BACKGROUND: A quantitative comfort model will aid in evaluating comfort levels of various target groups before the actual flight of an airplane. However, constructing the model is always a challenge due to the complexity of the phenomenon. OBJECTIVES: In this paper, we present quantitative comfort models to predict the (dis)comfort of passengers flying with turboprops based on objective measures. METHODS: Ninety-seven participants took part in two experiments conducted during real flights, during which forty of them had environmental and personal factors recorded using (self-developed) measurement tools. The collected data were analyzed to model the relations between objective measures and subjective feelings. RESULTS: Two preliminary models based on gradient boosting regression were developed. The models were able to predict the changes in comfort and discomfort of individual passengers with an accuracy of 0.12±0.01 and 0.21±0.01 regarding normalized comfort and discomfort scores, respectively. Additionally, contributions of different factors were highlighted. CONCLUSION: The outcomes of the models show that we took a step forward in modeling the human comfort experience using objective measurements. Anthropometry (including age), seat positions, time duration, and row (noise) emerged as leading factors influencing the feeling of (dis)comfort in turboprop planes.
BackgroundThe construction industry sector has one of the highest rates of workplace accidents and injuries. The workers are frequently exposed to hazardous working conditions including heavy physical workloads, unsafe environments, and inadequate use of personal protective equipment. These risks are exacerbated by informal employment, temporary work arrangements, and the growing number of migrant workers. A strong safety culture and positive attitudes toward occupational health and safety are crucial for preventing workplace accidents and improving working conditions.ObjectivesThis study aimed to evaluate the attitudes of construction workers toward occupational health and safety at a construction site in a rural area of western Türkiye.MethodsThis study employed a mixed methods approach. Quantitative data were collected from 372 workers using a safety culture scale and questionnaire on sociodemographic characteristics and working conditions. Qualitative data was obtained from 13 workers through in-depth interviews.ResultsMean safety culture score was 5.40 ± 0.88. Linear regression analysis revealed that having health insurance, performing heavy physical work, and using personal protective equipment were significantly associated with higher safety culture scores. The qualitative analysis revealed seven themes: perceived risks in the working environment and related risk factors, occupational health and safety training, precautions for occupational safety, individual precautions, experiences of occupational accidents, work schedules and individual factors, and motivation and rewards.ConclusionsThese findings may help guide interventions aimed at improving occupational health and safety, and reducing accidents in the construction sector.
BackgroundIndustrial environments face significant risks due to hazardous materials, machinery, and complex supply chains. Effective emergency preparedness is essential for minimizing human, environmental, and economic impacts during crises.ObjectiveThis study develops a comprehensive tool to assess emergency preparedness in industrial settings that integrates expert insights with quantitative analysis.MethodsThe study was conducted in four phases. A three-round Delphi study involved 24 subject matter experts (SMEs). Content validity was assessed using the content validity index (CVI) and content validity ratio (CVR). The fuzzy analytic hierarchy process (FAHP) was applied to assign weights to the dimensions and factors. SMEs also participated in validating the final tool. Cronbach's alpha was calculated to evaluate internal reliability.ResultsThe Delphi process identified eight dimensions and 40 key factors. The training & competency dimension received the highest weight (0.200), followed by exercises/drills/simulations (0.131) and risk assessment & hazard identification (0.125). Low inconsistency rates (maximum consistency ratio (CRm) = 0.002, geometric consistency ratio (CRg) = 0.007) confirmed the robustness of expert feedback. The CVI values for all 200 items exceeded 0.79, confirming their relevance, while CVR values were above 0.37, demonstrating good reliability (Cronbach's alpha = 0.81). The tool validation process, which includes expert consensus and psychometric testing, confirms its effectiveness for practical application.ConclusionThe developed tool provides a scientifically reliable, and comprehensive framework for assessing emergency preparedness in industrial environments. Future research should aim to extend the tool's validation to additional industrial sectors and integrate technological advancements to enable real-time data analysis and decision-making.
