{{short description|Taking care of one's own health}} {{About|the maintenance of one's personal well-being and health|a person's assessment of their own value and dignity|Self-esteem|other uses}}
{{Use dmy dates|date=March 2019}} {{Infobox interventions | Name = Self-care | Image = Walking for Health in Epsom-5Aug2009 (3).jpg | Caption = Walking is beneficial for the maintenance of good health. | ICD10 = | ICD9unlinked = | MeshID = D012648 | OPS301 = | OtherCodes = }}
'''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.<ref name="hacs" /> Individuals engage in some form of self-care daily with food choices, exercise, sleep, and hygiene.<ref name="hacs">{{cite book |title=Health and Canadian Society: Sociological Perspectives |editor1-last=Coburn |editor1-first=David |chapter=Exploring the Correlates of Self Provided Health Care Behaviour |author=Alexander Segall |author2=Jay Goldstein |editor2-first=Alex |editor2-last=D'Arcy |editor3-first=George Murray |editor3-last=Torrance |year=1998 |publisher=University of Toronto Press |isbn=978-0-8020-8052-3 |pages=279–280 |chapter-url=https://books.google.com/books?id=AZ4o0TI5LqwC |access-date=29 August 2013}}</ref> 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.<ref>{{Cite web |title=Self-care: What is it? Why is it so important for your health? |url=https://www.uab.edu/news/youcanuse/item/13176-self-care-what-is-it-why-is-it-so-important-for-your-health |access-date=2022-11-29 |website=UAB News |language=en-US}}</ref><ref>{{Cite web |title=Self-care interventions for health |url=https://www.who.int/news-room/fact-sheets/detail/self-care-health-interventions |access-date=2022-11-29 |website=www.who.int |language=en}}</ref> General benefits of routine self-care include prevention of illness, improved mental health, and comparatively better quality of life.<ref name=":10">{{Cite journal |last1=Jonkman |first1=Nini H. |last2=Schuurmans |first2=Marieke J. |last3=Groenwold |first3=Rolf H.H. |last4=Hoes |first4=Arno W. |last5=Trappenburg |first5=Jaap C.A. |year=2016 |title=Identifying components of self-management interventions that improve health-related quality of life in chronically ill patients: Systematic review and meta-regression analysis |journal=Patient Education and Counseling |volume=99 |issue=7 |pages=1087–1098 |doi=10.1016/j.pec.2016.01.022 |pmid=26856778}}</ref><ref name=":11">{{Cite journal |last1=Jonkman |first1=Nini H. |last2=Schuurmans |first2=Marieke J. |last3=Jaarsma |first3=Tiny |last4=Shortridge-Baggett |first4=Lillie M. |last5=Hoes |first5=Arno W. |last6=Trappenburg |first6=Jaap C.A. |year=2016 |title=Self-management interventions: Proposal and validation of a new operational definition |url=http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-134090 |journal=Journal of Clinical Epidemiology |volume=80 |pages=34–42 |doi=10.1016/j.jclinepi.2016.08.001 |pmid=27531245}}</ref><ref name=":13">{{Cite journal |last1=Jonkman |first1=Nini |last2=Westland |first2=Heleen |last3=Trappenburg |first3=Jaap CA |last4=Groenwold |first4=Rolf HH |last5=Bischoff |first5=Erik WMA |last6=Bourbeau |first6=Jean |last7=Bucknall |first7=Christine E. |last8=Coultas |first8=David |last9=Effing |first9=Tanja W. |last10=Epton |first10=Michael |last11=Gallefoss |first11=Frode |last12=Garcia-Aymerich |first12=Judith |last13=Lloyd |first13=Suzanne M. |last14=Monninkhof |first14=Evelyn M. |last15=Nguyen |first15=Huong Q. |year=2016 |title=Do self-management interventions in COPD patients work and which patients benefit most? An individual patient data meta-analysis |journal=International Journal of Chronic Obstructive Pulmonary Disease |volume=11 |pages=2063–2074 |doi=10.2147/COPD.S107884 |pmc=5012618 |pmid=27621612 |last16=Van Der Palen |first16=Job |last17=Rice |first17=Kathryn L. |last18=Sedeno |first18=Maria |last19=Taylor |first19=Stephanie JC |last20=Troosters |first20=Thierry |last21=Zwar |first21=Nicholas A. |last22=Hoes |first22=Arno W. |last23=Schuurmans |first23=Marieke J. |doi-access=free }}</ref><ref>{{cite web |last1=World Health Organization |title=WHO consolidated guideline on self-care interventions for health |url=https://app.magicapp.org/#/guideline/Lr21gL |access-date=8 September 2021}}</ref> 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.<ref>{{Cite journal |last1=Eze |first1=Nkiruka D. |last2=Mateus |first2=Céu |last3=Cravo Oliveira Hashiguchi |first3=Tiago |year=2020 |title=Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation |journal=PLOS ONE |volume=15 |issue=8 |article-number=e0237585 |bibcode=2020PLoSO..1537585E |doi=10.1371/journal.pone.0237585 |pmc=7425977 |pmid=32790752 |doi-access=free}}</ref>
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.<ref>{{Cite journal |last1=Sterling |first1=Madeline R. |last2=Barbaranelli |first2=Claudio |last3=Riegel |first3=Barbara |last4=Stawnychy |first4=Michael |last5=Ringel |first5=Joanna Bryan |last6=Cho |first6=Jacklyn |last7=Vellone |first7=Ercole |year=2020 |title=The Influence of Preparedness, Mutuality, and Self-efficacy on Home Care Workers' Contribution to Self-care in Heart Failure |journal=Journal of Cardiovascular Nursing |volume=37 |issue=2 |pages=146–157 |doi=10.1097/JCN.0000000000000768 |pmc=8196074 |pmid=33315614 }}</ref>
Self-care and '''self-management''', as described by Lorig and Holman, are closely related concepts.<ref name=":12">{{Cite journal |last1=Lorig |first1=Kate R. |last2=Holman |first2=Halsted R. |date=August 2003 |title=Self-management education: History, definition, outcomes, and mechanisms |url=https://academic.oup.com/abm/article/26/1/1-7/4630312 |journal=Annals of Behavioral Medicine |language=en |volume=26 |issue=1 |pages=1–7 |doi=10.1207/S15324796ABM2601_01 |pmid=12867348 |s2cid=3678991 |issn=0883-6612|url-access=subscription }}</ref> 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.<ref name=":12" />
== History == alt=Men standing side by side, arms linked, looking at the sky|thumb|Spending time with friends is a form of self-care While the concept of self care has received increased attention since 2016,<ref>{{Cite news |last =Harris |first =Aisha |date =2017-04-05 |title =A History of Self-Care |language=en-US |work =Slate |url=http://www.slate.com/articles/arts/culturebox/2017/04/the_history_of_self_care.html |access-date =2022-11-29 |issn =1091-2339 | quote = [...] in 2016, self-care officially crossed over into the mainstream. It was the new chicken soup for the progressive soul. The week after the election, Americans Googled the term almost twice as often as they ever had in years past.}}</ref> it has ancient origins. Some credit Socrates as an exponent of self-care in ancient Greece,<ref>{{Cite web |last=Taylor |first=Chris |date=2019-09-25 |title=You've been getting self-care all wrong. It's a political act and always has been. |url =https://mashable.com/article/self-care-history |access-date =2023-11-29 |website =Mashable |language =en | quote = [...] Socrates allegedly spoke in the last days of his life [...]: '[...] are you not ashamed for devoting all your care to increasing your wealth, reputation, and honors, while not caring for or even considering your reason, truth, and constant improvement of your soul?' [...] His self-care brand was questioning power.}}</ref><ref>{{Cite web |date=2015-03-27 |title=The Ideas of Socrates |url=https://academyofideas.com/2015/03/the-ideas-of-socrates-transcript/ |access-date=2022-11-29 |language=en-US | quote = '…once we know ourselves, we may learn how to care for ourselves, but otherwise we never shall.' (First Alcibiades)}}</ref> and care of oneself and of loved ones has been shown to exist since human beings appeared on earth.{{cn|date=April 2026}}
Use of the term "self-care" in English dates from at least 1567; the word's connection with health appears from 1861.<ref> {{oed | self-care}} </ref>
The civil-rights activist and poet Audre Lorde (1934-1992) connected self-care with the Black feminist movement.<ref> {{cite book |last1 = Lorde |first1 = Audre |author-link1 = Audre Lorde |date = 13 September 2017 |orig-date = 1988 |title = A Burst of Light: And Other Essays |url = https://books.google.com/books?id=B3QtDwAAQBAJ |publication-place = Mineola, New York |publisher = Courier Dover Publications |page = 130 |isbn = 9780486818993 |access-date = 24 April 2026 |quote = Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare. }} </ref> Self-care was used to preserve black feminists' identities, energize their activism, and preserve their minds during the civil-rights movement.<ref name=":122">{{Cite book |last1=Spurgas |first1= Alyson K. | last2 = Meleo-Erwin | first2 = Zoë |title =Decolonize Self-Care |date =2022 |publisher =OR Books |isbn =978-1-68219-335-8 |location= New York |oclc =1302578954}}</ref>
Self-care remains a primary form of personal and community healthcare worldwide; self-care practices vary greatly around the world.<ref name=":43">{{Cite journal |last1 =Kecklund |first1 =G. |last2 =Axelsson |first2 =John |date =2016 |title =Health consequences of shift work and insufficient sleep |journal =BMJ |language =en |volume =355 |article-number =i5210 |doi =10.1136/bmj.i5210 |pmid =27803010 |s2cid =206912413}}</ref>{{qn|date=April 2026}}<ref>{{Cite web |title=Self-care is changing health care around the world |url =https://www.doctorswithoutborders.org/latest/self-care-changing-health-care-around-world |access-date =2022-11-29 |website=Doctors Without Borders - USA |language=en}}</ref>{{Verify source|date=April 2026}}
