The effects of patient weight and sex on nurses' perceptions: a proposed model of nurse withdrawal

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Abstract
This investigation challenged the premise that nurses adhere to affective neutrality in their practice of nursing, and examined the effect of patient weight and sex on evaluations, attributions and care delivery decisions formed by nurses. The phenomenon of mutual withdrawal originally identified by Tudor in psychiatric nursing was adapted to the general nursing milieu and served as the conceptual framework. Emphasis in this study was given to the phenomenon of nurse withdrawal. A volunteer sample of 100 senior female baccalaureate students was randomly assigned to one of four conditions in a 2 X 2 factorial design with the following factors: (a) weight of the stimulus patient (normal versus obese); and (b) sex of the stimulus patient (male versus female). These independent variables were presented through descriptive vignettes and visual stimuli to participants completing a self-administered questionnaire. Dependent variables included evaluation, attribution and care delivery. Analysis of the questionnaire demonstrated that obese patients were evaluated more negatively than normal weight patients, F = 2.82, P less than 0.05, but were not held more responsible for an alleged transgression, nor did nurses indicate withdrawal. The phenomenon of social attractiveness was identified as an intervening variable lending support to the proposed model of nurse withdrawal. This finding is examined within the context of affective neutrality in the nurse-patient relationship. Implications for nursing practice, theory and research are discussed.

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