From Wikipedia, the free encyclopedia
(Redirected from Self care)
Jump to navigation Jump to search

Walking for Health in Epsom-5Aug2009 (3).jpg
Walking is beneficial for the maintenance of good health

Self-care has been defined as the process of taking care of oneself with behaviors that promote health and active management of illness when it occurs.[1] Individuals engage in some form of self-care daily with food choices, exercise, sleep, and dental care.[1] While the concept of self care has received increased attention in recent years, it has ancient origins. Socrates has been credited with founding the self-care movement in ancient Greece, and care are of oneself and loved ones has been shown to exist since human beings appeared on earth.[2] Self-care remains a primary form of healthcare worldwide.

Routine self-care is important for generally healthy people but self-care becomes essential when illness occurs.[3] Chronic illness (e.g., heart failure, diabetes, high blood pressure) requires behaviors that control the illness, decrease symptoms, and improve survival such as medication adherence and symptom monitoring. An acute illness like an infection (e.g., COVID) requires the same types of self-care behaviors required of people with a chronic illness, but the medication adherence and symptom monitoring behaviors associated with an acute illness are typically short lived. Routine health maintenance self-care behaviors that individuals engage in (e.g., adequate sleep) are still required of those dealing with acute or chronic illness.Kecklund, G (2016). "health consequences of shift work and insufficient sleep". BMJ. 355: i5210. doi:10.1136/bmj.i5210. PMID 27803010. S2CID 206912413.

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.[4] Benefits of routine self-care in generally healthy populations include prevention of illness and comparatively better quality of life.[5] 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.[6][7][8] Self-care is seen as a partial solution to the global rise in health care costs that is placed on governments worldwide.[9]

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. There is a growing body of knowledge related to these home care workers.[10]

Factors influencing self-care[edit]

There are numerous factors that affect self-care.[11] These factors can be grouped as personal factors (e.g., person, problem, and environment) and processes.[12]

Personal factors:

  • Lack of motivation;
  • Cultural beliefs;
  • Self-efficacy or confidence;
  • Functional and cognitive abilities;
  • Support from others;
  • Access to care.


  • Experience;
  • Knowledge;
  • Skill;
  • Values.[3]

External personal factors such as access to healthcare and one's living environment greatly influence self-care. Social determinants of health play an important role in self-care practices.[13] Access to care is one major determinant of an individual's ability to carry out self-care maintenance behaviors. This includes having access to transportation to visit a health care facility, offices/clinics opening hours, and affordability.[14] Access to facilities that promote self-care within an individual's living environment is another factor that influences self-care maintenance. For example, access to a safe environment for walking or exercise facilities such as a gym greatly influence self-care maintenance behaviors as does access to healthy food.[14]

Self-care practices are shaped by what are seen as the proper lifestyle choices of local communities. 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.[3] Goal setting is a practice associated with motivated self care.[3] 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.[15] An individual with impaired cognitive or functional abilities (e.g., memory impairment) also has a diminished capacity to perform self-care maintenance behaviors[3] such as medication adherence which relies on memory to maintain a schedule.[16]

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[3] Personal values have been shown to have an effect on self-care in Type 2 Diabetes Mellitus.[17]

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.[3]

There are numerous self-care requisites applicable to all individuals of all ages for the maintenance of health and wellbeing.[18] The balance between solitude or rest, and activities such as social interactions is a key tenet of self-care practices.[18] 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.[19] 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[edit]

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:[3] 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[20]
  • Self-Care of Hypertension Inventory[21]
  • Self-Care of Diabetes Inventory[22]
  • Self-Care of Coronary Heart Disease Inventory[23]
  • Self-Care of Chronic Illness Inventory[24]
  • Self-care of Chronic Obstructive Pulmonary Disease [25]

Middle-range theory of self-care of chronic illness[edit]

According to the middle-range theory of chronic illness,[3][26] 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.[27][26]

Below these concepts are discussed both as general concepts and as specific self-care behaviors are (e.g., exercise).