== Self-care and illness == alt=Graph showing the typical amount of sleep needed at different ages|thumb|Getting an appropriate amount of sleep each night is a form of self-care. 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.<ref>{{Cite journal |last1=Rodrigues |first1=Cecília |last2=Mendonça |first2=Denisa |last3=Martins |first3=Maria Manuela |date=2018-07-03 |title=Basic self-care in older acute medical in-patients: a retrospective cohort study |journal=Porto Biomedical Journal |volume=3 |issue=1 |article-number=e1 |doi=10.1016/j.pbj.0000000000000001 |issn=2444-8664 |pmc=6726298 |pmid=31595230}}</ref><ref>{{Cite web |title=Self-care during the COVID-19 pandemic |url=https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/self-care-tips-during-the-covid-19-pandemic |access-date=2022-11-29 |website=Mayo Clinic Health System |language=en}}</ref> 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.<ref name=":43"/>
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.<ref name="ReferenceA">{{Cite journal |last1=Riegel |first1=Barbara |last2=Moser |first2=Debra K. |last3=Buck |first3=Harleah G. |last4=Dickson |first4=Victoria Vaughan |last5=Dunbar |first5=Sandra B. |last6=Lee |first6=Christopher S. |last7=Lennie |first7=Terry A. |last8=Lindenfeld |first8=Joann |last9=Mitchell |first9=Judith E. |last10=Treat-Jacobson |first10=Diane J. |last11=Webber |first11=David E. |year=2017 |title=Self-Care for the Prevention and Management of Cardiovascular Disease and Stroke |journal=Journal of the American Heart Association |volume=6 |issue=9 |article-number=e006997 |doi=10.1161/JAHA.117.006997 |pmc=5634314 |pmid=28860232}}</ref> 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.<ref name=":10" /><ref name=":11" /><ref name=":13" /><ref>{{Cite journal |last1=De Maria |first1=Maddalena |last2=Ferro |first2=Federico |last3=Vellone |first3=Ercole |last4=Ausili |first4=Davide |last5=Luciani |first5=Michela |last6=Matarese |first6=Maria |date=May 2022 |title=Self-care of patients with multiple chronic conditions and their caregivers during the COVID-19 pandemic: A qualitative descriptive study |journal=Journal of Advanced Nursing |language=en |volume=78 |issue=5 |pages=1431–1447 |doi=10.1111/jan.15115 |pmid=34846083 |issn=0309-2402|doi-access=free }}</ref> 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.<ref>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.</ref>
== Factors influencing self-care == There are numerous factors that affect self-care.<ref>{{Cite journal|doi = 10.1016/j.ijnurstu.2019.103402|title = Self-care research: Where are we now? Where are we going?|year = 2021|last1 = Riegel|first1 = Barbara|last2 = Dunbar|first2 = Sandra B.|last3 = Fitzsimons|first3 = Donna|last4 = Freedland|first4 = Kenneth E.|last5 = Lee|first5 = Christopher S.|last6 = Middleton|first6 = Sandy|last7 = Stromberg|first7 = Anna|last8 = Vellone|first8 = Ercole|last9 = Webber|first9 = David E.|last10 = Jaarsma|first10 = Tiny|journal = International Journal of Nursing Studies|volume = 116|article-number = 103402|pmid = 31630807|pmc = 7035984}}</ref> These factors can be grouped as personal factors (e.g., person, problem, and environment), external factors, and processes.<ref name=":5">{{Cite journal|doi=10.1097/JCN.0000000000000244|title=The Situation-Specific Theory of Heart Failure Self-Care|year=2016|last1=Riegel|first1=Barbara|last2=Dickson|first2=Victoria Vaughan|last3=Faulkner|first3=Kenneth M.|journal=Journal of Cardiovascular Nursing|volume=31|issue=3|pages=226–235|pmid=25774844|s2cid=25743183}}</ref>
Personal factors: * Lack of motivation: when one doesn't have enough energy. This can be caused by stress, anxiety, or other mental health illnesses'''.<ref name=":5" />''' * Cultural beliefs: this includes traditional gender roles, family relationships, collectivism. This can also affect self care behaviors.<ref name=":5" /> * Self-efficacy or confidence: one's confidence can positively or negatively affect their mental state.<ref name=":6" /> * Functional and cognitive abilities: by not being perfect humans, one tends to focus on their weakness.<ref name=":6" /> * Support from others: such as from family or friends can be crucial to have a healthy and positive mindset to do self-care.<ref name=":6" /> * Access to care: depending on the self-care some require specific resources or objects in order to carry out.<ref name=":5" />
External factors:
* Living situation: can greatly affect an individual's self-care.<ref name=":6" /> * Surrounding environment: must be safe and promote self-care for all residents.<ref name=":6" /> * 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.<ref name=":5" />
Processes: * Experiences<ref name=":8">{{Cite journal |last1=Riegel |first1=Barbara |last2=Jaarsma |first2=Tiny |last3=Strömberg |first3=Anna |date=2012 |title=A Middle-Range Theory of Self-Care of Chronic Illness |journal=Advances in Nursing Science |volume=35 |issue=3 |pages=194–204 |doi=10.1097/ANS.0b013e318261b1ba |issn=0161-9268 |pmid=22739426 |s2cid=1029333 |url=http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-81836 }}</ref> * Knowledge<ref name=":8" /> * Skill<ref name=":8" /> * Values<ref name=":8" /> alt=Plastic box with separate, labeled compartments for each day of the week|thumb|Taking needed medicines is a form of self-care that may be difficult for people with memory problems. A box that organizes the correct pills for each day of the week may help. 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.<ref>{{Cite journal |last1=Baah |first1=Foster Osei |last2=Teitelman |first2=Anne M. |last3=Riegel |first3=Barbara |year=2019 |title=Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health-An integrative review |journal=Nursing Inquiry |volume=26 |issue=1 |article-number=e12268 |doi=10.1111/nin.12268 |pmc=6342665 |pmid=30488635}}</ref> 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.<ref name=":8" /> Goal setting is a practice associated with motivated self care.<ref name=":8" /> 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.<ref>{{Cite journal|last1=Gonzalez|first1=J.S.|last2=Safren|first2=S.A.|last3=Cagliero|first3=E.|date=2007|title=Depression, self-care, and medication adherence in type 2 diabetes|journal= Diabetes Care|volume=30 |issue=9|pages=2222–2227|doi=10.2337/dc07-0158|pmid=17536067|pmc=4440862}}</ref> An individual with impaired cognitive or functional abilities (e.g., memory impairment) also has a diminished capacity to perform self-care maintenance behaviors<ref name=":8" /> such as medication adherence which relies on memory to maintain a schedule.<ref name=":6">{{Cite journal|doi = 10.21203/rs.3.rs-809593/v1|title = Memory predicted self-care maintenance in patients with heart failure among cognitive functions: Results from a structural equation model|year = 2021|last1 = Kim|first1 = Jinshil|last2 = Kim|first2 = Sun Hwa|last3 = Shim|first3 = Jae Lan|last4 = Hwang|first4 = Seon Young|s2cid = 238673548|doi-access = free}}</ref>
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<ref name=":8" /> Personal values have been shown to have an effect on self-care in Type 2 Diabetes Mellitus.<ref>{{Cite journal|last1=Luciani|first1=Michela|last2=Rebora|first2=Paola|last3=Rossi|first3=Emanuela|last4=Tonoli|first4=Luca|last5=Androni|first5=Silvia|last6=Ballerini|first6=Enrico|last7=Fabrizi|first7=Diletta|last8=Riegel|first8=Barbara|last9=Ausili|first9=Davide|date=18 January 2019|title=How Do Basic Human Values Affect Self-Care of Type 2 Diabetes Patients? A Multicentre Observational Study|journal=Clinical Nursing Research|volume=29|issue=5|pages=304–312|doi=10.1177/1054773818825003|issn=1552-3799|pmid=30658535|s2cid=58574574}}</ref>
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.<ref name=":8" />
{{See also|Activities of daily living}} There are numerous self-care requisites applicable to all individuals of all ages for the maintenance of health and well-being.<ref name="scs" /> The balance between solitude or rest, and activities such as social interactions is a key tenet of self-care practices.<ref name="scs" /> 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.<ref name="scepashc">{{cite book |title=Self-care: Embodiment, Personal Autonomy and the Shaping of Health Consciousness |last=Ziguras |first=Christopher |year=2013 |publisher=Routledge |isbn=978-1-134-41969-2 |pages=14–15 |url=https://books.google.com/books?id=CksXt89K-6QC |access-date=31 August 2013}}</ref> 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:<ref name=":8" /> 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<ref>{{Cite journal|doi=10.1097/JCN.0000000000000543|title=Psychometric Testing of the Revised Self-Care of Heart Failure Index|year=2019|last1=Riegel|first1=Barbara|last2=Barbaranelli|first2=Claudio|last3=Carlson|first3=Beverly|last4=Sethares|first4=Kristen A.|last5=Daus|first5=Marguerite|last6=Moser|first6=Debra K.|last7=Miller|first7=Jennifer|last8=Osokpo|first8=Onome Henry|last9=Lee|first9=Solim|last10=Brown|first10=Stacey|last11=Vellone|first11=Ercole|journal=Journal of Cardiovascular Nursing|volume=34|issue=2|pages=183–192|pmid=30303894|pmc=7179813}}</ref> * Self-Care of Hypertension Inventory<ref>{{Cite journal|doi=10.1097/JCN.0000000000000827|title=Psychometric Testing of the Self-care of Hypertension Inventory Version 3.0|year=2021|last1=Dickson|first1=Victoria Vaughan|last2=Fletcher|first2=Jason|last3=Riegel|first3=Barbara|journal=Journal of Cardiovascular Nursing|volume=36|issue=5|pages=411–419|pmid=34117186|s2cid=235412764}}</ref> * Self-Care of Diabetes Inventory<ref>{{Cite journal|last1=Ausili|first1=Davide|last2=Barbaranelli|first2=Claudio|last3=Rossi|first3=Emanuela|last4=Rebora|first4=Paola|last5=Fabrizi|first5=Diletta|last6=Coghi|first6=Chiara|last7=Luciani|first7=Michela|last8=Vellone|first8=Ercole|last9=Di Mauro|first9=Stefania|date=16 October 2017|title=Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: the Self-Care of Diabetes Inventory|journal=BMC Endocrine Disorders|volume=17|issue=1|page=66|doi=10.1186/s12902-017-0218-y|issn=1472-6823|pmc=5644085|pmid=29037177 |doi-access=free }}</ref> * Self-Care of Coronary Heart Disease Inventory<ref>{{Cite journal|last1=Vaughan Dickson|first1=Victoria|last2=Lee|first2=Christopher S.