By occupational therapist Pia Beck
August 2014
I sometimes wonder if we healthcare professionals ask ourselves this question. Or do we simply embark upon the task and hopes for the best?
In my work as a consultant, I have often experienced that meeting the severely overweight becomes a dilemma between the severely overweight and the caregivers – instead of a relation with a high level of professionalism. Is that all right? Is it all right that we as professionals cannot give severely overweight people a good, fair and professional treatment?
I do not believe it is all right.
I believe that the problematic encounter with the severely overweight patients arise because we need to clarify whether we meet the patient as a professional caregiver or as a private person. If a meeting is between two private individuals, prejudice may dominate the meeting, which in a worst-case scenario can make the encounter a bad experience for the severely overweight patient. If the meeting is between a person who is severely overweight and in need of help and a healthcare professional there is a greater chance of the meeting being successful and of a high professional level.
Do we as healthcare professionals know exactly the definition of our roles as professionals? Do we know how to meet the severely overweight patient? What is the task? Do we need to provide wound care? Do we need to allocate equipment? Is the task about rehabilitation? Is the focus on the content of the task or do we put our own needs first?
Meeting the bariatric person some of the first questions that come to mind often are: Do the severely overweight patients have an active sex life? Are they sad about the way they look? How can we help them reduce their bodyweight? Why have they not simply stopped eating so much? How can we help them realize that life is not simply about eating?
Do we need to know the answer to these questions if the task is fitting the patient in a bed or a wheel chair? I do not think so.
Are we aware of our tasks as healthcare professionals? The care provider needs to make sure that the patients receives a coherent process where the patient feels safe. The approach should be multidisciplinary in both treatment, care and rehabilitation. As healthcare professionals, we work with a research-based and professionally oriented knowledge. Knowledge acquired through health science, natural science and human science.
The question is if these sciences in their current form are up to date in relation to the increasing population group of severely overweight people.
In Denmark, we are very hesitant in our efforts with bariatric patients. We say aloud that we do not have enough knowledge of the area and we do not have that many severely overweight patients.
We need empirical and clinical knowledge of this population group. Knowledge on how to handle, communicate, treat and rehabilitate the severely overweight patient is not present in literature of natural, human or social science. The empirical data is difficult to gather, as the severely overweight patients so not too frequently appear in the healthcare system.
Times are changing and so should our knowledge. Our professional educations are not capable of teaching the professional bachelors how to act when meeting the severely overweight population group. The amount of literature is limited and the practical experience is hard to obtain. We need to change this as the future brings an increase of people who are severely overweight. The question is, is this enough? Will an increased knowledge of the area make the encounter easier? I do not think so.
Scientists have asked more than 1,000 Danes who they believe should pay the bill for lifestyle diseases such as bariatrics. Only a third of the respondents believes that the healthcare system should pay for procedures such as gastric bypass.
The study shows a clear moral judgement of bariatric people. I believe that this judgement is part of the reason why we as healthcare professionals have a problem meeting the severely overweight patient.
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