title: A qualitative study to explore the attitude of clinical staff to the challenges of caring for obese patients.
abstract: OBJECTIVE
  To examine, from the perspective of staff, if obese patients have any additional care needs, and what the impact of these care requirements are on care provision. We have selected obese patients with venous leg ulceration as an example patient population to explore these questions.
  
  
  BACKGROUND
  Anecdotal evidence indicates obesity can increase care requirements and have implications for obesity for care provision. However, little research exists nationally or internationally that provides evidence from a health care perspective. Obesity is a contributory causative factor of lower limb ulceration. In addition to affecting the development of venous leg ulceration, obesity may also impact on the care an obese patient may require and receive.
  
  
  METHODS
  Qualitative study using semi-structured in interviews and framework analysis.
  
  
  METHODS
  Interviews were conducted with 18 health care professionals and one focus group with 12 health care professionals who cared for patients with venous ulceration. Data were analysed to identify recurring themes relating to the impact of obesity on care provision.
  
  
  RESULTS
  This study found that the increasing numbers of obese patients with leg ulcers are currently presenting challenges to care delivery in many different ways. There was an impact of obesity on patient experience in terms of dignity, safety and quality. Data indicated that neither hospital nor community care services were adequately set up to meet the needs of obese patients in general.
  
  
  CONCLUSIONS
  Health care providers need to recognise that increasing numbers of overweight and obese patients are presenting challenges to care delivery. The study also indicated the need for senior strategic leadership in planning for meeting the needs of obese patients.
  
  
  CONCLUSIONS
  Nursing is well placed to provide specialist support to co-ordinate services for obese/oversize patients if a suitable strategic and leadership role is developed. Nurses are used to offering patients help in areas of health promotion such as smoking cessation. Lessons learnt from this area could be applied to help and encourage staff to support patients with weight management.
authors.affiliation: Sheffield Teaching Hospitals Foundation Trust, NIHR CLAHRC-SYH, D-Floor Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lumley
authors.affiliation: Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK.
authors.forename: Catherine V
authors.initials: CV
authors.lastname: Homer
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Palfreyman
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors.forename: Phil
authors.initials: P
authors.lastname: Shackley
authors.affiliation: Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK.
authors.forename: Angela Mary
authors.initials: AM
authors.lastname: Tod
mesh_terms: D001291:Attitude of Health Personnel; D004645:Empathy; D017144:Focus Groups; D006801:Humans; D009765:Obesity / Q000150:complications / Q000523:psychology / Q000628:therapy*; D036301:Qualitative Research; D014647:Varicose Ulcer / Q000209:etiology / Q000523:psychology / Q000628:therapy*
keywords: impact on care; leg ulcer; nursing; obesity; overweight; qualitative research.; venous leg ulcers