Abstract:
Objective: Provide an understanding of the attributions Bachelor of Science in Nursing (BSN) students make about the cause of obesity, resulting in potential bias toward obese patients. Methods: A concurrent mixed-methods study examined the attitudes and beliefs of nursing students, two groups of undergraduates (one in first-year and one in final-semester). They completed demographics, the Nurses’ Attitudes toward Obesity and Obese Patients Scale (NATOOPS) and this data was further supplemented by findings from focus groups. Results: The results of the study demonstrated negative attitudes toward obesity for all five factors used to assess weight bias. The NATOOPS yielded statistically significant differences between the means of first-year and final-semester BSN students for the factors response to obese patients (p = 0.0114) and supportive roles for caring for obese patients (p = <0.0001). Male students’ scores indicated more negative attitudes as compared to female students’ scores (51.0 {8.1} vs. 46.7 {10.3}; p = 0.0293). There were not any statistically significant differences found between the BMI categories (underweight/normal weight and overweight/obese) scores indicating evidence of weight bias. White-Caucasian BSN students demonstrated statistically higher overall scores as compared to non-White students, indicating more negative attitudes (48.4 {9.7} vs. 43.9 {10.7} p = 0.0475). Focus group themes indicated obese patients were often viewed as being self-indulgent, lacking self-control, and being more challenging to care for. Both groups expressed negative attitudes, and held the obese person personally responsible. Discussion: Attribution theory was used as a theoretical lens for developing a greater understanding of the attribution influence on attitudes toward obese patients, resulting in weight bias. Identifying themes, as well as the point at which bias is most prevalent, may assist nurse educators in developing curriculum to effectively target and limit weight bias among BSN students.
