Only one in seven UK doctors' surgeries provide well-developed support programmes for obese patients, according to a survey of primary care nurses published in the latest Journal of Advanced Nursing.
Sheffield-based researchers surveyed just under 400 nurses in the north of England in mid 2006, including district nurses, practice nurses and health visitors.
Their aim was to ask the nurses about their clinical practice, views and support for patients with obesity.
The researchers discovered that 89 per cent of nurses recognise the need for more effective primary care services to tackle obesity and see obesity advice and support as part of their role.
However, one in five nurses also admitted that they felt awkward or embarrassed about talking to patients about obesity and only a fifth felt they were effective when it came to helping patients to lose weight.
Half said that they found providing care and support for obese patients particularly rewarding, but some also expressed negative attitudes and beliefs.
It’s estimated that one in five adults in the survey area – which covered four primary care trusts in the north of England - are obese, reflecting national UK trends.
Many of the nurses in the current survey also had weight problems - 14 per cent were obese and 29 per cent were overweight.
“Primary care nurses have an important role when it comes to helping patients to tackle obesity, which can lead to diseases like coronary heart disease and diabetes” says lead researcher Dr Ian Brown from Sheffield Hallam University.
“But they clearly need further training and organisational support to provide the help that obese people need to lose weight, in line with new UK health guidelines.
“Any training programmes should also address nurses’ beliefs and attitudes. While outright negatives stereotypes were rare, a number of nurses displayed potentially negative beliefs and attitudes relating to obesity and obese people. However, they were much less likely to do this if they were obese themselves”
Key findings of the study included:
Clinical practice
- 36 per cent of nurses (mainly practice nurses) carried out weight assessments in a typical week but another 36 said they’d never done one in their current post.
- 55 per cent had provided a patient with detailed advice about weight reducing diets and 30 per cent had done so in the last week, with similar percentages reported for exercise advice.
- 197 patients had been referred in the last four weeks – including 39 per cent to local exercise activities which receive health funding, 27 per cent to a dietician and five per cent to psychological support.
Beliefs
- 88 per cent said the health risks of obesity were not being overstated, but five per cent felt they were.
- 59 per cent said that obesity was the root cause of most of the problems faced by overweight patients.
- 57 per cent felt family history was an important factor in obesity and 28 per cent said hormones were a factor in middle-aged obesity.
- 69 per cent felt obesity was down to personal choices about food and exercise.
Attitudes to obese patients
- 54 per cent of nurses felt empathy for obese patients, but four per cent felt disgust.
- 45 per cent didn’t feel that obese patients had the motivation to change.
- 47 per cent found helping obese patients very rewarding.
- Eight per cent said obese patients were more lazy than non-obese patients.
Obesity management