Professional Documents
Culture Documents
Chapter I
Introduction
certain way - it's feeling good and staying healthy; having too much body fat
The number of people who are obese is rising. About 1.2 billion
people in the world are overweight and at least 300 million of them are
obese, even though obesity is one of the 10 most preventable health risks,
according to the World Health Organization. In the United States, more than
97 million adults - that's more than half - are overweight and almost one in
five adults is obese. Among teenagers and kids 6 years and older, more than
15% are overweight - that's more than three times the number of young
people who were overweight in the 1970s. At least 300,000 deaths every
(meaning the BMI is greater than that of 95% of people of the same age and
the 85th and 95th percentiles typically is considered at risk for overweight.
Obesity is the term used for extreme overweight. There are some exceptions
to this formula, though. For instance, someone who is very muscular (like a
bodybuilder) may have a high BMI without being obese because the excess
weight is from extra muscle, not fat. People gain weight when the body
takes in more calories than it burns off. Those extra calories are stored as fat.
The amount of weight gain that leads to obesity doesn't happen in a few
weeks or months. Because being obese is more than just being a few pounds
overweight, people who are obese have usually been getting more calories
But being obese and being overweight is not exactly the same thing.
An obese person has a large amount of extra body fat, not just a few extra
pounds. People who are obese are very overweight and at risk for serious
Obesity can run in families, but just how much is due to genes is hard
to determine. Many families eat the same foods, have the same habits (like
snacking in front of the TV), and tend to think alike when it comes to
overweight or learns eating and exercise habits that lead to weight gain.
Obesity is bad news for both body and mind. Not only does it make a person
feel tired and uncomfortable, it can wear down joints and put extra stress on
other parts of the body. There can be more serious consequences as well.
Not all obese people are aware of the risks that come along with their
occurs, and thus, tearing the kidneys apart, which is also a good indication of
different manner.
phenomenon.
In one small study of men and women who had suspected heart
healthy diet, has normal blood pressure, not diabetic, and do not smoke were
normal body weight and regular physical activity are both important in heart
health, together they are a potent force in enabling people to live healthy
lives.
early part of the 90's; surely not because it is non-existent in this part of the
world but because doctors & other health providers show not much interest
in this issue. The incidence of clinically severe obesity --- or simply the state
of exceeding the Ideal Body Weight (IBW) by 100 lbs. for males, or 80 lbs.
for females, is rising among Filipinos. Severe obesity refers to a Body Mass
Index (BMI) of >40 kg/m^2, the normal BMI being 19-25. Commonly
called morbid obesity, it gives rise to a host of diseases such as high blood
5
in the Philippines unless serious steps are taken to arrest the rise of its
alarming to note that some of these patients are very young," says Dr.
Is this obesity trend seen in the third world as well? National statistics
adopt more of the western lifestyle and diet as reflected by the so-called
the data gathered from the NUTRISTAT Protocol at St. Luke’s Medical
Center (1999 – 2000), 34% of the total admitted patients are malnourished
and yet surprisingly about one-fourth of them are obese. There was more
6
overweight (2/3) than undernourished (1/3) patients. These data may give us
THEORETICAL FRAMEWORK
Orem’s nursing theory has been used in research. Orem began developing
her theory in the 1950’s, a time when most nursing conceptual models were
(Fawcett, 2000).
that make up the general theory are: Self-Care, Self-Care Deficit, and
Nursing Systems. The Self-Care theory states that adults deliberately learn
and perform actions to direct their survival, quality of life, and well-being.
theory is the product of nursing in nursing system(s) by which nurses use the
7
nursing process to help individuals meet their self-care requisites and build
Due to enumerable factors, obesity has come into a wide range due to
and maintaining a healthy lifestyle. Some tend to overeat without taking into
consideration the nutrition that they acquire and the effects of the food they
are eating to their bodies. They became prone to heart diseases, including
knowledge and discipline regarding such matters that affect their health and
well being.
