thesis defense on factors affecting weight loss management among obese nurses

THESIS PRESENTATION
Presenter: Yasmeen BB
Masters of Science in Nursing (M.Sc. Nursing)
Lahore School of Nursing
University of Lahore
Supervisor I: Ma’am Madiha Mukhtar
Master of Science in Nursing
Supervisor II: Ma’am Hajra Sarwar
Master of Science in Nursing
Friday, March 15, 2024 2

FACTORS AFFECTING WEIGHT LOSS
MANAGEMENT AMONG OBESE
NURSES WORKING AT PUBLIC AND
PRIVATE HEALTH CARE SECTORS IN
SOUTH PUNJAB

Problem statement
Study objectives and questions
Significance of study
Introduction & Literature review
Methodology
 Result
 Discussion
 Conclusion
 Outcome & utilization
 References

PROBLEM STATEMENT
Obesity is highly prevalent in Pakistan as in other developing
and developed countries. High prevalence of obesity among
nurses potentially harms nurses’ own health. Obesity among
nurses limit the effectiveness of nurses’ health promotion role
and effecting their quality care health services in promoting,
preventing, restorative and rehabilitating the health of the
people.

 To explore the perceived facilitators affecting weight loss
management among obese nurses
 To explore the perceived obstacles affecting weight loss
management among obese nurses

What are the perceived facilitators affecting weight loss management
among obese nurses ?
What are the perceived obstacles affecting weight loss management
among obese nurses ?
RESEARCH QUESTION

The study can help
SIGNIFICANCE OF
STUDY
1) It can create insight among health care providers about
the factors that are the obstacles or facilitators to manage
the weight
2) Program can be launched by health care system
to participate in obesity control measures
3) It can contribute to the development of polices in health
care system for provision of weight loss management
services for health care providers at their workplace

Obesity is a major public health problem worldwide, and there are very high
rates of overweight and obesity than underweight adults; 39% of men and
40% of women aged 18 and over. Overweight and obesity have seen a
significant increase over the last four decades (OECD & Organization, 2020;
Organization, 2020).
INTRODUCTION & LITERATURE REVIEW

Body mass index and its
relation with socio-
demographic factors
among health care
workers.(Munir, et
al.,2021).
Descriptive
cross-
sectional/
correlational
162 medical
&paramedic
al staff
frequency and
relationship of
obesity with
socio-
economic
factors
A self-
administered
questionnaire
Out of a total of 162 subjects, 38 (24%) were
hypertensive and 18 (11%) were suffering from
diabetes.Risk factors like age, marital status, family
history of obesity, and smoking have a strong
correlation with obesity in faculty members of a
medical school.
Relationship between
night shift work, eating
habits and BMI among
nurses in
Lebanon.(Samhat, et
al.,2020).
Co-relation
307 nurses
demographic
and
professional
characteristics,
dietary habits
and intakes
A self-
administered
questionnaire
The majority of nurses (78. 2%) had irregular meals
timing with a significant decrease in the number of
complete meals consumed during the day and an
increase in the number of snacks consumed during
night.
Barriers and facilitators to
weight management in
overweight and obese
women(Lim,et al., 2019).
qualitative
study
phenomenol
ogical
Women with
PCOS (30)
Barriers to
lifestyle
changes in
women
Face to face in
depth interview
Women with PCOS face a number of personal,
environmental and social facilitators and barriers to
lifestyle modification for weight loss

Knowledge and Attitudes
Towards Obesity and
Bariatric Surgery in
Chinese Nurses (Fan, et al.,
2020).
5311 nurses
Cross Sectional
Knowle
dge and
Attitude
s
A self-
administ
ered
question
naire
65.2% of nurses with normal BMI, generally had
a high knowledge of obesity and related
cardiovascular diseases (98.6%) and type 2
diabetes mellitus (90.2%)
Association of obesity
measures and multi-
morbidity in Pakistan
(Jawed, et al., 2020).
Co-relational
1500 healthy
individuals and
individuals with
chronic
conditions
(BMI),
body fat
percenta
ge
(BF%)
A self-
administ
ered
question
naire
Multivariate logistic regression showed a
significant association of BMI with multi
morbidity.
Exploring Iranian obese
women's perceptions of
barriers to and facilitators
of self-management of
obesity (Kaveh, et
L.,2019).
Phenomenologic
al
Obese women
facilitat
ors to
self-
manage
ment of
obesity
Semi-
structure
d
intervie
ws
study conducted on barriers to obesity self-
management and facilitators' perception of obese
women in Iran were: self- awareness, positive
outcomes for successful weight loss, positive
outcomes for exercise and physical activity, peer
experience, correct and logical programs,
autonomy, and supporting umbrella

