Self care

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

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

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

Universal requisites

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

Health maintenance

Self care includes all health decisions people (as individuals or consumers) make for themselves and their families to ensure they are physically and mentally fit. Self care includes exercising to maintain physical fitness and promote good mental health, as well as eating well, practicing good hygiene and avoiding health hazards such as smoking and drinking to prevent ill health. The personal responsibility for self care in the context of preventative medicine was examined with a representative sample of the general public in a Citizens’ Jury, with the title: ‘My health – whose responsibility? A jury decides’.^[8]

The benefits of living a healthy lifestyle were analysed in the Caerphilly Heart Disease Study. Evidence showed a risk reduction in chronic diseases (including dementia and cognitive impairment) to be significantly associated with healthy lifestyles.^[9]

Self care is also taking care of minor ailments, long term conditions, or one’s own health after discharge from secondary and tertiary health care. For instances of neck pain, for example, self care is the recommended treatment.^[10]

Patients who are better informed and more educated possess greater motivation for self care.^[2] Individuals conduct self care and experts and professionals support self care to enable individuals to undertake enhanced self care. The recognition and evaluation of symptoms is a key aspect of self care.^[11] The main issues involved with self care and the onset of illness are medically related such managing drug side effects, emotions and psychological issues, changes to lifestyle and knowledge acquisition to assist in decision-making.^[2]

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

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

Support

Self care support can include the following:

• Self care information on health and human body systems, lifestyle and healthy eating.
• Support to capture, manage, interpret, and report observations of daily living (ODLs),^[12] the tracking of trends, and the use of the resulting information as clues for self care action and decision making.
• Information prescriptions^[13] providing personalised information and instructions to enable an individual to self care and take control of their health
• Self-care and self-monitoring devices and assistive technology^[14]
• Self care skills and life skills training programmes and courses for people
• Aid from spiritual care givers
• Advice from licensed counselors, clinical social workers, psychotherapists, pharmacists, physiotherapists and complementary therapists
• Self care support networks which can be face to face or virtual, and made up of peers or people who want to provide support to others or receive support and information from others. (Including a self care Primer for provider/consumer convergence.)
• Being attuned to one's spirituality

Approaches

Food pyramid

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

• General fitness training and physical exercise
• Healthy diet, meals, diet foods and fasting
• Smoking cessation and avoiding alcohol abuse
• Personal hygiene
• Life extension
• Pain management
• Stress management
• Alternative medicine such as homeopathy and home remedies
• Self-help and personal development
• Self care portals^[15] and the use of health apps

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  Sleeping. A drawing of two men taking a siesta.

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  Walking for Health.

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  Maintaining fitness at an elderly age

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  Checking blood pressure at home with an electronic sphygmomanometer.

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  Blood sugar testing for diabetes

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  Asthma inhalers contain a medication that treats the symptoms of asthma

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  Self-massage

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  Massage with robotic massage chairs.

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

Philosophy

Michael Foucault understood the art of living (French art de vivre, Latin ars vivendi) and the care of self (French le souci de soi) to be central to philosophy. The third volume of his three-volume study The History of Sexuality is dedicated to this notion. For Foucault, the notion of care of self (epimeleia heautou) of Ancient Greek and Roman philosophy comprises an attitude towards the self, others and the world, as well as a certain form of attention. For Foucault, the pursuit of the care for one's own well-being also comprises self-knowledge (gnōthi seauton).^[16][17]

The self-care deficit nursing theory was developed by Dorothea Orem between 1959 and 2001. The positively viewed theory explores the use professional care and an orientation towards resources.^[4] Under Orem's model self care has limits when its possibilities have been exhausted therefore making professional care legitimate. These deficits in self care are seen as shaping the best role a nurse may provide. There are two phases in Orem's self care; the investigative and decision-making phase and the production phase.^[18]

Culture of Health

Victor Skumin, Bagmati Zone, Nepal

In 1968, Victor Skumin proposed the term ″Culture of Health″, which has become widespread.^[19][20][21] The main task of a Culture of Health is to implement innovative health programs that support a holistic approach to physical, mental and spiritual well-being.^[22]

In 1994, he was elected to the post of the President-founder of the World Organisation of Culture of Health — International social movement "To Health via Culture" (Russian: Междунаро́дное обще́ственное Движе́ние «К Здоро́вью че́рез Культу́ру»). The organization operates in accordance with the registered in Ministry of Justice of the Russian Federation Charter. Key element of a Culture of Health is implement innovative health programs that support a holistic approach to physical, mental and spiritual well-being both inside and outside the workplace.^[23][24]In 1995, Skumin became the first editor-in-chief of the journal To Health via Culture. This journal of the World Organisation of Culture of Health (″World Health Culture Organization″) received an International Standard Serial Number (ISSN) 0204-3440.^[25] The Organization also has its own publishing house ("To Health via Culture"), who has the right to publish the books with the International Standard Book Number (ISBN).^[26]

The journal To Health via Culture

Key element of a Culture of Health is implement innovative health programs that support a holistic approach to physical, mental and spiritual well-being both inside and outside the workplace. The Culture of Health means recognizing health’s central importance in the lives.^[27][28] The essence of the teachings of the culture of health, reveals professor N. Gribok. He wrote at 2009,^[29]

Russian Professor Skumin insists on the fact that the culture of health should be considered as an integral part of the spiritual culture and the moral culture, culture of labour and culture of recreation, culture of personality and culture of relationships. According to the scientist, the culture of health is not only the mechanical connection of the two concepts—the concept of ″culture″ and the concept of ″health″. This is their synthesis, which forms a new quality, a new content. Skumin examines the culture of health as the specific science, that develops the theoretical and practical tasks of harmonious development of the spiritual, mental, and physical human force, forming of optimum environment, which provides a higher level of creativity of life. Thus, Skumin argues that the culture of health is a separate science, that creates new content. The main challenge of culture of health is the development of spiritual, mental and physical capabilities of man.

In a diverse country, "cultural competency" in medical practice and health policy has a growing and urgent role in reforming a health care system that serves us all. A culture of health is spreading in America. Many states are beginning to make cultural competency a mandatory part of medical training and continuing education for health professionals. At least five states including California, New Jersey, New Mexico, Washington, and Ohio have now enacted laws that require medical schools and licensing bodies to provide course work in cultural competency training. According to a recent study by the Pew Internet and American Life Project, 80 percent of US Web users search for health information online to help them make better health choices. Nearly 25 million Americans have access to cable video-on-demand through their local digital-cable provider. A Gallop Poll found that for consumers television still remains one of the most popular sources for health and medical news. Multimedia program the Culture of Health will successfully harnesses the power of TV, Internet and wireless cell phone technology to deliver the latest health information directly to viewers.^[30]

See also

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

References

Further reading

• The Relaxation Response

External links

Wikimedia Commons has media related to Self care.

Self care as health maintenance:

• Self Care in England
• Self Care in the UK
• Expert Patients Programme in England
• Self Care in Australia
• Learning a new way of living
• Self Care in Belarus