|last3=Yehle|first3=Karen S.|last4=Mola|first4=Ana|last5=Faulkner|first5=Kenneth M.|last6=Riegel|first6=Barbara|date=February 2017|title=Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI)|journal=Research in Nursing & Health|volume=40|issue=1|pages=15–22|doi=10.1002/nur.21755|issn=1098-240X|pmid=27686630|s2cid=22027492|url=https://repository.upenn.edu/nrs/193}}</ref> * Self-Care of Chronic Illness Inventory<ref>{{Cite journal|last1=Riegel|first1=Barbara|last2=Barbaranelli|first2=Claudio|last3=Sethares|first3=Kristen A.|last4=Daus|first4=Marguerite|last5=Moser|first5=Debra K.|last6=Miller|first6=Jennifer L.|last7=Haedtke|first7=Christine A.|last8=Feinberg|first8=Jodi L.|last9=Lee|first9=Solim|date=October 2018|title=Development and initial testing of the self-care of chronic illness inventory|journal=Journal of Advanced Nursing|volume=74|issue=10|pages=2465–2476|doi=10.1111/jan.13775|issn=1365-2648|pmid=29943401|hdl=1805/22476|s2cid=49415051|hdl-access=free}}</ref> * Self-care of Chronic Obstructive Pulmonary Disease <ref>{{Cite journal|doi = 10.1177/0163278719856660|title = The Self-Care in Chronic Obstructive Pulmonary Disease Inventory: Development and Psychometric Evaluation|year = 2020|last1 = Matarese|first1 = Maria|last2 = Clari|first2 = Marco|last3 = De Marinis|first3 = Maria Grazia|last4 = Barbaranelli|first4 = Claudio|last5 = Ivziku|first5 = Dhurata|last6 = Piredda|first6 = Michela|last7 = Riegel|first7 = Barbara|journal = Evaluation & the Health Professions|volume = 43|issue = 1|pages = 50–62|pmid = 31208201|s2cid = 190536253}}</ref>
== Middle-range theory of self-care of chronic illness == {{See also|Disease management (health)}}
According to the middle-range theory of chronic illness,<ref name=":8" /><ref name=":9">{{Cite journal|last1=Riegel|first1=Barbara|last2=Jaarsma|first2=Tiny|last3=Lee|first3=Christopher S.|last4=Strömberg|first4=Anna|date=19 November 2018|title=Integrating Symptoms Into the Middle-Range Theory of Self-Care of Chronic Illness|journal=Advances in Nursing Science|volume=42|issue=3|pages=206–215|doi=10.1097/ANS.0000000000000237|issn=1550-5014|pmid=30475237|pmc=6686959}}</ref> 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.<ref name="scilf">{{cite book |title = Self-care in Later Life: Research, Program, and Policy Issues |last = Palo Stoller |first = Eleanor |editor1-first = Marcia G. |editor1-last = Ory |editor2-first = Gordon H. |editor2-last = DeFriese |year = 1998 |publisher = Springer Publishing Company |isbn = 978-0-8261-9695-8 |pages = 24–25 |url = https://books.google.com/books?id=jnDcxXgIYucC |access-date = 28 August 2013}}</ref><ref name=":9" />
Below these concepts are discussed both as general concepts and as specific self-care behaviors are (e.g., exercise).
=== Self-care maintenance === alt=A man steadies himself by holding a grab bar in the shower, while another man shampoos his hair|thumb|Keeping the body clean is part of self-care. When people are unable to shower or bathe safely alone, they may enlist another person to help them. Self-care maintenance refers to those behaviors performed to improve well-being, preserve health, or to maintain physical and emotional stability.<ref name=":8" /> 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.<ref name="Jimmy & Jose">{{cite journal |last1=Jimmy |first1=B |last2=Jose |first2=J |title=Patient medication adherence: Measures in daily practice |journal=Oman Medical Journal |date=2011 |volume=26 |issue=3 |pages=155–159 |doi=10.5001/omj.2011.38 |pmid=22043406 |pmc=3191684 |doi-access=free}}</ref> Vaccinations provide immunity for the body to actively prevent an infectious disease.<ref name="Importance of vaccines">{{cite web |title=Importance of vaccines |url=http://www.vaccineinformation.org/vaccines-save-lives/ |publisher=The Immunization Action Coalition |access-date=13 April 2017}}</ref> Tobacco use is the largest preventable cause of death and disease in the US.<ref name="Tobacco use">{{cite web |title=Tobacco use |url=https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use#4 |website=Healthy People |publisher=Office of Disease Prevention and Health Promotion |access-date=13 April 2017}}</ref> 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.<ref name="Tobacco use" />
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.<ref name="Physical activity and health">{{cite web |title=Physical activity and health |url=https://www.cdc.gov/physicalactivity/basics/pa-health/ |publisher=Centers for Disease Control and Prevention |access-date=13 April 2017}}</ref> 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.<ref>{{Cite web|last=CDC|date=2020-09-17|title=Walking: The Physical Activity Guidelines for Americans|url=https://www.cdc.gov/physicalactivity/walking/index.htm|access-date=2021-04-07|website=Centers for Disease Control and Prevention|language=en-us}}</ref>
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.<ref name="How Morning Routine Is Important?">{{cite web |title=How Morning Routine Is Important? |work=The Hustlers Project |date=29 January 2023 |url=https://www.thehustlersproject.com/2023/01/morning-routine-ideas.html |access-date=2 April 2023 |archive-date=28 May 2023 |archive-url=https://web.archive.org/web/20230528031314/https://www.thehustlersproject.com/2023/01/morning-routine-ideas.html |url-status=dead }}</ref> Sleep deficiency increases the risk of heart disease, kidney disease, high blood pressure, diabetes, excess weight, and risk-taking behavior.<ref name="How Morning Routine Is Important?" /> Tooth brushing and personal hygiene can prevent oral infections.<ref>{{Cite journal |last1=Lertpimonchai |first1=Attawood |last2=Rattanasiri |first2=Sasivimol |last3=Arj-Ong Vallibhakara |first3=Sakda |last4=Attia |first4=John |last5=Thakkinstian |first5=Ammarin |date=December 2017 |title=The association between oral hygiene and periodontitis: a systematic review and meta-analysis |journal=International Dental Journal |language=en |volume=67 |issue=6 |pages=332–343 |doi=10.1111/idj.12317 |pmc=5724709 |pmid=28646499}}</ref>
[[File:Kamala Harris speaks about self care during the COVID-19 pandemic.ogg|thumb|Senator Kamala Harris talks about her self care during the COVID-19 pandemic in 2020.]] Health-related self-care topics include; * General fitness training and physical exercise<ref>{{Cite journal |last1=Oh |first1=Juntack |last2=Aquino |first2=Michele |date=2024-09-01 |title=Enhancing health-related fitness, self-efficacy, and quality of life in adults with physical disabilities: A 9-week community-based structured exercise and mindfulness program |journal=Advanced Exercise and Health Science |volume=1 |issue=3 |pages=187–194 |doi=10.1016/j.aehs.2024.07.001 |issn=2950-273X|doi-access=free }}</ref> * Healthy diet, meals, diet foods and fasting<ref>{{Cite journal |last1=Rizvi |first1=Zahara Ali |last2=Saleem |first2=Javeria |last3=Zeb |first3=Irfan |last4=Shahzad |first4=Ruhma |last5=Kayani |first5=Jawwad Afzal |last6=Faryal |first6=Joham |last7=Bukhari |first7=Gul Mehar Javaid |last8=Abdi |first8=Gholamreza |last9=Jain |first9=Mukul |date=2024-11-28 |title=Effects of intermittent fasting on body composition, clinical health markers and memory status in the adult population: a single-blind randomised controlled trial |journal=Nutrition Journal |volume=23 |issue=1 |page=147 |doi=10.1186/s12937-024-01046-9 |doi-access=free |issn=1475-2891 |pmc=11603954 |pmid=39609683}}</ref><ref>{{Cite journal |last1=Cave |first1=Laurie |last2=Milnes |first2=Linda J |last3=McHugh |first3=Gretl A |date=2021-06-30 |title=Self-care support of diet and the gut in the routine care of school-age children with long-term conditions: An integrative review |journal=Journal of Child Health Care |language=en |volume=26 |issue=4 |pages=668–682 |doi=10.1177/13674935211029124 |issn=1367-4935 |pmc=9667094 |pmid=34190624}}</ref> * Smoking cessation and avoiding excessive alcohol use<ref>{{Cite journal |last1=Card-Gowers |first1=Joshua |last2=Boniface |first2=Sadie |last3=Brown |first3=Jamie |last4=Kock |first4=Loren |last5=Martin |first5=Alexander |last6=Retat |first6=Lise |last7=Webber |first7=Laura |date=2025-01-16 |editor-last=Nilson |editor-first=Eduardo Augusto Fernandes |title=Long-term health consequences and costs of changes in alcohol consumption in England during the COVID-19 pandemic |journal=PLOS ONE |language=en |volume=20 |issue=1 |article-number=e0314870 |doi=10.1371/journal.pone.0314870 |doi-access=free |pmid=39820181 |pmc=11737736 |bibcode=2025PLoSO..2014870C |issn=1932-6203}}</ref><ref>{{Cite journal |last1=Dai |first1=Xiaochen |last2=Gil |first2=Gabriela F. |last3=Reitsma |first3=Marissa B. |last4=Ahmad |first4=Noah S. |last5=Anderson |first5=Jason A. |last6=Bisignano |first6=Catherine |last7=Carr |first7=Sinclair |last8=Feldman |first8=Rachel |last9=Hay |first9=Simon I. |last10=He |first10=Jiawei |last11=Iannucci |first11=Vincent |last12=Lawlor |first12=Hilary R. |last13=Malloy |first13=Matthew J. |last14=Marczak |first14=Laurie B. |last15=McLaughlin |first15=Susan A. |date=2022-10-10 |title=Health effects associated with smoking: a Burden of Proof study |journal=Nature Medicine |language=en |volume=28 |issue=10 |pages=2045–2055 |doi=10.1038/s41591-022-01978-x |issn=1078-8956 |pmc=9556318 |pmid=36216941}}</ref> * Personal hygiene<ref>{{Cite journal |last1=Yoo |first1=Hyun Jung |last2=Song |first2=Eugene |date=2021-08-24 |title=Effects of Personal Hygiene Habits on Self-Efficacy for Preventing Infection, Infection-Preventing Hygiene Behaviors, and Product-Purchasing Behaviors |journal=Sustainability |language=en |volume=13 |issue=17 |page=9483 |doi=10.3390/su13179483 |doi-access=free |bibcode=2021Sust...13.9483Y |issn=2071-1050}}</ref> * Life extension<ref>{{Cite journal |last1=Couteur |first1=David G Le |last2=Barzilai |first2=Nir |date=2022-08-02 |title=New horizons in life extension, healthspan extension and exceptional longevity |journal=Age and Ageing |language=en |volume=51 |issue=8 |article-number=afac156 |doi=10.1093/ageing/afac156 |issn=0002-0729 |pmc=9356533 |pmid=35932241}}</ref> * Pain management<ref>{{Cite journal |last1=Kang |first1=Youngjoo |last2=Trewern |first2=Louise |last3=Jackman |first3=John |last4=Soni) |first4=Anushka Irani (nee |last5=McCartney |first5=David |date=2024-01-02 |title=Chronic pain: supported self-management |url=https://www.bmj.com/content/384/bmj-2022-072362 |journal=BMJ |language=en |volume=384 |article-number=e072362 |doi=10.1136/bmj-2022-072362 |issn=1756-1833 |pmid=38167273|url-access=subscription }}</ref> * Stress management<ref>{{Cite journal |last1=Webster |first1=Katie E |last2=Halicka |first2=Monika |last3=Bowater |first3=Russell J |last4=Parkhouse |first4=Thomas |last5=Stanescu |first5=Dara |last6=Punniyakotty |first6=Athitya Vel |last7=Savović |first7=Jelena |last8=Huntley |first8=Alyson |last9=Dawson |first9=Sarah |last10=Clark |first10=Christopher E |last11=Johnson |first11=Rachel |last12=Higgins |first12=Julian PT |last13=Caldwell |first13=Deborah M |date=2025-03-04 |title=Effectiveness of stress management and relaxation interventions for management of hypertension and prehypertension: systematic review and network meta-analysis |journal=BMJ Medicine |language=en |volume=4 |issue=1 |article-number=e001098 |doi=10.1136/bmjmed-2024-001098 |issn=2754-0413|doi-access=free |pmid=40519356 |pmc=12164322 }}</ref> * Self-help and personal development<ref>{{Cite journal |last1=Hopkins |first1=Jonathan |last2=Narasimhan |first2=Manjulaa |date=2022-03-24 |title=Access to self-care interventions can improve health outcomes for people experiencing homelessness |url=https://www.bmj.com/content/376/bmj-2021-068700 |journal=BMJ |language=en |volume=376 |article-number=e068700 |doi=10.1136/bmj-2021-068700 |issn=1756-1833 |pmc=8943590 |pmid=35331989}}</ref> * Self-care portals<ref name="ups">{{cite web |url=http://www.pmlive.com/blogs/digital_intelligence/archive/2013/august/uk_preparing_self-care_portal_for_patients |title=UK preparing self-care portal for patients |author=Dominic Tyer |date=28 August 2013 |work=PMLive |publisher=PMGroup Worldwide Ltd |access-date=31 August 2013 |archive-date=15 April 2023 |archive-url=https://web.archive.org/web/20230415171830/http://www.pmlive.com/blogs/digital_intelligence/archive/2013/august/uk_preparing_self-care_portal_for_patients |url-status=dead }}</ref> and the use of health apps<ref>{{Cite journal |last1=Verdoodt |first1=Katleen |last2=Simons |first2=Marianne |last3=de Hoog |first3=Natascha |last4=Reijnders |first4=Jennifer |last5=Jacobs |first5=Nele |date=2024-05-09 |title=Personal growth initiative across the life span: a systematic review protocol of quantitative studies using the Personal Growth Initiative Scale-II |journal=Systematic Reviews |language=en |volume=13 |issue=1 |page=127 |doi=10.1186/s13643-024-02546-9 |doi-access=free |issn=2046-4053 |pmc=11084080 |pmid=38725024}}</ref>
Objective Measures of Specific Self-Care Maintenance Behaviors:
[[File:Device to check for diabetes 2.jpg|thumb|Blood sugar testing for diabetes is a form of self-care.]]
=== Interventions to improve maintenance behaviors=== Self-care is considered to be a continuous learning process.<ref name="scs">{{cite book |title=Self-care Science, Nursing Theory, and Evidence-based Practice |last=Taylor |first=Susan G. |author2=Katherine Renpenning |author3=Kathie McLaughlin Renpenning |year=2011 |publisher=Springer Publishing Company |isbn=978-0-8261-0779-4 |pages=39–41 |url=https://books.google.com/books?id=alHquhnlbHwC |access-date=25 August 2013}}</ref> Knowledge is essential but not sufficient to improve self-care.<ref>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.</ref> Multifaceted interventions that tailor education to the individual are more effective than patient education alone.<ref name=":0" />
* "Teach-back" is used to gauge how much information is retained after patient teaching. Teach-back occurs when patients are asked to repeat information that was given to them. The educator checks for gaps in the patient's understanding, reinforces messages, and creates a collaborative conversation with the patient.<ref name=":0">{{Cite journal|last1=White|first1=M|last2=Garbez|first2=R|last3=Carroll|first3=M|last4=Brinker|first4=E|last5=Howie-Esquivel|first5=J|date=2013|title=Is "teach-back" associated with knowledge retention and hospital readmission in hospitalized heart failure patients?|journal=Journal of Cardiovascular Nursing|volume=28|issue=2|pages=137–146|doi=10.1097/jcn.0b013e31824987bd|pmid=22580624|s2cid=32944459}}</ref> It is important for individuals with a chronic illness to comprehend and recall information received about their condition. Teach-back education can both educate patients and assess learning.<ref name=":0" /> For example, a provider can initiate teach-back is by asking, "I want to make sure that I explained everything clearly. If you were talking to your neighbor, what would you tell her/him we talked about today".<ref name=":1">{{Cite journal|last1=Peter|first1=D|last2=Robinson|first2=P|last3=Jordan|first3=M|last4=Lawrence|first4=S|last5=Casey|first5=K.J.|last6=Salas-Lopez|first6=D|date=2015|title=Reducing readmissions using teach-back: Enhancing patient and family education|journal=Journal of Nursing Administration|volume=45|issue=1|pages=35–42|doi=10.1097/NNA.0000000000000155|pmid=25479173|s2cid=22143891}}</ref> This phrase protects the patient's self-esteem while placing responsibility for understanding on both the provider and patient. One study performed showed that patients with heart failure who received teach-back education had a 12% lower readmission rate compared to patients who did not receive teach-back.<ref name=":1" /> Although the teach-back method is effective in the short-term, there is little evidence to support its long-term effect. Long-term knowledge retention is crucial for self-care, so further research is needed on this approach.<ref>{{Cite journal|last1=Kandula|first1=N.R.|last2=Malli|first2=T|last3=Zei|first3=C.P.|last4=Larsen|first4=E|last5=Baker|first5=D.W.|date=2011|title=Literacy and retention of information after a multimedia diabetes education program and teach-back|journal=Journal of Health Communication|volume=16|pages=89–202|doi=10.1080/10810730.2011.604382|pmid=21951245|s2cid=25790776|doi-access=free}}</ref> *Habits are automatic responses to commonly encountered situations such as handwashing after restroom use. A habit is formed when environmental cues result in a behavior with minimal conscious deliberation.<ref>{{Cite journal|last1=Judah|first1=G|last2=Gardner|first2=B|last3=Aunger|first3=R|date=2012|title=Forming a flossing habit: An exploratory study of the psychological determinants of habit formation|journal=The British Journal of Health Psychology|volume=18|issue=2|pages=338–353|doi=10.1111/j.2044-8287.2012.02086.x|pmid=22989272}}</ref> *Behavioral economics is a subset of the study of economics that examines how cognitive, social, and emotional factors play in role in an individual's economic decisions. Behavioral economics is now influencing the design of healthcare interventions aimed at improving self-care maintenance. Behavioral economics takes into account the complexity and irrationality of human behavior.<ref>{{Cite journal|last1=Matjasko|first1=J.L.|last2=Cawley|first2=J.H.|last3=Baker-Goering|first3=M.M.|last4=Yokum|first4=D.V.|date=2016|title=Applying behavioral economics to public health policy: Illustrative examples and promising directions|journal=American Journal of Preventive Medicine|volume=50|issue=5 Suppl 1|pages=S13–9|doi=10.1016/j.amepre.2016.02.007|pmc=4871624|pmid=27102853}}</ref> *Motivational interviewing is a way to engage critical thinking in relation to self-care needs. Motivational interviewing uses an interviewing style that focuses on the individual's goals in any context. Motivational interviewing is based on three psychological theories: cognitive dissonance, self-perception, and the transtheoretical model of change. Motivational interviewing is intended to enhance intrinsic motivation for change.<ref name=":2">{{Cite journal|last1=Simmons|first1=L.A.|last2=Wolever|first2=R.Q.|date=2013|title=Integrative health coaching and motivational interviewing: Synergistic approaches to behavior change in healthcare|journal=Global Advances in Health and Medicine|volume=24|issue=4|pages=28–35|pmc=3833556|pmid=24416683|doi=10.7453/gahmj.2013.037}}</ref> *Health coaching is a method of promoting motivation to initiate and maintain behavioral change. The health coach facilitates behavioral change by emphasizing personal goals, life experiences, and values.<ref name=":2" />
== Monitoring == Self-care monitoring is the process of surveillance that involves measurement and perception of bodily changes, or "body listening".<ref name=":8" /> It can be helpful to understand the concept of bodymind when monitoring self-care. Effective self-care monitoring also requires the ability to label and interpret changes in the body as normal or abnormal.<ref name=":8" /> Recognizing bodily signs and symptoms, understanding disease progression, and their respective treatments allow competency in knowing when to seek further medical help.<ref name="ReferenceA"/>
Self-care monitoring consists of both the perception and measurement of symptoms. Symptom perception is the process of monitoring one's body for signs of changing health. This includes body awareness or body listening, and the recognition of symptoms relevant to health.