BackgroundOne of the barriers women face in participating in the workforce is reproductive health issues.ObjectiveThis study was conducted to investigate the experiences of women when they encounter reproductive health issues in the workplace.MethodsThe sample comprised 15 women who had experienced a women's health condition within the past 2 to 12 months and were employed in income-generating positions. Data were collected through a semi-structured interview format, with interviews conducted individually via videoconference using an in-depth interview approach. The data were analyzed using inductive thematic analysis following Braun and Clarke's six-step framework.ResultsThe data collected from their statements were categorized into several themes: awareness of women's health, approaches to women's health problems at work, colleagues' attitudes toward these issues, and the gender of managers regarding women's health concerns. The findings revealed that training programs aimed at improving women's health were not organized in workplaces. In situations affecting women's health, such as pregnancy, childbirth, and infertility treatment, managers generally exhibited positive attitudes. However, there was a lack of understanding regarding conditions that are not outwardly visible, such as dysmenorrhea and ovarian cysts, which led to restrictions on taking leave. Women expressed that they would feel more comfortable addressing women's health issues and would be more likely to take leave if they worked under a female manager.ConclusionsThere is a prevailing belief that women's health issues should not be shared, particularly when working with a male manager. Participants' experiences suggest that female managers may facilitate safer communication around reproductive health concerns; however, supportive institutional policies, rather than manager gender alone, are likely more critical for sustainable change.
BackgroundThe rise of digital platforms and algorithmically-managed labour is reshaping traditional understandings of job quality, safety, and wellbeing.ObjectiveThis study examines how human and non-human factors shape immigrant workers' perceptions and experiences of safety and wellbeing in the platform economy of Metro Vancouver, Canada.MethodsGuided by a sociotechnical lens, the study employed a focused ethnographic design, drawing on content analysis of twenty-one policy-relevant documents and thirty semi-structured interviews with immigrant platform workers.ResultsAnalysis of policy documents and interview data identified three interconnected themes shaping platform workers' safety and wellbeing. The first theme, Misclassification Dilemma in the Context of Algorithmic Management, shows how ambiguous employment status and opaque algorithmic control conceal subordination, limit recourse, and undermine job quality and psychosocial wellbeing. The second theme, Empowered Yet Exposed, captures the paradox in which perceived autonomy and flexibility co-exist with physical risk, stress, and regulatory uncertainty and inconsistency, leaving workers unevenly protected. The third theme, Safety Overlooked and Migrant Frame Overused, demonstrates that immigrant platform workers face heightened safety and wellbeing risks shaped by socially and technologically mediated forms of marginalization, while migrant-focused policy framings obscure safety and wellbeing gaps affecting the broader platform workforce.ConclusionThese findings underscore the need to move policy and scholarly debates beyond a narrow focus on ride-hailing and food delivery to address the diverse forms of platform work and the sociotechnical conditions shaping workers' safety and wellbeing across platforms.
BackgroundManaging an affiliated private hospital through various hospital groups in Thailand may increase job stress among health workers and support staff.ObjectivesTo determine the prevalence and identify the factors affecting job stress among 2242 health workers and support staff in an affiliated private hospital in Thailand.MethodsThis cross-sectional analytical study included, via convenience sampling, health workers and support staff who worked at seven hospitals of an affiliated private hospital located in the Bangkok Metropolitan Region (BMR) and the Eastern Economic Corridor (EEC) of Thailand. Online-based questionnaires about personal and working factors and the Thai version of the job content questionnaires (Thai-JCQ) were used as research instruments. Descriptive statistics were used to explain personal and working factors and determine the prevalence of job stress. Multiple logistic regressions were used to identify the factors affecting job stress among health workers and support staff.ResultsAbout 16.01% of the participants experienced job stress. The results of multiple logistic regressions showed that gender, age, educational level, sufficiency of income, hospital location, working hours per week, shift work, physical job demand, social support, and hazards at work were the factors affecting job stress among health workers and support staff.ConclusionRelevant private hospital groups may utilize the findings of this study to develop a sustainable system of job stress management for health workers and support staff by emphasizing the significance of personal and working factors.
BackgroundThe theoretical framework of the study draws on Self-Determination Theory (SDT), Job Demands-Resources (JD-R) theory, and Conservation of Resources (COR) theory.ObjectiveThe study explores the association between the satisfaction of basic psychological needs at work and psychological well-being, and the role of work addiction as a moderator of that relationship, distinguishing between the effects of excessive and compulsive work.MethodsParticipants were 204 employees involved in community-based work in Portugal who regularly interact with vulnerable populations. Data was collected using an online survey.ResultsFindings show that the satisfaction of the relatedness need was negatively associated with depressive symptoms, and the satisfaction of both needs for relatedness and competence was positively related to social functioning. Unexpectedly, autonomy need satisfaction did not significantly predict well-being outcomes. Overall, the results of moderation analyses point to the detrimental effect of excessive work on the association between the satisfaction of both competence and relatedness needs and well-being outcomes and to the enhancing effect of compulsive work on the relation between the satisfaction of the relatedness need and social functioning.ConclusionsFindings highlight competence and relatedness need satisfaction as key antecedents of psychological well-being among community workers and point to the opposing moderated effects of excessive and compulsive work. The role of work addiction in community-based work is discussed and practical implications, as well as theoretical contributions, are presented.
