Abstract
There is good evidence to suggest that nurses’ bias towards patients with obesity has adverse psychological and physical health implications for patients in terms of poorer care from healthcare staff and the avoidance of healthcare. Despite important clinical implications the literature yields no consensus about specific factors relating to weight bias and no consistently used theoretical framework to interpret findings. Therefore this study aimed to draw on intergroup theories of weight bias to explore the relationship between weight bias in nurses and their self-esteem, BMI, qualification status, stress and burnout. The study used a cross sectional mixed method design, involving an online survey using standardized weight bias, self-esteem, stress and burnout measures and an open ended question about bias. Participants were 218 undergraduate and postgraduate nurses practicing within the United Kingdom. There was no evidence of weight bias and hence limited correlations detected between weight bias and self-esteem, BMI, qualification status, stress and burnout. Analysis of the open-ended responses suggests that social identity may influence weight bias, and the conceptual frameworks that nurses use to make sense of obesity. The used of standardised measures to explore factors relating to weight bias did not add clarity to the literature. However, qualitative data in this study enabled a better understanding of the complexity of attitudes towards obesity. Attitudes are portrayed in the context of a hierarchy of complex social identities situated within a broader social context. The qualitative analysis revealed that both these issues may make it difficult for nurses to ‘own’ more negative attitudes, which may explain the inability of more restrictive survey design methodologies to reveal the complexity of attitudes within a social context. Future research that uses methodologies that enable exploration of the complexity around the nursing role may further enhance our understanding of weight bias in nurses.