[[File:Blood pressure testing.jpg|thumb|upright|Checking blood pressure at home with an electronic sphygmomanometer. Monitoring chronic medical conditions is a form of self-care.]]
Changes in health status or body function can be monitored with various tools and technologies. The range and complexity of medical devices used in both hospital and home care settings are increasing.<ref>{{Cite book|title=The role of human factors in home health care|last=Olson|first=S|publisher=National Academies Press|year=2010}}</ref> Certain devices are specific to a common need of a disease process such as glucose monitors for tracking blood sugar levels in diabetic patients. Other devices can provide a more general set of information, such as a weight scale, blood pressure cuff, pulse oximeter, etc. Less technological tools include organizers, charts, and diagrams to trend or keep track of progress such as the number of calories, mood, vital sign measurements, etc.<ref>{{Cite journal |last1=Godevithana |first1=Janaka |last2=Wijesinghe |first2=Champa Jayalakshmie |last3=Wijesinghe |first3=Millawage Supun Dilara |date=2024-08-19 |title=Paper-based and mobile application-based self-monitoring tool for healthy dietary intake, development and applicability: a non-randomized trial |journal=BMC Digital Health |language=en |volume=2 |issue=1 |article-number=53 |doi=10.1186/s44247-024-00109-5 |doi-access=free |issn=2731-684X}}</ref>
=== Barriers to monitoring=== The ability to engage in self-care monitoring impacts disease progression. Barriers to monitoring can go unrecognized and interfere with effective self-care. Barriers include knowledge deficits, undesirable self-care regimens, different instructions from multiple providers, and limitations to access related to income or disability. Psychosocial factors such as motivation, anxiety, depression, confidence can also serve as barriers.<ref name=":3">{{Cite journal|last=Dickson|first=V|date=2011|title=A qualitative meta-analysis of heart failure self-care practices among individuals with multiple comorbid conditions.|url=https://www.researchgate.net/publication/51104736|journal=Journal of Cardiac Failure|volume=17|issue=5|pages=413–419|doi=10.1016/j.cardfail.2010.11.011|pmid=21549299}}</ref>
*High costs may prevent some individuals from acquiring monitoring equipment to keep track of symptoms.<ref name=":4">{{Cite journal|last1=Chua|first1=Siew-Siang|last2=Ong|first2=Woon May|last3=Ng|first3=Chirk Jenn|date=15 February 2014|title=Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study|journal=Patient Preference and Adherence|language=en|volume=8|pages=237–46|doi=10.2147/ppa.s57567|pmid=24627628|pmc=3931581 |doi-access=free }}</ref> *Lack of knowledge on the implications of physiological symptoms such as high blood glucose levels may reduce an individual's motivation to practice self-care monitoring.<ref name=":4" /> *Fear of outcomes/fear of using equipment such as needles may deter patients from practicing self-care monitoring due to the resulting anxiety, or avoidant behaviors.<ref name=":4" /> *Lack of family support may affect consistency in monitoring self-care due to the lack of reminders or encouragement.<ref>{{Cite journal|last=Woda|first=A|date=2015|title=Factors influencing self-care behaviors of African Americans with heart failure: A photovoice project|url=http://epublications.marquette.edu/nursing_fac/358|journal=Heart & Lung: The Journal of Acute and Critical Care|volume=44|issue=1|pages=33–38|doi=10.1016/j.hrtlng.2014.09.001|pmid=25444769|url-access=subscription}}</ref>
The presence of co-morbid conditions makes performing self-care monitoring particularly difficult.<ref name=":7">{{Cite journal|last1=Bayliss|first1=E.A.|last2=Steiner|first2=J.F.|last3=Fernald|first3=D.H.|last4=Crane|first4=L.A.|last5=Main|first5=D.S.|date=2003|title=Descriptions of barriers to self-care by persons with comorbid chronic diseases|journal=Annals of Family Medicine|volume=1 |issue=1|pages=15–21|doi=10.1370/afm.4|pmid=15043175|pmc=1466563}}</ref> For example, the shortness of breath from COPD can prevent a diabetic patient from physical exercise.<ref name=":7" /> Symptoms of chronic illnesses should be considered when performing self-care maintenance behaviors.<ref>{{Cite journal|doi = 10.1016/j.ijnurstu.2015.06.018|title = Predictors of hospitalization and quality of life in heart failure: A model of comorbidity, self-efficacy and self-care|year = 2015|last1 = Buck|first1 = Harleah G.|last2 = Dickson|first2 = Victoria Vaughan|last3 = Fida|first3 = Roberta|last4 = Riegel|first4 = Barbara|last5 = d'Agostino|first5 = Fabio|last6 = Alvaro|first6 = Rosaria|last7 = Vellone|first7 = Ercole|journal = International Journal of Nursing Studies|volume = 52|issue = 11|pages = 1714–1722|pmid = 26234935|url = https://repository.upenn.edu/cgi/viewcontent.cgi?article=1193&context=nrs}}</ref><ref>{{Cite journal|doi=10.1097/NNR.0b013e31827337b3|title=Multiple Comorbid Conditions Challenge Heart Failure Self-Care by Decreasing Self-Efficacy|year=2013|last1=Dickson|first1=Victoria Vaughan|last2=Buck|first2=Harleah|last3=Riegel|first3=Barbara|journal=Nursing Research|volume=62|issue=1|pages=2–9|pmid=23052421|s2cid=6813821|doi-access=free}}</ref><ref>{{Cite journal|doi = 10.1016/j.cardfail.2010.11.011|title = A Qualitative Meta-Analysis of Heart Failure Self-Care Practices Among Individuals with Multiple Comorbid Conditions|year = 2011|last1 = Dickson|first1 = Victoria Vaughan|last2 = Buck|first2 = Harleah|last3 = Riegel|first3 = Barbara|journal = Journal of Cardiac Failure|volume = 17|issue = 5|pages = 413–419|pmid = 21549299|url = https://repository.upenn.edu/cgi/viewcontent.cgi?article=1174&context=nrs}}</ref>
=== Interventions to improve monitoring behaviors=== Because self-care monitoring is conducted primarily by patients, with input from caregivers, it is necessary to work with patients closely on this topic. Providers should assess the current self-care monitoring regimen and build off this to create an individualized plan of care.<ref name=":3" /> Knowledge and education specifically designed for the patient's level of understanding has been said to be central to self-care monitoring. When patients understand the symptoms that correspond with their disease, they can learn to recognize these symptoms early on. Then they can self-manage their disease and prevent complications.<ref>{{Cite journal|last1=Wilde|first1=Mary H.|last2=Garvin|first2=Suzanne|date=1 February 2007|title=A concept analysis of self-monitoring|journal=Journal of Advanced Nursing|volume=57|issue=3|pages=339–350|doi=10.1111/j.1365-2648.2006.04089.x|pmid=17233653|issn=1365-2648}}</ref>
Additional research to improve self-care monitoring is underway in the following fields: *Mindfulness: Mindfulness and meditation, when incorporated into a one-day education program for diabetic patients, have been shown to improve diabetic control in a 3-month follow-up in comparison to those who received the education without a focus on mindfulness.<ref>{{Cite journal|last1=Gregg|first1=Jennifer A.|last2=Callaghan|first2=Glenn M.|last3=Hayes|first3=Steven C.|last4=Glenn-Lawson|first4=June L.|title=Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial.|journal=Journal of Consulting and Clinical Psychology|volume=75|issue=2|pages=336–343|doi=10.1037/0022-006x.75.2.336|pmid=17469891|year=2007|s2cid=11564671}}</ref> *Decision-making: How a patient's decision making capacity can be encouraged/improved with the support of their provider, leading to better self-care monitoring and outcomes.<ref>{{Cite journal|last=Bratzke|first=L|date=2015|title=Self-management priority setting and decision-making in adults with multimorbidity: A narrative review of literature|pmc=4315694|journal=International Journal of Nursing Studies|volume=52|issue=3|pages=744–55|pmid=25468131|doi=10.1016/j.ijnurstu.2014.10.010}}</ref> *Self-efficacy: Self-efficacy has been shown to be more closely linked to a patient's ability to perform self-care than health literacy or knowledge.<ref>{{Cite journal|last1=Chen|first1=Aleda M. H.|last2=Yehle|first2=Karen S.|last3=Albert|first3=Nancy M.|last4=Ferraro|first4=Kenneth F.|last5=Mason|first5=Holly L.|last6=Murawski|first6=Matthew M.|last7=Plake|first7=Kimberly S.|date=1 March 2014|title=Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence|journal=Research in Social & Administrative Pharmacy |volume=10|issue=2|pages=378–386|doi=10.1016/j.sapharm.2013.07.001|issn=1934-8150|pmc=3923851|pmid=23953756}}</ref> *Wearable technology: How self-care monitoring is evolving with technology like wearable activity monitors.<ref>{{Cite journal|last1=Chiauzzi|first1=Emil|last2=Rodarte|first2=Carlos|last3=DasMahapatra|first3=Pronabesh|date=9 April 2015|title=Patient-centered activity monitoring in the self-management of chronic health conditions|journal=BMC Medicine|volume=13|article-number=77|doi=10.1186/s12916-015-0319-2|issn=1741-7015|pmc=4391303|pmid=25889598 |doi-access=free }}</ref>
== Management == [[File:Asthma inhaler use.PNG|thumb|Asthma inhalers contain a medication that treats the symptoms of asthma. Recognizing asthma symptoms and taking asthma medication or other appropriate action is a type of self-management.]]Self-care management is defined as the response to signs and symptoms when they occur.<ref name=":8" /> Self-care management involves the evaluation of physical and emotional changes and deciding if these changes need to be addressed. Changes may occur because of illness, treatment, or the environment. Once treatment is complete, it should be evaluated to judge whether it would be useful to repeat in the future. Treatments are based on the signs and symptoms experienced. Treatments are usually specific to the illness.<ref name=":8" />
