31840 • Nurses' Knowledge, Beliefs, and Exercise Habits: A Focus on Cardiovascular Disease

Table of Contents

31840 • Nurses' Knowledge, Beliefs, and Exercise Habits: A Focus on Cardiovascular Disease

How to Receive Credit

Course Overview

Audience

Accreditations & Approvals

Designations of Credit

Individual State Nursing Approvals

Course Objective

Learning Objectives

Faculty

Faculty Disclosure

Division Planner

Division Planner Disclosure

Director of Development and Academic Affairs

Director Disclosure Statement

About the Sponsor

Disclosure Statement

Implicit Bias in Health Care

1. INTRODUCTION

2. NURSES AND PERSONAL HEALTH

IMPACT OF NURSES' HEALTH BEHAVIORS ON PATIENT CARE

BARRIERS TO HEALTHY BEHAVIORS AMONG NURSES

LITERATURE REVIEW

3. NURSES AS ROLE MODELS FOR PROMOTING HEALTHY BEHAVIORS

4. THE ROLE OF ONGOING EDUCATION AND PROFESSIONAL DEVELOPMENT

5. EVALUATION AND IMPLEMENTATION STRATEGIES

6. CASE STUDY

7. CONCLUSION

Works Cited

31840 • Nurses' Knowledge, Beliefs, and Exercise Habits: A Focus on Cardiovascular Disease

Tina Schmidt-McNulty, DHSc, MS, ACSM-CEP, RN

www.netce.com

Copyright © 2025 NetCE, All rights reserved.

Nurses are crucial in educating patients on preventing and managing CVD. However, the demanding nature of their profession places them at greater risk for health issues, including CVD. Despite understanding that regular physical activity is essential in reducing risks for CVD, many nurses do not exercise enough, which negatively affects their health and potentially the quality of patient care.

31840 • Nurses' Knowledge, Beliefs, and Exercise Habits: A Focus on Cardiovascular Disease

Education Category. Community Health

Release Date. 09/01/2025

Expiration Date. 08/31/2028

How to Receive Credit

To complete this course for continuing education credit please go to http://www.netce.com/course/3171 in your browser.

For assistance with receiving continuing education credit, please contact us at help@netce.com.

Course Overview

Nurses are crucial in educating patients on preventing and managing CVD. However, the demanding nature of their profession places them at greater risk for health issues, including CVD. Despite understanding that regular physical activity is essential in reducing risks for CVD, many nurses do not exercise enough, which negatively affects their health and potentially the quality of patient care.

Audience

This course is designed for nurses in all practice settings whose attention to self-care and cardiovascular disease prevention may impact their ability to live healthily and provide optimal patient care.

Accreditations & Approvals

In support of improving patient care, TRC Healthcare/NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. NetCE is accredited by the International Accreditors for Continuing Education and Training (IACET). NetCE complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, NetCE is authorized to issue the IACET CEU.

Designations of Credit

NetCE designates this continuing education activity for 1 ANCC contact hour(s). NetCE designates this continuing education activity for 1.2 hours for Alabama nurses. NetCE is authorized by IACET to offer 0.1 CEU(s) for this program. AACN Synergy CERP Category B.

Individual State Nursing Approvals

In addition to states that accept ANCC, NetCE is approved as a provider of continuing education in nursing by: Arkansas, Provider #50-2405; California, BRN Provider #CEP9784; California, LVN Provider #V10662; California, PT Provider #V10842; District of Columbia, Provider #50-2405; Florida, Provider #50-2405; Georgia, Provider #50-2405; Kentucky, Provider #7-0054 through 12/31/2025; South Carolina, Provider #50-2405; West Virginia RN and APRN, Provider #50-2405.

Course Objective

The purpose of this course is to highlight the relationship between nurses' health beliefs and self-care and their recommendations and teachings to patients, with the goal of supporting interventions to better support nurses' healthy lifestyle choices, self-care, and patient teaching.

