Patient perspectives of weight stigma across the cancer continuum: A scoping review.

BACKGROUND: Weight stigma has been defined as the social devaluation and denigration of individuals because of their weight. The purpose of this scoping systematic review was to assess and understand patient experiences with weight stigma in the cancer care setting. METHODS: We conducted a systematic scoping review of studies examining shame, prejudice, bias, and stigma in relation to weight and cancer-related care using five databases: PubMed, CINAHL Plus Full Text (ProQuest), Cochrane Library, PsycINFO (EBSCO), and Scopus. Articles were uploaded into Covidence for de-duplication and screening. Included studies were peer reviewed, reported adult patient experiences in cancer-related care, and were published in English between October 2012 and February 2023. Study characteristics and key findings were abstracted and qualitatively synthesized. RESULTS: Publications meeting inclusion criteria yielded five studies (n = 113 participants). Most focused on the experiences of women (n = 4) and cancers which predominantly impact women (i.e., breast, cervical, endometrial; n = 4). All stages of the cancer continuum were included with studies examining screening (n = 2), treatment (n = 1), and post-treatment survivorship (n = 2). Weight discrimination was discussed in four studies and weight-biased stereotypes were discussed in three studies. Experiences of weight bias internalization were reported in four studies. One study described an instance of implicit weight bias. CONCLUSIONS: Limited studies examine patient experiences of weight stigma in cancer care; however, current evidence suggests that patients do experience weight stigma in cancer-related care. This review highlights critical gaps and a need for more research on the prevalence and impact of weight stigma in cancer screening and care.

A Qualitative Exploration of Desired mHealth App Mechanisms Related to Daily Life Influences for College Nursing Students.

Introduction: Mobile health (mHealth) apps are digital health tools that allow for the delivery and access to vital health information, support, and encouragement needed to foster positive behavior change. Designing and developing mHealth solutions based on daily life influences for nursing students is imperative to establishing healthier physical and mental health habits. Methods: Multiple focus groups (n=10) were conducted, and a questionnaire (n=11) was administered to undergraduate students in the professional nursing component. Themed analysis of focus-group data was conducted along with descriptive analysis of the questionnaire. Results: All participants stated it has been more difficult to maintain a healthy lifestyle since beginning the nursing program. This deterioration can be attributed to three key areas: mental health needs/support, rigor of nursing school, and decline in positive health choices. Participants stated they would use an mHealth app designed specifically for nursing students to combat deterioration of their health. Conclusions: The results of this study (100% positive response rate) reveal mHealth applications might be a powerful tool in helping nursing students transform their physical and mental health. It appears that if an mHealth application is created with the specific "must-haves" of nursing students then we might experience a positive shift in health behaviors for nursing students, which will hopefully transcend into their careers as nurses.

Effects of the Perceived Risk of Contracting COVID-19 on Nursing Students' Well-Being.

BACKGROUND: Although mental health symptoms increased during the coronavirus disease 2019 (COVID-19) pandemic, little is known about the associations between nursing students' perceived risk of contracting COVID-19 and their academic and psychological well-being. This study examined associations between perceived COVID-19 risk, likelihood of completing nursing education, and mental health factors of nursing students. METHOD: A total of 979 nursing students completed self-report measures of perceived COVID-19 risk, anticipated academic completion, anxiety and depressive symptoms, stress, coping self-efficacy, hope, and social support. RESULTS: Students with higher perceived COVID-19 risk reported increased anxiety and depression as well as decreased likelihood of graduating, coping self-efficacy, and levels of social support. CONCLUSION: Findings indicate the need for increased mental health support for nursing students for successful completion of their programs. Educators should increase support and proactively strengthen positive psychology factors to mitigate the effects of COVID-19 and other crises on nursing students' well-being. [J Nurs Educ. 2022;61(11):641-645.].

Positive and negative psychosocial factors related to healthy and unhealthy weight control among nursing students.

