NUR2300: Obesity, Evidence-Based Practice in Queensland

This report examines obesity as a significant public health and nursing practice issue in Queensland, Australia, highlighting its increasing prevalence and associated health complications, such as heart disease, diabetes, and cancer. The study explores the causes of obesity, including poor nutrition, lifestyle factors, and genetic predispositions. It investigates the psychological impact on affected individuals, particularly children, and emphasizes the importance of evidence-based interventions like lifestyle changes, counseling, and public health initiatives. The report synthesizes findings from various literature sources, including clinical studies and government publications, to define the problem, identify the causes, and evaluate the effectiveness of current strategies. It recommends practice changes such as early diagnosis, lifestyle modifications, and increased public awareness campaigns to mitigate the impact of obesity and improve patient outcomes. The report also emphasizes the role of nurses in providing education, counseling, and support to individuals and families affected by obesity, and calls for greater involvement from government agencies in addressing this public health concern.

Running head: NURSING
Evidence Based Practice
Name
Institution

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Nursing; Evidence based practice
Queensland Australia has lately been experiencing an increase in the cases of children
being diagnosed as obese. Obesity has become a public health issue in Queensland. According to
Queensland Times of 9th 2018, the journal acknowledges that obesity has led to the rise of organ
transplant rates in most health facilities (Simpson, Griffin, & Mazzeo, 2017). In this paper,
therefore, we shall discuss obesity and its consequences as a nursing practice issue.
Obesity is a health condition characterized by too much fat in the body (Gregg, & Shaw,
2017). The fat accumulates after consumption of calories (Gregg, & Shaw, 2017). The calories
taken by the body is imbalanced with the calories broken down and released. The body then
struggles to balance between calories in and calories out. The fats are then deposited anyhow in
the body which creates a greater risk for the body. The body weight of the individual then
becomes past the health weight limit levels.
If the condition is not addressed, the body is at risk to acquire other secondary health
conditions. The other secondary health conditions associated with Obesity which really makes it
a concern to exploit include; heart complication, arthritis, high blood pressure and diabetes
(Stillman, Weinstein, Marsland, Gianaros, & Erickson, 2017). All these secondary diseases have
become public health and nursing health concerns in Queensland and the world at large. The
condition has even serious effects to women than children. For pregnant women, it causes pre-
mature deaths and is one cause of high mortality rates (Kachur, Lavie, Milani, & Ventura, 2017).
Obesity as a condition can be managed through practices such as regular and physical exercises,
proper observation of diet and minimized consumption of calorie foods. Apart from the
mentioned conditions, obesity can cause other conditions that are weight related. An example of
such a rare condition is brittle bones.

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It is important to recognize that at times Obesity might be generic (Garvey, Hurley, &
Kushner, 2016). When it is generic and inherited from parents to off springs it becomes very
difficult to control it. In the generic case, the condition is part of the genetic make-up of an
individual, it absolutely impossible to break the genetic make-up and create one free from the
condition (Garvey, Hurley, & Kushner, 2016).
Clinical question
Obesity is among the seven leading causes of death in Queensland Australia. Its presence
is accompanied by hypertension and the two types of diabetes. The latest estimate has shown that
over 1.9 million deaths caused by obesity occurred in the year 2017 (Wadden, & Bray, 2017).
For developing countries the condition is worse. Developing counties cater for 70% of all the
obese cases globally.
The big question then becomes, what is condition is Obesity, what are the causes, and
lastly what are some of the effects of the disease?
This paper will find the answers to what exactly is the obese condition (problem), what
the complications of the same (intervention) are, what the causes (comparison) are and what
success has the Queensland major medical practitioners achieved in fighting the disease
(outcome).
Search strategy
For purposes of acquiring full knowledge about obesity, there is need to gather
information of all sorts. Information has to be relevant and legit. All the information on the topic
has to be relevant. It was for the purpose of relevancy that the following search methods and
strategies were chosen:

