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ABSTRACT

Introduction: Obesity is an increasingly common long termcondition in most parts of the world. However, in many societies negative stereotypes are associated with larger body size. Community nurses have a key role in the prevention and management of obesity.
Objectives: To explore community nurses' attitudes and beliefs in advising patients about obesity and to explore the effects of the nurse's own body size in this context.
Methods: Community nurses of markedly different body size were interviewed in depth in a qualitative study in the north of England. The study employed theoretical sampling and 'framework' methods of analysis within a rigorous research design¹.
Results: Participants were aware of obesity stigma and this contributed to perceptions of obesity being a potentially sensitive issue to discuss with clients. Communication tactics were employed in managing the sensitivity with emphasis placed on maintaining good rapport. Participants took care in avoiding stereotypes in presenting their beliefs about obesity which were complex and ambivalent. Participants were conscious of their own body size in interactions with patients. A slim build appeared to amplify sensitivities surrounding obesity and add concerns about appearing to lack empathy or authentic experience. Those with a large body size made a virtue of their perceived greater empathy and experience but had concerns of being a poor role model and hypocritical in lifestyle advice. Self disclosure techniques oriented to demonstrating personal understanding and rapport were employed in interactions with patients to manage impressions made by body size.
Conclusions: Attitudes and beliefs of community nurses do not simply reflect societal stereotypes about obesity. Nurses' own body size may be an important factor in obesity management. Further training to strengthen lifestyle counselling techniques may be required by some nurses.

Reference: 1. Ritchie J. and Lewis J. (2003) Qualitative Research Practice. London, Sage.

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