Self-care: Concept, Rationale, and Framework

BMJ Global Health, 2021

Medicus, 2023

Introduction: Self-care concept is not a new idea, but during the scientific era that strengthened the authority of health care providers, the use of self-care became less valued Self-care has major benefits for individuals and health care systems Many factors influence self-care and several tools have been developed to measure an individual's ability to self-care Health workers play an important role helping people understand and use self-care practices Aim: To provide an overview on self-care approach to better understand different aspects of self-care as important intervention for improving health and well-being Methodology: A series of recently published articles in PubMed, Google Scholar, Scopus, Web of Science as well as WHO guidelines related to self-care were identified MEDICUS No. 7, ISSUE 2/ 2023 42 and used for this review A database of selected articles was created, and a reference list compiled Results: The effectiveness of self-care interventions has been found in several published articles In patients with various diseases, higher levels of self-care are associated with better health outcomes, including reduced hospitalizations, costs, and mortality Various studies report that self-care is influenced by several factors such as: age, education, socioeconomic and health education level, geographic environment, and family support WHO has developed competency standards for health workers to support people's ability to self-care Conclusions: Humanitarian crises-armed conflict, natural disasters, major disease outbreaks have a significant impact on global health and require innovative strategies that go beyond the health sector There is growing evidence of the effectiveness of selfcare interventions for improving health and well-being Health workers have a key role in implementing and promoting self-care interventions

Objectives: We provide the most recent population-level estimates of time spent in health self-care (including activities such as taking medicine, giving oneself an injection, and wound care). Additionally, we determine when, where, and with whom this time is distributed. Study design: We analyze pooled cross-sectional data on individuals aged 21 and older (N=36,033) from the nationally Methods: We report the likelihood of any self-care, the mean minutes spent in self-care among those who report any, and the percentage distribution of self-care across the day, in the presence of others, and by place. We examine these trends overall and by sex, race/ethnicity, income, age, education, employment status, disability, and health. Results: Overall, 6.7% of the population reports any health self-care on an average day, among whom an average of 76.6 minutes is spent in care. Individuals are most likely to report self-care in the morning, perform 76.1% of their care alone, and 97% in their own homes. These trends vary across sex, race/ethnicity, age, income, education, employment, disability, and health. Conclusions: Our results demonstrate at the population level that self-care is a time-intensive form of health management that is not equally distributed by time, place, the availability of others, or by sociodemographic characteristics. It is important to consider these inequities in order to provide optimal support for patient care outside of health facilities.

JBI library of systematic reviews, 2009

Purpose: The purpose of this paper is to delineate five concepts that are often used synonymously in the nursing and related literature: self-care, self-management, self-monitoring, symptom management, and self-efficacy for self-care. Method: Concepts were delineated based on a review of literature, identification of relationships, and examination of commonalities and differences. Findings: More commonalities than differences exist among self-care, self-management, and self-monitoring. Symptom management extends beyond the self-care concepts to include healthcare provider activities. Self-efficacy can mediate or moderate the four other concepts. Relationships among the concepts are depicted in a model. Conclusions: A clearer understanding of the overlap, differences, and relationships among the five concepts can provide clarity, direction and specificity to nurse researchers, policy makers, and clinicians in addressing their goals for health delivery. Clinical Relevance: Concept clarity enables nurses to use evidence that targets specific interventions to individualize care toward achieving the most relevant goals.

Journal of Nursing Scholarship, 2018

This systematic review identified, synthesized, and integrated concept analyses on self-care and related concepts. Design The guidelines for systematic literature reviews of the Joanna Briggs Institute were followed. Methods The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, and EMBASE databases were searched for concept analyses published in the past 20 years. Findings A total of 26 concept analyses were identified that had been published on self-care, self-care agency, self-monitoring, self-management, self-management support, symptom management, and self-efficacy. Differences and commonalities in the examined literature were identified, and a model was delineated, explaining the relations among the various concepts from the nursing perspective. Conclusions The healthcare literature has broadly described self-care and related concepts; however, consensus on the definitions remains beyond our reach and should not be expected, due to the different perspectives and paradigms from which the concepts are interpreted. From a nursing perspective, self-care can be considered a broad concept encompassing the other concepts, which describe more specific individual levels of activities and processes. Clinical Relevance Nurses are actively involved in disease management and self-management support as well as in promoting self-care in healthy and sick people. Referring to a model on self-care and related concepts could avoid misinterpretations in nursing practice, research, and policy.

