Self-care is the process of establishing behaviors to ensure holistic well-being of oneself, to promote health, and actively manage illness when it occurs. Individuals engage in some form of self-care daily with food choices, exercise, sleep, and hygiene. Self-care is not only a solo activity, as the community—a group that supports the person performing self-care—overall plays a role in access to, implementation of, and success of self-care activities.
Routine self-care is important when someone is not experiencing any symptoms of illness, but self-care becomes essential when illness occurs. General benefits of routine self-care include prevention of illness, improved mental health, and comparatively better quality of life. Self-care practices vary from individual to individual. Self-care is seen as a partial solution to the global rise in health care costs that is placed on governments worldwide.
A lack of self-care in terms of personal health, hygiene and living conditions is referred to as self-neglect. Caregivers or personal care assistants may be needed. There is a growing body of knowledge related to these home care workers.
Self-care and self-management, as described by Lorig and Holman, are closely related concepts. In their spearheading paper, they defined three self-management tasks: medical management, role management, and emotional management; and six self-management skills: problem solving, decision making, resource utilization, the formation of a patient–provider partnership, action planning, and self-tailoring.
History
While the concept of self care has received increased attention since 2016, it has ancient origins. Some credit Socrates as an exponent of self-care in ancient Greece, and care of oneself and of loved ones has been shown to exist since human beings appeared on earth.
Use of the term "self-care" in English dates from at least 1567; the word's connection with health appears from 1861.
The civil-rights activist and poet Audre Lorde (1934-1992) connected self-care with the Black feminist movement. Self-care was used to preserve black feminists' identities, energize their activism, and preserve their minds during the civil-rights movement.
Self-care remains a primary form of personal and community healthcare worldwide; self-care practices vary greatly around the world.
Self-care and illness
Chronic illness (a health condition that is persistent and long lasting, often impacts one's whole life, e.g., heart failure, diabetes, high blood pressure) requires behaviors that control the illness, decrease symptoms, and improve survival such as medication adherence and symptom monitoring. An acute illness like an infection (e.g., COVID) requires the same types of self-care behaviors required of people with a chronic illness, but the medication adherence and symptom monitoring behaviors associated with an acute illness are typically short lived. Routine health maintenance self-care behaviors that individuals engage in (e.g., adequate sleep) are still required of those dealing with acute or chronic illness.
For the majority of people with a chronic illness, time spent having that illness managed by a health professional is vastly outweighed by time spent in self-care. It has been estimated that most people with a chronic illness spend only about 0.001% or 10 hours per year of their time with a healthcare provider. In people with chronic illness, self-care is associated with fewer symptoms, fewer hospitalizations, better quality of life, and longer survival compared to individuals in whom self-care is poor. Self-care can be physically and mentally difficult for those with chronic illness, as their illness is persistent and treated in a vastly different manner from an acute illness.Hedva, Johanna. "Sick Woman Theory." The Asian American Literary Review. Volume 10, Issue 2, Fall/winter 2019, Open in Emergency : a Special Issue on Asian American Mental Health. Edited by Mimi Khúc, 2nd edition., The Asian American Literary Review, Inc., 2019. pp. 140-148.
Factors influencing self-care There are numerous factors that affect self-care. These factors can be grouped as personal factors (e.g., person, problem, and environment), external factors, and processes.
Personal factors: Lack of motivation: when one doesn't have enough energy. This can be caused by stress, anxiety, or other mental health illnesses. Cultural beliefs: this includes traditional gender roles, family relationships, collectivism. This can also affect self care behaviors. Self-efficacy or confidence: one's confidence can positively or negatively affect their mental state. Functional and cognitive abilities: by not being perfect humans, one tends to focus on their weakness. Support from others: such as from family or friends can be crucial to have a healthy and positive mindset to do self-care. Access to care: depending on the self-care some require specific resources or objects in order to carry out.
External factors:
Living situation: can greatly affect an individual's self-care. Surrounding environment: must be safe and promote self-care for all residents. Proximity of health care facilities: are important to have at a close radius from one's household. As well as office/clinic opening hours and affordability must be taken into consideration.
Processes: Experiences Knowledge Skill Values
Self-care practices are shaped by what are seen as the proper lifestyle choices of local communities. Social determinants of health play an important role in self-care practices. Internal personal factors such as motivation, emotions, and cognitive abilities also influence self-care maintenance behaviors. Motivation is often the driving force behind performing self-care maintenance behaviors. Goal setting is a practice associated with motivated self care. A person with depression is more likely to have a poor dietary intake low in fruits and vegetables, reduced physical activity, and poor medication adherence. An individual with impaired cognitive or functional abilities (e.g., memory impairment) also has a diminished capacity to perform self-care maintenance behaviors such as medication adherence which relies on memory to maintain a schedule.
