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Article Excerpt
The aging population is expected to increase from 35 million in 1999 to 40 million in 2010, and 70 million by 2030, according to the Healthy People 2010 Database (National Center for Health Statistics, 2000). As the population ages, chronic disease will continue to be an issue requiring significant medical interventions by healthcare providers, placing added stress on an already compromised healthcare system, and thus, affecting care costs and resources. It is imperative to include patients in their care and encourage them to take some responsibility for their self care to help control chronic disease and the healthcare costs associated with it. Several studies indicate that patients involved in self management of disease processes often have better patient outcomes (Costantini, 2006; Curtin & Mapes, 2001; Curtin, Mapes, Petillo, & Oberley, 2002; Curtin, Mapes, Schatell, & Burrows-Hudson, 2005).
Obesity has become a prevalent problem in the United States. The Centers for Disease Control and Prevention (CDC) (2009a) states that "during the past 20 years, there has been a dramatic increase in obesity in the United States" (p. 1). Research has shown that as weight increases to reach the levels referred to as over-weight or obesity, the risks for coronary heart disease, type 2 diabetes, hypertension, and cancers also increases (CDC, 2009b; National Heart, Lung, and Blood Institute/National Institute of Diabetes and Digestive and Kidney Diseases, 1998). One of the complications of diabetes is the development of nephropathy leading to end stage renal disease (ESRD).
Diabetes-related complications and nephropathy account for 50% of new cases of ESRD (U.S. Renal Data System [USRDS], 2008). The number of patients with ESRD will continue to rise, causing an increased need for medical and nursing intervention.
Theory
Dorthea Orem believed that people...
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