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Literature review
For the purpose of literature review, articles and medical journals were used. The focus of
the search was reduced to articles done within the past five years. Each of the articles chosen
contains information from different parts of the world. Widening the scope to articles with data
from all over the world gives a better understanding of what to expect as we narrow down to
Queensland Australia. Such global data also helps in giving prevalence of the disease globally. A
lot of the reviews are done by professional in the field of medicine. A number of the reviews
have been published by professors while most are professional academic doctors. Professional
doctors who have researched about obesity and have learnt the patterns of the disease. To crack
down the information better, the research had to identify terminologies mostly used by the
reviews and is relevant to the knowledge of obesity. Some of the identified terms include; body
fat, calories, metabolism, weight and diabetes. All these terms share relevancy with obesity
directly or indirectly.
Community collection
Many volunteers from the Queensland community were asked to participate in the
research activity. Community participation helped the research in getting the sample population
of obese individuals picked from different places. The sample population from the community
included those affected, participants and the ones already seeking medical attention. A sample of
300 people from the community was used. An activity that lasted for five days was also done.
Relevant data including height, weight, age and medical history was also collected. Their
relevancy helped in collecting any possible trends that might have contributed to the rise of
obesity and over-weight cases. Affected individuals had the privilege of interacting with medical
experts.

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Clinical records
Hospital records that contain all the information of statistical data on the reported case of
obesity were collected from various health facilities with the Queensland region. The data from
these health facilities were so relevant in comparing each of the data. With the data comparison
across the four years was also quite easy. The main focus from the collection taken was to
identify the changing numbers of patients recorded to have been affected by the disease. A
bigger portion was predicted to be suffering from overweight and not obesity (Griffiths et al.,
2019). The clinical records and data acted as the most relevant data towards wanting to learn
more about obesity. The changing trends in the world and those that were unique only to
Queensland, Australia were also derivable from the clinical data records.
Strategy of choosing the five literature sources
The method chosen for the purpose of this research was online web searches. The online
web searches are easier and faster. Hand searching of research references and the internet is quite
easier than hand searching. From the internet, the search focused on websites that are electronic
designed for archived books and databases (Bayliss, 2017). An example of the searched engine is
Google scholar which is specifically tailored to identify academic articles only. Another Search
engine used is pub med. Pub med is an engine made for all articles that are medical related
(Bayliss, 2017). Within the search engines the research narrowed down to titles and any abstracts
of relevance. The articles that had any titles related to obesity would be submitted to further
probing through reading the abstracts. It is through the abstracts that articles of relevance were
determined (Bayliss, 2017). The online, search engine and screening method of article selection
was preferable since it is not only fast but also convenient through focusing on a period number
of years. The search strategy will help the research come up with the definition of the condition,

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the causes, the effects, the treatment strategies and the outcome, which are all a summary of the
research question.
Literature synthesis of the best evidence
Discussion
Impact of obesity by Jepsen et al., (2018) is a relevant text. The information from this
book is reliable and valid. The validity and reliability is of the book is determined by the authors
who are counselors. The counselors documented a journal from the children who were affected
by obesity and being overweight psychologically. Such documentation from professional
counselors makes the book relevant. The literature exclaims that children between the ages of 6
to 16 are highly psychologically affected by the obese condition. In Queensland for every 10
children one of them is obese (Jepsen et al., 2018). Psychologically, these children feel tortured
by their body condition and they are afraid to try out new possibilities within the learning
environment. In some extreme cases obese children have gone further and attempted suicide due
to the kind of psychological torture they undergo (Jepsen et al., 2018). Applying such to nursing
practice is that more attention should be given to adolescent to the nurse. The nurses should
struggle as much as they can to make sure adolescent and children who are obese and overweight
are counseled (Jepsen et al., 2018). They should be advised against luxurious life styles while
they get exposed to more physical exercise.
The second literature focuses on the relationship between obesity and other conditions.
This literature by Font-Burgada, Sun & Karin (2016) is valid since it recovers data from clinical
data of obese individuals suffering from secondary infections. An individual suffering obesity
has the Cushing syndrome. The syndrome slows down breakdown of the fats and other metabolic
activities. When these metabolic activities are slowed down they cause secondary infections.

