Challenges in Nursing Care of Morbidly Obese Patients: Nurses’ Viewpoints

Abstract

Background: Parallel with the growing obesity problem in the world, the number of obese patients admitted to hospitals is soaring. With the hospitalization of the obese patients, healthcare team faces many challenges. Based on studies in many countries, most of the problems are related to inadequate equipment and space, shortage of nursing staff, high pressure on the staff for transferring patients, which causes physical damage. In this study, we examined problems related to the care of obese patients in Iran from the perspective of personnel in surgical wards and operating rooms. Methods: This cross-sectional study was conducted in 2015. Data were collected using a three-section researcher-made questionnaire completed by the staff. The first part collected demographic information, while the second part pertained to patient's problems and the challenges that the staff faced regarding equipment and clinical activities. The third part covered personnel's opinion about priorities of care of obese patients. The collected data were analyzed by statistical tests in SPSS software, Chi-square test, fisher exact test and descriptive statistic. Results: Two hundred people participated (25% male and 75% female) in this study. Regarding the equipment, the biggest challenges for the personnel were related to the lifters and then the clothing and bed sheets. Concerning clinical activities, repositioning the patient (56.1%), transferring between the wards and clinics and changing clothes were the biggest challenges. The participants believe the priorities for obese patient care include employing more staff and supplying equipment. Conclusions: Taking the increasing number of obese patients in hospitals along with the importance of staff health, and providing appropriate patient care, it is necessary to provide the required equipment for obese patient care and to educate the staff for delivering high-quality care.

Healthcare Workers’ Experiences of Strategies in Caring for Patients with Obesity: A Qualitative Content Analysis

“…Patients with obesity (PWO) stay in hospital (2) due to non-communicable diseases (3), and nurses have to handle challenges even when providing the most basic nursing care for these patients (4). Examples of difficult patient care situations include measuring blood pressure, monitoring hemodynamics, positioning, bathing (5), transferring the patient (5,6), intubating or inserting tracheostomy and a laryngeal mask airway (7,8) palpating the carotid pulse during resuscitation, as well as performing CPR (4) and venipuncture (5). Fat tissue, patients' large size (6), and the lack of treatment-care facilities appropriate to their weights (5,9,10) are the most common causes of patient care challenges, which have consequences for both nurses (such as increased workload (11), fatigue (12), and back injury (13)) and patients such as falling from the bed during difficult movements (14), fracture, head trauma, skin damage, and bedsores, which can cause patient safety incidents (15).…”

Nurse’s Experiences of Care Challenges of Admitted Patients with Obesity: A Qualitative Content Analysis Study

“…Nurses are in charge of providing care for patients in hospitals. Patients have different and more care needs due to their large sizes (10,11). Nurses may have difficulty in changing a patient's position (12), transferring them (10), and controlling vital signs while taking care of them (12), all of which can lead to poor quality of care.…”

“…Patients have different and more care needs due to their large sizes (10,11). Nurses may have difficulty in changing a patient's position (12), transferring them (10), and controlling vital signs while taking care of them (12), all of which can lead to poor quality of care. Healthcare providers have reported poor quality care, unmet needs of PWO (11), and weight bias (e.g., the use of unpleasant words and negative judgments) (13).…”