Sağlık Bakım Profesyonellerinin Obezite Sorunu Olan Kadın Hastalara Yönelik Tutum, Ön Yargı ve Obez Hasta Bakımına Yönelik Engelleri

Abstract

Amaç: Bu tanımlayıcı ve ilişki arayıcı çalışma, Türkiye'de obezite sorunu olan kadın hastalara bakım veren sağlık bakım profesyonellerinin (SBP) tutumlarını, önyargılarını ve hasta bakım engellerini değerlendirmek için yapılmıştır. Materyal ve Metot: Çalışmanın örneklemini, Türkiye'deki kamu ve üniversite hastanelerinde kadın obez hastalara bakım sağlayan ve bu çalışmaya katılmayı gönüllü olan 411 SBP oluşturmuştur. Veriler, Bilgi Formu, GAMS-27 Obezite Önyargı Ölçeği (GAMS-27), Obez Bireylere Yönelik Tutum Ölçeği (ATOP) ve Obez Hasta Bakım Engelleri Soru Formu (OHBEF) kullanılarak online çevrimiçi toplanmıştır. Bulgular: SBP’lerin ölçeklerdeki ortalama puanları, OHBEF=65,09±8,80, GAMS-27=77,91±4,52 ve ATOP= 59,24±0,23 idi. SBP’lerin OHBEF puan ortalaması yaş, erkeklerin ortalama Beden Kitle İndeksi (BKI) ve meslek grubu ile ilişkili olduğu belirlendi (p<0,05). Ayrıca, SBP'lerin ATOP puan ortalamaları, sosyodemografik özellikleri arasında ilişkili saptanmadı (p>0,05). Sonuç: Bu çalışma, SBP'lerin obezite hastası olan kadınlara karşı önyargılı ve olumsuz tutumlar sergilediğini ve bunun hasta bakımı için malzeme ve ekipman eksikliği, cinsiyet, yaş, BKI ve meslek grubu ile ilişkili olduğunu ortaya koymuştur.

Keywords

• Kadın
• obezite
• sağlık bakım profesyoneli
• tutum

Attitudes, Prejudices and Barriers of Healthcare Professionals towards Female Patients with Obesity

Abstract

ABSTRACT Objective: This descriptive and correlational study was conducted to evaluate the attitudes, prejudices, and patient care obstacles of healthcare professionals (HPs) who work in the healthcare and allied healthcare services and serve female patients with obesity in Türkiye. Materials and Methods: The sample of the study included 411 HPs who provided care to female patients in public and university hospitals in Türkiye and who volunteered to participate in this study. Data were collected online using an Information Form, GAMS-27 Obesity Prejudice Scale (GAMS-27), the Attitudes Toward Obese People Scale (ATOP), and the Questionnaire on Patient Care Obstacles for Patients with Obesity (OHBEF). Results: The mean scores of HPs on the abovementioned scales were OHBEF= 65.09±8.80, GAMS-27= 77.91±4.52, and ATOP= 59.24±0.23. The mean score of HPs on the OHBEF was related to age, mean Body Mass Index (BMI) of men, and occupational group (p<0.05). Additionally, the mean scores of HPs on the ATOP were not related to their sociodemographic characteristics (p>0.05). Conclusions: This study revealed that HPs had prejudiced and negative attitudes toward female patients with obesity, and this was related to a lack of materials and equipment for patient care, sex, age, BMI, and occupational group.

Keywords

• Attitudes
• barriers
• female
• healthcare professionals
• obesity

Ethical Statement

The approval of Istanbul University – Cerrahpasa, Social Humane Ethics Committee (Date: 07.01.2020, decision no: 2019/173) was obtained. The permissions of the authors of the scales used in the study were obtained via e-mail. During the study, the Helsinki Declaration criteria were complied with to protect the healthcare professionals' data, and written via e-mail consent was obtained from all the healthcare professionals participating in the study.

References

1. Centers for Disease Control and Prevention. Adult obesity prevalence maps. Updated September 21, 2023.  https://www.cdc.gov/obesity/data/prevalence-maps.html. Accessed October 3, 2024.
2. Ak ES, Türkmen A, Özbaş A, Fındık ÜY. Examination of attitudes of nurses working in surgical services toward obesity and obese patients. Bariatr Surg Pract Patient Care. 2021;16(3). doi:10.1089/bari.2020.0072
3. Wang J, Zhu L, Liu L, et al. Overweight and Obesity are risk factors of severe illness in patients with COVID-19. Obesity (Silver Spring). 2020;28(11):2049-2055. doi:10.1002/oby.22979
4. Sert H, Seven A, Çetinkaya S, Pelin M, Aygin D. Evaluation of prejudice against obesity in health high school students. Online Turkish J Heal Sci. 2016;1(4):9-17.
5. Hales C, Gray L, Russell L, MacDonald C. A. Qualitative study to explore the impact of simulating extreme obesity on health care professionals' attitudes and perceptions. Ostomy Wound Manage. 2018;64(1):18-24.
6. Fulton M, Dadana S, Srinivasan VN. Obesity, stigma, and discrimination. Updated October 26, 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2024.
7. Perkins RB, Wentzensen N, Guido RS, Schiffman M. Cervical cancer screening: a review. Jama. 2023;330(6):547-558. doi:10.1001/jama.2023.13174
8. Talumaa B, Brown A, Batterham RL, Kalea AZ. Effective strategies in ending weight stigma in healthcare. Obesity Reviews. 2022;23(10):e13494. doi:10.1111/obr.13494