Self-care management includes recognizing symptoms, treating the symptoms, and evaluating the treatment.<ref name="ReferenceB">{{cite journal |last1=Lee |first1=KS |last2=Lennie |first2=TA |last3=Dunbar |first3=SB |last4=Pressler |first4=SJ |last5=Heo |first5=S |last6=Song |first6=EK |last7=Biddle |first7=MJ |last8=Moser |first8=DK |title=The association between regular symptom monitoring and self-care management in patients with heart failure |journal=Journal of Cardiovascular Nursing |date=2015 |volume=30 |issue=2 |pages=145–151 |doi=10.1097/JCN.0000000000000128|pmid=24434828 |pmc=4098015 }}</ref> Self-care management behaviors are symptom- and disease-specific. For example, a patient with asthma may recognize the symptom of shortness of breath. This patient can manage the symptom by using an inhaler and seeing if their breathing improves.<ref name=":8" /> A patient with heart failure manages their condition by recognizing symptoms such as swelling and shortness of breath.<ref name="ReferenceB" /> Self-care management behaviors for heart failure may include taking a water pill, limiting fluid and salt intake, and seeking help from a healthcare provider.<ref name="ReferenceB" />
Regular self-care monitoring is needed to identify symptoms early and judge the effectiveness of treatments.<ref name="ReferenceB" /> Some examples include: *Inject insulin in response to high blood sugar and then re-check to evaluate if blood glucose lowered{{Citation needed|date=March 2019}} *Use social support and healthy leisure activities to fight feelings of social isolation.<ref>{{cite web|title=30 Day Self Care Challenge|url=https://whatsgoodonline.co.uk/health/30-day-self-care-challenge/|date=4 March 2021}}</ref> This has been shown to be effective for patients with chronic lung disease<ref>{{cite journal |last1=Kaptein |first1=AA |last2=Fischer |first2=MJ |last3=Scharloo |first3=M |title=Self-management in patients with COPD: theoretical context, content, outcomes, and integration into clinical car |journal=International Journal of Chronic Obstructive Pulmonary Disease |date=2014 |volume=9 |pages=907–917|doi=10.2147/COPD.S49622 |pmid=25214777 |pmc=4159069 |doi-access=free }}</ref>
=== Barriers to management ===
==== Access to care ==== Access to care is a major barrier affecting self-care management.<ref name=":8" /> Treatment of symptoms might require consultation with a healthcare provider. Access to the health-care system is largely influenced by providers. Many people with a chronic illness do not have access to providers within the health-care system for several reasons. Three major barriers to care include: insurance coverage, poor access to services, and being unable to afford costs.<ref>{{cite journal |last1=DeVoe |first1=J.E |last2=Baaez |first2=A |last3=Angier |first3=H |last4=Krois |first4=L |last5=Edlund |first5=C |last6=Carney |first6=P.A |title=Insurance + access ≠ health care: typology of barriers to health care access to low-income families |journal=Annals of Family Medicine |volume=5 |issue=6 |pages=511–518 |doi=10.1370/afm.748 |pmid=18025488 |year=2007|pmc=2094032 }}</ref> Without access to trained health care providers, outcomes are typically worse.<ref name=":8" />
==== Financial constraints ==== Financial barriers impact self-care management. The majority of insurance coverage is provided by employers. Loss of employment is frequently accompanied by loss of health insurance and inability to afford health care. In patients with diabetes and chronic heart disease, financial barriers are associated with poor access to care, poor quality of care, and vascular disease. As a result, these patients have reduced rates of medical assessments, measurements of Hemoglobin A1C (a marker that assesses blood glucose levels over the last 3 months), cholesterol measurements, eye and foot examinations, diabetes education, and aspirin use.<ref>{{cite journal |last1=Parikh, P.B. |display-authors=etal |title=The impact of financial barriers on access to care, quality of care and vascular morbidity among patients with diabetes and coronary heart disease |journal=Journal of General Internal Medicine |date=2014 |volume=29 |issue=1 |pages=76–81|pmid=24078406 |pmc=3889957 |doi=10.1007/s11606-013-2635-6 }}</ref> Research has found that people in higher social classes are better at self-care management of chronic conditions. In addition, people with lower levels of education often lack resources to effectively engage in self-management behaviors.<ref>{{cite journal |last1=Cramm |first1=J.M |last2=Nieboer |first2=A.P |title=Self-management abilities, physical health and depressive symptoms among patients with cardiovascular diseases, chronic obstructive pulmonary disease, and diabetes |journal=Patient Education and Counseling |date=2012 |volume=87 |issue=3 |pages=411–415 |doi=10.1016/j.pec.2011.12.006|pmid=22222024 |doi-access=free }}</ref>
==== Age ==== Elderly patients are more likely to rate their symptoms differently and delay seeking care longer when they have symptoms.<ref>{{cite journal |last1=Lam |first1=C |last2=Smeltzer |first2=S.C |title=Patterns of symptom recognition, interpretation, and response in heart failure patients: An integrative review |journal=Journal of Cardiovascular Nursing |date=2013 |volume=28 |issue=4 |pages=348–359 |doi=10.1097/jcn.0b013e3182531cf7|pmid=22580629 |s2cid=24560362 }}</ref><ref>{{Cite journal|doi=10.1097/JCN.0000000000000445|title=State of the Science in Heart Failure Symptom Perception Research|year=2018|last1=Lee|first1=Solim|last2=Riegel|first2=Barbara|journal=Journal of Cardiovascular Nursing|volume=33|issue=3|pages=204–210|pmid=28858886|s2cid=4764672}}</ref> An elderly person with heart failure will experience the symptom of shortness of breath differently than someone with heart failure who is younger.<ref>{{Cite journal|pmid = 19609179|year = 2009|last1 = Jurgens|first1 = C. Y.|last2 = Hoke|first2 = L.|last3 = Byrnes|first3 = J.|last4 = Riegel|first4 = B.|title = Why do elders delay responding to heart failure symptoms?|journal = Nursing Research|volume = 58|issue = 4|pages = 274–282|doi = 10.1097/NNR.0b013e3181ac1581}}</ref> Providers should be aware of the potential delay in provider-seeking behavior in elderly patients which could worsen their overall condition.
==== Prior experience ==== Prior experience contributes to the development of skills in self-care management. Experience helps the patient develop cues and patterns that they can remember and follow, leading to reasonable goals and actions in repeat situations.<ref name=":8" /> A patient who has skills in self-management knows what to do during repeated symptomatic events. This could lead to them recognizing their symptoms earlier, and seeking a provider sooner.<ref name="hacs" />
==== Health care literacy ==== Health care literacy is another factor affecting self-care management. Health care literacy is the amount of basic health information people can understand. Health care literacy is the major variable contributing to differences in patient ratings of self-management support.<ref name="auto">{{cite journal |last1=Wallace |first1=A.S |last2=Carlson |first2=J.R |last3=Malone |first3=R.M |last4=Joyner |first4=J |last5=DeWalt |first5=D.A |title=The influence of literacy on patient-reported experiences of diabetes self-management support |journal=Nursing Research |volume=59 |issue=5 |pages=356–363 |doi=10.1097/nnr.0b013e3181ef3025 |pmid=20808193 |year=2010|pmc=2946184 }}</ref> Successful self-care involves understanding the meaning of changes in one's body. Individuals who can identify changes in their bodies are then able to come up with options and decide on a course of action.<ref name=":8" /> Health education at the patient's literacy level can increase the patient's ability to problem solve, set goals, and acquire skills in applying practical information. A patient's literacy can also affect their rating of healthcare quality. A poor healthcare experience may cause a patient to avoid returning to that same provider. This creates a delay in acute symptom management. Providers must consider health literacy when designing treatment plans that require self-management skills.<ref name="auto" />
==== Co-morbid conditions ==== A patient with multiple chronic illnesses (multimorbidity) may experience compounding effects of their illnesses. This can include worsening of one condition by the symptoms or treatment of another.<ref name="auto1">{{cite journal |last1=Bayliss |first1=E.A |last2=Steiner |first2=J.F |last3=Fernald |first3=D.H |last4=Crane |first4=L.A |last5=Main |first5=D.S |title=Descriptions of barriers to self-care by persons with comorbid chronic diseases |journal=Annals of Family Medicine |date=2003 |volume=1 |issue=1 |pages=15–21|pmid=15043175 |doi=10.1370/afm.4 |pmc=1466563}}</ref> People tend to prioritize one of their conditions. This limits the self-care management of their other illnesses. One condition may have more noticeable symptoms than others. Or the patient may be more emotionally connected to one illness, for example, the one they have had for a long time. If providers are unaware of the effect of having multiple illnesses, the patient's overall health may fail to improve or worsen as a result of therapeutic efforts.<ref name="auto1" />
=== Interventions to improve management=== There are many ways for patients and healthcare providers to work together to improve patients and caregivers' self-care management. Stoplight and skill teaching allow patients and providers to work together to develop decision-making strategies.
