The development and evaluation of a holistic approach to obesity management for primary care nurses.

The prevalence of obesity (BMI greater than or equal to 30kg/m2) in the Scottish population is rising at an alarming pace. The health implications for those affected and the lack of sustained success in treatment, demands that new strategies be explored to improve patient outcomes (Harvey et al. 2005). Primary care nurses appear well placed to address obesity management. Therefore, the aim of this research was to develop and evaluate an evidence based, holistic, person centred approach to management, which was relevant to both professionals and those who are obese. A conceptual framework was developed to encompass the physical, social and emotional components of weight management in conjunction with the nursing models of Roper, Logan and Tierney and Peplau. The approach used mixed methods of data collection, which was carried out in two phases. Outcomes from the initial exploratory, longitudinal survey phase, involving 64 outpatients attending a specialist obesity clinic, showed that physical, social and emotional factors, in conjunction with beliefs about weight management are interrelated. Evidence from the exploratory phase contributed to the development of materials for the intervention phase which was implemented in primary care by nine practice nurses (PNs) who recruited 28 obese individuals for a three month period. Methods of data collection included questionnaires, booklets, field notes and interviews. The key findings of this study confirmed that obesity is complex and a holistic, person centred approach to weight management through partnership working between nurses and obese individuals can be effective. While PNs have a key role to play in obesity management they recognised their need for appropriate tools and education to help individuals towards self-management. The results also suggested that nurses and individuals who took ownership of this approach had successful outcomes in terms of weight loss