Learning Objectives

Upon completion of this course, you should be able to:

1. Outline the role of nurses in promoting and modeling health and wellness for patients.

2. Relate the importance of nurses' health to performance and patient care.

3. Discuss strategies for nurses to incorporate healthier lifestyle choices.

Faculty

Tina Schmidt-McNulty, DHSc, MS, ACSM-CEP, RN, is an instructor in the Department of Kinesiology and Nutrition at the University of Illinois Chicago. Her academic foundation in health, exercise instruction/programming, and nursing is strengthened by specialized certifications in clinical exercise physiology and group fitness. Her professional background includes clinical nursing experience in cardiovascular care and cardiac rehabilitation, as well as coaching at the high school level, where she developed seasonal training programs. She is also an active member of the Exercise is Medicine Clinical Practice Committee.

With more than 30 years in the fitness industry as a presenter, author, coach, and instructor, Dr. Schmidt-McNulty has published numerous articles on special populations and health risk factors, and has led initiatives promoting fitness and wellness in corporate, hospital, and university settings. Her work reflects a commitment to bridging academic knowledge with practical application, encouraging student engagement, and building a strong foundation for lifelong learning in health and exercise sciences.

Faculty Disclosure

Contributing faculty, Tina Schmidt-McNulty, DHSc, MS, ACSM-CEP, RN, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planner

Mary Franks, MSN, APRN, FNP-C

Division Planner Disclosure

The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Director of Development and Academic Affairs

Sarah Campbell

Director Disclosure Statement

The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Implicit Bias in Health Care

The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.

Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.

1. INTRODUCTION

Florence Nightingale, a pioneer in nursing, emphasized the necessity of personal health and self-care to prevent illness and promote wellness [1]. She believed self-care was essential for nurses to provide quality patient care, a relevant principle today. Nurses often face numerous challenges undermining their health and wellness, such as family responsibilities, demanding work schedules, and burnout [2]. Research has linked poor health behaviors, particularly insufficient physical activity, to increased risks of chronic diseases, making self-care even more crucial [3].

2. NURSES AND PERSONAL HEALTH

Despite possessing knowledge of prevention strategies and understanding the benefits of physical activity, many nurses do not follow these recommendations. This contributes to the increased prevalence of hypertension, obesity, and related health conditions within the nursing profession [4,5]. As noted, common barriers include time constraints, stress, and fatigue, making it challenging for nurses to engage in regular self-care, including physical activity [6]. These challenges not only affect nurses' health but can also impact the quality of care they provide.

IMPACT OF NURSES' HEALTH BEHAVIORS ON PATIENT CARE

Nurses, as health promoters, play a crucial role in influencing patients to adopt healthy behaviors. Those who maintain healthy lifestyles are more likely to inspire patients to follow suit, thereby demonstrating the significant impact of nurses on health promotion [7,8]. Conversely, patients may be less inclined to trust health advice from nurses who do not practice these behaviors themselves [9,10]. Thus, nurses should prioritize their health to effectively serve as role models, reinforcing the connection between their personal habits and patient outcomes.

BARRIERS TO HEALTHY BEHAVIORS AMONG NURSES

Awareness of personal health risks can significantly influence engagement in self-care practices. Greater recognition of these risks has been linked to improved self-care habits [11,12]. However, despite access to health knowledge and resources, many nurses need help prioritizing their health [13]. Psychological and environmental barriers, such as lack of time, energy, and support, hinder the adoption of healthy behaviors [6]. Understanding these barriers is critical to developing effective programs that support nurses in overcoming these challenges.

LITERATURE REVIEW

Nurses face unique challenges that place them at increased risk for chronic diseases, including cardiovascular disease (CVD). Long shifts, high stress levels, and the physical demands of patient care often lead to poor health practices, such as insufficient physical activity, inadequate sleep, and unhealthy dietary habits [14]. Studies highlight that nurses experience higher rates of obesity, hypertension, and hyperlipidemia compared with the general population [15,16].