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Such an infection is blood pressure which happens when there is deficiency in the pumping of
blood (Font-Burgada, Sun, & Karin, 2016). For the purpose of the practice, nurses should in this
case intervene and come up with a treatment plan that prevents secondary infection for
overweight and obese people.
In this journal the focus was to discuss the major causes of obesity in both children and
adults (Sahoo et al., 2015). The journal is valid since the professors involved in the publication
took several years studying the condition. In the journal, the major causes of obesity have been
mentioned as poor nutrition, age lifestyle, conditions like pregnancy and the genetic make-up. It
is advisable that nurses undertake public health teaching on women, on diet and lifestyle
generally. On issues genetic, it might be difficult to deal with genetic cause of obesity (Sahoo et
al., 2015).
GBD 2015 Obesity Collaborators, 2017 released a publication that explains the effects of
obesity. The most dangerous effect of obesity discussed is that it causes cancer. Cancer as a
disease is very difficult and wanting. Most people affected with cancer require financial, social
and most importantly psychological support. Cancer is the most deadly effect of obesity that the
publication discusses. Other minor effects include psychological tortures, reduced quality of life
and other secondary infections (GBD 2015 Obesity Collaborators, 2017). Nurses are advised to
challenge the patient’s family to give an obese individual all the supported required with
intentions of avoiding any post-obese medical conditions.
This last article is medical magazine. The Queensland Newspaper of 9th May printed
information regarding progress that the region had made in trying to reduce the killer effects of
obesity. The information is credible and legit since it involves government agencies. According
to the magazine the health minister of Queensland had indicated three ways that the region was

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to tackle obesity (Alexandria, 2018). In the first, they had released a research team to help
establish how they would tackle the menace. Further, the minister indicated that they had
invested $8.5 million campaign on public awareness. The program was to be enrolled on street
advertisements, media advertisements and the direct for over the next three months (Alexandria,
2018). The nurse practice involved here is that when handled as a public health issue a solution
might be found for the same. Involving the government agencies is also very important in
handling a matter of such public concern (Alexandria, 2018).
Recommendation for practice change
It is in the public domain that obesity is a disease associated with a wide range of serious
complications. However, the good news is that it can be prevented (Wannamethee, & Atkins,
2015). When it is diagnosed early enough it will be possible to control the complications that are
associated with it. It is also recommendable for the general public to consider simple lifestyle
measures as the basic treatment plan of obesity. For nurses they should advise many patients to
change their lifestyle and avoid getting infected or so (Mina et al., 2015). Nurses should make
available to the general public any relevant information regarding obesity, the risks and the
warnings signs of the condition. Knowledge of basic information on treatment will save a very
good number of lives. In conclusion, everyone within and out the medical condition should find
it their responsibility to prevent the occurrence of obesity, failure of which the condition will be
worse even with the intervention of WHO.

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References
Alexandria F, (2018). Time for Queensland to step up for Obesity. Queensland Times
Newspaper. (1).
Bayliss, D. R. (2017). Decision-Making in Prostate Cancer--Choosing Active Surveillance Over
Other Treatment Options: A Literature Review. Urologic nursing, 37(1).
Font-Burgada, J., Sun, B., & Karin, M. (2016). Obesity and cancer: the oil that feeds the
flame. Cell metabolism, 23(1), 48-62.
Garvey, W. T., Hurley, D. L., & Kushner, R. F. (2016). Patient-Centered care of the patient with
obesity. Endocrine Practice, 22, 9.
GBD 2015 Obesity Collaborators. (2017). Health effects of overweight and obesity in 195
countries over 25 years. New England Journal of Medicine, 377(1), 13-27.
Gregg, E. W., & Shaw, J. E. (2017). Global health effects of overweight and obesity. (33-37)
Griffiths, L. J., Cortina‐Borja, M., Bandyopadhyay, A., Tingay, K., De Stavola, B. L., Bedford,
H., ... & Dezateux, C. (2019). Are children with clinical obesity at increased risk of
inpatient hospital admissions? An analysis using linked electronic health records in the
UK millennium cohort study. Pediatric obesity, 14(6), e12505.
Jepsen, S., Caton, J. G., Albandar, J. M., Bissada, N. F., Bouchard, P., Cortellini, P., ... & Geurs,
N. C. (2018). Periodontal manifestations of systemic diseases and developmental and
acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on
the Classification of Periodontal and Peri‐Implant Diseases and Conditions. Journal of
clinical periodontology, 45, S219-S229.
Kachur, S., Lavie, C. J., Milani, R. V., & Ventura, H. O. (2017). Obesity and cardiovascular
diseases. Minerva medica, 108(3), 212-228.