Study Setting
Population
METHODS And MATERIALS
An Exploratory Qualitative Study
All the female charge nurses working at private
and public health care settings
Nishtar Medical University & Hospital Multan
(Public),
Medicare Hospital Multan (Private)
Study Design

METHODS / MATERIALS
Study Duration
Study Design
Sample Size
Sampling Technique
& Selection
Duration of study was 9 months
Sample size for the study was decided when the
data saturation achieved that was 12
Purposive sampling technique &Female Nurses
with Body Mass Index (BMI) of 25 or more than 25

DATA COLLECTION
 Participants were enrolled until reaching data saturation.
 Face-to-face interviews, guided by a self-designed tool,
 Data was gathered confidentially in a designated room, authorized by
the hospital.
 Researchers utilized probing questions
 Data collection and analysis done simultaneously

 Step 1: Become familiar with the data,
Step 2: Generate initial codes,
Step 3: Search for themes,
Step 4: Review themes,
 Step 5: Define themes,
Step 6: Write-up
DATAANALYSIS

DEMOGRAPHIC FACTORS
Sr.No. Age Marital status Height(cm
)
Previous
weight(kg)
Current
weight(kg)
Previous Currents
M.PI 30 Unmarried 158 70 66 28.0 26.4
M.P2 35 Married 164 66 75 26.3 27.9
M.P3 28 Unmarried 161 66 70 25.5 27.0
M.P4 29 Married 155 60 64 25.0 26.6
M.P5 26 Unmarried 156 64 66 26.3 27.1
N.P1 37 Married 165 80 78 29.4 28.7
N.P2 31 Unmarried 163 70 68 26.3 25.6
N.P3 35 Married 168 77 74 27.3 26.2
N.P4 28 Unmarried 166 80 74 29.0 26.9
N.P5 33 Unmarried 168 84 68 32.4 26.2
N.P6 25 Unmarried 161 67 77 25.8 29.7
N.P7 38 Married 163 76 80 28.6 30.1
Mean 31.25 27.49 27.36

BARRIERS AFFECTING WEIGHT LOSS MANAGEMENT AMONG OBESE NURSES AT INDIVIDUAL
LEVEL
Codes Sub-themes Themes
 Hard and irrational diet,eating pattern
 False eating at Duty time
 Surrounded individuals with unhealthy habits
 Use food as a way to cope with emotional challenges
Adopting hard and
irrational diet, eating
pattern 1)
Poor
modifications
of
life style
 Inadequate stress, anxiety, depression, sadness and difficult
conditions management
 Chronic stress
 Depression
 Difficulty to manage stress and stress related conditions
 Disturbed family life
 mobile use as a cope with anxious situation or during stress
 sadness
 stress
Inadequate stress,
anxiety, depression,
sadness and difficult
conditions
management

BARRIERS AFFECTING WEIGHT LOSS MANAGEMENT AMONG OBESE NURSES AT INDIVIDUAL
LEVEL
Codes
Sub-themes Themes
 Limited access to healthy food
 Poor lifestyle and habits
 Unpredictable patterns
 Limited access to healthy food
 Shopping
 Sleeping
 unhealthy foods intake
Poor life style
habits
1)Poor
modifications
of
life style

 Lack of awareness
 Consuming high-calorie
 Emotional eating
 Engage in extreme dieting
Lack of awareness
2)
Poor
motivation for
weight loss
 Lack of motivation
 Lack of resources
 Lack of self-care
 Lack of support
Lack of motivation
 Patient care priority
 Unable to maintain daily record of food
Prioritizing patient care
 Wrong way of gaining knowledge about obesity and dieting
 Wrong information about disease or obesity
 Wrong way of dieting
 Lack of understanding about nutrition and healthy lifestyle
choices
Wrong way of gaining knowledge
about obesity and dieting

BARRIERS AFFECTING WEIGHT LOSS MANAGEMENT AMONG OBESE NURSES AT ENVIRONMENTAL LEVEL
CODES SUB-THEMES THEMES
 Disturbed eating due to Shift
 Eat to manage the stress
 Emotional and mental well-being
 Overeating
 Time constraints
Disturbed eating due to shift
change
3)
Duty shift affecting
on eating,sleep and
exercise
 Disturbed eating habits due to hostel, mess and hospital
cafeteria
 Fast foods
 Hospital cafeteria
 Hostel life
Disturbed eating habits due to
hostel , mess and hospital
cafeteria