BACKGROUND: Although nursing students are educated on the importance of exercising regularly and maintaining a well-balanced diet, many do not practice healthy weight management behaviors, and some even use unhealthy weight loss methods. Yet, little research has examined both positive and negative psychosocial variables related to weight control among nursing students. PURPOSE: The present study aimed to identify the most salient psychosocial variables related to healthy and unhealthy weight control among nursing students. METHOD: Using survey data from 241 nursing students, structural equation modeling was conducted to examine the relative contributions of eight interrelated psychosocial variables, including constructs from a strengths perspective (health-specific hope, health self-efficacy, social support, and body satisfaction) and from a deficit perspective (depression, anxiety, weight perception, and barriers to physical activity). RESULTS: Results showed that the degree to which individuals perceive themselves to be overweight was related to both healthy and unhealthy weight control. Aside from weight perception, health self-efficacy produced the strongest association with healthy weight control, and anxiety produced the strongest association with unhealthy weight control. The structural model explained 23 % of the variance in healthy weight control and 29 % of the variance in unhealthy weight control. CONCLUSIONS: These findings emphasize the need for tailored, integrated weight management interventions for nursing students that equip them with effective anxiety management skills and build self-efficacy.

Undergraduate versus graduate nursing students: Differences in nutrition, physical activity, and self-reported body mass index.

ObjectiveThis study compared self-reported nutrition, physical activity, and body mass index (BMI) in undergraduate versus graduate nursing students.ParticipantsRespondents included 233 undergraduate and 230 graduate nursing students in a Southeastern public university.MethodsThe study was an exploratory, descriptive, cross-sectional comparison administered via online questionnaire including self-reported demographics, nutritional intake, physical activity, and BMI.ResultsUndergraduates reported exercising more than graduate students. Graduate students reported consuming significantly more vegetables than undergraduates; however, more graduate students self-reported BMIs in overweight and obese categories than undergraduates.ConclusionsFindings provide a foundational understanding that interventions or educational programs to improve self-care behaviors of nursing students should be tailored depending on the educational level of the students. Educators must establish self-care skills within nursing students at all levels to help them preserve their health in the fast-paced, strenuous, and stressful work of all echelons of nursing upon completion of the educational program.

Weight Bias and Stigma: Impact on Health.

Weight bias and stigma exist in a variety of realms in our society (media, education, employment, and health care), and unfortunately many view it as a socially acceptable form of discrimination. Patients with obesity often avoid scheduling appointments for health promotion visits and routine care due to perceived weight bias and stigma from their health care provider. Within the health care setting, it is important that health care providers strategically focus on reducing obesity bias and provide high-quality obesity management. People-first language should be used and waiting rooms and examination rooms should be accommodating to people of all sizes.

A practical approach to obesity prevention: Healthy home habits.

ABSTRACT: Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as "obesity," "overweight," "healthy habits," "physical activity," "obesogenic behaviors," "family meals," "screen time," "depression," "sugary beverages," and "portion sizes." The information was synthesized into three content areas: nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.

Characteristics of Negative and Positive Mental Health Among Nursing Students in the United States.

BACKGROUND: Researchers have documented significant psychological problems among nursing students, but findings have been inconclusive as to whether nursing students are "at-risk" for mental health problems compared with their non-nursing peers. AIMS: This study examined whether nursing students have unique mental health characteristics compared with students from other professions. METHOD: Undergraduates (N = 18,312; nursing n = 1,399) were selected from the 2016-2017 National Healthy Minds Study. Participants completed the Patient Health Questionnaire-9 (depression), the Generalized Anxiety Disorder-7 (anxiety), and the Flourishing Scale (positive psychology). RESULTS: Nursing students were equally likely to screen positive for depression and anxiety compared with their non-nursing peers. However, when controlling for gender, age, and year in school, multigroup structural equation modeling analyses revealed that female (but not male) nursing students reported significantly higher levels of specific anxiety symptoms and certain psychological strengths than female students from other professions. Nursing students are equally likely to screen positive for depression or anxiety as their non-nursing peers; however, anxiety disorders may reflect symptom profiles unique to nursing students. CONCLUSIONS: Findings suggest a need for tailored screening and interventions to reduce mental health problems and harness psychological strengths unique to nursing students.

