Knowledge, Attitudes, and Role of Nurses in Obesity Management

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This report delves into the critical role of nurses in managing obesity, a significant health concern, particularly in the UK. It explores nurses' knowledge of obesity's causes, effects (physical, psychological, and social), and the importance of dietary and pharmacological management. The study highlights nurses' awareness of their role in motivating, counseling, and encouraging patients towards healthier habits, including exercise. The report also examines nurses' attitudes towards obese patients, noting variations and the impact of societal discrimination. The search strategy employed electronic databases (The Cochrane Library, Pubmed, Science Direct) using specific keywords and inclusion/exclusion criteria. The findings emphasize the need for nurses to possess comprehensive knowledge, including the ability to assess patients, identify risk factors, and provide appropriate interventions, including understanding genetic and environmental factors contributing to obesity. The report underscores the importance of nursing education in enhancing nurses' capacity to provide high-quality care and preventive strategies. Overall, the report highlights the multifaceted role of nurses in addressing the complex issue of obesity.
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THE KNOWLEDGE,
ATTITUDES AND ROLE
OF THE NURSE IN THE
MANAGEMENT OF
OBESITY
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ABSTRACT
This particular study is regarding knowledge, attitude and role of nurses in the
management of serious problem obesity. From this research it is found that nurses have good
knowledge regarding the proper dietary and pharmacologic management of obese patients. They
are aware of their important role which includes motivating obese people, counselling and
encouraging them regarding proper food habits and requirement of physical workout. Along with
that they are also aware of the physical, psychological and social effects of obesity and aware
their patients regarding its fatal impact.
On the basis of this research nurses were found to have different attitudes with their
patients. In some case they were found to have feeling of discomfort when they council their
patients regarding their body shape and size. Even in some case they were found to have positive
and negative attitudes for obese people. It was also found that this problem not only causes the
physical and psychological problems but also destroys ones social life. As in society these
peoples have to face much discrimination of the basis of their overweight and sometimes due this
many obese people tends to commit suicides.
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TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
SEARCH STRATEGY....................................................................................................................1
Electronic search: ..................................................................................................................1
Search Terminologies: ...........................................................................................................2
Inclusion and exclusion criteria: ............................................................................................3
Boolean operators: .................................................................................................................3
KNOWLEDGE OF THE NURSES.................................................................................................3
ATTITUDE OF NURSES...............................................................................................................6
ROLE OF THE NURSES................................................................................................................8
CAUSES OF OBESITY..................................................................................................................9
EFFECTS AND CONSEQUENCES OF OBESITY.....................................................................11
Physical effect and consequences of obesity:.......................................................................11
Psychological effect and consequences of obesity:..............................................................13
Social effect and consequences of obesity:..........................................................................14
CONCLUSION..............................................................................................................................14
RECOMMENDATION.................................................................................................................15
REFERENCES..............................................................................................................................16
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INTRODUCTION
The condition in which a person accumulate high amount of fat in the body is defined as
obesity. In case where the body weight of an individual is 20% more than the usual weight then
that person is considered as obese. Similarly, if the body mass index of the person is more than
30 then also he or she is considered as obese. Obesity in United kingdom is an important health
concern and is considered as one of the preventable causes of death. According to the data
published by WHO (World Health organisation), around 28.1 % adults in UK are clinically
obese having BMI (Body Mass Index) greater than 30. As per the views of experts by 2020, one
third of the UK population could be found obese (Arora and et.al., 2013).
Thus, this reason makes it important to choose this topic as the part of discussion. As this
topic is highly important and problematic in the context of people living in UK because of their
lifestyle and lack of physical workout they suffer from the problem of obesity.. This topic will
include discussion on some major key point related to obesity and role of nurses. It will comprise
level of knowledge of nurses and their attitude regarding the obese patients. This assignment will
also comprise the role of nurses in the management of this major issue along with its prevailing
effects and consequences faced by people of UK.
SEARCH STRATEGY
Search strategy is a structured and systematic organisation of steps that are used to search
a database. This helps in conducting the specific search and to come up with relevant and
peculiar information related to the research topic (Wang and et.al., 2011). There are various steps
in the search strategy used to perform the focused research which includes:
Electronic search:
This search strategy includes exploring the electronic data that is present in the form of
computerized database. These databases consist of structured set of information that can be used
to get the updated information related to research topic (Ogden and et.al., 2014). There are
several electronic databases that consist of journals and books that contain the specific
information regarding various topics. Along with that, there are several online libraries that
provide excess to literature that is related to a particular research subject. For the present
literature review, following databases were searched in accordance to the topic:
Databases selected Description
The Cochrane Library The Cochrane library is pile that contain six
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databases which contain high quality evidences
that helps in the decision making process in
healthcare fields. It is only database that provide
abstract along with the summary of literature
review and critic about overall information. It
contains the full length journals and articles that
provide the user with economic evaluation from
the whole world (The Cochrane Library, 2017).