The American Heart Association (AHA) and the World Health Organization (WHO) emphasize the critical role of nurses in reducing the global burden of heart disease. Effective patient education on risk factors—such as poor diet, inactivity, and smoking—relies on nursing professionals [17]. However, the demanding nature of the profession can impede their ability to model healthy behaviors, complicating efforts to promote personal and professional wellness.

Emerging research suggests that a proper understanding of personal risk is essential for engaging in preventive health behaviors. Research indicates that nurses who assess their risk are likely to adopt health-promoting practices [12]. Unfortunately, many underestimate their vulnerability, leading to complacency and a reluctance to implement lifestyle changes [18]. Misplaced optimism, whereby nurses perceive their risk to be lower than it is, can impede motivation for self-care [19].

3. NURSES AS ROLE MODELS FOR PROMOTING HEALTHY BEHAVIORS

Given their crucial role in patient education, nurses must stay informed about CVD prevention, guidelines, and treatment. Nurses who maintain healthy lifestyles are more likely to influence patients to adopt similar behaviors, reinforcing the importance of their role as health advocates [7,20]. Research demonstrates that patients are more inclined to adopt recommended changes, such as increasing physical activity, when advised by healthcare professionals who practice these behaviors themselves [7].

However, nurses frequently encounter obstacles in maintaining healthy behaviors, particularly sustaining regular physical activity. Challenges such as fatigue, heavy workloads, and lack of time due to extended shifts often hinder their ability to engage in recommended exercise routines [21]. Addressing these barriers through targeted professional development and wellness initiatives can empower nurses to enhance their health and better support their patients.

4. THE ROLE OF ONGOING EDUCATION AND PROFESSIONAL DEVELOPMENT

To provide high-quality, evidence-based care, nurses should prioritize ongoing professional development. Nurses are expected to stay informed on evidence-based recommendations for disease prevention and health promotion [13]. This requires support from unit managers and hospital administrators, who are critical in fostering a culture that encourages continuous learning and professional growth [5,22].

Integrating evidence-based physical activity guidelines into education programs can improve nurses' ability to translate these recommendations into practice. Nurses with current knowledge are more effective in promoting lifestyle modifications to their patients [23,24]. However, many nurses would benefit from up-to-date knowledge, reinforcing the need for ongoing professional development opportunities that focus on applying these guidelines to personal and professional settings [8].

5. EVALUATION AND IMPLEMENTATION STRATEGIES

The Health Belief Model (HBM) offers a useful framework for understanding the health behaviors of nurses, particularly those related to physical activity [25]. The model suggests that an individual's perception of their disease risk, the severity of the condition, and the perceived benefits and barriers to behavior change all shape their actions [26]. Nurses' perceptions of their health risks can influence their willingness to engage in physical activity and counsel patients on similar behaviors [12]. By recognizing these factors, healthcare institutions can design initiatives that better support nurses adopting healthy lifestyles, enhancing their well-being and patient care quality.

Wellness initiatives in healthcare settings can be effectively implemented through a structured approach that addresses organizational and individual needs. Conducting a needs assessment through surveys can help identify critical wellness needs, barriers to maintaining a healthy lifestyle, and prevalent risk factors (e.g., work-related stress, cardiovascular risks) [27]. Based on this assessment, priorities for intervention, such as stress reduction, physical activity, healthy eating, mental health support, and sleep hygiene, can be set [12].

Tailored wellness programs can then be designed. Physical activity initiatives may include on-site fitness options, group classes like yoga and aerobics, and active breaks during shifts to reduce physical and mental strain [7]. Nutrition initiatives should ensure access to healthy meals and snacks, promote water consumption, and offer dietary counseling [28]. Mental health support is another essential component, with offerings such as mindfulness training, meditation sessions, and access to counseling services to help manage workplace stress [29].

Leadership and peer support play critical roles in promoting wellness. Appointing wellness champions within the nursing staff can create role models for healthy behaviors, while active management involvement demonstrates the organization's commitment to employee well-being [7]. Ensuring flexibility and accessibility is also important. Wellness activities should be adaptable to the shift schedules of healthcare staff, allowing participation regardless of working hours [26].

