People are less likely to believe or act on healthy lifestyle advice from an overweight nursing professional, according to research by a former nurse who says it is time to be more honest about this taboo topic. In fact, healthy living advice may have more impact if it is delivered anonymously online and not face-to-face by someone who clearly has their own health problems, argues psychology graduate and former mental health nurse Helen McDowall.
“There is an incongruity here and something fundamental needs to change”
As part of her new study – titled Perceptions of health and source credibility in relation to weight differentials in health professionals – participants were asked to rate the credibility of health advice given by an imaginary nurse shown to have lost or gained weight. She said the findings demonstrated that participants were less likely to believe statements about healthy eating made by an overweight health professional and more likely to believe someone who was not overweight. This was also true when it came to non-weight-related advice on quitting smoking, she noted.
Ms McDowall worked as a registered mental health nurse for 19 years and then moved into other caring roles before embarking on a psychology degree at the University of Chichester.
“We are supposed to be non-judgemental and avoid embarrassing our patients”
She undertook the study for her final year dissertation and said she was inspired to explore the controversial topic by her own recent experiences of observing healthcare professionals at work. “It all came about because my husband has got cancer and I spent a long time last summer sitting around in hospital waiting rooms,” she said. “There were vending machines in every waiting room at my local hospital,” she said. “I saw nurses drinking full sugar Fanta and tucking into chocolates and it seemed incongruous and hypocritical to me. I wondered whether other members of the public were thinking critically like that or whether they just accepted it,” she told Nursing Times.
In all, 98 people aged 18 to 85 took part in the online exercise and were divided into two groups.
All were first shown anonymous health information and then introduced to an imaginary female nurse called Charlie described as a “highly respected nurse practitioner” with more than 10 years’ experience and expertise in both healthy eating and quitting smoking.
“Lots of my colleagues at university said I was mad bringing this subject up”
As well as being told a bit about Charlie’s background, participants were also shown a silhouette image depicting her as a healthy weight or clearly obese, and told to rate the credibility of her tips on healthy eating and smoking cessation.
They were then asked to “jump forward in time three years” and look at another picture of Charlie that showed she had either lost or gained “a lot of weight” and rate her advice again. Ratings for believability, authoritiativeness and Charlie’s character increased among those who observed her weight loss while ratings dropped for those who saw the nurse become obese.
“The results make intuitive sense, but nobody’s actually talking about it,” said Ms McDowall, who highlighted that a disproportionate number of NHS staff were classed overweight compared to the general public.
Source: Helen McDowall
She said her findings suggested that people might be more likely to follow healthy lifestyle advice if it was anonymous. “It may mean giving advice on the internet, without the involvement of a relationship, might be more effective because it is neutral and avoids the automatic judgements people make that are hard-wired into our minds,” she said.
Some trusts are establishing virtual nursing services, where people can get advice on issues like breastfeeding from a qualified nurse they never see through social media and messaging services. Ms McDowall told Nursing Times she understood all the issues that may make it harder for nurses to lead a healthy lifestyle, including feeling too tired to exercise, not being able to take proper breaks, the fact they often grabbed the nearest high energy snack just to get through a shift.
“I have been there, I have done the 36-hour shifts and 78-hour weeks and don’t want to do it anymore,” she said. “I am not sitting here in judgement, but what I am saying is that there is an incongruity here and something fundamental needs to change,” she told Nursing Times. She said she believed part of the problem was that nurses themselves felt constrained when it came to having frank conversations about sensitive topics like weight with their patients.
“We are supposed to be non-judgemental and avoid embarrassing our patients,” she said. “We’re not supposed to identify the obvious – we’re not supposed to say ‘you’re fat because you eat too much and don’t exercise enough’.”
Ms McDowall said: “I think this creates an environment which is safe for people who have weight issues – or any health-related issues – to be and to work and not be judged. Lots of my colleagues at university said I was mad bringing this subject up, because nobody is interested in talking about it and just want to push it under the carpet,” she said. “But we need to talk about it. It’s about being honest and transparent and recognising that healthcare organisations not only have a responsibility to members of the public, but also a responsibility to look after their staff and give them the opportunities, the working patterns, the facilities, the time to be able to live a healthy lifestyle,” she added.
By Jo Stephenson
Source: Nursing Times
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