The Nutritional Health Beliefs of Nurses in Japan, Thailand, China and Australia

Main Article Content

Sue Turale
Teresa Elizabeth Stone
Warunee Fongkaew


                  Nurses’ beliefs about food and nutrition influence the care and advice they give patients, their families, nurses and others, but these beliefs have not been extensively researched before. This paper presents findings from the qualitative phase of a large q-methodology study that involved both quantitative and qualitative methods. The phase of the study reported here utilized a qualitative descriptive approach regarding a range of beliefs, and in-depth interviews with 240 participants who comprised 30 academics and 30 clinical nurses each from China, Thailand, Japan and Australia. Content analysis was employed to analyse the extracted data regarding their beliefs about nutrition and nutritional supplements, and the sources of these beliefs. Findings and resultant discussion are reported about 17 specific nutritional beliefs.

                We concluded that many nurses in all the surveyed countries had some false and scientifically unsupported beliefs about nutrition, derived primarily from the media or personal experience. Study findings speak to the need for nurses to critically examine the sources of information they use in their practice and teaching, as well as a need for research to be reported responsibly and accurately. The review of the presented evidence about nutrition will assist nurses in their clinical and teaching practice, and hopefully inspire them to use evidence-based practice in future.

Article Details

How to Cite
Turale S, Elizabeth Stone T, Fongkaew W. The Nutritional Health Beliefs of Nurses in Japan, Thailand, China and Australia. PRIJNR [Internet]. 2020 Jan. 2 [cited 2022 Jun. 27];24(1):20-38. Available from:
Original paper


1. Brown AW, Ioannidis JP, Cope MB, Bier DM, Allison DB. Unscientific beliefs about scientific topics in nutrition. Advances in Nutrition: An Intern Review J. 2014; 5(5):563-5.

2. Spector RE. Cultural diversity in health and illness. J Trans Nurs. 2002;13(3):197-9.

3. Cai D, Stone TE, Petrini MA, McMillan M. An exploration of the health beliefs of Chinese nurses’ and nurse academics’ health beliefs: A Q-methodology study. Nurs & Health Sci. 2016;18(1):97-104.

4. Stone TE, Maguire J, Kang SJ, Cha C. Practical issues of conducting a Q methodology study: Lessons learned from a cross-cultural study. Adv in Nurs Sci. 2017;40(3).

5. Akhtar-Danesh N, Baumann A, Cordingley L. Q-Methodology in nursing research: A promising method for the study of subjectivity. West J of Nurs Res. 2008;30(6):759-73.

6. Cass S, Chaboyer W, Ball L, Leveritt M. Effect of nutrition care provided by primary health professionals on adults’ dietary behaviours: a systematic review. Family Pract. 2015;32(6):605-17.

7. Xu X, Parker D, Ferguson C, Hickman L. Where is the nurse in nutritional care? Contem Nurs. 2017;53(3):267-70.

8. Murphy JL, Girot EA. The importance of nutrition, diet and lifestyle advice for cancer survivors – the role of nursing staff and interprofessional workers. J of Clin Nurs. 2013;22(11-12):1539-49.

9. Mollohan EA. Dietary culture: A concept analysis. Adv in Nurs Sci. 2018;41(4):E1-E12. Accessed 10 May 2019.

10. Sandelowski M. Whatever happened to qualitative descriptive? Res in Nurs and Health. 2000;23:334-40.

11. Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative:Lippincott Williams & Wilkins; 2011.

12. Lincoln YS, Guba EG. Naturalistic inquiry: Sage; 1985.

13. Arble DM, Bass J, Laposky AD, Vitaterna MH, Turek FW. Circadian timing of food intake contributes to weight gain. Obesity. 2009;17(11):2100-2.

14. Kinsey AW, Ormsbee MJ. The health impact of nighttime eating: old and new perspectives. Nutrients. 2015;7(4):2648-62.

15. Bevins F, De Smet A. Making time management the organization’s priority. McKinsey Quarterly.

16. Newman BY. Medical myths even some doctors believe. Optometry - Journal of the American Optometric Association. 2009;80(8):413-4.

17. Wolraich ML, Wilson DB, White JW. The effect of sugar on behavior or cognition in children: a meta-analysis. JAMA. 1995;274(20):1617-21.

