Self-care

Walking for Health.

Sleep is a fundamental human need

In health care, self-care is any necessary human regulatory function which is under individual control, deliberate and self-initiated.^[1]

Some place self-care on a continuum with health care providers at the opposite end to self-care.^[2] In modern medicine, preventive medicine aligns most closely with self-care. A lack of adherence to medical advice and the onset of a mental disorder can make self-care difficult.^[3] Self-care is seen as a partial solution to the global rise in health care costs placed on governments. The notion that self-care is a fundamental pillar of health and social care means it is an essential component of a modern health care system governed by regulations and statutes.^[4]

Self-care is considered a primary form of care for patients with chronic conditions who make many day-to-day decisions, or self-manage, their illness.^[5] Self-management is critical and self-management education complements traditional patient education in primary care to support patients to live the best possible quality of life with their chronic condition.^[1][5] Self-care is learned, purposeful and continuous.^[6] In philosophy, self-care refers to the care and cultivation of self in a comprehensive sense, focusing in particular on the soul and the knowledge of self.

Universal requisites

There are a number of self-care requisites applicable to all humans across all ages and necessary to fundamental human needs.^[6] For example, as humans we need to intake sufficient air, water and food; care also needs to be taken with the process of elimination and excrement. There must be a balance between rest and activity as well as between solitude and social activities.^[6] The prevention and avoidance of human hazards and participation in social groups are also requisites. Maturity requires the autonomous performance of self-care duties.^[7]

Health maintenance

Maintaining fitness at an elderly age

Checking blood pressure at home with an electronic sphygmomanometer.

Blood sugar testing for diabetes

Asthma inhalers contain a medication that treats the symptoms of asthma

Self-care includes all health decisions people (as individuals or consumers) make for themselves and their families to ensure they are physically and mentally fit.

Self-care includes exercising to maintain physical fitness and promote good mental health. The Center for Disease Control and Prevention (CDC) recommends 2 hours and thirty minutes of moderate activity each week. Examples of this include brisk walking, swimming, dancing, riding a bike, and even jumping rope. Another important aspect to self care includes eating well such as eating fresh fruits and vegetables, lean meats and other proteins while limiting processed foods. Limiting saturated fats, trans fats, sugars, and sodium will also contribute to a healthy diet. In addition, avoiding health hazards such as smoking and limiting drinking and alcohol consumption will prevent ill health and contribute to overall better health.^[8]

The personal responsibility for self-care in the context of preventative medicine was examined with a representative sample of the general public in a Citizens’ Jury, with the title: ‘My health – whose responsibility? A jury decides’.^[9]

The benefits of living a healthy lifestyle were analysed in the Caerphilly Heart Disease Study. Evidence showed a risk reduction in chronic diseases (including dementia and cognitive impairment) to be significantly associated with healthy lifestyles.^[10]

Self-care is also taking care of minor ailments, long term conditions, or one’s own health after discharge from secondary and tertiary health care. For instances of neck pain, for example, self-care is the recommended treatment.^[11]

Patients who are better informed and more educated possess greater motivation for self-care.^[2] Individuals conduct self-care and experts and professionals support self-care to enable individuals to undertake enhanced self-care. The recognition and evaluation of symptoms is a key aspect of self-care.^[12] The main issues involved with self-care and the onset of illness are medically related such managing drug side effects, emotions and psychological issues, changes to lifestyle and knowledge acquisition to assist in decision-making.^[2]

Self-care support has crucial enabling value and considerable scope in developing countries with an already overburdened health care system. But it also has an essential role to play in affluent countries where people are becoming more conscious about their health and want to have a greater role in taking care of themselves.

To enable people to do enhanced self-care, they can be supported in various ways and by different service providers.

Support

Self-care support can include the following:

• Self-care information on health and human body systems, lifestyle and healthy eating.
• Support to capture, manage, interpret, and report observations of daily living (ODLs),^[13] the tracking of trends, and the use of the resulting information as clues for self-care action and decision making.
• Information prescriptions^[14] providing personalised information and instructions to enable an individual to self-care and take control of their health
• Self-care and self-monitoring devices and assistive technology^[15]
• Self-care skills and life skills training programmes and courses for people
• Aid from spiritual care givers
• Advice from licensed counselors, clinical social workers, psychotherapists, pharmacists, physiotherapists and complementary therapists
• Self-care support networks which can be face to face or virtual, and made up of peers or people who want to provide support to others or receive support and information from others (including a self-care primer for provider/consumer convergence.)
• Being attuned to one's spirituality

Approaches

Food pyramid

Self-massage

Massage with robotic massage chairs.

Self-care practices are shaped by what are seen as the proper lifestyle choices of local communities. Health-related self-care topics include;

• General fitness training and physical exercise
• Healthy diet, meals, diet foods and fasting
• Smoking cessation and avoiding alcohol abuse
• Personal hygiene
• Life extension
• Pain management
• Stress management
• Alternative medicine such as homeopathy and home remedies
• Self-help and personal development
• Self-care portals^[16] and the use of health apps

A lack of self-care in terms of personal health, hygiene and living conditions is referred to as self-neglect. The use of caregivers and Personal Care Assistants may be needed. An aging population is seeking greater self-care knowledge primarily within families connections and with responsibility usually belonging to the mother.^[7]

Philosophy

Michael Foucault understood the art of living (French art de vivre, Latin ars vivendi) and the care of self (French le souci de soi) to be central to philosophy. The third volume of his three-volume study The History of Sexuality is dedicated to this notion. For Foucault, the notion of care of self (epimeleia heautou) of Ancient Greek and Roman philosophy comprises an attitude towards the self, others and the world, as well as a certain form of attention. For Foucault, the pursuit of the care for one's own well-being also comprises self-knowledge (gnōthi seauton).^[17][18]

The self-care deficit nursing theory was developed by Dorothea Orem between 1959 and 2001. The positively viewed theory explores the use professional care and an orientation towards resources.^[4] Under Orem's model self-care has limits when its possibilities have been exhausted therefore making professional care legitimate. These deficits in self-care are seen as shaping the best role a nurse may provide. There are two phases in Orem's self-care; the investigative and decision-making phase and the production phase.^[19]

See also

• Americans with Disabilities Act of 1990#Major life activities
• Executive functioning
• Integrative medicine

References

Further reading

• The Relaxation Response

External links

Wikimedia Commons has media related to Self-care.

Self-care as health maintenance:

• Self-care in England
• Self-care in the UK
• Expert Patients Programme in England
• Self-care in Australia
• Learning a new way of living
• Self-care in Belarus
• Healthy Lifestyle News