BARRIERS AFFECTING WEIGHT LOSS MANAGEMENT AMONG OBESE NURSES AT ENVIRONMENTAL LEVEL
 Hostel mess
 Disturbed exercise schedule
 & Gym
 High stress environment
Disturbed exercise schedule
4)
Hospital environment
affecting weight loss
management
 Disturbed sleep
 Overburden
 Tiredness
Disturbed sleep
 Demanding work schedule
 Disturb schedule
 Irregular physical activity
 Lack of access to healthcare professionals for weight
management
 Poor time management
 Shift work disruptions
 Inadequate work place environment
Time management
Shift work disruptions

BARRIERS AFFECTING WEIGHT LOSS MANAGEMENT AMONG OBESE NURSES
AT ENVIRONMENTAL LEVEL
 Shortage of nurses
 Limited workforce
 Duty time
Limited work force
4)
Hospital
environment
affecting weight
loss management
 Stress and emotional eating
 Strict diet
Stress and emotional
eating pattern
 Poor administration
 Poor leadership
Poor administration

FACILITATORS OF WEIGHT LOSS MANAGEMENT AMONG OBESE NURSES
 Appearance
 Good Look
 Prettiness and Charming Look
 Ugly look
Physique
1)
Weight Loss
Consciousness
 Diseases Awareness
 Good administration
 Good Health
Awareness
 Customized Plans
 Calories monitoring
 Controlled diet
Customized Plans
 Education and Awareness
 Access to Information
 BMI
Education and
Awareness
 External motivator
 Peer Influence
 Peer Pressure
Motivation from
external resources

Friday, March 15, 2024
Codes Sub-themes Theme
 Family Support
 Family dynamics,eating habits, and lifestyle choices
 Consequences for weight loss success
Family System
Positive consequences
for weight loss success
Healthy Eating Promotion
Life style and habits
Listen music
Long-Term Sustainability/
Healthy eating behaviour
Practice relaxation techniques
Do prayers when stressed
Performing Prayers, Salat,Nemaz
Practicing relaxation
activities
Stress Management
Problem share with friend
Management of stressors
Weight loss
Walk
Watching dramas
Watching TV
Weight loss maintenance
24

Codes Sub-themes Theme
Availability of parks,sidewalks or any point for walk
or exercise
Suggestion
Suggestive
participant’s
Responses
Incentives
Skills
Incentives
Social Support
Supportive Environment
Social Support

DISCUSSION
One major theme that emerge was the poor modification of lifestyle. Nurses often engage in
habits that are harmful to their physical, mental, and emotional health, including irregular
eating patterns, unhealthy snacks, and excessive consumption of fried and processed foods
(Alzabni et al., 2023).
Nurses play a crucial role in patient care, and their health and well-being are essential for
the efficient functioning of the healthcare system. Unfortunately, the demanding nature of
their job, long working hours, and exposure to unhealthy dietary options make it challenging
for nurses to maintain a healthy lifestyle (SARI et al., 2023).

DISCUSSION
Diet and sleep were important aspects that were altered by shift changes. Shift
work frequently results in unpredictable eating patterns, a lack of healthy food
alternatives, and a dependence on short, energy-dense meals (Heath et al., 2019).
The study's findings align with previous research that has shown that poor dietary
habits and sedentary lifestyles contribute to the increasing prevalence of
overweight and obesity among healthcare professionals (Ross et al., 2019;
Kunyahamu et al., 2021).

DISCUSSION
• The study findings underscore the need for addressing nurses' mental health and providing
strategies to cope with workplace-related stressors. Moreover, the study highlights the role
of poor motivation for weight loss among nurses (NP2, NP3, MP3). Nurses often prioritize
patient care over their own well-being, leading to a lack of time and resources for proper
diet planning and exercise. The motivation to lose weight is crucial, and finding ways to
enhance nurses' self-motivation and self-awareness is essential for effective weight
management (Kaveh & Peyrovi, 2019).

CONCLUSION
Study highlighted challenges for obese nurses in weight management due to demanding
work environments.
Barriers include limited time, resources, and motivation.
 Poor management and a strenuous environment contribute to unhealthy eating habits.
Emphasizing comprehensive measures for roster management, communication, nurse
shortages, health facilities, and employee incentives to improve the work environment
and patient care.

LIMITATIONS
Sample Size and Diversity: A sample size of 12 participants is relatively small, which limit
the transferability of findings to a broader population of obese nurses. (age, gender, ethnicity,
work setting, etc).
Selection Bias: The participants in study not be representative of all obese nurses. (have
unique characteristics or experiences that differ from non- participants)
Self-Reporting and Social Desirability Bias : social desirability bias (reporting what they
perceive as socially acceptable), or inaccuracies in self-reporting.
External Factors & contextual specificity

RECOMMENDATIONS
Broader studies on the hospital managers and coworkers to explore potential solutions.
Implement targeted interventions and policy changes within healthcare organizations to
address the study's identified obstacles.
Prioritize emotional well-being in the nursing profession by developing a supportive
work environment that recognizes and resolves the unique emotional issues that nurses
confront, such as patient discomfort and the stress of the job.

