This paper examines adult obesity as a core concept shared by two prominent contemporary nursing theories: Dorothea Orem's Self-Care Deficit Nursing Theory (SCDNT) and Nola Pender's Health Promotion Model. The paper defines each theory's foundational components, compares how each conceptualizes the nurse's role in addressing obesity, and analyzes the practical implications of both models for nursing care. Orem's framework emphasizes identifying self-care deficits and empowering patients through structured support, while Pender's model focuses on cognitive-perceptual and modifying factors that influence health-promoting behavior. Together, the two frameworks offer complementary strategies for developing individualized nursing care plans for obese adult patients.
Core concepts can be defined as the main components of any theory upon which the theory can be formulated or a model can be designed. Certain concepts help in the development of nursing theories, and while different theorists have produced a variety of theories and models, many share the same core concepts. The aim of this paper is to identify a core concept that is common to two or more contemporary nursing theories, compare and analyze the concept definitions among the selected theories, and then discuss where and how one selected theory may best be applied to nursing practice.
The core concept selected for this purpose is obesity, while the nursing models selected are Orem's Self-Care Deficit Nursing Theory and Pender's Health Promotion Model.
Obesity in adults is one of the most serious problems in the United States. According to research, nearly 127 million Americans are affected by this condition — that is, they are overweight. Due to obesity, Americans face at least 300,000 deaths each year (Wilson & Kershaw, 2003). Additionally, the cost of healthcare associated with obesity is approximately $100 billion (Williams, 2001). Most nurses working in healthcare settings are facing serious challenges due to the increased number of adult patients with obesity. This paper analyzes the problem of obesity from the perspectives of Dorothea Orem's and Nola Pender's models.
"The role of obesity in the etiology of diseases such as hypertension, diabetes, and coronary artery disease is well established. Obesity is also recognized as a major risk factor in the development of many other diseases, such as gastroesophageal reflux, arthritis of weight-bearing joints, sleep apnea, and certain types of cancer" (Wang, 2001). Obesity is associated with increased morbidity and mortality. Nurses caring for obese patients should recognize the need to use specialized assessment and management strategies to prevent poor patient outcomes.
The issues related to adult obesity and their application to nursing practice can best be analyzed and described with the help of Pender's Health Promotion Model and Orem's Self-Care Deficit Nursing Theory. Analysis using these models can provide better goal-setting for professional nursing practices related to adult obesity.
The premise of Orem's theory rests on concepts related to goal-setting in nursing practice. According to this theory, human beings have the ability to take meaningful steps to regulate their health, life, and well-being (Tomey & Alligood, 2002). According to Orem, the Self-Care Deficit Nursing Theory (SCDNT) is based on a general theory and is comprised of three interrelated theories: (a) the theory of self-care, which describes the reasons people care for themselves; (b) the theory of self-care deficit, which argues that there is a specific reason people require the assistance of the nursing profession; and (c) the nursing systems theory, which is based on the concept that significant relationships must be built in order to make nursing practice more efficient and effective. According to Orem, relevant information about the patient is essential to determine whether a self-care deficit exists. This information is critical for nurses when creating a care plan, developing nursing interventions, and ultimately producing efficient and effective nursing care. Orem operationalized this through a comprehensive assessment using the SCDNT model (Lannon, 2007).
According to Pender's Health Promotion Model, there is a multidimensional nature to the interaction between persons and their environment in the pursuit of healthcare. This widely used model is divided into several segments relating to health-promoting lifestyle. These segments are modifying factors, cognitive-perceptual factors, and certain other variables that affect the likelihood of a particular action. For the maintenance and acquisition of a health-promoting lifestyle, cognitive-perceptual factors remain significant participants in the motivation mechanism for health-promoting behavior (Hahler, 2002). Key components of these factors include perceived health control, perceived health importance, perceived health status, perceived level of self-efficacy, health definition, and perceived advantages and barriers to health-promoting behavior. Factors associated with modification of this health-promotion model include biological, demographic, interpersonal, behavioral, and situational factors. Pender asserts that the focus of health promotion is directed toward a positive state associated with superior well-being and healthcare.
Orem's theory helps analyze nursing practice application in a unified direction, guiding the efficient role of nursing in any healthcare setting related to adult obesity. Collecting important patient information using the vital concepts of Orem's theory will generally help the nursing care unit to define and identify any self-care deficit. The existence of a self-care deficit — a situation in which a patient lacks the ability to care for himself or herself — is an alarming condition. Several factors can be identified in the case of an obese patient (Goodwin & Peterson, 2002). These factors are universal self-care requisites, which include food, activity, and rest. There are also deviation-related self-care determinants whose requisites include obesity and difficulty ambulating.
An obese patient should seek advice and knowledge from a certified healthcare professional, as the patient will typically wish to lose weight and be perceived as more active by friends and family. Obesity is a serious condition, and weight loss is important because the patient's health can deteriorate further if appropriate precautions are not taken. This may lead to the development of additional physiological problems. The self-care instinct of the obese patient is essential and should come from within; unwillingness to engage may result in serious health consequences. Additionally, the patient requires a nursing care plan that includes, but is not limited to, educational materials on healthy dietary choices, an exercise program designed to increase self-worth, a nutritional consultation, and positive support from family and friends. Orem's theory can serve as a guide for such patients, providing self-esteem, a support system, knowledge of healthy behaviors, and improvement in ambulation difficulties (Cox & Taylor, 2005).
In Pender's Health Promotion Model, the theoretical framework was designed to investigate behaviors that enhance lifestyle, including weight loss and exercise. The purpose of this model is to provide guidance to obese individuals regarding healthier lifestyles. Important variables within this model for obese individuals include ambulation difficulties and exercise behaviors.
"Contrasts how each theory addresses obesity"
"Practical nursing care applications of both models"
Wang, H. H. (2001). A comparison of two models of health-promoting lifestyle in rural elderly Taiwanese women. Public Health Nursing, 18(3), 204–211.
Williams, L. A. (2001). Imogene King's interacting systems theory: Application in emergency and rural nursing. Online Journal of Rural Nursing and Health Care, 2(1).
Wilson, F. L., Mood, D. W., Risk, J., & Kershaw, T. (2003). Evaluation of education materials using Orem's self-care deficit theory. Nursing Science Quarterly, 16(1), 68–76.
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