Local nurses’ attitudes towards obesity and their impact on the quality of nursing care of obese patients : a quantitative study

Abstract

Obesity rates have increased exponentially worldwide, including Malta, with recent statistical data indicating that almost 70% of Maltese adults are overweight or obese (Cuschieri et al., 2016). Obesity is known to cause multiple secondary health problems and in recent years, public health authorities have come to recognise this physical state as a medical condition, claiming control over its definition and management. Public health authorities have created biomedical discourses which depict obesity as unhealthy, such that while the fat body was once highly valorised and attributed with beauty and fertility, today, obesity is attributed with negative attitudes. Studies among health professionals, indicate that nurses may also hold such negative attitudes towards obese people. Social processes that lead to obesity stigma, suggest that negative attitudes towards obesity can lead to obese people being discriminated against, and this discrimination has already been reported within health care (Brown 2006). The primary aim of this research was to explore the association, if any, between local nurses’ negative attitudes towards obesity and the quality of nursing care of adult obese patients. A cross-sectional quantitative research design was used to test the following hypothesis: Negative attitudes towards obesity among nurses negatively impact the nursing care provided to adult obese patients. A questionnaire was used to assess nurses’ attitudes towards obesity, the quality of nursing care of adult obese patients, the perceived barriers to providing good quality nursing care to obese patients and the participants’ demographic data. The questionnaire included both close-ended and open-ended questions. A link to the questionnaire was set up on the Facebook page of the Malta Union of Midwifes and Nurses (MUMN) such that all nurses who are members of this official Facebook page could voluntarily participate. Quantitative data was analysed using SPSS while qualitative data was analysed using thematic content analysis. Findings revealed an overall low level of negative attitudes towards obesity among the study sample. However, when present, these negative attitudes were significantly associated with the quality of nursing care of obese patients. Indeed, the findings showed that negative attitudes resulted in compromised nursing care, accepting the hypothesis. However, apart from negative attitudes, the qualitative component showed that nurses provide a lower level of nursing care to obese patients due to other factors. These included the risk of injury while caring for an obese patient, inadequate human resources, the lack of adequate equipment and the lack of education on obesity management. Nurses emphasised the need for these organisational barriers to be addressed in order to enhance the quality of care of obese patients and ultimately the obese patient’s experience with health care.