Finally, wellness programs should be evaluated and adapted over time. Monitoring outcomes, such as participation rates and health improvements, and collecting feedback can help refine initiatives to ensure they remain relevant and practical. By aligning wellness initiatives with the unique needs of nursing staff and embedding them into the organizational culture, healthcare facilities can significantly improve staff well-being and patient care quality [13,29]. As Florence Nightingale emphasized, nurses should "teach not by preaching but by setting an example through their actions" [7]. By prioritizing their health and well-being, nurses can effectively promote healthy behaviors among patients, contributing to improved health outcomes and a more robust healthcare system.

6. CASE STUDY

A cross-sectional study explored cardiovascular nurses' self-perceived cardiovascular risk factors, attitudes, perceived barriers toward physical activity, and their practices in promoting a healthy lifestyle by recommending physical activity to patients [30]. A convenience sample of full-time, part-time, and PRN nurses working consistently in U.S. cardiovascular units was recruited. Using validated instruments, data were collected via an online survey that assessed demographics, self-perceived CVD risk, physical activity habits, and health promotion practices.

Results revealed that a significant portion of the nurses in this case study (74.2%) had low self-perceived CVD risk, while 25.8% had higher risk scores. Most nurses (87.1%) fell below recommended physical activity levels, emphasizing the need for targeted interventions to promote exercise within the nursing community. The study found that nurses with higher CVD knowledge scores were three times more likely to recommend exercise to patients. These findings indicate that enhancing nurses' CVD knowledge and addressing skill-related barriers may support greater health promotion practices.

The study highlights the importance of understanding the relationship between nurses' perceived health risks, knowledge of CVD, and health promotion behaviors. Many nurses perceive themselves as knowledgeable about CVD risk reduction, yet their physical activity habits do not align with this knowledge. Factors such as workplace environment, job type, and fatigue can hinder the application of this knowledge to personal health practices [5,22]. This understanding can enlighten healthcare professionals and guide the development of effective interventions to promote nurses' health and well-being.

This particular study found that the majority of nurses did not meet the recommended minimum 150 minutes of moderate physical activity per week [31,32]. While some nurses engaged in light-to-moderate activities, it was often insufficient to provide the health benefits associated with regular exercise. Nurses working in highly demanding environments may overestimate their activity levels due to the physical nature of their work shifts [21]. Occupational activities such as walking during shifts were not continuous or vigorous enough to meet recommended guidelines, highlighting the need for targeted strategies to encourage leisure-time physical activity [8,15,33].

Accurate perception of personal CVD risk is essential for motivating health behavior change. Previous studies have shown a positive correlation between individual or family history of CVD and perceived risk, but this does not always translate into healthier behaviors [12,18]. The current study found no significant differences between high-risk and low-risk groups regarding knowledge, perceived risk, or intention to change behaviors.

Perceived barriers, such as a lack of energy and time, were frequently reported among this sample, consistent with other research indicating that long work hours, high stress, and external responsibilities can impede nurses' engagement in physical activity [5,22]. Addressing these barriers through targeted interventions is crucial to support nurses' health and their ability to effectively counsel patients on adopting healthy lifestyles.

7. CONCLUSION

Nurses are crucial in educating patients on preventing and managing CVD. However, the demanding nature of their profession places them at greater risk for health issues, including CVD [3]. Despite understanding that regular physical activity is essential in reducing risks for CVD, many nurses do not exercise enough, which negatively affects their health and potentially the quality of patient care [28,34].

Educational interventions based on the Health Belief Model could motivate nurses to prioritize their health by addressing perceived barriers and enhancing self-efficacy [13,35]. Integrating wellness initiatives and continuous CVD education can support nurses in making lasting changes and improving patient care [29,35]. These efforts will ultimately benefit nurses and their patients, contributing to a healthier workforce and improved patient outcomes.

Works Cited

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