BackgroundEmotional exhaustion is a central component of burnout and is highly prevalent among police officers due to the emotionally demanding nature of policing work. Psychosocial safety climate (PSC), as an organizational resource, may influence emotional exhaustion directly and through emotional regulation strategies such as surface acting.ObjectiveThis study aimed to examine the relationship between psychosocial safety climate, surface acting, and emotional exhaustion among police officers, and to investigate whether surface acting mediates the association between PSC and emotional exhaustion.MethodsPolice officers from police stations in Guangxi, China, completed anonymous online questionnaires. The study employed the Psychosocial Safety Climate Scale (PSC-12), the Emotional Labor Scale, and the Emotional Exhaustion Scale. Data were analyzed using IBM SPSS Statistics 27.0 and regression-based mediation analysis.ResultsA more positive psychosocial safety climate was significantly associated with lower emotional exhaustion and lower levels of surface acting. Surface acting was positively associated with emotional exhaustion. Mediation analysis indicated that surface acting partially mediated the relationship between psychosocial safety climate and emotional exhaustion.ConclusionsThe findings suggest that psychosocial safety climate may be associated with emotional exhaustion both directly and indirectly through surface acting. Strengthening organizational support and fostering psychologically safe work environments may help reduce emotional strain among police officers.
BackgroundDigital leadership is increasingly recognized as critical to organizational digital transformation. How digital leadership fosters employee proactive behavior through job characteristics remains insufficiently understood.ObjectiveDrawing on Job Demands-Resources theory, this study develops and tests a dual-pathway model examining how digital leadership influences employee proactive behavior through digital job demands and digital job resources, with employee digital literacy as a boundary condition.MethodsData were collected through a three-wave time-lagged survey of 533 employees across four industries undergoing digital transformation in China. Mediation and moderation effects were tested using bootstrapping procedures and hierarchical multiple regression with the PROCESS macro.ResultsDigital leadership was positively associated with employee proactive behavior through two complementary pathways: reduced digital job demands and enhanced digital job resources. Employee digital literacy moderated both pathways, such that the indirect effects were stronger among employees with higher digital literacy.ConclusionsOrganizations should invest in digital leadership development programs that address both demand optimization and resource empowerment, and should cultivate employee digital literacy. Further research is needed to examine these mechanisms across different cultural contexts, digital platform ecosystems, and demographic groups.
BackgroundMusculoskeletal disorders are common among specialized construction workers due to repetitive, physically demanding work. However, biomechanical risks and the specific involvement of body segments in vaulted roof construction remain insufficiently characterized.ObjectiveIdentify the most exposed body segments and measure biomechanical risk in vaulted roof construction.MethodsThis observational study took place at six construction sites. Thirteen workers participated: six vault masters and seven helpers, all actively working on vaulted roof construction. Each worker completed six work cycles. We conducted task analysis, static biomechanical analysis, and the Susan Rodgers postural assessment. We measured muscle load as a percentage of maximum voluntary contraction (%MVC).ResultsTask analysis identified critical upper limb postures in both workers. The master vaulter spent 51% of the work cycle with their arms raised above shoulder level while handling significant loads, while the helper maintained similar postures for 90% of the cycle without significant loads. %MVC values exceeded recommended limits in the master vaulter left wrist (18%), left shoulder (24-25%), and right (26%). In the helper, both shoulders showed moderate muscle demand (%MVC: 14-16%). Susan Rodgers' method indicated a high-priority strain in the shoulder and arm during the master vaulter key postures, while the helper presented a low to moderate risk.ConclusionVaulted roof construction requires sustained overhead work and elevates strain on shoulders and wrists. The biomechanical risks are notably higher in the master vaulter than in the helper, underscoring the need for targeted ergonomic measures to reduce muscle strain and prevent occupational musculoskeletal disorders.