BMC Family Practice

Background: Self-care is a key component of current policies to manage long term conditions. Although most people with long-term health problems care for themselves within lay networks, consultation rates for long-term undifferentiated illness remain high. Promotion of self-care in these individuals requires an understanding of their own self-care practices and needs to be understood in the context of health care pluralism. The aim was to investigate the extent and nature of self-care practices in patients experiencing long term health problems, sources of information used for self-care, and use of other forms of health care (conventional health care and complementary and alternative medicine). Methods: The study involved a cross-sectional community-based survey set in three general practices in South West England: two in urban areas, one in a rural area. Data were collected using a postal questionnaire sent to a random sample of 3,060 registered adult patients. Respondents were asked to indicate which of six long term health problems they were experiencing, and to complete the questionnaire in reference to a single (most bothersome) problem only. Results: Of the 1,347 (45% unadjusted response rate) who responded, 583 reported having one or more of the six long term health problems and 572 completed the survey questionnaire. Use of self-care was notably more prevalent than other forms of health care. Nearly all respondents reported using self-care (mean of four self-care practices each). Predictors of high self-care reported in regression analysis included the reported number of health problems, bothersomeness of the health problem and having received a diagnosis. Although GPs were the most frequently used and trusted source of information, their advice was not associated with greater use of self-care. Conclusions: This study reveals both the high level and wide range of self-care practices undertaken by this population. It also highlights the importance of GPs as a source of trusted information and advice. Our findings suggest that in order to increase self-care without increasing consultation rates, GPs and other health care providers may need more resources to help them to endorse appropriate self-care practices and signpost patients to trusted sources of self-care support.

1981

but that HSA goals do not reflect a strong commitment to self care. R e p ro d u c e d with perm iss ion of th e copyright ow ner. F u r th e r reproduction prohibited without perm iss ion .

JBI Database of Systematic Reviews and Implementation Reports, 2010

Types of Outcomesindividual experiences of self-care through self-report. Reports from family members who assisted or provided support for self-care were included. Search strategy The search strategy aimed to find both published and unpublished studies (e.g., theses). A three-step search strategy was used in each component of this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all identified keywords and index terms was then undertaken across all included databases. Thirdly, the reference lists of all identified reports and articles were searched for additional studies. The databases searched included: CINAHL; MEDLINE; EMBASE; PsycINFO; AMED; Cochrane Library; Scirus; and Mednar Methodological quality Methodological quality of the studies was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument Critical Appraisal Checklist for Interpretive & Critical Research. Two appraisers independently reviewed each study. Data collection and analysis Qualitative data were extracted from included studies using an adaptation of the standardized JBI Data Extraction Tool for Qualitative Evidence. Data synthesis The data were synthesized using narrative form. Results and conclusions Engaging in self-care is a process involving being aware of self, acquiring knowledge and taking responsibility for meeting needs at whatever level they are presented. The performance of self-care behaviours can be influenced both positively and negatively by the attitudes of others. Throughout life, the purpose for performing self-care differs and individuals face challenges that interfere with their ability to master these self-care behaviours. Individuals who are able to find symbolic meaning in the disease/disability or reframe the implications positively are more capable of adapting and maintaining their focus on caring for themselves. Studies revealed that individuals may abandon self-care when overwhelmed by symptoms or disability and/or when they feel that they are not supported. Implications for practice It is valuable for health care professionals to understand the struggle that individuals experience when trying to engage in self-care. Furthermore, health care professionals need to be cognizant of how important their support is, in terms of encouraging individuals to adopt and maintain self-care behaviours. Implications for research This review has provided an insight into the process of engaging in self-care through the different developmental stages of life, as well as the adoption of self-care behaviours to meet different requisites. Further research would be valuable to integrate the range of health care interventions provided to individuals across different disability or disease groupings who engage in self-care activities.

Heliyon, 2022

PurposeChronic disease care is considered a challenging dilemma for health organizations’ sustainability and patient health. Self-care is key to chronic disease management and is substantially important in all aspects of health and levels of care. In the past years, research regarding self-care in the context of chronic disease has evolved, yet this complex concept continues to be ambiguous as there are differences in the way self-care is clearly conceptualized in the literature. A discussion of an in-depth concept analysis of self-care in the older adult population with chronic disease and an outline of its defining common attributes, referents, antecedents, consequences, and related concepts.DesignQualitative concept analysis concerning the concept of self-care in the older adult population with chronic disease.MethodsAn extensive review of the literature concerning the concept of self-care in the older adult population with chronic disease was conducted using different databases. Literature from nursing and other disciplines was selected to differentiate this concept from other related concepts. Rodgers's evolutionary methodology of concept analysis was used to investigate the concept of self-care in detail to better understand its meanings in the context of chronic disease.ResultsMultiple definitions of self-care exist, and a consensus definition was not shown to have been achieved across disciplines. The common attributes, referents, antecedents, consequences, and related concepts were identified, and a model case was constructed by the authors to clarify the concept of self-care in the context of the older adult population living with chronic disease. This concept analysis provides a theoretical definition of self-care of the older adult population living with chronic disease to offer nurses and others insight into the concept, which will ultimately provide a foundation for further research needed in the areas of clinical practice, policy, and education. Identification of the core of the self-care concept affords professionals and researchers the ability to identify appropriate practice priorities, enhance current practices, and develop theories and guidelines regarding self-care, leading to improvements in patient care and outcomes.