Evaluation of nurse's attitudes toward adult patients of size

Obesity is a growing epidemic in the United States, with waistlines expanding (overweight) for almost 66% of the population (National Health and Nutrition Examination Survey 1999-2004). The attitude of society, which includes healthcare providers, toward people of size has traditionally been negative, regardless of their own gender, age, experience, and occupation. The purpose of the present study was to determine whether bariatric sensitivity training could improve nursing attitudes and beliefs toward adult obese patients and whether nurses' own body mass index (BMI) affected their attitude and belief scores.

An on-line survey was conducted of nursing attitudes and beliefs regarding adult obese patients. The responses were compared between 1 hospital that offered bariatric sensitivity training and 1 that did not. The primary study measures were 2 scales that have been validated to assess weight bias: Attitudes Toward Obese Persons (ATOP) and Beliefs Against Obese Persons (BAOP). The primary outcome measures were the scores derived from the ATOP and BAOP scales.

Data were obtained from 332 on-line surveys, to which 266 nurses responded with complete data, 145 from hospital 1 (intervention) and 121 from hospital 2 (control). The mean ATOP scores for hospital 1 were modestly greater than those for hospital 2 (18.0 versus 16.1, P = .03). However, no differences were found between the 2 hospitals for the mean BAOP scores (67.1 versus 67.1, P = .86). No statistically significant differences were found between the 2 hospitals among the BMI groups for either ATOP or BAOP. Within each hospital, no statistically significant trend was found among the BMI groups for either ATOP or BAOP. The association of BMI with the overall ATOP (r = .13, P = .04) and BOAP (r = .12, P = .05) scores was very weak, although marginally significant. The association of the overall ATOP score with the BAOP score was weak, although significant (r = .26, P < .001).

Annual bariatric sensitivity training might improve nursing attitudes toward obese patients, but it does not improve nursing beliefs, regardless of the respondent's BMI.