Clinical Leadership and Management Perceptions of Inpatients with Obesity: An Interpretative Phenomenological Analysis

Evidence indicates growing demand on community health and social care services by people with severe obesity (BMI ≥40 kg/m2), often due to functional limitations. The experiences of this population are largely unexplored. As part of a larger mixed‐methods study, this qualitative study explored the lived experience of people with severe obesity using community health and social care services. Participants were recruited via community professionals and visited at home. They consented to individual, audio‐recorded, semistructured interviews, which were transcribed and analysed using thematic analysis. Nine women and three men (n = 12) participated, aged 40–76 (mean 60) years, BMI ranged from 45 to 74 (mean 59) kg/m2, and eight were housebound. Three overarching themes were identified. Firstly, the hidden struggles of living with a larger body affected all participants, including functional limitations affecting mobility and personal care. These contributed to a sense of being stuck physically, socially, and biographically. Secondly, most participants reported implicit weight bias by a system structurally unprepared to care for people with larger bodies. The majority of participants showed strong internalised weight bias, linked to shame and self‐blame for their poor function and larger bodies. Thirdly, a day‐to‐day coping theme highlighted strategies regularly used by participants: resigned acceptance, avoidance and denial, exercising choice, and support from informal carers. These findings demonstrate that participants experienced unmet physical and psychological care needs associated with living with a larger body, leading to poor quality of care and life. Given rising prevalence, changes to care services are needed. Specific recommendations include staff training about the needs of people with severe obesity, ensuring that the physical infrastructure of care services can safely accommodate people with severe obesity, and improving access to effective, person‐centred weight management treatments.

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The lived experience of patients with obesity at a metropolitan public health setting

Pazsa

Said

Haines

et al. 2022

BMC Health Serv Res

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Background Patient-centred care models for acutely hospitalised people living with obesity are poorly understood and the quality of evidence low. Objective The aim of this study was to explore and better understand the lived experience of people living with obesity, in the inpatient hospital context. Design A qualitative methodology using Interpretative Phenomenological Analysis (IPA) was used. Data were collected via a single semi-structured interview with each participant. Setting and participants The study was completed at a metropolitan public health service. Ten previously hospitalised patients who live with obesity were included. Results Three main themes emerged: meeting physical care needs of people with obesity on hospital wards, interpersonal interactions between patients and healthcare professionals, and the psychosocial impact of being obese in the hospital setting. Priorities included timely provision of appropriate equipment and infrastructure design to meet care needs and facilitate better wellbeing. To improve patient experience, an emphasis on basic principles of quality care provision to enhance interpersonal interactions, along with improved awareness of the impact of weight bias and obesity stigma in healthcare are supported. Participants found hospitalisation stressful, but valued support from healthcare professionals regarding weight loss. Discussion These data provide new insights in to the lived experience of people living with obesity in the hospital setting. Items which are low cost, such as appropriately sized chairs and gowns, as well facilitators to independent mobility such as electric wheelchairs are suggested to improve both experience and care outcomes. Interpersonal interactions demonstrated obesity stigma in the hospital setting, with participants expressing the desire for more appropriate communication. People living with obesity self-reflected in the inpatient setting, suggesting that staff should be trained to utilise the opportunity to provide weight loss advice. Conclusions The themes identified in this study provide insight into the lived experience of people with obesity in hospital. This understanding provides direction for the development of improved models of care for people living with obesity in this setting and beyond.

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Clinical Leadership and Management Perceptions of Inpatients with Obesity: An Interpretative Phenomenological Analysis

Cited by 3 publications

References 34 publications

Occupational therapy in overweight and obesity care: Australian perspectives from a mixed methods study

Occupational therapy in overweight and obesity care: Australian perspectives from a mixed methods study

The Lived Experiences of People with Severe Obesity Who Use Community Health and Social Care Services: A Qualitative Interview Study

The lived experience of patients with obesity at a metropolitan public health setting

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