Nursing students' resilience, depression, well-being, and academic distress: Testing a moderated mediation model.

AIM: Academic distress is a leading cause of attrition among nursing students. The present study tested a positive psychology-oriented model detailing the potential links between nursing students': (a) psychological resilience; (b) depressive symptoms; (c) intrapersonal well-being; (d) interpersonal well-being; and (e) academic distress. Additionally, we tested whether the academic benefits of resilience were conditional upon nursing students' perceptions of their campus climate as supportive of mental health and well-being. DESIGN: A correlational, cross-sectional design was employed. METHOD: Nursing students (N = 933) were selected from the national 2017-2018 Healthy Minds Study (HMS). Students completed measures of resilience, depressive symptoms, intrapersonal well-being (flourishing), interpersonal well-being (belonging), and academic distress. RESULTS: Conditional process modelling tested depression, belonging, and flourishing as mediators of the associations between resilience and academic distress variables. Furthermore, perceptions of campus climate were included as potential moderators of these mediation effects. Results indicated that the protective academic benefits of resilience were primarily explained by decreases in depression but that this effect was strongest for nursing students with negative perceptions of their campus climate. CONCLUSION: Findings highlight the psychological and academic benefits of greater resilience and the moderated mediation results suggest that such benefits were conditional on the broader campus climate. IMPACT: Nurse educators and policymakers should consider addressing contextual factors, such as campus climate, in addition to resilience training in their efforts to reduce the negative academic impacts of mental health problems and stress in nursing school.

An NP's guide to current physical activity recommendations.

Physical inactivity is a public health crisis that contributes to many of the chronic diseases that affect Americans. This review emphasizes the beneficial health implications of physical activity along with the dangers of sedentary lifestyles. It also provides advice tailored to NPs to help their patients become more physically active.

Nurse practitioner students' observations of preceptor engagement in obesity management and weight bias: A mixed-methods approach.

BACKGROUND: Obesity is considered a growing epidemic in the United States. Nurse practitioners (NPs) have the opportunity to serve as leaders in addressing concerns related to disease management, particularly obesity. Currently, we lack an awareness of how NP students are learning obesity management from their preceptors. PURPOSE: Thus, the current study sought to explore how NP students perceive preceptors' behaviors when managing patients with obesity. METHODOLOGICAL ORIENTATION: This study used a mixed-methods design. Participants were asked to report how often they observed their preceptors engage in different strategies when interacting with patients with obesity (e.g., calculate body mass index, identify goals). Students were then asked to respond to the statement: "share observations you made of how patients with obesity were treated in this environment." Students completed 2 clinical rotations during this period and, thus, were asked to answer the questions twice to capture experiences at both clinical sites. SAMPLE: Researchers surveyed 225 NP students completing clinical rotations in 3 settings (Family Practice, Pediatrics, and Obstetrics/Gynecology). CONCLUSIONS: Quantitative results revealed significant differences in the frequency of observed obesity management behaviors by all preceptors. Qualitative results revealed that NP students most often observed preceptors displaying interpersonal warmth without weight bias when working with patients with obesity. Contrary to current literature, this sample of NP students observed their preceptors engaging in positive interactions with individuals with obesity. IMPLICATIONS FOR PRACTICE: Educators must continue to teach students to engage in unbiased behavior toward patients. It is critical to continue to improve obesity management content offered in NP programs.

Characteristics of and Factors Influencing College Nursing Students' Willingness to Utilize mHealth for Health Promotion.