Pubmed Pubmed provides access to MEDLINE database
that provides user with more that 27 million
citations regarding biomedical literature,
journals related to life sciences and many online
books on biomedical topics. The citation in
Pubmed contains links that provide researchers
with full length text (Pubmed, 2017).
Science Direct Science Direct is the database that provides
researchers excess to database of life sciences,
health sciences, social science and humanities.
It provides information regarding the 3500
academic journals and 34000 e-books (Science
Direct, 2017).
Search Terminologies:
There is need of some defined words or terminologies to conduct the topic based specific
search. These words are known as keywords (Wang and et.al., 2011). These are identified prior
to the process of searching for journals and books for literature. It also includes the synonym of
the keywords that are used to conduct the research for particular topics. The important terms that
are used for searching articles for present literature review are:
TERM 1 Knowledge, Understanding, Awareness,
TERM 2 Attitude, Outlook, Point of view, Standpoint.
TERM 3 Role, Part, , Duty.
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TERM 4 Management, Administration, ,.
TERM 5 Obesity, Overweight, ,.
TERM 6 Nurse, Carer, Caregiver, Attendant.
Inclusion and exclusion criteria:
On the basis of keywords, one can search for the literature related to the research topic.
Inclusion and exclusion criteria help in the identification of those journals and articles that
should be used for our topic and those that should be excluded. With the help of this, only
relevant literature can be searched and appropriate information can be gathered on that basis
(Doody and Doody, 2011). Following inclusion and exclusion criteria is been set to conduct the
search for journals, articles and research papers:
Inclusion criteria Exclusion criteria
Researches done in English language only. Researches done in any other language than
English.
Researches conducted from the year 2010-
2017.
Researches done prior to 2010.
Studies carried on done knowledge, attitude
and role of nurses in the management of the
obesity.
Research done on prevention and cure of
obesity.
Research done only on management of obesity. Researches done on management of any other
problem.
Boolean operators:
Boolean operators are the terms that are used as conjunctions to exclude or combine the
keyword during research to get effective results. This approach helps in conserving the time
utilized while searching for relevant information related to research topic. The three common
Boolean operator are: AND, NOT and OR (Colbert and Jangi, 2013).ï‚· Use of AND: It helps in narrowing the search and provide information that contain all the
search terms.
ï‚· Use of OR: In contrast to the AND, this operator broadens the search by telling database
that any of the word from mentioned keyword can be present in search result.
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KNOWLEDGE OF THE NURSES
Obesity deteriorates the health status of an individual by increasing risk of coronary heart
disease, heart stroke, diabetes and cancer. According to Murphy and Girot (2013), nurses can
take actions by making themselves more knowledgeable about obesity and then position
themselves as educator and role models for communities and patients. As a fact, good nursing
skills and practical information helps them to provide best with advanced care.
The widespread obesity problem has presented the challenge to public health. Hence, it
requires the immediate medical interventions and modifications. Nurses have important role to
play in diagnosing and preventing the weight related problems by providing the health related
counselling to the patients. As per the views of Wright and et.al., (2013) nurse first should
estimate the pervasiveness of particular problem among the adults and children in the UK. This
information will help nurses in identifying the age group that is more prone to this problem.
In reference to the ongoing situation in the UK it necessary for nurses to have knowledge
regarding every aspect of nursing care strategies. According to Holmes and et.al., (2016) it is
important for nurses to have proper information regarding the diet and exercise practices to help
patients in overcoming the obesity. They should also have appropriate knowledge regarding the
measure of weight, height and waist circumference that help them in assessing the patients and
determine if they require treatment.
According to Tomiyama and et.al., (2015) nurse should be aware regarding the risk
factors that are associated with obesity and should have appropriate knowledge and awareness
regarding the guidelines for obesity management. In this case nursing education plays the
important role in order to provide the high quality care and preventive strategies to the obese
people. Current finding along with the experience in respect to the obese people nurses can opt
for the practices that help in eradicating this problem in more efficient way from the society.
This also includes the review of patients weekly food and exercise goals in order to over come
the problem related to obesity. Thus, proper knowledge is required by the nurse which help them
in developing their own capacity in order to provide scientific and professional expertise to
patients.
In accordance with Robson and Haddad (2012), nursing education helps in building the
knowledge among them which helps in reducing the burden to disease from patients. This key of
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knowledge also helps them in finding many other preventive measures that may help patients in
recovering from the prevailing condition with much greater impact. Along with that, nurses are
also able to work in double shifts and deal with different patients on the basis of their knowledge.
As per the views of Hockenberry, Wilson and Rodgers (2016), lack of this knowledge and
experience in nurses has direct effect on their routine work. They are not able to actively
participate in the decision making process.