Background Rapid AI integration into healthcare necessitates proactive action to leverage benefits and reduce risks to clients and occupational therapy. Research on AI integration in occupational therapy shows promising outcomes. Objective This study assessed knowledge, use, and attitudes regarding AI in occupational therapy worldwide to inform development of guidance documents and resources for future policy, professional development, and practice in occupational therapy. Methods This cross-sectional descriptive study was conducted using a 28-item electronic survey. A global panel convened by the World Federation of Occupational Therapists (WFOT) reviewed the survey and translated it from English into French, German, and Spanish. WFOT distributed the survey via online communications and social media between September and November 2025. Analysis included descriptive statistics, nonparametric tests, and thematic analysis. Results Responses from 884 surveys representing 81 countries were analyzed. Most respondents were occupational therapists (87.8%), and one-third had over 20 years of experience. Two-thirds (68.4%) expressed positive views toward AI integration in occupational therapy. Over half (56.3%) reported using AI at work, most often for documentation, administrative tasks, education, research, intervention planning, and communication. Respondents learned about AI through online resources, peer networks, and continuing education. Qualitative analysis revealed three themes related to equity, implementation conditions, and ethical responsibilities. Conclusions The findings reveal high interest and increasing AI use for workflow support. Although attitudes were generally positive, respondents also raised important concerns. Professional organizations have an essential role in developing guidelines related to AI in occupational therapy, supporting education, ensuring ethical use, and advocating for research.
BackgroundHigh-intensity work and rising occupational stress in manufacturing highlight the need to examine protective factors like physical activity.ObjectiveThis study explored the impact of physical activity attitudes and behavior on work stress and life satisfaction among Chinese manufacturing employees.MethodsA cluster-sampled cross-sectional survey recruited 1202 factory employees (mean age 26.76 ± 5.33 years; 482 females, 720 males) and collected data on physical activity levels, attitudes, work stress, and life satisfaction in the factory of China.ResultsThe findings revealed that: (1) varying levels of physical activity influenced attitudes towards physical activity (F(2626) = 5.695, p = 0.004) and life satisfaction (F(2626) = 3.135, p = 0.044), but had no significant effect on work stress; (2) a positive attitude towards physical activity correlated positively with life satisfaction (r = 0.199, p < 0.001) and physical activity levels (r = 0.170, p < 0.001), while negatively with work stress (p s < 0.001); (3) the positive attitude towards physical activity, coupled with moderate physical activity levels, contributed to an enhancement in employees' life satisfaction. Additionally, the effect of physical activity attitude on life satisfaction was moderated by fatigue levels (β = -0.004, SE = 0.002, p = 0.044).ConclusionEmployees' attitudes towards physical activity are closely related to their performance in physical activities and significantly predict their life satisfaction. Fatigue emerges as a moderating factor in this relationship.
BackgroundLong-term factory work involves repetitive, physically demanding tasks that contribute to musculoskeletal degeneration in later life, particularly affecting the knee and cervical spine among ageing workers. Qualitative evidence on how retired industrial workers perceive occupational strain, arthritis progression and post-retirement rehabilitation remains limited.ObjectiveTo explore the lived experiences of retired factory workers with knee and neck arthritis, focusing on perceived occupational causation, functional limitations and access to post-retirement rehabilitation services.MethodsA qualitative phenomenological design within an interpretivist framework was used. Sixteen retired factory workers aged 57-73 years with clinically diagnosed knee or neck arthritis were purposively sampled from factory panel clinics and community groups. Data were collected via in-depth semi-structured interviews, audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis informed by the COREQ checklist.ResultsSix themes were identified: life-long occupational strain, normalisation and under-reporting of early pain, daily functional limitations, emotional and psychosocial impacts, barriers to accessing post-retirement rehabilitation, and coping strategies including home-based remedies and family support. Participants consistently linked their arthritis to decades of repetitive, physically demanding work and described substantial mobility limitations, psychosocial distress and reduced independence in retirement, alongside limited awareness of and financial barriers to structured physiotherapy.ConclusionsCumulative occupational strain in factory work is associated with late-life musculoskeletal morbidity, functional decline and psychosocial distress among retired workers. Improving ergonomic prevention and ensuring accessible community-based rehabilitation and continuity between occupational health and community services may enhance quality of life for ageing industrial workers.