More than half of practicing nurses have suboptimal physical or mental health. Impaired health is associated with a 76% higher likelihood that nurses will make medical errors. Improving the health habits of nursing students is essential to shaping and sustaining health prior to joining the workforce. Technology such as mobile health applications holds great promise in facilitating behavioral change and encouraging healthy habits in nursing students. Identifying the predictors of willingness to use mobile health is essential to creating mobile health applications that will engage nursing students and promote sustainable usage. Evaluation of psychological, attitudinal, and health-related correlates of mobile health can highlight predictors of willingness to use mobile health, which can influence nursing students' utilization and long-term engagement with mobile health applications. Analysis of these correlates shows that psychological attributes, such as hope, play a role in the willingness to use and may facilitate engagement in the utilization of a mobile health application. Development of a mobile health application that increases hope and helps establish healthy habits may enable nursing students to remain healthy throughout their lives, creating a new generation of happier, healthier nurses and, ultimately, improving safety for patients under their care.

Competency in obesity management: An educational intervention study with nurse practitioner students.

BACKGROUND: The National Center for Health Statistics reported that obesity is at epidemic levels in the United States, with an estimated 70.7% of adults affected by overweight and obesity. The disease state of obesity affects all generations and is pervasive among all socioeconomic groups. PURPOSE: This study was designed to examine the impact of implementing educational modules to determine if the intervention improved knowledge and comfort levels for Nurse Practitioner students when managing patients with obesity. METHODS: Nurse Practitioner students completed a survey regarding knowledge and comfort level in managing patients with obesity. Students then completed modules designed to train health care providers on the management of obesity. A postmodule assessment was administered to determine if the obesity management modules improved competency and perceived skills when treating patients with overweight and obesity. RESULTS: Participants' mean score on the knowledge test represented a significant improvement following training. Their comfort level in managing patients with obesity increased. IMPLICATIONS FOR PRACTICE: Implementing these modules in graduate education may be a helpful avenue to improve competency in obesity management. Acknowledging that obesity is a disease and requires a multifaceted approach when helping patients improve their health. This change in perception may lead to better goal-setting with the patient, empathetic understanding, and broader patient involvement in the treatment.

NP student encounters with obesity bias in clinical practice.

This study explores NP students' encounters with obesity stigma and bias in their clinical environment as well as recommendations to decrease obesity stigma and bias. Results indicate a need for continued education on the topic of weight management within NP curricula.

Use of a 'pose rate' to quantify yoga.

OBJECTIVE: To develop a method that describes the physical activity completed during yoga, and to use this method to compare three different yoga video categories: weight loss, beginner, and stress relief/meditation. DESIGN: This study conducted content analysis of commercially available yoga videos in which pre-determined characteristics of yoga routines were recorded. Outcome measures included the yoga routine characteristics of: duration of each yoga routine, number of completed poses, body position of each pose, and pose rate. RESULTS: Twenty-two routines from yoga videos were analyzed. Duration of routine between the three different categories was not significantly different. There were significant differences between the video categories based on the characteristics of total number of poses and the pose rate, with weight loss routines having the highest values compare to beginner routines and stress relief/meditation (total number of poses: 74.1, 34.3, 25.6 poses, p < 0.05; Pose rate: 2.5m 1.5, 1.1 poses/min, p < 0.05, respectively). Additionally, differences were observed between body postures in poses with weight loss videos including more standing poses (38.8, 17.0, 5.7 poses, p < 0.05, respectively) and a lower percentage of seated (9.9%, 15.8%, 39.0%, p < 0.05, respectively) and supine poses (10.9%, 18.5%, 28.8%, p < 0.05, respectively) compared to the beginner and stress/meditation videos. CONCLUSIONS: The characteristics of total poses, pose rate, and total standing poses showed significant differences between different styles of yoga. Further research should be conducted to validate these characteristics as an intensity measures and to assess if these characteristics have variations between different yoga styles.