Weight management is one of the most difficult care setting to reduce the impact of
obesity in the patients. As per the views of Kevern (2012), weight management require nurses to
have proper knowledge regarding the dietary and nutritional options provided to the patients. It is
also important for the nurses to have understanding regarding the non-pharmacological treatment
option available for the treatment of obese people. This includes the information regarding
proper calorie intake and physical exercises. In today's scenario, nurses are able to set up the
SMART goal: Specific, measurable, achievable, relevant and time specific goals for the patients
that help in the getting rid of the problem in more efficient way.
Nurses should have appropriate knowledge and information related to various genetic and
environmental factors that effect the obesity. As there are certain genetic disorders that prevails
in the children's from the parents and lead to the obesity. Educated nurses have the ability to
detect the presence of such types of genetic disorders and can help their patients by providing
them with appropriate treatment procedures and medical therapies. In the latest scenario nurses
are trained and given knowledge regarding the proper management of the genetic disorders that
exists in patients. Also, they are acknowledged with general procedures and management
strategies to encourage their patients in adopting the healthy lifestyle. The lifestyle also plays
major role in existence of obesity. In the country like UK the people have busy lifestyle and are
not able to give time to involve themselves in some physical workout or exercises.
According to Arora, T. and et.al., (2013) nurses are aware of the fatal causes of obesity
that can effect the life of obese patients. The nurses should awake people through their
experience and knowledge about the several complications that results due to presence of
obesity. Nurses working in various hospitals and health care centres posses ample of information
about the physical and psychological impacts of the obesity. Through this knowledge they can
provide counselling to the patients regarding the preventive steps they should adapt to reduce the
impact of this serious problem. They can help them by involving their family members in the
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treatment procedures that can further encourage them in accepting the treatment procedures.
Nurse should also provide information and knowledge to the family regarding the negative
impacts of obesity. Thus, by awaking the family members they get more conscious about their
loved ones who are suffering from obesity to get rid of it. This concludes that the knowledge of
proper and effective communication is necessary in the nursing during the management of
obesity.
Thus, the nurses should have knowledge about various aspects such as efficiency in
communication, weight management, pharmacological management, dietary management and
information regarding the roots and causes of obesity and their treatment procedures. This is
important for nurses for appropriate and effective management of obesity.
ATTITUDE OF NURSES
Obesity is the most common health related problem in UK. It poses many challenges for
the patients and their care providers. National Institute of Health (NIH) in 2004, executed a
programme namely Obesity Research task force that considered obesity as highly pervading
public health problem. Similarly, the Centre of Disease Control and Prevention defines obesity
as the preventable death which is growing at the faster rate in the nation and may overtake
tobacco in terms of leading cause of death. Obesity leads too much health related problems that
pose heavy risk to life which includes: diabetes mellitus, respiratory disease, coronary artery
disease, gout arthritis, cancer and gallbladder disease.
Attitude of nursing regarding obese people varied widely. May of the nurses have
positive attitude regarding their role and treatment of the obese patients, even in many cases
nurses are found with lack of confidence and are unable to manage the obese people. Nurses
have expressed the attitude of discomfort when they encourage the patients regarding their
weight as this is a personal and sensitive topic. They have feeling of uneasiness when they
discuss with their patients regarding their weight. According to the Keskin, Engin and Dulgerler
(2010), there are some nurses who have a feeling regarding the fact that the obese people also
have their own choice regarding their size and weight, as a result, they do not take any action. It
is also necessary for the nurse to get appropriate information regarding the history of the patients
and the complexity of their situation in order to provide them the best possible care. By getting
knowledge about the patient's history a change come in the attitude of the nurses. They become
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highly concern regrading the health problems and ultimately show the positive attitude towards
them.
As per the views of Holmes and et.al., (2016) there are many nurses and physicians found
with negative weight based attitudes against the obese patients, it includes the prejudice and
discrimination against them. As a result, these practices highly effect their behaviour and
confidence that further hinders their ability to treat the overweight people. This negative attitude
not only affects the nurses but also poses a bad impact on the mental status of such people. This
ruins the relationship and feeling of trust among the patients and nurses. Through this attitude the
patients suffers through change in their treatment procedures given by nurses. The nurses make
obese people believe that they are self responsible foe their increased body mass index. Nurses
make them feel embarrassed and guilty by saying that through their own habits they have
become overweight and fatty. Thus, the obese people are not able to make them emotionally
stable and get effected by this interaction. This mentally upset then and result in anxiety and
depression. These complications further ruins their ongoing condition by developing the eating
disorder to get them relaxed from stress. These disorders generally includes bulimia and binge
eating, in which the obese patients tends to eat at night and consumes alcohol. This further
increase the intake of calories that increase the amount of fats and may result in the type 2
diabetes mellitus. Thus, instead of getting cure the obese people further ruins their own health
condition. This is due to the negative attitude of nurses towards the treatment of obese people.