Self-care maintenance[edit]

Self-care maintenance refers to those behaviours performed to improve well-being, preserve health, or to maintain physical and emotional stability.[3] Self-care maintenance behaviours 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.[28] Vaccinations provide immunity for the body to actively prevent an infectious disease.[29] Tobacco use is the largest preventable cause of death and disease in the US.[30] 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.[30]

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.[31] 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.[32]

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. File:USDA Food Pyramid.gif|Food pyramid

Hygiene is another important part of self-care maintenance. Hygienic behaviours include adequate sleep, regular oral care, and hand washing. Getting seven to eight hours of sleep each night can protect physical and mental health.[33] Sleep deficiency increases the risk of heart disease, kidney disease, high blood pressure, diabetes, excess weight, and risk-taking behaviour.[33] Tooth brushing and personal hygiene can prevent oral infections.[citation needed]

Senator Kamala Harris talks about her self care during the COVID-19 pandemic in 2020.

Health-related self-care topics include;

Objective Measures of Specific Self-Care Maintenance Behaviors:

Checking blood pressure at home with an electronic sphygmomanometer.
Blood sugar testing for diabetes
Asthma inhalers contain a medication that treats the symptoms of asthma

Interventions to improve maintenance behaviors[edit]

Self-care is considered to be a continuous learning process.[18] Knowledge is essential but not sufficient to improve self-care.[35] Multifaceted interventions that tailor education to the individual are more effective than patient education alone.[36]

  • "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.[36] 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.[36] 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".[37] 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.[37] 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.[38]
  • 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.[39]
  • 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.[40]
  • 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.[41]
  • 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.[41]


Self-care monitoring is the process of surveillance that involves measurement and perception of bodily changes, or "body listening".[3] Effective self-care monitoring also requires the ability to label and interpret changes in the body as normal or abnormal.[3] Recognizing bodily signs and symptoms, understanding disease progression, and their respective treatments allow competency in knowing when to seek further medical help.[4]

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.

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.[42] 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.[citation needed]

Barriers to monitoring[edit]

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.[43]

  • High costs may prevent some individuals from acquiring monitoring equipment to keep track of symptoms.[44]
  • 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.[44]
  • 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.[44]
  • Lack of family support may affect consistency in monitoring self-care due to the lack of reminders or encouragement.[45]

The presence of co-morbid conditions makes performing self-care monitoring particularly difficult.[46] For example, the shortness of breath from COPD can prevent a diabetic patient from physical exercise.[46] Symptoms of chronic illnesses should be considered when performing self-care maintenance behaviours.[47][48][49]

Interventions to improve monitoring behaviors[edit]

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.[43] 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.[50]

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.[51]
  • 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.[52]
  • 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.[53]
  • Wearable technology: How self-care monitoring is evolving with technology like wearable activity monitors.[54]


Self-care management is defined as the response to signs and symptoms when they occur.[3] 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.[3]

Self-care management includes recognizing symptoms, treating the symptoms, and evaluating the treatment.[55] 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.[3] A patient with heart failure manages their condition by recognizing symptoms such as swelling and shortness of breath.[55] 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.[55]

Regular self-care monitoring is needed to identify symptoms early and judge the effectiveness of treatments.[55] Some examples include:

  • Inject insulin in response to high blood sugar and then re-check to evaluate if blood glucose lowered[citation needed]
  • Use social support and healthy leisure activities to fight feelings of social isolation.[56] This has been shown to be effective for patients with chronic lung disease[57]

Barriers to management[edit]

Access to care: Access to care is a major barrier affecting self-care management.[3] 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.[58] Without access to trained health care providers, outcomes are typically worse.[3]

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.[59] 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.[60]

Age: Elderly patients are more likely to rate their symptoms differently and delay seeking care longer when they have symptoms.[61][62] An elderly person with heart failure will experience the symptom of shortness of breath differently than someone with heart failure who is younger.[63] 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.[3] 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.[1]