BackgroundPresenteeism, defined as attending work despite reduced functional capacity, has been widely studied in occupational health and organizational research. However, the role of the physical work environment remains underexplored and inconsistently integrated into dominant conceptual models.ObjectiveThis integrative review examines the role of the physical work environment in presenteeism in knowledge-intensive workplaces, while considering organizational structures and health-related resources, and synthesizes these relationships into a unified theoretical framework.MethodsA structured search and synthesis procedure was conducted across five databases (Scopus, Web of Science, PubMed, PsycINFO, and Google Scholar), yielding 28 articles that met the inclusion and exclusion criteria. Studies were synthesized using thematic and comparative analysis across three domains: physical environmental exposures, organizational conditions, and individual psychological factors.ResultsEnvironmental exposures, including noise, air quality, lighting, thermal comfort, and ergonomics, are linked to reduced work functioning alongside attendance norms, job demands, and resource depletion. Presenteeism emerges from the combined influence of workplace context and individual capacity, with impaired functioning contributing to further resource depletion over time. The review presents the Integrated Multifactor Framework of Presenteeism (IMFP), which organizes these relationships into a coherent theoretical framework.ConclusionsThe IMFP extends existing models by incorporating the physical environment as a structural input and specifying a recursive feedback process between outcomes and resource depletion. The framework provides a theoretical foundation for future empirical investigation and targeted workplace interventions to reduce presenteeism.
BackgroundProlonged sedentary behavior among office workers is associated with reduced physical function, increased fatigue, and decreased occupational well-being. Short-burst walking interventions have shown promise in counteracting these risks but require further evidence regarding their feasibility and functional impact in workplace settings.ObjectiveTo evaluate the feasibility and preliminary efficacy of a short-burst walking intervention on functional mobility and self-reported work outcomes among sedentary middle-aged employees.MethodsA single-group pre-post pilot study was conducted with 46 participants (mean age 49.87 ± 6.45 years). The 4-week intervention involved brief walking sessions integrated into work hours (5-10 min, 3-5 times/day, 5 days/week). Feasibility metrics included recruitment, adherence, satisfaction, and attrition. Outcome measures included the Five Times Sit-to-Stand (5xSTS), Timed Up and Go (TUG), gait speed, balance, functional reach, and self-reported occupational outcomes. The primary outcomes were feasibility indicators (recruitment, adherence, satisfaction, and attrition), while secondary outcomes were exploratory efficacy measures, including functional mobility (5xSTS), TUG, gait speed, balance, and functional reach) and self-reported occupational outcomes (productivity, fatigue interference, mental fatigue, job satisfaction, and work engagement), assessed to estimate potential intervention effects and inform future trials.ResultsFeasibility was high, with a recruitment rate of 89.13%, adherence of 87.25%, and participant satisfaction of 4.56 ± 0.61. Statistically significant improvements were observed in 5xSTS (-1.45 s, p < 0.001), TUG (-0.67 s, p = 0.002), gait speed (+0.12 m/s, p = 0.006), and single-leg stance (+3.69 s, p = 0.017). Self-reported productivity increased (+1.08 points, p = 0.001), and fatigue interference decreased (-1.09 points, p < 0.001). Work engagement scores improved by +2.25 points (p = 0.002).ConclusionsThe intervention was feasible and well-tolerated, with significant gains in both physical and occupational functioning. These findings support further evaluation through larger controlled trials. While the intervention appears feasible and shows promising preliminary functional benefits, its efficacy should be interpreted cautiously and requires confirmation through adequately powered randomized controlled trials.
BackgroundThe rapid advancement of artificial intelligence (AI) technologies generates concerns about potential job losses in certain occupational groups. In this context, developing effective policy tools in higher education and skill transformation has become essential to ensure that university graduates can adapt to technological change.ObjectiveWhile the literature mainly focuses on the effects of AI and robotics on employment, limited research examines university students' awareness of AI and its relationship with future employment expectations. Therefore, this study investigates AI awareness among university students in Erzurum, Türkiye, and its association with their employment expectations.MethodsA survey including questions on demographic characteristics, perceived employability, and AI awareness was conducted with 500 students from different departments. The relationship between AI awareness and employment expectations was analyzed using exploratory factor analysis, confirmatory factor analysis, and Hierarchical Multiple Regression.ResultsThe research findings showed that all sub-dimensions of AI awareness had positive and significant effects on perceived employability. The skills sub-dimension had the strongest effect (β=0.447), followed by the cognitive sub-dimension (β=0.360), and the ethics sub-dimension showed a relatively more limited positive and significant contribution (β=0.142). Based on these findings, it is concluded that individuals' awareness of AI may strengthen their perceived employability through cognitive, skills, and ethical components, thus supporting the relevant hypotheses of the study.ConclusionsThe results emphasize the importance of increasing university students' awareness and competence in AI. Based on these findings, several policy recommendations are proposed to strengthen AI-related knowledge and skills among students.