9. Akpor OA, Akingbade TO, Olorunfemi O. Lack of adequate equipment for healthcare – the agony of patients and nurses: a review. Indian J Contin Nurs Educ. 2023;24(1):7-10. doi:10.4103/ijcn.ijcn_96_21
10. Turkish Statistical Institute. Health Statistics. Published 2017. https://data.tuik.gov.tr/Kategori/GetKategori?p=saglik-ve-sosyal-koruma-101&dil=1. Accessed July 3, 2024.
11. Ünal D. Evaluation of health care workers’ attitudes towards obese individuals. Master's thesis, Başkent University, Institute of Health Sciences, Department of Nutrition and Dietetics; Ankara, Türkiye; 2018.
12. Ercan A, Akçil Ok M, Kiziltan G, Altun S. Development of the obesity bıas scale for health sciences students: GAMS 27-obesity bias scale. Int Peer-Reviewed J Nutr Res. 2015;2(3):29-43.
13. Allison DB, Basile VC, Yuker HE. The measurement of attitudes toward and beliefs about obese persons. Int J Eat Disord. 1991;10(5):599-607. doi:10.1002/1098-108X(199109)10:5<599::AID-EAT2260100512>3.0.CO;2-%23
14. Dedeli O, Bursalioglu SA, Deveci A. Validity and reliability of the Turkish version of the attitudes toward obese persons scale and the beliefs about obese persons scale. Clin Nurs Stud. 2014;2(4):105-116. doi:10.5430/cns.v2n4p105
15. Tavşancıl E. Tutumların Ölçülmesi ve SPSS ile Veri Analizi Yöntemleri. 6th ed. Ankara: Nobel Akademik Yayıncılık Eğitim Danışmanlık Tic. Ltd. Şti; 2019.
16. Puhl RM. Weight stigma and barriers to effective obesity care. Gastroenterology Clinics. 2023;52(2):417-428. doi:10.1016/j.gtc.2023.02.002
17. Usta E, Akyolcu N. The evaluation of surgical nurses’ knowledge and applications on the care of overweight. Florence Nightingale Journal of Nursing. 2014;(1):1-7.
18. Fuzzell LN, Perkins RB, Christy SM, Lake PW, Vadaparampil ST. Cervical cancer screening in the United States: Challenges and potential solutions for underscreened groups. Preventive Medicine. 2021;(144):106-400. doi:10.1016/j.ypmed.2020.106400
19. Lawrence BJ, Kerr D, Pollard CM, Theophilus M, Alexander E, Haywood D, O’Connor M. Weight bias among health care professionals: a systematic review and meta‐analysis. Obesity. 2021;29(11):1802-1812. doi:10.1002/oby.23266
20. Yılmaz HÖ, Yabancı Ayhan N. Is there prejudice against obese persons among health professionals? A sample of student nurses and registered nurses. Perspect Psychiatr Care. 2019;55(2):262-268. doi:10.1111/ppc.12359
21. Ercan A, Altun S, OK MA. The impact of occupational education on obesity prejudice of university students. Prog Nutr. 2021;23(1). doi:10.23751/pn.v23i1.8921
22. Puhl RM, Phelan SM, Nadglowski J, Kyle TK. Overcoming weight bias in the management of patients with diabetes and obesity. Clin Diabetes. 2016 Jan;34(1):44-50. doi:10.2337/diaclin.34.1.44.
23. Aker S, Şahin MK. Obesity bias and stigma, attitudes, and beliefs among intern doctors: A cross-sectional study from Türkiye. Obes Surg. 2024;34(1):86-97. doi:10.1007/s11695-023-06919-2
24. Yavuz AY, Baysal H. Prejudice obesity of midwives and nurses in the primary health care. Adnan Menderes University Faculty of Health Sciences Journal. 2020;4(3):195-202.
25. Aydin T, Erçelik ZE, Gönen B, Aydin D, Günşen U. Determining the obesity pre-judgments of university students. Balıkesir J Heal Sci. 2020;9(2):67-74.
26. Jayawickrama RS, O'Connor M, Flint SW, Hemmingsson E, Lawrence BJ. Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities. E Clinical Medicine. 2023;58:101-894. doi:10.1016/j.eclinm.2023.101894
27. Robinson EL, Ball LE, Leveritt MD. Obesity Bias among health and non-health students attending an Australian university and their perceived obesity education. J Nutr Educ Behav. 2014;46(5):390-395. doi:10.1016/j.jneb.2013.12.003
28. Yılmaz HÖ, Nurcan Y, Ömer Yilmaz H, Ayhan NY. Attitudes and behaviors of nursing students towards obese individuals. ACTA Sci Med Sci. 2018;2(6):3-9.
29. Tomiyama AJ, Carr D, Granberg EM, et al. How and why weight stigma drives the obesity “epidemic” and harms health. BMC Med. 2018;16(1):123. doi:10.1186/s12916-018-1116-5
30. Wise FM, Harris DW, Olver JH. Attitudes to obesity among rehabilitation health professionals in Australia. J Allied Health. 2014;43(3):162–168.