Nurses' Experience of Care Challenges of Hospitalized Patients with Obesity: A Qualitative Content Analysis Study

Keywords

obesity
challenge
nursing care
patient safety
nurse experience

Categories

How to Cite

Bagheri, M. ., Heidari, A. ., & Manzari, Z. S. . (2022). Nurses’ Experience of Care Challenges of Hospitalized Patients with Obesity: A Qualitative Content Analysis Study. Iranian Red Crescent Medical Journal, 24(7). Retrieved from https://ircmj.com/index.php/IRCMJ/article/view/1969

Abstract

Background: Nurses have difficulties in caring for patients with obesity (PWO) due to their large size and complex care needs. As there have been few studies on these challenges, it is necessary to identify them for PWO through access to nurses’ experiences.

Objectives: This study aimed to explain the nurses’ experiences of the challenges of caring for admitted PWO.

Methods: This qualitative study was performed on 12 nurses working in two large urban teaching hospitals in Iran. They were selected using the purposive sampling method. Data were collected using semi-structured interviews during 2018-2020. Content analysis and MAXQDA software (version 10) were used to analyze data.

Results: According to the results, "threat to the patient safety" was the main theme extracted from nurses’ experiences, which included three categories, namely "from care difficulty to inaccurate care", "exacerbation of clinical complications", and "limited self-care". The category of "from care difficulty to inaccurate care" consisted of the subcategories of "care difficulty" and "inevitability of performing inaccurate care". The category of "exacerbation of clinical complication" was composed of the subcategories of "domino-like deterioration of the clinical condition", "multiple physical problems", "patient injury", and "death". The category of "limited self-care" included the subcategories of "patient difficulties with personal hygiene", "limited ability to move/change position", and "inability to meet defecation needs".

Conclusion: According to nurses, "threat to patient safety" was the main challenge of caring for PWO. Patients with obesity could receive competent care from nurses who have a thorough awareness of the obesity threat to patient safety.

References

WHO. Obesity and overweight. https://wwwwhoint/news-room/fact-sheets/detail/obesity-and-overweight. Retrieved on June 9, 2021.

Tabrizi JS, Sadeghi-Bazargani H, Farahbakhsh M, Nikniaz L, Nikniaz Z. Prevalence and associated factors of overweight or obesity and abdominal obesity in Iranian population: a population-based study of northwestern Iran. Iranian journal of public health. 2018;47(10):1583.

Rockx MAJ, Fox SA, Stitt LW, Lehnhardt KR, McKenzie FN, Quantz MA, et al. Is obesity a predictor of mortality, morbidity and readmission after cardiac surgery? Canadian journal of surgery. 2004;47(1):34.

Padwal RS, Wang X, Sharma AM, Dyer D. The impact of severe obesity on post-acute rehabilitation efficiency, length of stay, and hospital costs. Journal of obesity. 2012;2012:https://doi.org/10.1155/2012/972365.

Nguyen AT, Tsai C-l, Hwang L-y, Lai D, Markham C, Patel B. Obesity and mortality, length of stay and hospital cost among patients with sepsis: a nationwide inpatient retrospective cohort study. PLoS One. 2016;11(4):e0154599. https://doi.org/10.1371/journal.pone.

Moriconi D, Masi S, Rebelos E, Virdis A, Manca ML, De Marco S, et al. Obesity prolongs the hospital stay in patients affected by COVID-19, and may impact on SARS-COV-2 shedding. Obesity research & clinical practice. 2020;14(3):205-9. https://doi.org/10.1016/j.orcp.2020.05.009.

Hauck K, Hollingsworth B. The impact of severe obesity on hospital length of stay. Medical care. 2010:335-40. https://www.jstor.org/stable/27798453.

Miyazawa D. Why obesity, hypertension, diabetes, and ethnicities are common risk factors for COVID‐19 and H1N1 influenza infections. Journal of Medical Virology. 2020:https://doi.org/10.1002/jmv.26220.