BackgroundGlobal healthcare systems continue to face a persistent quality gap driven by fragmented and inconsistent clinical decision-making. Although competency-based medical education (CBME) frameworks define clinician roles, they provide limited practical guidance and tools for real-time decision-making. Additionally, contemporary literature failed to incorporate modern healthcare paradigms into everyday clinical decision-making.ObjectiveTo develop a structured, competency-aligned, seven-step cognitive roadmap that standardizes clinical decision-making primarily for high-stakes, acute care.MethodsWe employed a conceptual development methodology to synthesize evidence from cognitive psychology, clinical reasoning research, CBME frameworks, and healthcare quality paradigms. Concepts were mapped to sequential milestones and refined into cognitive schemes.ResultsThe roadmap comprises seven milestones supported by structured decision aids in the form of cognitive schemes: hypothesis-driven history and physical examination; technical summarization (problem representation); a novel tri-label diagnostic framing; an innovative two-step differential diagnosis, including endotyping; rational test ordering; the 5S therapeutic scheme; and the ACT discharge planning tool.ConclusionsThe roadmap operationalizes CBME competencies into actionable cognitive schemes. Together, these tools aim to embed evidence-based practice, quality, safety, competency roles, empathy, precision medicine, and shared decision-making into everyday clinical reasoning. Future research should empirically validate their impact on diagnostic excellence, therapeutic appropriateness, and patient and staff experience.
BackgroundManual materials handling (MMH) tasks in rice mills in India are labour intensive.ObjectiveInvestigation of physical workload on seven manual material handling (MMH) tasks among male workers in rice mills and comparison of the VO2 obtained from experiments in the present study with the models developed for Indian workers.MethodsExperiments were performed to measure the working heart rate (HR) in the eight rice mills and submaximal test was performed to measure oxygen uptake (VO2) in the laboratory. A model was developed to estimate the VO2 during MMH tasks for workers in rice mills.ResultsThe workload was observed to be comparatively higher in carrying 50 kg rice bags from the godown to vehicles and for this task, the mean values of working HR, ΔHR, peak HR and VO2 were 129 bpm, 56 bpm, 150 bpm and 1.17 l/min, respectively. The workload to fill rice in the bags was relatively lower and the working HR, VO2 and ΔHR were 110 bpm, 0.95 l/min and 40 bpm, respectively. The VO2max of all the tasks was higher than the 35% VO2max for 8-h work for Indian workers. The VO2 prediction models developed so far for Indian workers underestimated the actual VO2 in the MMH tasks in the rice mills. The accuracy of the developed model was 0.92.ConclusionAccording to workload classification, MMH tasks in the rice mills varied from moderate to heavy tasks. There is a need for reducing the workload of the rice mill workers.
BackgroundShift work is a well-established occupational risk factor for psychological strain in healthcare professionals, yet its association with physical health outcomes such as body mass index (BMI) remains inconsistent. Drawing on a biopsychosocial and occupational health psychology framework, this study examined the psychological and behavioral pathways that may underlie the association between shift work and BMI in nursing professionals.ObjectiveTo examine, using a cross-sectional structural equation modeling approach, whether psychological distress and irregular eating patterns were associated with the relationship between shift work with night shifts and body mass index (BMI) among nursing professionals.MethodsA cross-sectional design was employed with a sample of 194 actively employed nurses (78.4% women; M age = 38.7 years). Psychological distress was modeled as a latent construct comprising anxiety, stress, and emotional exhaustion, assessed using the Depression Anxiety Stress Scales-21 (DASS-21) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Irregular eating patterns were operationalized through meal skipping and between-meal snacking. BMI was calculated from self-reported weight and height. Structural equation modeling with bootstrap confidence intervals was used to test a sequential mediation model while controlling for age and sex.ResultsShift work was positively associated with psychological distress, which in turn was associated with irregular eating patterns. These eating behaviors were directly associated with higher BMI. The total indirect association between shift work and BMI was statistically significant (95% bootstrap confidence interval excluding zero), particularly through irregular eating patterns, whereas the sequential pathway involving psychological distress did not reach statistical significance, suggesting that organizational constraints related to shift work may exert a more direct influence on eating behaviors than psychological distress alone.ConclusionsThe findings are broadly consistent with a biopsychosocial model in which the association between shift work and BMI is linked to intermediate psychological and behavioral processes. Although the cross-sectional design precludes causal inference, the results highlight the importance of addressing both psychological strain and eating-related self-care behaviors within occupational health interventions aimed at nurses working rotating night shifts.
