SSoouutthh DDaakkoottaa SSttaattee UUnniivveerrssiittyy OOppeenn PPRRAAIIRRIIEE:: OOppeenn PPuubblliicc RReesseeaarrcchh AAcccceessss IInnssttiittuuttiioonnaall RReeppoossiittoorryy aanndd IInnffoorrmmaattiioonn EExxcchhaannggee Electronic Theses and Dissertations 2016 RReellaattiioonnsshhiipp BBeettwweeeenn SSeellff--CCaarree AAggeennccyy,, SSeellff--CCaarree PPrraaccttiicceess,, aanndd BBooddyy MMaassss IInnddeexx AAmmoonngg NNuurrssiinngg PPrrooffeessssiioonnaallss Takara Schomberg South Dakota State Follow this and additional works at: https://openprairie.sdstate.edu/etd Part of the Nursing Commons RReeccoommmmeennddeedd CCiittaattiioonn Schomberg, Takara, "Relationship Between Self-Care Agency, Self-Care Practices, and Body Mass Index Among Nursing Professionals" (2016). Electronic Theses and Dissertations. 1090. https://openprairie.sdstate.edu/etd/1090 This Thesis - Open Access is brought to you for free and open access by Open PRAIRIE: Open Public Research Access Institutional Repository and Information Exchange. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Open PRAIRIE: Open Public Research Access Institutional Repository and Information Exchange. For more information, please contact [email protected]. RELATIONSHIP BETWEEN SELF-CARE AGENCY, SELF-CARE PRACTICES, AND BODY MASS INDEX AMONG NURSING PROFESSIONALS BY TAKARA SCHOMBERG, BSN, RN A thesis submitted in partial fulfillment of the requirements for the degree Master of Science Major in Nursing Specialization in Nurse Educator South Dakota State University 2016 iii This paper is dedicated to the friends and family who have helped to watch my daughter, my co-workers who went above and beyond to accommodate my crazy schedule, and my family. I want to make special mention of my incredible husband, John, and daughter, Keziah. They have made such sacrifices but have been a source of unwavering love and support. iv ACKNOWLEDGEMENTS The author would like to express deep appreciation for the assistance and guidance of Dr. Linda Burdette, thesis committee chair and program advisor for this author. Dr. Burdette leant invaluable guidance and support through the refinement of this study and the presentation of its results. Her experience and commitment to health and health promotion were an invaluable source of knowledge and encouragement. I am also grateful for the guidance and support of my thesis committee members, Dr. Marylou Mylant, College of Nursing, and Dr. Brian Britt, graduate faculty representative. Without a committee that shared my passion for this project, this study could not have been accomplished. A special thanks to Dr. Linda Herrick, associate dean of undergraduate nursing, for stepping in and assisting with committee work and the guidance of this project when needed. I am exceedingly grateful to the nurses who agreed to participate in this study, some of whom reached out via email to lend support and encouragement to this project. The opportunity to learn from the experience of these nursing professionals was invaluable. v CONTENTS LIST OF ABBREVIATIONS………………………………………………………… viii LIST OF FIGURES……………………………………………………………………… ix LIST OF TABLES……………………………………………………………………… x ABSTRACT…………………………………………………………………………… xi CHAPTERS 1. INTRODUCTION……….…………………………………………………… 1 BACKGROUND…………………………………………………………… 2 PURPOSE…………………………………………………………………… 5 RESEARCH QUESTION…………………………………………………… 5 GOAL………………………………………………………………………… 5 SIGNIFICANCE…………………………………………………………… 6 2. REVIEW OF THE LITERATURE………………………………………… 9 NURSES AS HEALTH ROLE MODELS………………………………… 11 NURSES & SELF-CARE PRACTICES…………………………………… 17 WEIGHT MANAGEMENT & BURN-OUT……………………………… 30 SUMMARY OF LITERATURE REVIEW…………………………………33 GAPS IN LITERATURE……………………………………………………36 DEFINITION OF TERMS………………………………………………… 38 CONCEPTUAL FRAMEWORK…………………………………………… 40 3. METHOD……………………………………………………………………43 STUDY DESIGN…………………………………………………………… 43 STUDY SETTING………………………………………………………… 44 vi STUDY POPULATION…………………………………………………… 46 ETHICAL CONSIDERATIONS…………………………………………… 46 SURVEY INSTRUMENTS……………………………………………… 49 STUDY SAMPLE………………………………………………………… 53 DATA COLLECTION…………………………………………………… 56 DATA ANALYSIS………………………………………………………… 57 4. RESULTS………………………………………………………………… 59 RESULTS & ANALYSIS………………………………………………… 59 DESCRIPTIVE STATISTICS……………………………………………… 60 CORRELATIONAL STATISTICS………………………………………… 68 5. DISCUSSION & CONCLUSIONS …………………………………………72 6. DISCUSSION OF RESULTS……………………………………………… 72 IMPLICATIONS…………………………………………………………… 75 LIMITATIONS…………………………………………………………… 80 IMPLICATIONS FOR FUTURE RESEARCH…………………………… 84 CONCLUSION…………………………………………………………… 85 APPENDICES A. DEMOGRAPHICS, LIFESTYLE, PROFESSIONAL BACKGROUND SURVEY……………………………………………………………………… 88 B. DSCAI-90 & SCORING……………………………………………………… 91 C. DSCPI-90 & SCORING…………………………………………………………97 D. PERMISSION FOR USE OF TOOLS………………………………………… 101 E. SURVEY INVITATION COVER LETTER………………………………… 102 vii F. IRB APPROVAL-EXPEDITED ……………………………………………… 104 G. NUMBERS FOR SYSTEMATIC RANDOMIZED PARTICIPANT SELECTION ………………………………………………………………………………… 106 H. MEAN SCORES……………………………………………………………… 107 I. DEMOGRAPHIC, LIFESTYLE, PROFESSIONAL BACKGROUND STATISTICS………………………………………………………………… 109 J. BMI DISTRIBUTION BY CATEGORY…………………………………… 111 K. CORRELATION AND SIGNIFICANCE COEFFICIENTS………………… 112 REFERENCES………………………………………………………………………… 113 viii ABBREVIATIONS BMI body mass index BON Board of Nursing BPA bisphenol A DSCAI-90 Denyes Self-Care Agency Instrument DSCPI-90 Denyes Self-Care Practices Instrument NHS Nurses’ Health Study NHSII Nurses’ Health Study II RN Registered Nurse SCA self-care agency SCP self-care practices SD Standard Deviation US United States ix LIST OF FIGURES Figure 1. Theorized Self-Care Relationships among Nursing Professionals. ………… 44 Figure 2. BMI Category Rates Among Sample Participants. ………………………… 64 Figure 3. Distribution and Skew of BMI Scores. ……………………………………… 65 Figure 4. Distribution and Skew of DSCAI-90 Total Scores. ………………………… 66 Figure 5. Distribution and Skew of DSCPI-90 Total Scores. ………………………… 68 Figure 6. Relationship between DSCAI-90 and DSCPI-90 …………………………… 69 Figure 7. Relationship between DSCPI-90 and BMI………………………………… 70 Figure 8. Relationship between DSCAI-90 and BMI………………………………… 71