CONCEPTUAL FRAMEWORK
among women. It also showed that weight gain in the young adult years
produced an increased risk for CVD in both men and women. Some of the
most interesting studies that show obesity itself cause an increase in the risk
of CVD come from examining the hearts of obese people. The confusion
8
that can occur in a discussion of obesity and CVD relates to the fact that
poor fitness also increases the risk of CVD. Since poor fitness can often
and the association between CVD and obesity is, in reality, simply the
association between poor fitness and CVD. Of course, unfit men as a whole
were significantly more likely to die of CVD than fit men. Thus, even
though a lack of fitness is clearly a risk factor for CVD, once fitness is taken
into account, obesity still plays a role. In fact, the authors conclude that a
lack of fitness represented only 39% of the CVD risk in obese men. A lack
of fitness adds to overweight and obesity. In other words, fitness and obesity
Active men with high BMI had a 35% higher CVD hazard ratio than
active men with low BMI. Of course, the active men and women all had
lower CVD hazard ratios than the inactive men and women. This, of course,
tells us that obesity and physical inactivity are both independent risk factors
for CVD. This is why the authors note, “In conclusion, our study confirmed
that both physical inactivity and obesity are important risk factors for CVD.”
9
As you can see, then, obesity is an independent risk factor for CVD.
10
11
RESEARCH PARADIGM
INPUT
Demographic Profile:
• Age
• Gender
• Height
• Weight
• Religion
Obese person handle their physical status with regards to:
• Exercise
• Daily Routine
Factors and how they contribute on development of obesity in terms of:
• Physiological factors
• Environmental factors
Obese person perceive their level of awareness with regards to:
• risk of having Cardiovascular Disease
Problems that an obese person may encounter with regards to:
• Daily Living
Preventive practices of obese person in regards to:
• Prevention of risk factors
• Health education to patient
PROCESS
Analysis of input data
Gathering of data
• Questionnaire
Output
Increase the level of awareness of health care management of obese person with the risk
of having Cardiovascular Disease
questions:
1.1 Age
1.2 Gender
1.3 Height
1.4 Weight
1.5 Religion
2. How do obese person handle their physical status with regards to:
2.1 Exercise
4. How do obese person perceive their level of awareness about the risk
5. What are the problems that an obese person may encounter with their
daily living?
6. What practices are the obese person do to improve their health status
Nursing Students:
This study will help the nursing students to guide them in becoming
prepared when dealing with obese person high risk in cardiovascular disease.
This further helps them to improve their nursing process such as assessment,
planning, intervention and evaluation. This study will also create awareness
implementing possible health status. And help those obese persons to control
cardiovascular disease.
14
activities related to their health and daily a living. This will further help and
guide them developing their skills for carrying themselves. And this study
Obese Persons:
The must benefited one of this study will be the obese person because
improving themselves may hopefully realize they are those people who are
high risk in cardiovascular disease. This study will help them to control and
cope with the preventive measure and prioritize the aspect of care.
cardiovascular disease.
The respondent of this study are those twenty obese nursing students
from Arellano University Legarda Street, Manila from second year to forth
year ages between 15-23 years old. The aspect looked into were the severity
of the obesity problem. The respondent will contribute to the study as they
15
shared their ideas on what the present generation presumption about obesity.
DEFINITION OF TERMS
Arteriosclerosis
includes a variety of conditions that cause artery walls to thicken and lose
elasticity.
Weight
Height
Cardiac Arrest
Cardiovascular Disease
hypertension.
Cardiac Output
contraction.
Hypertension
Hypotension
Overweight
disease. This is usually a thickening and stenos is of one or more of the heart
valves and often requires surgery, to repair or replace the involved valve
17
Chapter II
These instances prompted the researcher to review and conduct studies about
obesity to prevent the spreading problems over and within the countries.
Related Literature
Foreign Literature
Literature 1
mass index (BMI) of greater than 30. BMI is a measurement of body fat
developing heart disease, high blood pressure, stroke, diabetes, and many
those with a "pear," or lower body, fat distribution pattern. Big hips are
Since 1999, Davy's research has been focused on determining the role
that part of the nervous system that speeds the heart, contracts blood vessels,
and initiates other physiological reactions to mobilize the body for action in
19
Literature 2
smoking have all been directly related to CHD. Obesity is on the rise in the
United States and has also been associated with CHD. This review clearly
Study, and the Cancer Prevention Study II. Morbid obesity was found to
risk in obesity.
