Attitudes of Nurses toward Obesity and Obese Patients

Obesity is a major public health problem, and one which health care professionals have to address at many levels (4). Nursin an obese patient in acute care settings may be articularly stressful because of the physical d i f icd ty of moving and mobilizing such patients. &ere is evidence that some nurses may view such patients negatively, not only because there are problems of care, but also because they may share the negative stereotypes of the general population, attitudes which have not been adequately addressed by professional educators (2). Educational efforts have been hampered by the lack of a scale for systematic measurement of attitudes to obese adults and obese patients. The present study emplo ed methods drawn from attitude research (1) in developing a scale to measure nurses' attitudYes about obese patients. Through pilot testing a pool of 70 items was reduced through com onent analysis and other methods into a 15-item Nursing Management Scale (e.g., "I Eel disgust when caring for an obese adult patient") and a 13-itern Personality and Lifestyle Scale (e.g., "Most obese adults are lazy"). Cross-validation was obtained in a study of 107 R.N. graduate, female nurses (ages 21 to 55 yr., mean 30.5) i n + r e urban hos itals, using the semantic dzferential method (3). Principal components analysls of semantic cfifferential responses with "an obese adult:' as the stimdus produced three main factors: Passivity and Weakness (traditional "activ~ty" factor), Softness and Unsociability (traditional "potency" factor), and Badness and Cruelty (traditional "evaluation" factor). Pearson rs for the 107 subjects show that scores on the Nursing Management Scale correlate 0.59 with semantic differential component Passivity and Weakness, 0.54 with Softness and Unsociability, and 0.59 with Badness and Cruelty. Scores on the Personality and Lifestyle Scale correlate 0.64 with Passivity and Weakness, 0.54 with Softness and Unsociability, and 0.60 with Badness and Cruelty. These two specially devised attitude scales correlate 0.75 so a negative view of obese adults is linked to a negative view of caring for obese patients. AU correlations are si nificantly different from zero ( ~ 1 . 0 1 ) . Combining t t e two new attitude scales, older nurses had less favourable views of obesity and obese patients (r, 0.32). Those with more years of rofessional education had more favourable attitudes (r, -0.32). Dissatisfaction with own holy weight was linked to negative attitudes toward obese adults (r , 0.26). A hospital effect was found (11, 0.30, p < .05), independent of age and education. This effect may reflect differences in patient populations and organization of nursing roles amon the hospitals. The need for continuing protssional education in the care of unpopular atients is indicated by nurses' responses to items, such as "Caring for an obese patient usua$y repulses me," to which 24.3% agreed or strongly agreed, while 12.1% responded in this way to "I'd rather not touch an obese patient."