18. Lipman TO. The chicken soup paradigm and nutrition support: rethinking terminology. J of Parentral and Enteral Nutr. 2003;27(1):93-4.

19. Welsh A. Chicken soup for colds and flu: Does it really help? USA: CBS Interactive Inc; 2016 [
20. Imai S-i. SIRT1 and caloric restriction: an insight into possible trade-offs between robustness and frailty. Curr Opin in Clin Nutri and Metab Care. 2009;12(4):350.

21. Ashton K, Bellis MA, Davies AR, Hughes K, Winstock A. Do emotions related to alcohol consumption differ by alcohol type? An international cross-sectional survey of emotions associated with alcohol consumption and influence on drink choice in different settings. BMJ Open. 2017;7(10):e016089.

22. Lee N. Do different drinks make you different drunk? Sydney: The Conversation; 2017 [Available from: The%20Conversation%20for%20December%201%20 2017%20-%2089157484&utm_content=Latest%20from%20The%20Conversation%20for%20December%201%202017%2-%289157484+CID_5bf585fc1fa4fc27d8ee 653005250c48&utm_source=campaign_monitor&utm_term=Do%20
different%20drinks%20make%20you%20different%20drunk. Accessed 10 May 2019.

23. Cao Y, Willett WC, Rimm EB, Stampfer MJ, Giovannucci EL. Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies. BMJ. 2015;351:h4238.

24. Du DH, Bruno R, Dwyer T, Venn A, Gall S. Moderate alcohol consumption is ssociated with a decreased prevalence of some but not all cardio-metabolic risk factors in young adults. Am Heart Assoc; 2016.

25. Stockwell T, Zhao J, Panwar S, Roemer A, Naimi T, Chikritzhs T. Do “moderate” drinkers have reduced mortality risk? A systematic review and meta-analysis of alcohol consumption and all-cause mortality. J of Stud on Alcohol and Drugs. 2016;77(2):185-98.

26. O’’Connor A. The claim: a glass of warm milk will help you get to sleep at night New York: NY Times; 2007.

27. St-Onge M-P, Mikic A, Pietrolungo CE. Effects of diet on sleep quality. Adv in Nutr. 2016;7(5):938-49.

28. Mellor D. Lining your stomach with milk before a big night out – and other alcohol myths Sydney: The Conversation; 2017 [Available from:

29. Suzuki S. Optimal weight gain during pregnancy in Japanese women. J of Clin Med Res. 2016;8(11):787.

30. Gillespie C. Seven super surprising benefits of drinking plain hot water USA: Reader’s Digest; nd. Available from: Accessed 10 May 2019.

31. Traverso V. Are China’s days of hot drinking water over? New York: Atlas Obscura; 2018. Available from: https:// Accessed 11 May 2019.

32. Valtin H. “Drink at least eight glasses of water a day.” Really? Is there scientific evidence for “8× 8”? Amer J of Physiology-Regulatory, Integrative and Comparative Physiology. 2002;283(5):R993-R1004.

33. Wolf R, Wolf D, Rudikoff D, Parish LC. Nutrition and water: drinking eight glasses of water a day ensures proper skin hydration—myth or reality? Clinics in Dermat. 2010;28(4):380-3.

34. Gould-Martin K. Hot cold clean poison and dirt: Chinese folk medical categories. Soc Sci & Med Part B: Med Anthro. 1978;12:39-46.

35. Liu HL, Chen KH, Peng NH. Cultural practices relating to menarche and menstruation among adolescent girls in Taiwan—qualitative investigation. J of Ped and Adol Gyne. 2012;25(1):43-7.

36. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. New Engl J of Med. 2011;364(25):2392-404.

37. Bedwell SJ. Seven tips for better digestion USA:;2011. Available from: Accessed 8 May 2019.

38. Cespedes A. Do You get fat if you sleep after eating?Texas: Livestrong Foundation; 2017. Available from: 9 May 2019

39. Fong M, Madigan C. Should we eat breakfast like a king, lunch like a prince, and dinner like a pauper? Sydney: The Conversation; 2017. Available from: Accessed 3 May 2019.

40. Allan GM, Arroll B. Prevention and treatment of the common cold: making sense of the evidence. Canad Med Assoc J. 2014;186(3):190-9.

41. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. The Cochrane Library. 2013.

