Nurses' self-efficacy and practices relating to weight management of adult patients: a path analysis

Background: Health professionals play a key role in the prevention and treatment of excess weight and obesity, but many have expressed a lack of confidence in their ability to manage obese patients with their delivery of weight-management care remaining limited. The specific mechanism underlying inadequate practices in professional weight management remains unclear. The primary purpose of this study was to examine a self-efficacy theory-based model in understanding Registered Nurses' (RNs) professional performance relating to weight management. Methods: A self-report questionnaire was developed based upon the hypothesized model and administered to a convenience sample of 588 RNs. Data were collected regarding socio-demographic variables, psychosocial variables (attitudes towards obese people, professional role identity, teamwork beliefs, perceived skills, perceived barriers and self-efficacy) and professional weight management practices. Structural equation modeling was conducted to identify correlations between the above variables and to test the goodness of fit of the proposed model. Results: The survey response rate was 71.4% (n = 420). The respondents reported a moderate level of weight management practices. Self-efficacy directly and positively predicted the weight management practices of the RNs (beta = 0.36, p < 0.01), and fully or partially mediated the relationships between perceived skills, perceived barriers, professional role identity and teamwork beliefs and weight management practices. The final model constructed in this study demonstrated a good fit to the data [chi(2) (14) = 13.90, p = 0.46; GFI = 0.99; AGFI = 0.98; NNFI = 1.00; CFI = 1.00; RMSEA = 0.00; AIC = 57.90], accounting for 38.4% and 43.2% of the variance in weight management practices and self-efficacy, respectively. Conclusions: Self-efficacy theory appears to be useful in understanding the weight management practices of RNs. Interventions targeting the enhancement of self-efficacy may be effective in promoting RNs' professional performance in managing overweight and obese patients.