Factors influencing nurses' intentions to provide weight management education to hospitalized obese adults

Obesity is a sensitive, global health problem that impacts individuals of all ages and places individuals at risk for various chronic health problems. Nurses caring for hospitalized obese clients are in a prime position to provide them with timely information on weight management. This study utilized an exploratory sequential mixed method design to examine medical-surgical nurses' intentions to provide weight management education to hospitalized obese adults and the factors that influence nurses' intentions. In phase 1, a focus group interview guide and nurse demographic form (NDF) were developed. Focus groups were conducted and analysis resulted in the creation of 15 salient beliefs and 12 broad categories. In Phase 2, focus group results were used to construct the Weight Management Education Survey (WMES) guided by Azjen's Theory of Planned Behavior (TPB) for question development. A total of 71 WMES items were developed based on the main TPB components: 24 attitude; 16 subjective norm; 26 perceived behavioral control; and 5 intention. The WMES was piloted with 12 RNs in the same setting; nurses also completed the NDF. In phase 3, the WMES with minor changes was electronically administered with the NDF to a national pool of 354 RNs who held membership in the Academy of Medical Surgical Nurses. Of the nurses who completed the WMES, 85.8% (n = 318) responded they would provide weight management education if clients asked for the information. A 12-factor solution explained 80% of the variation in response; seven of those factors explained 52% of the variation in the principle component of "intention". Factors significant in predicting nurses' intentions included: "health benefits" (p < 0.0001), "reducing costs and admissions" (p < .0001), "client/family approval" (p < 0.0001), "institutional approval" (p < 0.0001), "home-based weight management plan on admission" (p < 0.0001), "staffing and timing" (p = 0.0055), and "acute illness priority" (p =0.0022). After removing variation explained by factors, demographics explained less than 5% variation in nurses' intentions. Establishing a standardized collaborative approach for instituting "a home-based weight management plan on admission" may increase the likelihood that nurses will choose to provide weight management education for their clients