(CHD), is the number one cause of mortality in the United States. During the
20
States and there is strong evidence to indicate obesity as a risk factor for
factor for CHD, and then compares morbid obesity vs. nonmorbid obesity as
The studies used in this review include the Framingham Heart Study,
Nurse's Health Study, Buffalo Health Study, and the Cancer Prevention
Study II, which identify obesity as an independent risk factor for CHD. The
in the United States, we will explore treatment options and new theories in
is proposed.
Literature 3
establish obesity as an independent risk factor for CHD. The following are
four large studies that document a strong association between obesity and
CHD.
the U.S., with nearly 70% of adults being classified as overweight or obese
compared with fewer than 25% 40 years ago. Although too often obesity is
account for over 300,000 deaths annually in the U.S., thus overtaking
risk factors. Obese patients are more likely to be hypertensive than lean
protein, data from both the Framingham Heart Study and a large cohort of
U.S. nurses have indicated that obesity is an independent risk factor for
Diastolic abnormalities occur with all types of LVH, with the most marked
contractility early in obesity. Alpert et al. have confirmed the adverse effects
recent epidemiologic study from the Framingham Heart Study indicates that
being overweight and obesity are potent predictors of subsequent clinical HF.
Literature 4
Obesity are diseases, thus, natural results in a person making extra poor
decision about food choices and physical exercise. It's something that can be
reverse in virtually 100% of the cases by changing these two simple things.
24
As a result, it rests firmly under the control of the patient, especially if they
are educated about health nutrition and to make intelligent choices about
what kinds of food and grocery products they consume. To call obesity a
This idea is reinforced by language of doctors and health care providers who
say things such as "Oh, you are obese," which sounds like you've been
afflicted with some external invader that took over your health and make
overweight children go hand and hand. The more TV a child watches, the
more likely he is to get fat. "In a list of nine strategies set in 2000 to fight
obesity, Surgeon General David Satcher listed, "Reduce time spent watching
TV and other sedentary behaviors". (By the way, none of the strategies
McDonald's offer such as grilled chicken Caesar salad with fat-free herb
vinaigrette dressing: a total of 135 calories. The dinner makes the choice.
25
students as "food to limit". In the school where they sold, students ate fewer
fruits and vegetables and consumed more calories from fat and saturated fat
Local Literature
Literature 1
Health (2007). It was mentioned that the entire health sector has to face
care delivery system, inadequate regulatory mechanism and poor health care
disease, cancer and diabetes are the major problems faced by the health
sector. A health sector reform agenda has been developed to address the need
financed that would bring the country towards its national goal and
objectives for health and the realization of the common vision of health for
the Filipinos.
26
Literature 2
many of these people long to be slim. As in the west, the bloating of Asia has
food chains spread through Asia they were being followed by a proliferation
Literature 3
effect a child's present and future health and have direct impact on quality of
life including:
• High blood pressure, high cholesterol and abnormal blood lipid levels,
sexually mature than their peers, raising expectations that they should
act as old as they look, not as old as they are; overweight girls may
adulthood)
• Depression
cholesterol, and diabetes) can lead to serious adult medical conditions like
children may reduce the risk of developing these conditions as they get
older.
Literature 4
of the Philippines College of Medicine (UPCM) says that the fat cells
(adipocytes) in the intraabdominal area are not just storage sites for excess
energy but constitute an active endocrine gland that responds to signals from
higher centers in the brain through the autonomic nervous system and other
endocrine tissues.
are responsible for giving humans greater risk for chronic diseases.
Prof. Cynthia Manabat of the UPCM, cited that there exist adiposity
signals that are involved in a mechanism used by the body to know whether
29
irregular physical activity over time, the body has a mechanism for
with energy expenditure over time. If fat stores in the body decrease this
change is sensed by adiposity signals that will inhibit catabolic and stimulate
increase food intake to maintain energy balanced. If the fat stores increase,
this change will be sensed by adiposity signals telling the CNS, to initiate
energy expenditure and the CNS will dictate the body to decrease food
their influence over a persons genes and gene formation expression are being
studied. She also says nutrigenomics advances the view that under certain
circumstances, diet may be a risk factor for disease and influence health and
chemicals can alter gene expression and change the genome structure; diet
30
genes regulated by diet also play a role in chronic diseases; and intelligent
Related Studies
Many studies had been conducted both in local and foreign countries
that are related to the problems brought by obesity. This portion provides
information that is relevant and helpful to the different phase of the problem
at hand.
