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Abstract:
Objective: The purpose was to examine the relationship between self-care, self-care practices, and obesity among rural midlife women framed in two theories, Dorothea Orem‘s self-care and rural nursing theory. Background: The prevalence and consequences of obesity and overweight identified substantial needs to be addressed. No studies were identified related to the relationship of self-care to rural mid-life women and obesity. No studies found utilized both Orem‘s theory and the rural nursing theory as a theoretical framework. Methods: The study utilized a nonexperimental, predictive correlational cross-sectional design. Participants completed demographic and basic conditioning factors (BCFs) data, Denyes Self-Care Agency Instrument, DSCAI-90©, and Denyes Self-Care Practice Instrument, DSCPI-90© instruments. Anthropometric measurements were height, and weight. A predictive model of self-care in rural midlife women was constructed based on Orem‘s self-care theory and rural nursing theory. Results: The participants were 224 ambulatory rural women, ages 40-64 years, from 10 northern counties of an upper plains state. Mean age was 52 years. Mean BMI was 29.165. Facilitators and barriers to self-care agency and self-care were identified by Pearson product moment correlation coefficient and hierarchical regression analysis. Self-care agency predicted self-care. Hypothesized model was tested and revised. BMI had the greatest direct effect on self-care agency. Self-care agency had the greatest direct effect on self-care. F test confirmed BMI may predict self-care agency, F (1,221) = 16.887, p=.000, Fcrit = 6.67. A positive relationship was not found between self-care agency, self-care, and distance. A significant negative relationship was not found between chronic diseases and self-care agency (r=-.103, p= .062). A negative relationship was found between chronic diseases and self-care (r=-.194, p =.002). Qualitative data identified the meaning of health, self-care and impact of distance for rural midlife women. Conclusions: The study provided new knowledge of the relationship of self-care, selfcare practices and obesity in the context of the rural environment. This new knowledge will assist nurses in tailoring realistic approaches to overweight and obesity in rural women.
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