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.[64] 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.[3] 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.[64]

Co-morbid conditions: A patient with multiple chronic illnesses may experience compounding effects of their illnesses. This can include worsening of one condition by the symptoms or treatment of another.[65] 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.[65]

Interventions to improve management[edit]

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 is an action plan for the daily treatment of a patient's chronic illness created by the healthcare team and the patient.[66] 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.[67]
  • 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.[67]
  • 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.[67]

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.[68]

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.[69] 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.[citation needed]

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.[70][71] 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.[citation needed]

Support can include:


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 is dedicated to this notion. For Foucault, the notion of care for the 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).[75][76]

Around the same time that Foucault developed his notion of care for the self, 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." With the rise of the term in the medical usages, for instance, to combat anxiety, the association with black feminism has fallen away in clinical and popular usage.[77] However, in feminist and queer theory, the link to Lorde and other scholars is retained.[78]

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.[79] 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.[80]

See also[edit]


  1. ^ a b c Alexander Segall; Jay Goldstein (1998). "Exploring the Correlates of Self Provided Health Care Behaviour". In Coburn, David; D'Arcy, Alex; Torrance, George Murray (eds.). Health and Canadian Society: Sociological Perspectives. University of Toronto Press. pp. 279–280. ISBN 978-0-8020-8052-3. Retrieved 29 August 2013.
  2. ^ Taylor, C. (2019). A brief history of self-care, and the OG (original guru), Socrates.
  3. ^ a b c d e f g h i j k l m n o p q r s Riegel, Barbara; Jaarsma, Tiny; Strömberg, Anna (2012). "A Middle-Range Theory of Self-Care of Chronic Illness". Advances in Nursing Science. 35 (3): 194–204. doi:10.1097/ANS.0b013e318261b1ba. ISSN 0161-9268. PMID 22739426. S2CID 1029333.
  4. ^ a b Riegel, Barbara; Moser, Debra K.; Buck, Harleah G.; Dickson, Victoria Vaughan; Dunbar, Sandra B.; Lee, Christopher S.; Lennie, Terry A.; Lindenfeld, Joann; Mitchell, Judith E.; Treat‐Jacobson, Diane J.; Webber, David E. (2017). "Self‐Care for the Prevention and Management of Cardiovascular Disease and Stroke". Journal of the American Heart Association. 6 (9). doi:10.1161/JAHA.117.006997. PMC 5634314. PMID 28860232.
  5. ^ World Health Organization. "WHO consolidated guideline on self-care interventions for health". Retrieved 8 September 2021.
  6. ^ Jonkman, Nini H.; Schuurmans, Marieke J.; Groenwold, Rolf H.H.; Hoes, Arno W.; Trappenburg, Jaap C.A. (2016). "Identifying components of self-management interventions that improve health-related quality of life in chronically ill patients: Systematic review and meta-regression analysis". Patient Education and Counseling. 99 (7): 1087–1098. doi:10.1016/j.pec.2016.01.022. PMID 26856778.