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Mina, R., Klein-Gitelman, M. S., Nelson, S., Eberhard, B. A., Higgins, G., Singer, N. G., ... &
Levy, D. M. (2015). Effects of obesity on health-related quality of life in juvenile-onset
systemic lupus erythematosus. Lupus, 24(2), 191-197.
Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015).
Childhood obesity: causes and consequences. Journal of family medicine and primary
care, 4(2), 187.
Simpson, C. C., Griffin, B. J., & Mazzeo, S. E. (2017). Psychological and behavioral effects of
obesity prevention campaigns. Journal of health psychology, 1359105317693913. (230-
234)
Stillman, C. M., Weinstein, A. M., Marsland, A. L., Gianaros, P. J., & Erickson, K. I. (2017).
Body–brain connections: The effects of obesity and behavioral interventions on
neurocognitive aging. Frontiers in aging neuroscience, 9, 115.
Wadden, T. A., & Bray, G. A. (Eds.). (2018). Handbook of obesity treatment. Guilford
Publications.
Wannamethee, S. G., & Atkins, J. L. (2015). Muscle loss and obesity: the health implications of
sarcopenia and sarcopenic obesity. Proceedings of the Nutrition Society, 74(4), 405-412

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APPENDIX A

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APPENDIX B
Author Objectives/ main
information from the
literature
Data strategy
(Jepsen et al., 2018) The literature discusses the
impact of obesity and
overweight issues on the
psychological growth of a
child before the adolescent
age.
Literature review

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(Font-Burgada, Sun, & Karin,
2016).
Discusses the relationship
between the being obese and
health practices that make you
acquire other chronic diseases.
Literature review
(Sahoo et al., 2015). Determine the cause of obesity
and over weight in terms of
diet and the general well being
of an individual
Literature review
(GBD 2015 Obesity
Collaborators, 2017)
Exploits the immediate effects
and consequences of
overweight and obesity.
Literature review
(Alexandria, 2018) Discusses the progress and the
intervention taken in
Queensland. How the progress
has become more and more
effective.
Synthesis findings
EVIDENCE SUMMARY TABLE

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SEARCH
QUESTION
TOPIC
The big
question then
becomes,
what is
condition is
Obesity, what
are the
causes, and
lastly what
are some of
the effects of
the disease?
AUTHOR
date
Study
design
Key
information
Validity
check
e.g.
bias
Authors
finding
Author
conclusion
Review
comments
(Jepsen et al.,
2018)
Research;
Text
10
P-Obesity
among
children
I- counseling
C-increased
number of
affected
children
psychology
O –reduced
luxurious life
Valid
and
reliable
Applying
psychological
counseling to
nursing
practice and
that more
attention
should be
given to
adolescents
who are obese
Children
should be
advised
against
luxurious
life styles
while they
get exposed
to more
physical
exercise.
Perfect