Chuang J-F, Rau C-S, Liu H-T, Wu S-C, Chen Y-C, Hsu S-Y, et al. Obese patients who fall have less injury severity but a longer hospital stay than normal-weight patients. World journal of emergency surgery. 2016;11(1):1-6. https://doi.org/10.1186/s13017-015-0059-9

Foroozesh R, Sadati L, Nosrati S, Karami S, Beyrami A, Fasihi T. Challenges in nursing care of morbidly obese patients: Nurses’ viewpoints. Journal of Minimally Invasive Surgical Sciences. 2017;6(2):1-7 . https://doi.org/10.5812/minsurgery.12040.

Lumley E, Homer CV, Palfreyman S, Shackley P, Tod AM. A qualitative study to explore the attitude of clinical staff to the challenges of caring for obese patients. Journal of clinical nursing. 2015;24(23-24):3594-604. https://doi.org/10.1111/jocn.13016.

Baqraf F, Mohamed MA, Mahgoub AA. Obstacles Face Nursing Staff Toward Care of Critically Ill Obese Patient in Intensive Care Units. Assiut Scientific Nursing Journal. 2020;8(23.00):100-12.

Wakefield K, Feo R. Confronting obesity, stigma and weight bias in healthcare with a person centred care approach: A case study. Australian Nursing and Midwifery Journal. 2017;25(1):28-31. https://search.informit.com.au/documentSummary;dn=909958228125391;res=IELHEA.

Wharton S, Lau DC, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: a clinical practice guideline. Cmaj. 2020;192(31):E875-E91. https://doi.org/10.1503/cmaj.191707.

O’Shea D, Kahan S, Lennon L, Breen C. Practical Approaches to Treating Obesity: Patient and Healthcare Professional Perspectives. Advances in Therapy. 2021;38(7):4138-50. https://doi.org/10.6084/m9.figshare.14407043.

Hales C, de Vries K, Coombs M. Managing social awkwardness when caring for morbidly obese patients in intensive care: A focused ethnography. International Journal of Nursing Studies. 2016;58:82-9. https://doi.org/10.1016/j.ijnurstu.2016.03.016.

Hales C, Coombs M, de Vries K. The challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study. Australian Critical Care. 2018;31(1):37-41. https://doi.org/10.1016/j.aucc.2017.02.070.

Shea JM, Gagnon M. Working with patients living with obesity in the intensive care unit: a study of nurses' experiences. ANS Advances in nursing science. 2015;38(3):E17. https://doi.org/0.1097/ANS.0000000000000074.

Griebling TL. Re: Continence Care for Obese Nursing Home Residents. The Journal of Urology. 2011;186(1):213-4. https://doi.org/10.1016/j.juro.2011.03.084.

Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative health research. 2005;15(9):1277-88. https://doi.org/10.177/1049732305276687.

Buus N, Perron A. The quality of quality criteria: Replicating the development of the Consolidated Criteria for Reporting Qualitative Research (COREQ). International Journal of Nursing Studies. 2020;102:103452 https://doi.org/10.1016/j.ijnurstu.2019.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004;24(2):105-12. https://doi.org/10.1016/j.nedt.2003.10.00.

Polit D, Beck C. Essentials of nursing research: Appraising evidence for nursing practice. 9th ed ed. Philadelphia: Lippincott Williams & Wilkins; 2018.

Bouldin SD. Obesity in Health Care: Perceptions of Health Care Providers and Patients at an Academic Medical Center [D.H.A.]. Ann Arbor: thesis.The University of Mississippi Medical Center; 2020.

Herdman TH, Kamitsuru S. NANDA International, Inc. Nursing Diagnoses: Definitions & Classification 2018-2020: Thieme; 2018.

Diab GMAE, Ebrahim RMR. Factors leading to missed nursing care among nurses at selected hospitals. American Journal of Nursing. 2019;7(2):136-47. https://doi.org/10.12691/ajnr-7-2-5.

Booth C, Moore C, Eddleston J, Sharman M, Atkinson D, Moore J. Patient safety incidents associated with obesity: a review of reports to the National Patient Safety Agency and recommendations for hospital practice. Postgraduate medical journal. 2011;87(1032):694-9. http://dx.doi.org/10.1136/pgmj.2010.106989.

Harris JA, Castle NG. Obesity and nursing home care in the United States: a systematic review. The Gerontologist. 2019;59(3):e196-e206. https://doi.org/10.1093/geront/gnx128.