Self-care is influenced by an individual's attitude and belief in his or her self-efficacy or confidence in performing tasks and overcoming barriers. Cultural beliefs and values may also influence self-care. Cultures that promote a hard-working lifestyle may view self-care in contradictory ways Personal values have been shown to have an effect on self-care in Type 2 Diabetes Mellitus.
Social support systems can influence how an individual performs self-care maintenance. Social support systems include family, friends, and other community or religious support groups. These support systems provide opportunities for self-care discussions and decisions. Shared care can reduce stress on individuals with chronic illness.
There are numerous self-care requisites applicable to all individuals of all ages for the maintenance of health and well-being. The balance between solitude or rest, and activities such as social interactions is a key tenet of self-care practices. The prevention and avoidance of human hazards and participation in social groups are also requisites. The autonomous performance of self-care behaviors is thought to aid elderly patients. Perceived autonomy, self-efficacy and adequate illness representation are additional elements of self-care, which are said to aid people with chronic conditions. Measurement of self-care behaviors A variety of self-report instruments have been developed to allow clinicians and researchers to measure the level of self-care in different situations for both patients and their caregivers: These instruments are freely available in numerous languages. Many of these instruments have a caregiver version available to encourage dyadic research.
Self-Care Heart Failure Index Self-Care of Hypertension Inventory Self-Care of Diabetes Inventory Self-Care of Coronary Heart Disease Inventory Self-Care of Chronic Illness Inventory Self-care of Chronic Obstructive Pulmonary Disease
Middle-range theory of self-care of chronic illness
According to the middle-range theory of chronic illness, these behaviors are captured in the concepts of self-care maintenance, self-care monitoring, and self-care management. Self-care maintenance refers to those behaviors used to maintain physical and emotional stability. Self-care monitoring is the process of observing oneself for changes in signs and symptoms. Self-care management is the response to signs and symptoms when they occur. The recognition and evaluation of symptoms is a key aspect of self-care.
Below these concepts are discussed both as general concepts and as specific self-care behaviors are (e.g., exercise).
Self-care maintenance
Self-care maintenance refers to those behaviors performed to improve well-being, preserve health, or to maintain physical and emotional stability. Self-care maintenance behaviors include illness prevention and maintaining proper hygiene.
Specific illness prevention measures include tobacco avoidance, regular exercise, and a healthy diet. Taking medication as prescribed by a healthcare provider and receiving vaccinations are also important specific self-care behaviors. Vaccinations provide immunity for the body to actively prevent an infectious disease. Tobacco use is the largest preventable cause of death and disease in the US. Overall health and quality of life have been found to improve, and the risk of disease and premature death are reduced due to the decrease in tobacco intake.
The benefits of regular physical activity include weight control; reduced risk of chronic disease; strengthened bones and muscles; improved mental health; improved ability to participate in daily activities; and decreased mortality. The Centre for Disease Control and Prevention (CDC) recommends two hours and thirty minutes of moderate activity each week, including brisk walking, swimming, or bike riding.
Another aspect of self-care maintenance is a healthy diet consisting of a wide variety of fresh fruits and vegetables, lean meats, and other proteins. Processed foods including fats, sugars, and sodium are to be avoided, under the practice of self-care.
Hygiene is another important part of self-care maintenance. Hygienic behaviors include adequate sleep, regular oral care, and hand washing. Getting seven to eight hours of sleep each night can protect physical and mental health. Sleep deficiency increases the risk of heart disease, kidney disease, high blood pressure, diabetes, excess weight, and risk-taking behavior. Tooth brushing and personal hygiene can prevent oral infections.
Health-related self-care topics include; General fitness training and physical exercise Healthy diet, meals, diet foods and fasting Smoking cessation and avoiding excessive alcohol use Personal hygiene Life extension Pain management Stress management Self-help and personal development Self-care portals and the use of health apps
Objective Measures of Specific Self-Care Maintenance Behaviors:
Interventions to improve maintenance behaviors Self-care is considered to be a continuous learning process. Knowledge is essential but not sufficient to improve self-care.Dickson VV & Riegel B. Are we teaching what patients need to know? Building skills in heart failure self-care. Heart & Lung, 2009, 38(3), 253-261. PMID 19486796. Multifaceted interventions that tailor education to the individual are more effective than patient education alone.