Changing practice nurses' management of obesity

Introduction: The aim of this study was to assess ways of improving practice nurses' (PNs) management of obesity. Methods: PNs completed a questionnaire concerning their obesity-related beliefs and behaviours, before and 1 month after being randomly allocated to either a 'learner-centred' group (who received a leaflet and were invited to attend an interactive seminar), an 'expert group' (who received the leaflet), or a control group. At 1 month follow-up, PNs were also asked to give a brief questionnaire to five consecutive patients who they saw for weight loss advice, concerning the content and style of the consultation. After 6 months, PNs and patients were sent a questionnaire about their consultation style and weight loss, respectively. Results: At baseline the PNs felt confident in giving weight loss advice, but stated that outcomes were poor and that the responsibility for this lay with the patients suggesting a professional-centred approach to management. In terms of the intervention, the two educational packages had no differential effects on PNs' beliefs about obesity. However, PNs in the 'learner group' reported spending longer on their consultations and being more patient centred, and their patients were more satisfied with the consultation and reported that they were offered calorie controlled diets the least frequently. In contrast, PNs in the 'expert group' reported giving weight loss advice more frequently and being less patient centred, and their patients reported greater confidence in the likelihood of weight loss and reported that they were more likely to be offered traditional weight loss interventions. The packages had no differential effects on patient weight. Conclusion: PNs' management of obesity can be changed. However, being more patient centred may not always be the desired outcome. Perhaps a patient-centred perspective should involve an assessment of whether this approach is best suited to each individual patient.