Foreign Studies
Study 1
nutrition labels and percentage calorie intake from fat, 301 adolescents aged
10 to 19. Teen boys who actually do read the labels tend to eat more protein
and fat than those who don't. Dietary fat intake in the U.S. adolescents has
been found to be about 3.5% which is at the higher and if the recommended
20% to 35% range for daily fat intake (depending on a person's metabolism).
31
the eating habits, body composition and physical fitness of nearly 1,000
students and found out that the tendency toward obesity begins well before
research effort, the Berkley Preschool Nutrition Study, which began with a
who helped design the teenagers study. "In her studies, particularly the two
longitudinal studies, she got detailed information about how children eat and
relationship with their parents. All kinds of details that had not been
organized on that way. She got into details of how they lived," Shapiro said.
Shapiro recalled that one of the most surprising findings from the
teenagers study was that adolescence was too late to study the onset of
and early childhood was a more critical factor for obesity that excessive
calorie consumption. The studies also provided solid evidence that obesity
commonly believed that obesity was a problem of the overfed rich, but she
showed the inverse to be true. Among children and teenagers, the poor were
Study 2
Science Center, San Antonio (2006) said that; The reasons for the
sensitivity to insulin; evidence indicates that these maneuvers can also lower
Study 3
(2005) said that; overweight and obese men with baseline CVD or CVD risk
factors were at higher risk for all-cause and CVD mortality compared with
without CVD as the referent, the strongest predictor of CVD death in obese
men was baseline CVD RR’s for obese men with diabetes mellitus, high
cholesterol, hypertension, smoking, and low fitness were similar and ranged
from 4.4 for smoking to 5.0) for low fitness. Relative risks for all-cause
34
mortality in obese men ranged from 2.3 for men with hypertension to 4.7 for
those with CVD at baseline. Relative risk for all-cause mortality in obese
men with low fitness was 3.1 and in obese men with diabetes mellitus 3.1
and as slightly higher than the RR’s for obese men who smoked or had high
all body mass index groups after adjustment for other mortality predictors.
population-attributable risk of 39% for CVD mortality and 44% for all-cause
mortality. Baseline CVD had population attribute risks of 51% and 27% for
Study 4
risk of cardiovascular disease has attracted great interest but also raised
many questions and controversy," says David Eddy, MD, PhD, medical
build Diabetes PHD, a risk calculator that simulates the biology underlying
treatments. ADA now has asked Eddy and his team to use the Archimedes
model to develop the CMR Calculator, a new, interactive tool that by the end
of the year will be available to help physicians evaluate the potential impact
as body mass index, waist circumference ratio, fasting plasma glucose, blood
Simulations of new clinical trials and epidemiological and cohort studies are
Study 5
37
Scott M. Grundy, MD, PhD (2005) said that; it appears that 50% of
children who are overweight are also overweight as adults, but it is not
adult. CVD risk factors, such as elevated blood pressure, elevated total
cholesterol and LDL cholesterol, and low levels of HDL cholesterol track
from childhood, although less strongly than BMI. Overweight children also
tend to have a cluster of risk factors. Risk factors tend to occur in families
Children with a family history of CVD are heavier than those without family
history of disease. All of this suggests that the obese child has an elevated
and women. The greatest weight gain in men occurs in those with the highest
BMI and those in the older age groups. Compared with women, men live
longer and are obese later in life. In women, the greatest weight gain is in the
weight gain between men and women is that as women's educational level
rises, obesity decreases, for both white and black women, whereas in men,
Local Studies
Study 1
In the study conducted by FNRI in 1998, it was found out that among
preschool age children (0-5 yrs. old) 9 of every 1000 are overweight for their
height: 1 in every 1000 children are overweight: and 2 in every child, less
than 1 year old are overweight for their height. Among children 6-10 years
years old, the female adolescents are more at risk to overweight and obesity
malls and eating at fast food restaurants. Even as they eat, however, many of
these people long to be slim. As in the west, the bloating of Asia has been
Study 2
Reyela (200) revealed that the common CVD for obese patient are
a systolic blood pressure above 140 mmHg of the diastolic pressure above
Study 3
The same view is held by Alcantara (2000) who emphasized that CVD
Study 4
Bermudez (2001) study reveals that CVD have varied and multi
causes and risk factors, ranging from infectious agents, environmental and
Study 5
40
are the most rapidly escalating disease problems of the country today.