RECOMMENDATIONS
Research and execute treatments for obese nurses
Work towards stigmatization weight-related challenges in the nursing profession and
promoting a culture of understanding and support.
A long-term study aims to assess the effects of weight loss programs on work
satisfaction, performance, and general well-being among obese nurses

ACTIVITY
MONTHS
1 2 3 4 5 6 7 8 9 10 11 12
Data collection
Data analysis and interpretation
Thesis compilation & Publication
Thesis presentation and
submission
Evaluation
GANTT CHART

DATA COLLECTION FROM THE PARTICIPANTS

PLAGIARISM

RESEARCH ETTHICAL COMMITTEE LETTER

BOS & DRC

FAHS & BIOSTATISTICIAN

DATA COLLECTION PERMISSION LETTER FROM
HOSPITALS

CONTINUE….
REFERENCES
Alzabni, A. H., Alzabni, J. M., Al-Shammari, A. S., & Magzoub, M. (2023). Obesity and Eating Habits of Undergraduate
Female Nursing Students at Hail University, Saudi Arabia. International Journal, 7(1), 1-3.
Fan, M., Hong, J., Cheung, P. N., Tang, S., Zhang, J., Hu, S., Jiang, S., Chen, X., Yu, S., Gao, L., Wang, C., Chen, W., &
Yang, W. (2020). Knowledge and Attitudes Towards Obesity and Bariatric Surgery in Chinese Nurses. Obesity
Surgery, 30(2), 618-629. https://doi.org/10.1007/s11695-019-04173-z
Heath, G., Dorrian, J., & Coates, A. (2019). Associations between shift type, sleep, mood, and diet in a group of shift
working nurses. Scandinavian journal of work, environment & health, 45(4), 402-412.
Jawed, M., Inam, S., Shah, N., & Shafique, K. (2020). Association of obesity measures and multimorbidity in Pakistan:
findings from the IMPACT study. Public Health, 180, 51-56.
https://doi.org/https://doi.org/10.1016/j.puhe.2019.10.017
Kaveh, O., & Peyrovi, H. (2019). Exploring Iranian obese women's perceptions of barriers to and facilitators of self-
management of obesity: A qualitative study. Journal of family medicine and primary care, 8(11), 3538-3543.
https://doi.org/10.4103/jfmpc.jfmpc_527_19

Kunyahamu, M. S., Daud, A., & Jusoh, N. (2021). Obesity among Health-Care Workers: Which Occupations Are at
Higher Risk of Being Obese? International journal of environmental research and public health, 18(8), 4381.
Lim, S., Smith, C. A., Costello, M. F., MacMillan, F., Moran, L., & Ee,C.(2019). Barriers and facilitators to weight
management in overweight and obese women living in Australia with PCOS: a qualitative study. BMC
endocrine disorders, 19(1), 1-9.
Munir, M., Malik, H. N., Alam, M. J., Arif, A., & Khalid, F. (2021). Body mass index and its relation with socio-
demographic factors among healthcare workers. Biomedica, 37(2).
OECD, & Organization, W. H. (2020). Overweight and obesity. https://doi.org/doi:https://doi.org/10.1787/a47d0cd2-
en
Organization, W. H. (2020). Overweight and obesity.
REFERENCES

Ross, A., Touchton-Leonard, K., Perez, A., Wehrlen, L., Kazmi, N., & Gibbons, S. (2019). Factors that
influence health-promoting self-care in registered nurses: Barriers and facilitators. ANS. Advances in
nursing science, 42(4), 358.
Samhat, Z., Attieh, R., & Sacre, Y. (2020). Relationship between night shift work, eating habits and BMI
among nurses in Lebanon. BMC Nursing, 19(1), 25. https://doi.org/10.1186/s12912-020-00412-2
SARI, H., KILINÇ, Z., Soysal, Ş., & Özel, M. (2023). Evaluation of the frequency and awareness of obesity
among healthcare workers. European Review for Medical & Pharmacological Sciences,27(10).
Shafi, Z., Arif, S., & Nasir, A. (2020). Association of long duty hours and unhealthy dietary habits among
nurses at private and public sector in Karachi, Pakistan. Journal of Liaquat University of Medical &
Health Sciences, 19(01), 55-61.
REFERENCES

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