Practice nurses' beliefs about obesity and weight related interventions in primary care

Objective: To examine practice nurses' beliefs about obesity and their current practices and the role of the weight management context and their own BMI on these factors. Design: Cross sectional questionnaire. Subjects: Questionnaires concerning beliefs about obesity and current practices were completed by 586 practice nurses. Results: The subjects rated lifestyle as the main cause and cardiovascular problems as the main consequences of obesity, regarded weight loss as beneficial and reported high confidence in their ability to give advice to obese patients. However, their expectations of patient compliance and actual weight loss were low indicating that practice nurses rate their advice giving skills as independent to the outcome of this advice. Further, failed weight loss was explained in terms of patient and not professional factors. In addition, the results indicated variability in their beliefs and behaviour according to the location of this advice and the practice nurse's own BMI. In particular, practice nurses who run weight loss clinics reported giving weight loss advice more frequently, spending longer counselling obese patients, reported greater confidence in giving weight loss advice and more optimism about outcomes. Further, those with low BMIs rated obesity as more preventable, reported being less likely to advise patients to use a calorie controlled diet and more likely to suggest eating less in general. Conclusion: Education programmes for practice nurses should not only include skills training but emphasise both the factors involved in advice giving and self appraisal. Such appraisal should include a role for both the practice nurse's and the patient's behaviour to minimise the 'operation was a success but the patient died' approach to obesity management.