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Article Excerpt
Self-care behaviors are learned and are affected by one's environment, culture, and values. These behaviors regulate and maintain human structural integrity, function, and development. Orem's Self-Care Deficit Nursing Theory (Orem, 2001) describes the relationship existing among self-care actions, development, and individual and group function (Fawcett, 2000). In this sense, the role of the family and school are of great importance because that is where children can learn healthy lifestyles from an early age (Moore, 1995).
International organizations have recognized that health education should be taught at school at the same time as other subjects (Campos, Campos, & Jaimovich, 1999; Canadian Association of University Schools of Nursing, Canadian Nurses Association, & The College of Family Physicians of Canada, 2002; Fawcett, 2000). Nurses can make an important contribution in schools, especially if their functions include health promotion. The school constitutes an excellent place to teach healthy behaviors, detect unhealthy practices, and perform interventions to change behaviors (Campos, Urrutia, Guzman, & Vargas, 1997).
Many Latin American countries are experiencing a nutritional transition characterized by a shift from a preponderance of under-nutrition to a rapidly rising prevalence of diet-related chronic diseases, such as obesity, diabetes mellitus, and high blood pressure. This nutritional shift has been associated with modern urbanization and technological innovations that result in reduced energy output by individuals, and by changes in dietary habits (Rivera, Barquera, Gonzalez-Cossio, Olaiz, & Sepulveda, 2004). In the Republic of Chile, dietary habits are shifting equally rapidly, especially for the moderate and low-income population (Popkin, 2004). The consumption of energy dense and processed fast foods and soft drinks has increased, while physical activity has diminished due to changes in technology in the workplace, among other factors (Rivera et al., 2004).
Although Chile now has an improved level of health due to recent reforms, some aspects related to the quality of life are deteriorating, especially in the poorest sectors of the population. The consumption of junk food and soft drinks has increased, while physical activity has diminished. In addition, tobacco and alcohol consumption has increased. As a result of this problematic life style, obesity rates have increased in the population, especially among children, adolescents, and women of fertile age (Salinas & Vio, 2003).
According to the Chilean Ministry of Health, about 7.5% of Chilean children 6 years of age or younger are obese (greater than 95th percentile in Centers for Disease Control and Prevention [CDC] growth charts), 14% of teens are obese, and about 33% of adults are obese. The obesity rate for children in Chile is the highest in Latin America (Espinosa, 2005). These figures compare to rates of obesity in the United States of 13.9% for children 2 to 5 years, 18.8% for children 6 to 11 years, 17.4% for teens 12 to 19 years, and 32.9% for adults (CDC, 2008).
Tobacco smoking has increased in Chile, especially for youth ages 13 to 15 years. In this age group, 44% of females and 31% of males reported smoking at least one cigarette in the past 30 days. Most children age 12 to 18 are enrolled in secondary school (92% of females; 91% of males) (Population Reference Bureau, 2007).
As evidenced by these nutritional and health findings, it is apparent that the self-care practices of children in the Republic of Chile warrant further investigation for the development of future nutrition and health care interventions to decrease the risk for obesity and other lifestyle-related disorders.
A recent nutrition study of 88 children ages 8 to 11 years documented the nutritional and self-care deficiencies of children in the Republic of Chile (Olivares, Bustos, Moreno, Lera, & Cortez, 2006). Children in this study consumed low levels of vegetables, fruits, and dairy products, but high levels of high-calorie beverages and food. Greater than 55% of children did not engage in physical activities after school.
Previous theory-based research by Moore (1995) stated that to validate the use of Orem's theory in children, an explanation of their self-care practices is needed. With this purpose, Moore developed the Child and Adolescent Self-care Performance Questionnaire in 1991 and studied its psychometric properties.
Carper (1998) recommended that researchers studying self-care "need to determine if they plan to measure personal abilities for self-care or the actions taken by an individual for self-care and choose their instruments appropriately" (p. 196). The Adolescent Self-Care Performance Questionnaire measures children's performance of self-care activities related to the three areas of self-care requisites, which include universal, developmental, and health deviation requirements for care (Orem, 2001). Therefore, the instrument can provide relevant information about behavior-related content for school curricula.
The purpose of this study was...
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