  7. ^ Jonkman, Nini H.; Schuurmans, Marieke J.; Jaarsma, Tiny; Shortridge-Baggett, Lillie M.; Hoes, Arno W.; Trappenburg, Jaap C.A. (2016). "Self-management interventions: Proposal and validation of a new operational definition". Journal of Clinical Epidemiology. 80: 34–42. doi:10.1016/j.jclinepi.2016.08.001. PMID 27531245.
  8. ^ Jonkman, Nini; Westland, Heleen; Trappenburg, Jaap CA; Groenwold, Rolf HH; Bischoff, Erik WMA; Bourbeau, Jean; Bucknall, Christine E.; Coultas, David; Effing, Tanja W.; Epton, Michael; Gallefoss, Frode; Garcia-Aymerich, Judith; Lloyd, Suzanne M.; Monninkhof, Evelyn M.; Nguyen, Huong Q.; Van Der Palen, Job; Rice, Kathryn L.; Sedeno, Maria; Taylor, Stephanie JC; Troosters, Thierry; Zwar, Nicholas A.; Hoes, Arno W.; Schuurmans, Marieke J. (2016). "Do self-management interventions in COPD patients work and which patients benefit most? An individual patient data meta-analysis". International Journal of Chronic Obstructive Pulmonary Disease. 11: 2063–2074. doi:10.2147/COPD.S107884. PMC 5012618. PMID 27621612.
  9. ^ Eze, Nkiruka D.; Mateus, Céu; Cravo Oliveira Hashiguchi, Tiago (2020). "Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation". PLOS ONE. 15 (8): e0237585. Bibcode:2020PLoSO..1537585E. doi:10.1371/journal.pone.0237585. PMC 7425977. PMID 32790752.
  10. ^ Sterling, Madeline R.; Barbaranelli, Claudio; Riegel, Barbara; Stawnychy, Michael; Ringel, Joanna Bryan; Cho, Jacklyn; Vellone, Ercole (2020). "The Influence of Preparedness, Mutuality, and Self-efficacy on Home Care Workers' Contribution to Self-care in Heart Failure". Journal of Cardiovascular Nursing. 37 (2): 146–157. doi:10.1097/JCN.0000000000000768. PMC 8196074. PMID 33315614.
  11. ^ Riegel, Barbara; Dunbar, Sandra B.; Fitzsimons, Donna; Freedland, Kenneth E.; Lee, Christopher S.; Middleton, Sandy; Stromberg, Anna; Vellone, Ercole; Webber, David E.; Jaarsma, Tiny (2021). "Self-care research: Where are we now? Where are we going?". International Journal of Nursing Studies. 116: 103402. doi:10.1016/j.ijnurstu.2019.103402. PMC 7035984. PMID 31630807.
  12. ^ Riegel, Barbara; Dickson, Victoria Vaughan; Faulkner, Kenneth M. (2016). "The Situation-Specific Theory of Heart Failure Self-Care". Journal of Cardiovascular Nursing. 31 (3): 226–235. doi:10.1097/JCN.0000000000000244. PMID 25774844. S2CID 25743183.
  13. ^ Baah, Foster Osei; Teitelman, Anne M.; Riegel, Barbara (2019). "Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health-An integrative review". Nursing Inquiry. 26 (1): e12268. doi:10.1111/nin.12268. PMC 6342665. PMID 30488635.
  14. ^ a b Havranek, E.P.; Mujahid, M.S.; Barr, D.A. (2015). "Social determinants of risk and outcomes for cardiovascular disease: A scientific statement from the American Heart Association". Circulation. 132 (9): 873–898. doi:10.1161/CIR.0000000000000228. PMID 26240271. S2CID 8548491.
  15. ^ Gonzalez, J.S.; Safren, S.A.; Cagliero, E. (2007). "Depression, self-care, and medication adherence in type 2 diabetes". Diabetes Care. 30 (9): 2222–2227. doi:10.2337/dc07-0158. PMC 4440862. PMID 17536067.
  16. ^ Kim, Jinshil; Kim, Sun Hwa; Shim, Jae Lan; Hwang, Seon Young (2021). "Memory predicted self-care maintenance in patients with heart failure among cognitive functions: Results from a structural equation model". doi:10.21203/ S2CID 238673548. {{cite journal}}: Cite journal requires |journal= (help)