==== Stoplight ==== Stoplight is an action plan for the daily treatment of a patient's chronic illness created by the healthcare team and the patient.<ref>{{Cite book |last= |first= |url=https://books.google.com/books?id=jm4aDgAAQBAJ&q=stoplight+action+plan&pg=PT960 |title=Community Health Paramedicine |date=2017-01-29 |publisher=Jones & Bartlett Learning |isbn=978-1-284-14206-8 |language=en}}</ref> It makes decision making easier by categorizing signs and symptoms and determining the appropriate actions for each set. It separates signs and symptoms into three zones: * ''Green'' is the safe zone, meaning the patient's signs and symptoms are what is typically expected. The patient should continue with their daily self-care tasks, such as taking daily medications and eating a healthy diet.<ref name="aafa, n.d.">(aafa, n.d.)</ref> * ''Yellow'' is the caution zone, meaning the patient's signs and symptoms should be monitored as they are abnormal, but they are not yet dangerous. Some actions may need to be taken in this zone to go back to the green zone, for instance taking additional medication. The patient may need to contact their healthcare team for advice.<ref name="aafa, n.d." /> * ''Red'' is the danger zone, meaning the patient's signs and symptoms show that something is dangerously wrong. If in this category the patient needs to take actions to return to the green category, such as taking an emergency medication, as well as contact their healthcare team immediately. They may also need to contact emergency medical assistance.<ref name="aafa, n.d." />
The stoplight plan helps patients to make decisions about what actions to take for different signs and symptoms and when to contact their healthcare team with a problem. The patient and their provider will customize certain signs and symptoms that fit in each stoplight category.<ref>(Lung Foundation, n.d.)</ref>
==== Skills teaching ==== Skills teaching is a learning opportunity between a healthcare provider and a patient where a patient learns a skill in self-care unique to his or her chronic illness.<ref>{{Cite journal|pmid = 21121566|year = 2010|last1 = Bennett|first1 = H. D.|last2 = Coleman|first2 = E. A.|last3 = Parry|first3 = C.|last4 = Bodenheimer|first4 = T.|last5 = Chen|first5 = E. H.|title = Health coaching for patients with chronic illness|journal = Family Practice Management|volume = 17|issue = 5|pages = 24–29}}</ref> Some of these skills may be applied to the daily management of the symptoms of a chronic illness. Other skills may be applied when there is an exacerbation of a symptom.
A patient newly diagnosed with persistent asthma might learn about taking oral medicine for daily management, control of chronic symptoms, and prevention of an asthma attack. However, there may come a time when the patient might be exposed to an environmental trigger or stress that causes an asthma attack. When unexpected symptoms such as wheezing occur, the skill of taking daily medicines and the medicine that is taken may change. Rather than taking oral medicine daily, an inhaler is needed for quick rescue and relief of symptoms. Knowing to choose the right medication and knowing how to take the medicine with an inhaler is a skill that is learned for the self-care management of asthma.<ref>{{Cite journal |last1=Volerman |first1=Anna |last2=Kan |first2=Kristin |last3=Carpenter |first3=Delesha |last4=Press |first4=Valerie G. |date=2021-03-29 |title=Strategies for Improving Inhalation Technique in Children: A Narrative Review |journal=Patient Preference and Adherence |language=English |volume=15 |pages=665–675 |doi=10.2147/PPA.S267053 |doi-access=free |pmc=8018416 |pmid=33824582}}</ref>
In skills teaching, the patient and provider need to discuss skills and address any lingering questions. The patient needs to know when and how a skill is to be implemented, and how the skill may need to be changed when the symptom is different from normal.<ref>{{cite journal |last1=Dickson |first1=Victoria Vaughan |last2=Riegel |first2=Barbara |title=Are we teaching what patients need to know? Building skills in heart failure self-care |journal=Heart & Lung: The Journal of Acute and Critical Care |date=May 2009 |volume=38 |issue=3 |pages=253–261 |doi=10.1016/j.hrtlng.2008.12.001|pmid=19486796 }}</ref><ref>{{cite web|url=http://seekingcuriosity.com/index.php/2017/07/11/seeking-curiosity-how-embracing-uncertainty-strengthens-empathy/|title=Seeking Curiosity: How Embracing Uncertainty Strengthens Empathy|work=Seeking Curiosity |date=11 July 2017|access-date=20 December 2017}}</ref> See the summary of tactical and situational skills above. Learning self-care management skills for the first time in the care of a chronic illness is not easy, but with patience, practice, persistence, and experience, personal mastery of self-care skills can be achieved.<ref>{{Cite journal |last=Ltd |first=BMJ Publishing Group Ltd and RCN Publishing Company |date=2004-07-01 |title=3 themes described how self care management was learned and experienced by patients with chronic illness |url=https://ebn.bmj.com/content/7/3/94 |journal=Evidence-Based Nursing |language=en |volume=7 |issue=3 |page=94 |doi=10.1136/ebn.7.3.94 |issn=1367-6539 |pmid=15252922}}</ref> alt=Dinner plate with fish tacos, oranges, corn, and beans, next to a cup of milk|thumb|Eating healthy meals, with fruit, vegetables, and protein, is a form of self-care. Support can include: * 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),<ref name="RWJFe-primer3">[http://www.projecthealthdesign.org/media/file/E-primer_3.pdf Health in Everyday Living] {{webarchive|url=http://arquivo.pt/wayback/20160522145954/http://www.projecthealthdesign.org/media/file/E-primer_3.pdf |date=22 May 2016 }} Robert Wood Johnson Foundation primer</ref> the tracking of trends, and the use of the resulting information as clues for self-care action and decision making. * Information prescriptions<ref name=IP>{{cite web|url=http://www.informationprescription.info/|title=じっくり選ぶ結婚指輪の効果とは – 家内の希望で購入した結婚指輪のおかげで今でも夫婦円満です。|website=www.informationprescription.info|access-date=20 December 2017}}</ref> providing personalized 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.<ref name=FAST>{{cite web|url=http://www.fastuk.org/atforumactivities/involvement.php|title=Website of the Foundation for Assistive Technology|access-date=20 December 2017}}</ref> * Medication therapy management * Self-care skills and life skills training programs and courses for people.{{Citation needed|date=March 2019}} * Advice from licensed counselors, clinical social workers, psychotherapists, pharmacists, physiotherapists and complementary therapists.{{Citation needed|date=March 2019}} * 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).{{Citation needed|date=March 2019}} * Knowledge of easily accessible resources such as local parks.<ref>{{Cite journal |last1=Derose |first1=Kathryn P. |last2=Wallace |first2=Deshira D. |last3=Han |first3=Bing |last4=Cohen |first4=Deborah A. |date=June 2021 |title=Effects of park-based interventions on health-related outcomes: A systematic review |journal=Preventive Medicine |language=en |volume=147 |article-number=106528 |doi=10.1016/j.ypmed.2021.106528 |pmc=8096710 |pmid=33745954}}</ref>
== Self-care for caregivers == {{Main|Caregiver stress}} Long-term caregivers, such as women whose husbands have dementia, frequently neglect to care for themselves.<ref name=":15">{{Cite web |last=Lynn |first=Alison |date=27 Apr 2022 |title=The Criticality of Self-Care by Dementia Caregivers |url=https://www.americanbar.org/groups/senior_lawyers/resources/voice-of-experience/2010-2022/criticality-self-care-dementia-caregivers/ |access-date=2025-11-11 |website=Voice of Experience (American Bar Association) |language=en}}</ref> In trying to keep their loved ones safe and get through each day, they may not make time to take a shower, spend a few minutes alone in another room, or attend their own medical appointments.<ref name=":15" />
== Self-care in philosophy ==
=== Black feminist philosophy === [[File:Woman Shopping LV.jpg|alt=Woman wearing jewelry and carrying designer shopping bag|thumb|Costly forms of self-indulgence, such as buying luxury goods or going to a day spa, get misrepresented in advertisements and on social media as a form of self-care. These ads tend to elevate beauty standards and trends popular among wealthy white women. ]] The notion of self-care as a revolutionary act in the context of social trauma was developed as a social justice practice in Black feminist thought in the US. Notably, civil rights activist and poet Audre Lorde wrote that in the context of multiple oppressions as a black woman, "caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare." Lorde's philosophy states that as an oppressed community member, the preservation of her identity through acts that energize and sustain her is a form of activism and resistance. This self-care focuses on any acts which are healing and beneficial to one's survival and thereby enable resistance.
