean age, working experience, and BMI were found 29.52 ± 8.568, 7.35 ± 6.177, and 23.30 ± 3.148 respectively of the study nurses. ndings unveiled the majority of 114 (38.13%) females had normal BMI while 97 (32.44%) male subjects had normal BMI. Furthermore, 3 (1%) males and 10 (3.34%) females were found underweight. With respect to overweight, 42 (14.05) and 25 (8.36%) were male and female respectively. As for as obesity concern, a rare number of females 1 (0.33%) were obese whereas 7 (2.34%) males were obese.   Table 2 revealed the job and lifestyle-related questions from study participants. This table highlighted that the majority of nurses were working 6 days and 36 hours of duty per day. It is also noti ed that most (69.6%) nurses have time to sit during duty hours. One-third (63.5%) of the study subjects were also involved in some sort of activities like household etc along with duty. While only 77 (25.8%) were involved in the exercise. Mostly 122 (40.8%) nurses were using a motorbike as a conveyance for duty, whereas, a few 20 (6.7%) were using the car. A huge number of the participants 254 (84.9%), 263 (88%), and 200 (66.9%) were taking fruits and snacks, always eating breakfast and using supper/dinner respectively.  Table 3 showed the association of underweight, normal weight, overweight, and obesity with demographic variables. Gender variable was found statistically signi cant (p-value=0.003) with BMI. This table exhibits that male nurses are more overweight or obese as compared to female nurses. Moreover, the educational status of the participants was also found signi cant (p-value=0.002), diploma level nurses were found more obese as compared to a higher level of education. Overweight was also recorded as high in Dow University Hospital as compared to Civil Hospital; this variable is also statistically signi cant with BMI. Another variable that indicated a signi cant association with BMI was job nature (p-value=0.003). BMI recorded more than 25 in those nurses who were performing single jobs. The study concluded the majority of nurses had normal BMI and a small number of study nurses were found obese. However, a quarter of nurses are recognized as overweight. Furthermore, a signi cant association was established between BMI with gender, the nature of the job, and the education of nurses.  [19]. A very small number of female nurses 1 (0.33%) was found obese in this study. These ndings are contradicted by a study conducted in Saudi Arabia that established a large number of female nurses 30.6% were obese [20]. Additionally, the study conducted in Pakistan, showed 13.8% of female nurses were obese [14]. In another study, the author observed 27% of female nurses were obese [21]. Current study ndings showed a statistically signi cant association between BMI with gender (p-value= 0.003). This study's nding is consistent with previous research [22]. In addition, the present study results revealed a signi cant association between BMI with education (p-value= 0.002) and the nature of the job (pvalue =0.003). These study results are comparable with the study conducted in Peru, in which education and the nature of jobs had signi cant associations [23]. On the other hand, dissimilar results were found in the study conducted in China which unveiled that obesity was signi cantly associated with female gender, and fast-food intake [24].