  17. ^ Luciani, Michela; Rebora, Paola; Rossi, Emanuela; Tonoli, Luca; Androni, Silvia; Ballerini, Enrico; Fabrizi, Diletta; Riegel, Barbara; Ausili, Davide (18 January 2019). "How Do Basic Human Values Affect Self-Care of Type 2 Diabetes Patients? A Multicentre Observational Study". Clinical Nursing Research. 29 (5): 304–312. doi:10.1177/1054773818825003. ISSN 1552-3799. PMID 30658535. S2CID 58574574.
  18. ^ a b c Taylor, Susan G.; Katherine Renpenning; Kathie McLaughlin Renpenning (2011). Self-care Science, Nursing Theory, and Evidence-based Practice. Springer Publishing Company. pp. 39–41. ISBN 978-0-8261-0779-4. Retrieved 25 August 2013.
  19. ^ Ziguras, Christopher (2013). Self-care: Embodiment, Personal Autonomy and the Shaping of Health Consciousness. Routledge. pp. 14–15. ISBN 978-1-134-41969-2. Retrieved 31 August 2013.
  20. ^ Riegel, Barbara; Barbaranelli, Claudio; Carlson, Beverly; Sethares, Kristen A.; Daus, Marguerite; Moser, Debra K.; Miller, Jennifer; Osokpo, Onome Henry; Lee, Solim; Brown, Stacey; Vellone, Ercole (2019). "Psychometric Testing of the Revised Self-Care of Heart Failure Index". Journal of Cardiovascular Nursing. 34 (2): 183–192. doi:10.1097/JCN.0000000000000543. PMC 7179813. PMID 30303894.
  21. ^ Dickson, Victoria Vaughan; Fletcher, Jason; Riegel, Barbara (2021). "Psychometric Testing of the Self-care of Hypertension Inventory Version 3.0". Journal of Cardiovascular Nursing. 36 (5): 411–419. doi:10.1097/JCN.0000000000000827. PMID 34117186. S2CID 235412764.
  22. ^ Ausili, Davide; Barbaranelli, Claudio; Rossi, Emanuela; Rebora, Paola; Fabrizi, Diletta; Coghi, Chiara; Luciani, Michela; Vellone, Ercole; Di Mauro, Stefania (16 October 2017). "Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: the Self-Care of Diabetes Inventory". BMC Endocrine Disorders. 17 (1): 66. doi:10.1186/s12902-017-0218-y. ISSN 1472-6823. PMC 5644085. PMID 29037177.
  23. ^ Vaughan Dickson, Victoria; Lee, Christopher S.; Yehle, Karen S.; Mola, Ana; Faulkner, Kenneth M.; Riegel, Barbara (February 2017). "Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI)". Research in Nursing & Health. 40 (1): 15–22. doi:10.1002/nur.21755. ISSN 1098-240X. PMID 27686630. S2CID 22027492.
  24. ^ Riegel, Barbara; Barbaranelli, Claudio; Sethares, Kristen A.; Daus, Marguerite; Moser, Debra K.; Miller, Jennifer L.; Haedtke, Christine A.; Feinberg, Jodi L.; Lee, Solim (October 2018). "Development and initial testing of the self-care of chronic illness inventory". Journal of Advanced Nursing. 74 (10): 2465–2476. doi:10.1111/jan.13775. hdl:1805/22476. ISSN 1365-2648. PMID 29943401. S2CID 49415051.
  25. ^ Matarese, Maria; Clari, Marco; De Marinis, Maria Grazia; Barbaranelli, Claudio; Ivziku, Dhurata; Piredda, Michela; Riegel, Barbara (2020). "The Self-Care in Chronic Obstructive Pulmonary Disease Inventory: Development and Psychometric Evaluation". Evaluation & the Health Professions. 43 (1): 50–62. doi:10.1177/0163278719856660. PMID 31208201. S2CID 190536253.
  26. ^ a b Riegel, Barbara; Jaarsma, Tiny; Lee, Christopher S.; Strömberg, Anna (19 November 2018). "Integrating Symptoms Into the Middle-Range Theory of Self-Care of Chronic Illness". Advances in Nursing Science. 42 (3): 206–215. doi:10.1097/ANS.0000000000000237. ISSN 1550-5014. PMC 6686959. PMID 30475237.