Study 6
Chapter III
RESEARCH METHODOLOGY
METHOD USED
The data for this study were gathered through the use of the
Questionnaire
42
The main instruments used in conducting the study and to collect data
for the study were the questionnaires. This was used because it gathers data
transfer than any other method. Besides, the respondents were students, and
they are literate, they could read and answer the questions with ease.
Constructions
be included in the study. These data are more convenient to use because they
are already condensed and organized. The libraries make this data more
Validation
Administration
students of Arellano University. This was retrieved at a given time set and
Interview
Interview was one of the techniques used in gathering data for the
students of Arellano University which are the respondent of the study. The
researchers approached and interviewed the students to enable for them gain
Observation
This was employed using the senses to gather relevant information about
obesity.
44
2006 – 2007.
SAMPLING PROCEDURE
school year 2006 – 2007, with the use of Random sampling procedure.
45
Chapter IV
Table I
old, and three or fifteen percent respondents belongs to age bracket between
15 – 17 yrs. old.
Table II
Gender in this case, has not been a very strong risk factor for obesity.
Table III
Table III exhibits that sixteen or eighty percent of the total number of
bracket. Ten percent or two of which are 5’6” – 5’11” in height, while those
who belong to the height bracket of 4’6” – 4’11” and 4’0” – 4’5” are equally
five percent.
Height is a crucial factor for getting the Body Mass Index of a person,
and therefore being able to determine if a person is obese or not. But in this
weight problems, and this concludes that physical appearance is not enough
Table IV
This table presents the weight of the respondents, that six or thirty
considered to be the highest, while the rest of them which have four or
kilograms and 59 – 68 kilograms that have the same number and percentage.
overweight range (from 25.0 to 29.9) may not have excess body fatness,
48
most people with a BMI in the obese range (equal to or greater than 30) will
And thus, may be concluded that obesity may not be definite unless
Table V
the respondents, that majority of them are Roman Catholic which have
Religion Number of Respondents Percentage (%)
Roman Catholic 19 95.00
Iglesia ni Kristo 1 5.00
TOTAL 20 100.00
nineteen or ninety five percent of the total number of the respondents while
cardiovascular disease.
Table VI
PHYSICAL ACTIVITY
49
food energy intake exceeds energy expenditure, fat cells throughout the body
take in the energy and store it as fat. In all individuals, the excess energy
calories consumed. This means that very fine perturbations in the energy
balance can lead to large fluctuations in weight over time. And thus,
Table VII
PHYSICAL ACTIVITY
50
Table VII, regularity of exercise shows that thirty three percent or four
are used of having exercise daily, while there are twenty five percent or three
for once a week and twice a week regularity of exercise, and only two or
seventeen percent for the rest of them who are having exercise once a
Form Number of Respondents Percentage (%)
Aerobic 9 75.00
Anaerobic 3 25.00
TOTAL 12 100.00
month.
once or twice a week is not bad considering the routine and time
intake whether solid or liquid, but at least it’s better than nothing.
Table VIII
EXERCISE PREFERENCE
exercise.
This table shows that few of the respondents give special time for
only a small number of them is willing to spend much of their time to burn
their calories, live a healthy life, and promote well being by considering
exercise as part of their routine. While most of them only depend on their
Table IX
SMOKING PREFERENCE
respondent population do smoke or have tried smoking at least once, and the
Table X
SMOKING FREQUENCY
Table XI
drink weekly, and the remaining individual, which is five percent of the
as their way of socializing or when other matters permit them to. Drinking
alcohol has not been a part of their daily routine, and thus, only consume
the subjects, which in this case are nursing students, are somehow aware of
Table XII
the population's eating and health conditions, and thus, making them
54
susceptible to increasing their risk for being obese. These factors are often
percent of the total. These aspects are self-manageable, and could be treated
without any help from the health service providers. Since that is the case, it
metabolism and .food intolerance are solely considered, when ruling out
other health problems that may lead to obesity. While some respondents say
form.
Table XIII
cause obesity.