This initial interpretation of self-care differs from the popularized version seen today. With the rise in social media and capitalist marketing, a more whitewashed and commercialized interpretation has shifted what is normally considered self-care.<ref name=":122"/> Differing from Lorde's definition, some self-care interpretations center on the indulgence of self in accordance with white beauty standards and trends. Examples of this can be the purchasing of feminine beauty goods or sharing of activities or dietary fads.<ref name=":122"/> This can result in overspending, especially on trendy non-necessities, sometimes rationalized with references to internet memes like girl math or dupe culture.<ref>{{Cite news |last=Wang |first=Amy X. |date=2025-10-07 |title=They Got to Live a Life of Luxury. Then Came the Fine Print. |url=https://www.nytimes.com/2025/10/07/magazine/buy-now-pay-later-klarna-affirm-shopping.html |access-date=2025-10-11 |work=The New York Times |language=en}}</ref> In addition to this difference, modern day self-care as advertised on social media ignores the communal aspect of care which Lorde thought to be essential.<ref name=":022">{{Cite web |title=Audre Lorde, self-care and its roots in Black history |url=https://www.mentalhealthtoday.co.uk/blog/awareness/why-acknowledging-and-celebrating-the-black-feminist-origins-of-self-care-is-essential |access-date=2022-11-09 |website=MHT |language=en}}</ref> With the rise of the term in the medical usages, for instance, to combat anxiety, as well as the commercialization of products with linkages with self-care, the association of the term with black feminism has fallen away in clinical and popular usage.<ref>{{Cite news |last1=Meltzer |first1=Marisa |date=10 December 2016 |title=Soak, Steam, Spritz: It's All Self-Care |newspaper=The New York Times |url=https://www.nytimes.com/2016/12/10/fashion/post-election-anxiety-self-care.html}}</ref> However, in feminist and queer theory, the link to Lorde and other scholars is retained.<ref>{{Cite thesis |url=https://repositories.lib.utexas.edu/handle/2152/26823 |title=Radical self-care: Performance, activism, and queer people of color |date=May 2014 |type=Thesis}}</ref>
=== Western philosophy === In one interpretation, French philosopher Michel 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,'' published in 1976, is dedicated to this notion. For Foucault, the notion of ''care for the self'' (''epimeleia heautou,'') following a traditionally Western (Ancient Greek and Roman) interpretation of self-care 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).<ref>18.Foucault M: Technologies of the Self. Amherst: University of Massachusetts Press; 1988. As cited by: {{cite journal |author1=Thomas J. Papadimos |author2=Joanna E. Manos, Stuart J. Murray |title=An extrapolation of Foucault's Technologies of the Self to effect positive transformation in the intensivist as teacher and mentor |journal=Philosophy, Ethics, and Humanities in Medicine |year=2013 |volume=8 |number=7 |page=7 |doi=10.1186/1747-5341-8-7|pmid=23866101 |pmc=3717278 |doi-access=free }}</ref><ref>M. Foucault: The Hermeneutics of the Subject: Lectures at the College de France 1981–1982</ref>
Later on, the self-care deficit nursing theory was developed by Dorothea Orem between 1959 and 2001. This popular Western theory centers on the medical facet of self-care, and explores the use professional care and an orientation towards resources.<ref name="nuth">{{cite book|last=Kollack|first=Ingrid|title=Nursing Theories: Conceptual and Philosophical Foundations|publisher=Springer Publishing Company|year=2006|isbn=978-0-8261-4006-7|editor1-last=Kim|editor1-first=Hesook Suzie|page=45|chapter=The Concept of Self Care|access-date=31 August 2013|editor2-last=Kollak|editor2-first=Ingrid|chapter-url=https://books.google.com/books?id=OY1OT_0vDaEC}}</ref> 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.<ref name="dapon">{{cite book |title=Developing a Philosophy of Nursing |chapter=Commentary |editor1-first=June F. |editor1-last=Kikuchi |editor2-first=Helen |editor2-last=Simmons |last=Laurin |first=Jacqualine |year=1994 |publisher=Sage |isbn=978-0-8039-5423-6 |page=27 |chapter-url=https://books.google.com/books?id=c5dVzZb8MEIC |access-date=31 August 2013}}</ref> Under this theory, Orem begins to assess the importance of others and support in a more communal form of self-care, while still centering on the physical and medical aspects of care as opposed to the more spiritual or radical political resistance theories. This idea of communal care was pioneered by the Black feminist community in an effort to preserve themselves and resist oppression.<ref name=":022" />
== Self-Care in the Workplace == Self-care in the workplace have been associated with positive employee well-being and organizational productivity.<ref name=":52">{{Cite journal |last1=Pakdee |first1=Sirinthip |last2=Cheechang |first2=Pimploy |last3=Thammanoon |first3=Rachatawan |last4=Krobpet |first4=Sittisak |last5=Piya-amornphan |first5=Nitita |last6=Puangsri |first6=Pavarud |last7=Gosselink |first7=Rik |date=2025-04-15 |title=Burnout and well-being among higher education teachers: Influencing factors of burnout |journal=BMC Public Health |language=en |volume=25 |issue=1 |page=1409 |doi=10.1186/s12889-025-22602-w |doi-access=free |issn=1471-2458 |pmc=11998155 |pmid=40234791}}</ref> Trauma-informed models of care include self-care practices as a critical component of organizational health.<ref name=":02">{{Cite journal |last=Evans |first=Kelli |date=2025-01-01 |title=Trauma-Informed Self-Care Practices in Speech-Language Pathology and Related Professions: A Scoping Review |url=https://journals.lww.com/10.1097/TLD.0000000000000356 |journal=Topics in Language Disorders |language=en |volume=45 |issue=1 |pages=41–59 |doi=10.1097/TLD.0000000000000356 |issn=0271-8294|url-access=subscription }}</ref> Self-care helps employees to manage their stress levels and prevent burnout. Organizational self-care has been associated with improved job satisfaction, reduced absenteeism, and enhanced job performance.<ref name=":52" /><ref name=":14">{{Cite journal |last1=Shanafelt |first1=Tait D. |last2=Noseworthy |first2=John H. |date=2017-01-01 |title=Executive Leadership and Physician Well-being |url=https://linkinghub.elsevier.com/retrieve/pii/S0025619616306255 |journal=Mayo Clinic Proceedings |language=en |volume=92 |issue=1 |pages=129–146 |doi=10.1016/j.mayocp.2016.10.004 |pmid=27871627 }}</ref>
Self-care practices that employees can engage in, in the workplace include setting healthy working boundaries, engaging in regular breaks, participating in wellness programs, fostering supportive relationships with colleagues and maintaining work-life balance.<ref name=":14" />
In high-stress professions such as healthcare, education, and social work, the responsibility of self-care extends beyond the individual and becomes a shared organizational duty.<ref>{{Cite journal |last=Alekseenko |first=I. F. |date=1975 |title=[Fractional identification of proteins of erythrocyte hemolysate subjected to disc electrophoresis in polyacrylamide gel] |journal=Zdravookhranenie Kirgizii |issue=5 |pages=35–36 |issn=0132-8867 |pmid=1939}}</ref><ref>{{Cite journal |last1=Kinman |first1=Gail |last2=Grant |first2=Louise |date=2017 |title=Building Resilience in Early-Career Social Workers: Evaluating a Multi-Modal Intervention |journal=The British Journal of Social Work |volume=47 |issue=7 |pages=1979–1998 |doi=10.1093/bjsw/bcw164 |jstor=26612899 |issn=0045-3102|hdl=10547/621932 |hdl-access=free }}</ref> Some scholars argue that institutional factors such as heavy workloads, lack of autonomy, can undermine individual self-care efforts, suggesting the needs for systemic interventions alongside personal practices. In addition to acknowledging and assessing organization problems, organizational self-care includes institutional policies and advocacy that encourage employees to use:<ref name=":22">{{Cite journal |last1=Cole |first1=Rebecca |last2=Fantus |first2=Sophia |last3=Hawkins |first3=Lataya |last4=Chakraborty |first4=Priyanjali |date=2025-01-01 |title=Professional Self-Care in Social Work Practice: A New Conceptual Framework |url=https://academic.oup.com/sw/article/70/1/31/7905790 |journal=Social Work |language=en |volume=70 |issue=1 |pages=31–38 |doi=10.1093/sw/swae049 |pmid=39566096 |issn=0037-8046|url-access=subscription }}</ref><ref name=":14" />
* Employee assistance programs<ref>{{Cite journal |last1=Abdul Aziz |first1=Amani Fadzlina |last2=Ong |first2=Tiffanie |date=2025-01-31 |title=Access to employee assistance programs and employee wellbeing: a cross-sectional study of employees in Southeast Asia |journal=BMC Public Health |language=en |volume=25 |issue=1 |page=398 |doi=10.1186/s12889-025-21358-7 |doi-access=free |issn=1471-2458 |pmc=11783774 |pmid=39891072}}</ref> * Paid time off (sick and vacation) * Healthcare<ref>{{Cite journal |last1=Wang |first1=Heming |last2=Lu |first2=Yu-Kun |last3=Wu |first3=Lue |last4=Oh |first4=Dong Yoon |last5=Shen |first5=Boqiang |last6=Lee |first6=Seung Hoon |last7=Vahala |first7=Kerry |date=2020-12-23 |title=Dirac solitons in optical microresonators |journal=Light: Science & Applications |volume=9 |issue=1 |page=205 |doi=10.1038/s41377-020-00438-w |pmid=33361759 |bibcode=2020LSA.....9..205W |issn=2047-7538|pmc=7758338 }}</ref><ref name=":32">{{Cite journal |last1=Al-Fayez |first1=Diana |last2=Goodman |first2=Doug |date=2024-03-01 |title=Health-Related Assistance Programs, Leadership Support, and Organizational Performance: Evidence From the U.S. Federal Agencies |url=https://journals.sagepub.com/doi/10.1177/00910260231173082 |journal=Public Personnel Management |language=en |volume=53 |issue=1 |pages=6–35 |doi=10.1177/00910260231173082 |issn=0091-0260|url-access=subscription }}</ref> * Flexible Work Arrangements<ref name=":14" /><ref name=":32" /> * Staff Satisfaction Surveys<ref name=":14" /> * Supportive and frequent supervision<ref name=":22" /><ref name=":42">{{Cite journal |last1=Peterson Dealey |first1=Rhonda |last2=Lamb |first2=Jenny |date=2024-11-04 |title=Self-care is a social justice issue: social work students' themes of social injustice within their self-care experiences |url=https://www.tandfonline.com/doi/full/10.1080/02615479.2024.2423689 |journal=Social Work Education |volume=44 |issue=7 |language=en |pages=1720–1736 |doi=10.1080/02615479.2024.2423689 |issn=0261-5479|url-access=subscription }}</ref> * Training<ref name=":02" /> * Spaces to engage in self care<ref name=":22" /> * Wellness Programs (diet/exercise plans)<ref name=":32" />
== Self-Care and Capitalism == The intersection of self-care and capitalism has generated scholarly discussion. Self-care was originally established as behaviors to ensure holistic well-being of oneself. As self-care has entered the mainstream, it has been refined as a set of consumer behaviors such as buying expensive self-care products and services.<ref name=":62">{{Cite journal |last1=Knowles |first1=Laura |last2=Cummings |first2=Jorden |date=2024-05-01 |title=Influencers' Presentation of Self-care on YouTube: It's Essential, But Inaccessible |url=https://link.gale.com/apps/doc/A798701233/OVIC?u=maco12153&sid=bookmark-OVIC&xid=ee82cbb3 |journal=Journal of Social Media in Society |volume=13 |issue=1 |via=Tarleton State University}}</ref>
Commercialized self-care can create a barrier to access of self-care, allowing for self-care to be more readily accessible to those with financial means.<ref name=":42" /> Marketing self-care products or services as "essential" can reinforce cycles of over consumption or create an unattainable vision of self-care<ref name=":62" />
== See also == * {{section link|Americans with Disabilities Act of 1990|Major life activities}} * Executive functioning * Integrative medicine * Public space * Shelter (building)
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== References == {{Reflist|30em}}
== External links == *{{Commons category-inline}} *[http://www.dh.gov.uk/en/Healthcare/Selfcare/index.htm Self-care in England] {{Webarchive|url=https://web.archive.org/web/20090430155247/http://www.dh.gov.uk/en/Healthcare/Selfcare/index.htm |date=30 April 2009 }} *[https://self-management.eu/ COMPAR-EU, EU funded project (Horizon2020) on self-management] *[https://www.selfcarefederation.org Global Self-Care Federation] *[https://aesgp.eu Association of the European Self-Care Industry]
{{Health care}} {{Authority control}}
Category:Self-care Category:Self