SELF-CARE: A CLARIFICATION OF MEANING AND EXAMINATION OF SUPPORTIVE STRATEGIES
Godfrey, Christina Maria
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Background Considering ~9 million Canadians have one or more chronic health conditions, and >3.3 million report some level of disability, the burden of care is substantive for individuals and health system. With such conditions, self-care is essential but may pose challenges to both individuals and providers of care. As a concept, self-care is poorly understood. Further, evidence for effective self-care support is diffuse and typically studied relative to specific conditions. Objectives To investigate the concept of self-care three objectives were undertaken: 1) explore and describe the construct of self-care as understood by individuals/families, health care professionals, researchers, policy-makers; and industry; 2) produce new knowledge for health care professionals about interventions for self-care across a range of population groups; 3) develop a provisional framework to inform practice and research. Method A multi-phase enquiry was undertaken. Phase 1 Concept clarification including: 1) synthesis of qualitative evidence on the experience of self-care reported by individuals/families; 2) content analysis and definitional study of the meaning of self-care; 3) concept analysis of self-care; 4) creation of a conceptual schema encompassing these perspectives. Phase 2 Self-care Interventions: Integrative study of systematic reviews, synthesizing evidence for self-care interventions from multiple disease/impairment groupings. Results Three modes of self-care were revealed : ‘Care of self’ self-care performed on one’s own behalf; ‘care by other’ acknowledging individuals with disabilities who guide and direct care provided by another person; and ‘care of other’- care of families and others at a community level. Analysis of 30 self-care interventions across 16 conditions demonstrated that educational sessions and self-care management plans are emerging as effective strategies to support and guide self-care. Conclusion Self-care is a complex care concept that is becoming an expected element in today’s health care environment. A full understanding of how it is viewed, including the individual’s perspective, is vital for enactment and beneficial support. This comprehensive understanding of the concept along with evidence for effective interventions drawn from multiple groups will assist health care professionals to improve their assessments and provide them with strategies to support self-care needs –ultimately, contributing to enabling individuals to maintain their highest level of functioning.