42. Bouzari A, Holstege D, Barrett DM. Vitamin retention in eight fruits and vegetables: a comparison of refrigerated and frozen storage. J of Agric and Food Chem. 2015;63(3):957-62.

43. Rickman JC, Barrett DM, Bruhn CM. Nutritional comparison of fresh, frozen and canned fruits and
vegetables. Part 1. Vitamins C and B and phenolic compounds. J of the Sci of Food and Agric.

44. Hursel R, Westerterp-Plantenga MS. Catechin- and caffeine-rich teas for control of body weight in humans. The Amer J of Clin Nutr. 2013;98(6):1682S-93S.

45. Setiawan VW, Zhang ZF, Yu GP, Lu QY, Li YL, Lu ML, et al. Protective effect of green tea on the risks of chronic gastritis and stomach cancer. Intern J of Cancer. 2001;92(4):600-4.

46. Matthew F. Reconsidering the effects of monosodium glutamate: A literature review. J Amer Acad of Nurs Pract. 2006;18(10):482-6.

47. Dalheim A, Harthug S, Nilsen RM, Nortvedt MW. Factors influencing the development of evidence-based practice among nurses: a self-report survey. BMC Health ServRes. 2012;12(1):367.

48. Estabrooks CA, Rutakumwa W, O’Leary KA, ProfettoMcGrath J, Milner M, Levers MJ, et al. Sources of practice knowledge among nurses. Qual Health Res. 2005; 15(4):460-76.

49. Thompson DS, Estabrooks CA, Scott-Findlay S, Moore K, Wallin L. Interventions aimed at increasing research use in nursing: a systematic review. Implem Sci. 2007;2(1):15.

50. Thompson C, McCaughan D, Cullum N, Sheldon TA, Mulhall A, Thompson DR. Research information in nurses’ clinical decision making: what is useful? J Advan Nurs. 2001;36(3):376-88.

51. Stokke K, Olsen NR, Espehaug B, Nortvedt MW. Evidence based practice beliefs and implementation among nurses: a cross-sectional study. BMC Nurs. 2014;13(1):8.

52. Clinton P. Almost 40% of peer-reviewed dietary research turns out to be wrong. Here’s why USA: The New Food Economy; 2018. Available from: https://newfood 9 May 2019.

53. Kearns CE, Schmidt LA, Glantz SA. Sugar industry and coronary heart disease research: a historical analysis of internal industry documents. JAMA Internal Med. 2016;176(11):1680-5.

54. Arbesman S. The half-life of facts: Why everything we know has an expiration date. New York: Penguin; 2013.

55. McCook A. Errors trigger retraction of study on Mediterranean diet’s heart benefits New York: NPR Science Desk/Retraction Watch; 2018

56. Fong M, Caterson ID, Madigan CD. Are large dinners associated with excess weight, and does eating a smaller dinner achieve greater weight loss? A systematic review and meta-analysis. British J of Nutri. 2017;118(8):616-28.

57. Milich R, Wolraich M, Lindgren S. Sugar and hyperactivity: A critical review of empirical findings. Clin Psych Rev. 1986;6(6):493-513.

58. Wender EH, Solanto MV. Effects of sugar on aggressive and inattentive behavior in children with attention deficit disorder with hyperactivity and normal children. Pediatrics. 1991;88(5):960-6.

59. Thomas M. Monday’s medical myth: chicken soup cures the common cold Sydney: The Coversation; 2011. Available from: Accessed 9 May 2019 60. Pedersen ER, Neighbors C, Larimer ME. Differential alcohol expectancies based on type of alcoholic beverage consumed. J of Stud on Alcohol and Drugs. 2010;71(6):925-9.

61. Wiley AS. Milk for “Growth”: Global and local meanings of milk consumption in China, India, and the United States. Food and Foodways. 2011;19(1-2):11-33.

62. Southwell P, Evans C, Hunt J. Effect of a hot milk drink on movements during sleep. BMJ. 1972;2(5811):429-31.

63. Renton A. If MSG is so bad for you, why doesn’t everyone in Asia have a headache? London: The Guardian; 2005. Available from: 9 May 2019.

64. NSW Government. Monosodium glutamate (MSG) Sydney: NSW Government, Australia; 2018.

Most read articles by the same author(s)

1 2 3 4 5 > >>