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APPENDIX C
(Jepsen et al., 2018) https://scholar.google.com/scholar?
hl=en&as_sdt=0%2C5&as_ylo=2015&q=Jepsen%2C+S.%2C+Caton%2C+J.+G.%2C+Albandar
%2C+J.+M.%2C+Bissada%2C+N.+F.%2C+Bouchard%2C+P.%2C+Cortellini%2C+P.%2C+...+
%26+Geurs%2C+N.+C.+
%282018%29.+Periodontal+manifestations+of+systemic+diseases+and+developmental+and+ac
quired+conditions
%3A+Consensus+report+of+workgroup+3+of+the+2017+World+Workshop+on+the+Classificat
ion+of+Periodontal+and+Peri%E2%80%90Implant+Diseases+and+Conditions.
+Journal+of+clinical+periodontology%2C+45%2C+S219-S229&btnG=#d=gs_cit&u=
%2Fscholar%3Fq%3Dinfo%3AzjcsaqqG_IsJ%3Ascholar.google.com%2F%26output%3Dcite
%26scirp%3D0%26hl%3Den
(Font-Burgada, Sun, & Karin, 2016).
https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&as_ylo=2015&q=Font-Burgada
%2C+J.%2C+Sun%2C+B.%2C+%26+Karin%2C+M.+%282016%29.+Obesity+and+cancer
%3A+the+oil+that+feeds+the+flame.+Cell+metabolism%2C+23%281%29%2C+48-62&btnG=

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(Font-Burgada, Sun, & Karin, 2016).
https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&as_ylo=2015&q=Sahoo%2C+K.
%2C+Sahoo%2C+B.%2C+Choudhury%2C+A.+K.%2C+Sofi%2C+N.+Y.%2C+Kumar%2C+R.
%2C+%26+Bhadoria%2C+A.+S.+%282015%29.+Childhood+obesity
%3A+causes+and+consequences.+Journal+of+family+medicine+and+primary+care
%2C+4%282%29%2C+187.&btnG=
(GBD 2015 Obesity Collaborators, 2017)
https://scholar.google.com/scholar?
hl=en&as_sdt=0%2C5&as_ylo=2015&q=GBD+2015+Obesity+Collaborators.+
%282017%29.+Health+effects+of+overweight+and+obesity+in+195+countries+over+25+years.
+New+England+Journal+of+Medicine%2C+377%281%29%2C+13-27&btnG=
(Alexandria, 2018)
http://statements.qld.gov.au/Statement/2013/10/24/time-for-queensland-to-step-up-fight-against-
obesity
APPENDIX D: CASP
CRITICAL APPRAISAL SKILLS PROGRAMME
CASP´s 11 questions to help you make sense of a trial
A/ Are the results of the trial valid?

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Screening Questions
1 Did the trial address a clear question?
Can you tell what
Yes  Can't tell  No

2 Was the assignment of patients to treatments
randomized?
Yes
 Can't tell  No

3 Were all of the patients who entered the trial
properly accounted for at its conclusion
Yes
 Can't tell  No

All accounted for
• was follow up complete?
• were patients analysed in the groups to which
they were randomised?
•
Detailed Questions
4 Were patients, health workers and study
personnel ‘blind’ to treatment?
• were the patients
• were the health workers
• were the study personnel
Yes
 Can't tell  No

5 Were the groups similar at the start of the trial?
• In terms of other factors that might effect the
outcome such as age, sex, social class
Yes
 Can't tell  No

6 Aside from the experimental intervention, were
the groups treated equally?
Yes
 Can't tell  No


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B/ What are the results?
7 How large was the treatment effect?
Look at the result for each of the outcomes measured
8 How precise re the estimates of the treatment
effect?
What are the confidence limits or P-values for each
estimate?
The treatment effect was large enough
The estimates were precise with confidence level at
95% and p-value of 0.05
C/ Will the results help locally?
9 Can the results be applied to the local
population?
Yes Can't tell No
Consider whether there good reasons to think that the
patients covered by the trial may be importantly different
from your own
  
10 Were all clinically important outcomes considered?
If not, does this affect the decision?
Yes
 Can't tell  No

11 Are the benefits worth the harms and costs? Yes Can't tell No

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This is unlikely to be addressed by the trial. But what do
you think?
  