Exploring student nurses’ attitudes towards those who are obese and whether these attitudes change following a simulated activity

Thumbnail Image
File version
Accepted Manuscript (AM)
Hunter, J
Rawlings-Anderson, K
Lindsay, T
Bowden, T
Aitken, LM
Griffith University Author(s)
Primary Supervisor
Other Supervisors
File type(s)

Background: As the prevalence of obesity increases worldwide the field of bariatric medicine has emerged, focussing on the causes, prevention and treatment of obesity. People who are obese regularly face bias from healthcare professionals, which can negativity impact on care delivery and patient outcomes. The introduction of bariatric empathy suits into simulated practice may enable student nurses to appreciate the needs of, and influence their attitudes towards, obese people. Objectives: The aim of this study was to explore student nurses’ attitudes towards those who are obese and whether these attitudes change following a simulated activity. Design: A mixed methods study incorporating a pre-post design. Setting: A UK university which provides pre-registration nursing education. Participants: Nursing students in part 1 (n = 39) and part 2 (n = 29) in adult and mental health fields. Methods: Part 1 and 2 nursing students completed the “Nurses’ attitudes towards obesity and obese patients scale” (NATOOPS) questionnaire. Part 2 students also took part in a simulation activity while wearing a bariatric empathy suit and completed the NATOOPS questionnaire again immediately after the simulation activity. Students who wore the empathy suits were invited to a focus group. Results: Part 1 students reported poorer attitudes on the NATOOPS scale than Part 2 students. After wearing the bariatric empathy suits students reported changed attitudes on the NATOOPS in three areas: response to obese patients, characteristics of obese patients and supportive roles in caring for obese patients. Five themes emerged from the focus groups related to physical and psychological impact of the suits; thinking differently; simulation as a learning experience and challenges and recommendations. Conclusions: Following a structured educational experience student nurses’ attitudes were more positive towards obese patients. The characteristics of the educational activity that appeared to influence student nurses’ attitudes was related to the “lived experience” of wearing bariatric empathy suits.

Journal Title
Nurse Education Today
Conference Title
Book Title
Thesis Type
Degree Program
Publisher link
Patent number
Grant identifier(s)
Rights Statement
© 2018 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
Rights Statement
Item Access Status
Access the data
Related item(s)
Curriculum and pedagogy
Persistent link to this record