However, many studies have also shown that nurses in today's world have highly positive
attitude toward obese patients (Arora and et.al., 2013). These nurses interact with the patients
and understand their problems regarding their increased weight. These type of nurses calmly
listen to their queries and provide them with intervention through their dietary and
pharmacological management techniques. They help patients in making and diet chart which also
includes the physical activities that can help them in reducing their weight. In case if they are not
able to come up with this problem on the basis of diet chart and physical exercise then nurses
helps them by their pharmacological management strategy. In this strategy, they provide patients
with medicines that help in reducing their weight.
It is due enhancement in the education of the nurses. Moreover, they are being taught to
behave and not lose their cool in front of an obese patient. It rather helps the patient to get cured
faster. There is a complex mix of positive and negative attitude towards these kinds of patients.
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A handhold from the side of the nurse motivate the patient to lose weight and lead a healthy and
normal lifestyle. Understanding this subject in appropriate manner can reduce the incidence of
negative attitude towards the patients. There are other factors that can impact the attitude of the
nurse which includes, age, gender, experience, weight and body mass index of the body etc. A
nurse with high body mass index tend to understand the condition of an obese patient in better
way and can help him in better manner. Hence, an influence from the side of nurse can have
higher impact on the condition of the patient. Increasing prevalence of obesity in the patient
makes it a point for the nurses that they understand the patient and treat them so that its incidence
can be reduced. Positivity from the nurse delivers the hope to the patients that they will be able
to overcome the impact of obesity on their body.
Thus, there are different kinds of attitudes that are shown by nurses on their patients
which may be negative, positive and neutral. In case of old people, nurses generally show
positive attitude to them and provide them efficient and advanced nursing care techniques. It is
necessary to aware nurses regarding the negative impact of their bad attitude towards the obese
patients. As it is the duty of the nurse and main principle of this nursing profession to treat the
patients with the best possible care.
ROLE OF THE NURSES
The nursing profession plays an important role in obesity management. To play such
roles nurse require specific education regarding the pathology of the obesity, it epidemiology,
and effect of obesity on the health of the patients. This helps them to play the major roles in
behaviour management, pharmacological management and dietary management. There are some
nurses that also play the role of supplementary prescribed practice in which they act as health
educator in the primary and secondary care centres.
According to Spivack and et.al., (2010) the nurse can play an important role by coming in
contact with the patient and provide them with management practices and advice to overcome
the situation of obesity. In the hospital, the nurse also plays a major role in arranging the proper
sizes of chair for the obese people and weighing scales having the capacity to measure the weight
up to 200 kg.
There are many psychological features that lead a person to obesity which may include:
stress, loneliness and boredom. Along with this, there are many other triggers that can lead to
obesity such as: stress related to the employment, divorces, family concerns, breaks in
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relationship and illness also causes obesity. Thus, it becomes important for the nurses to know
about the dietary history of the patients and explore the food habits that contain high calories and
lead them to obesity. Along with that current medical history can be analysed by the nurses as
many medicines aids in increasing the body weight and lead to obesity. Common examples of
such medicines are: antipsychotics, thiazolidinediones, anticonvulsants and antidepressants.
As per the views of DeLaune and Ladner (2010), the most important role of the nurses is
to conduct the physical examination that includes the measurement of height, circumference of
waist, weight, blood pressure along with the tests regarding many other disease that results in
increasing the body weight such as diabetes mellitus type 2 and hypothyroidism. Nurses involved
in the obesity management are able to perform screening that includes the primary prevention
strategy in which the measurement of the Body Mass Index and other measurement are taken. It
also includes the modification in the behaviour and diet of the patients to manage the effect of
obesity.
According to Murphy and Girot (2013), there is need of obesity management nurses that
can efficiently perform diffusion with obese people about the weight problem they are facing and
its consequences on their health. They should encourage the obese patients to increase the intake
of carbohydrate instead of fat that will provide them with same amount of energy.
In the role of the dietary management nurse helps patients by preparing a dirt chart for
them. This includes the food that contains low calories along the limited time of physical
exercises. Nurses also play the major role in pharmacological management of the obese people
by providing them with medicines which help them in treating the obesity. These medicines
include herbal as well as over the counter medicines. In case when then diet chart and routine of
performing the physical activities fail nurses can provide them with anti-obesity medication that
helps them to improve their nutrition habits. Nurses also plays important role in providing the
patients with pharmacotherapy that helps patient in meeting their lifestyle goals.
As per the views of Wright and et.al., (2013) the nurses should also introduce the patients
with non-pharmacological treatment options in case if the obese people are effected by the
medicines. This method includes the addition of low fats and high carbohydrate containing food
along with the appropriate time for regular exercises.
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