Table XIV
eighty percent of which do believe that their weight problem could definitely
Disease. And while the other twenty percent are not yet aware of the health,
Greater risk awaits obese individuals who are not at all aware of the
Table XV
appeared not to be suffering from any health problem; although in this case,
Table XVI
five of the total, in terms of their lifestyle activities prefer to modify their
daily routine and engage into physical activities much more often in order to
Chapter V
Diseases.
University.
observation were also employed to supplement the data collected from the
questionnaire.
SUMMARY OF FINDINGS
been answered:
59
1. Respondent’s Profile
1.1 Sixty five percent of the total respondents belonged to age bracket
18 – 20 yrs. old.
1.2 The respondents were equally divided among men and women.
height bracket.
89 – 98 kilograms.
2. Physical Status
smoke occasionally.
60
4. Respondent’s Awareness
4.2 Eighty percent of which did believed that their weight problem could
Cardiovascular Disease.
5. Complications
5.1 Most of the respondents appeared not to be suffering from any health
problem.
61
6. Lifestyle Modification
CONCLUSIONS
drawn:
1. That there are more obese on the age of 18-20 year old.
14.Almost every on of the obese are aware that they have the high risk of
16.Modifying daily routine and engaging into physical activities are the
RECOMMENDATIONS
life. It is one's most prized possessions, and thus, truly deserves to be taken
care of. A bright future and positive outlook in life beings here and continues
awareness:
the recommendations.
BIBLIOGRAPHY
A. Book
Atkinso, Lucyjo and Nancy Marie Fortunato, Berry and Kohn’s Operating
room
Technique And Edition, Nancy L. Coon, Mosby- Year Book
Incorporation
11830, Industrial West line Drive St. Louis, Missouri 63146
Kozier, Barbara, and Glenora Erb, and Audrey Berman and Shirlee Snyder,
Fundamentals of Nursing, Seventh Edition, Pearson Education South
Asia
PTELTD, Philippines 2004.
66
B. Periodicals
C. Others
Victor, Lucio C., Obesity bring forth many chronic Disease, January 2006,
APPENDIX A
ARELLANO UNIVERSITY
SCHOOL OF NURSING
LEGARDA, MANILA,
PHILIPPINES
29 January 2007
Thru:
Loida A. Arias R.N.,M.A.N.
Level-III Chairman
Dear Madam,
68
The undersigned, Group four (IV) Level three (III) section twenty five
(25) nursing students of Arellano University is currently undertaking a
research study entitled “Level of Awareness of Obese Persons on the Risk of
Having Cardiovascular Diseases”.
Rest assured that all information derived will be treated with utmost
confidentiality.
Thank you very much for your kind support and assistance.
Respectfully Yours,
1. Respondent’s Profile
1.1.Age
___ 15 – 17 yrs. Old
___ 18 – 20 yrs. Old
___ 21 – 23 yrs. Old
1.2.Gender
___ Male ___Female
69
1.3.Height
___ 4’0” – 4’5” ___ 5’0”– 5’5”
___ 4’6” – 4’11” ___ 5’6”– 5’11”
1.4. Weight Please indicate your weight in pounds (lbs.) or in kilograms
(kg.).
____________
1.5.Religion
___Roman Catholic ___Islam
___Jehovah’s Witness ___Protestant
___Iglesia ni Kristo Others please specify
___________
2. Physical Status
2.1.Do you exercise?
___ Yes ___ No
2.1.a. If Yes, how often?
___ Once a day ___ Twice a week
___ Once a week ___ Once a month
Others please specify ____________
2.1.b. What form of exercise?
___ Aerobic (walking, jogging, biking, etc.)
___ Anaerobic (weight-lifting, and the like)
2.2.Do you smoke or at least have tried to?
___ Yes ___ No
2.2.a. If Yes, how often?
___ Everyday ___ Occasionally
70
___ Weekly
2.2.b. Do you drink alcoholic beverages?
___ Everyday ___ Occasionally
___ Weekly
3. Factors affecting Obesity
3.1.What physiological factor/s you think has/have mostly influenced
your diet?
___ Slow metabolism
___ Food intolerance
___ Excess starch diet
Others please specify _______________
6. Lifestyle Modification
6.1.Are you planning of modifying your lifestyle in order to improve
your health and promote wellness?
___ Yes ___ No
6.2.If yes, how?
________________________________________________________
CURRICULUM VITAE