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Resistance to Change Within an Organization

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This quantitative dissertation study analyzes the confidence level in receiving health teaching from either an overweight or a weight-appropriate nurse educator. Hicks, Rouhana, Schmidt, Seymour, & Sullivan (2008) article titled, "Nurses' Body Size and Public Confidence in Ability to Provide Health Education", is analyzed to examine cause and effect interactions among different variables.

Description of Methodology

Problem Statement

Hicks, et al. (2008) describes the problem statement of whether there is an association between a nurse's weight and patient's confidence in the health education received from that nurse. An abundance of literature exists on the prevalence of obesity and some on nurse hesitancy to address risks because of associated emotions; however, the problem is important in planning effective interventions to reduce obesity.

Purpose Statement

The purpose of the report being analyzed is "to replicate research about confidence level in receiving health teaching from either an overweight or a weight-appropriate nurse" (Hicks et al., 2008) and the relationship between variable weight and the response variable confidence.

Research Question

Cooper and Schindler (2011) defines a research question as a interrogative statement to direct a study that focuses on describing variables, describing relationships among variables, and determining the differences between two or more groups. The report being analyzed states the central question is "What do patients actually think about nurses' body sizes, and does it have any influence on their perception of confidence in a nurses' ability to teach them about healthy life styles?" (Hicks et al., 2008, p. 350).

Evaluation of Methodology

Study Design

The study design was quasi-experimental, conducted to explain relationships, clarify why certain events happen, and examine causality between selected independent and dependent variables (Cooper and Schindler, 2011). Though pre-tests influence participants, their absence threatens internal validity. Pre-test was inferred from literature stating nurses and the public are equally exposed to social stigma of obesity. Another potential threat was absence of direct link between participants and a healthy learning environment where nurse expertise, approaches, and weight can be considered. Threat to external validity included the small non-diverse sample, and absence of an established norm for the specific instrument.


The researchers ended discussion of findings by stating the hypothesis was supported, "that the observed difference in confidence level between groups was explained by which image, normal weight or over-weight, the respondents viewed, and not by other factors" (Hicks et al., 2008, p. 352). After data is collected and analyzed, findings either support or do not support the hypothesis. The relationship between independent and dependent variables affected the study outcome. In the report being analyzed, the independent variable weight is manipulated by providing an image of a weight appropriate or an over-weight nurse. The dependent variable is confidence, the response to be measured after a respondent views an image.

Conceptual Framework

The conceptual model analyzed in this study is embedded in literature about the impact of obesity on health and social interactions. As noted by Hicks et al. (2008), the model analyzed suggests that a patient's success in following diet and exercise recommendations is related to his or her confidence in the individual delivering diet and exercise information, which is influenced by weight of the educator. In this report, the researchers purposefully summarized literature on various aspects of obesity to develop the research question and support problem significance. They broadly described the obesity epidemic and associated health concerns, then specified the impact on nurses. "In a survey of 760 nurses, 54% were over-weight or obese, with a mean BMI of 27.2" (p. 349).



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