  27. ^ Palo Stoller, Eleanor (1998). Ory, Marcia G.; DeFriese, Gordon H. (eds.). Self-care in Later Life: Research, Program, and Policy Issues. Springer Publishing Company. pp. 24–25. ISBN 978-0-8261-9695-8. Retrieved 28 August 2013.
  28. ^ Jimmy, B; Jose, J (2011). "Patient medication adherence: Measures in daily practice". Oman Medical Journal. 26 (3): 155–159. doi:10.5001/omj.2011.38. PMC 3191684. PMID 22043406.
  29. ^ "Importance of vaccines". The Immunization Action Coalition. Retrieved 13 April 2017.
  30. ^ a b "Tobacco use". Healthy People. Office of Disease Prevention and Health Promotion. Retrieved 13 April 2017.
  31. ^ "Physical activity and health". Centers for Disease Control and Prevention. Retrieved 13 April 2017.
  32. ^ CDC (17 September 2020). "Walking: The Physical Activity Guidelines for Americans". Centers for Disease Control and Prevention. Retrieved 7 April 2021.
  33. ^ a b "Why is sleep important". National Heart, Lung, and Blood Institute. Retrieved 13 April 2017.
  34. ^ Dominic Tyer (28 August 2013). "UK preparing self-care portal for patients". PMLive. PMGroup Worldwide Ltd. Retrieved 31 August 2013.
  35. ^ 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.
  36. ^ a b c White, M; Garbez, R; Carroll, M; Brinker, E; Howie-Esquivel, J (2013). "Is "teach-back" associated with knowledge retention and hospital readmission in hospitalized heart failure patients?". Journal of Cardiovascular Nursing. 28 (2): 137–146. doi:10.1097/jcn.0b013e31824987bd. PMID 22580624. S2CID 32944459.
  37. ^ a b Peter, D; Robinson, P; Jordan, M; Lawrence, S; Casey, K.J.; Salas-Lopez, D (2015). "Reducing readmissions using teach-back: Enhancing patient and family education". Journal of Nursing Administration. 45 (1): 35–42. doi:10.1097/NNA.0000000000000155. PMID 25479173. S2CID 22143891.
  38. ^ Kandula, N.R.; Malli, T; Zei, C.P.; Larsen, E; Baker, D.W. (2011). "Literacy and retention of information after a multimedia diabetes education program and teach-back". Journal of Health Communication. 16: 89–202. doi:10.1080/10810730.2011.604382. PMID 21951245. S2CID 25790776.
  39. ^ Judah, G; Gardner, B; Aunger, R (2012). "Forming a flossing habit: An exploratory study of the psychological determinants of habit formation". The British Journal of Health Psychology. 18 (2): 338–353. doi:10.1111/j.2044-8287.2012.02086.x. PMID 22989272.
  40. ^ Matjasko, J.L.; Cawley, J.H.; Baker-Goering, M.M.; Yokum, D.V. (2016). "Applying behavioral economics to public health policy: Illustrative examples and promising directions". American Journal of Preventive Medicine. 50 (5 Suppl 1): S13–9. doi:10.1016/j.amepre.2016.02.007. PMC 4871624. PMID 27102853.
  41. ^ a b Simmons, L.A.; Wolever, R.Q. (2013). "Integrative health coaching and motivational interviewing: Synergistic approaches to behavior change in healthcare". Global Advances in Health and Medicine. 24 (4): 28–35. doi:10.7453/gahmj.2013.037. PMC 3833556. PMID 24416683.
  42. ^ Olson, S (2010). The role of human factors in home health care. National Academies Press.
  43. ^ a b Dickson, V (2011). "A qualitative meta-analysis of heart failure self-care practices among individuals with multiple comorbid conditions". Journal of Cardiac Failure. 17 (5): 413–419. doi:10.1016/j.cardfail.2010.11.011. PMID 21549299.
  44. ^ a b c Chua, Siew-Siang; Ong, Woon May; Ng, Chirk Jenn (15 February 2014). "Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study". Patient Preference and Adherence. 8: 237–46. doi:10.2147/ppa.s57567. PMC 3931581. PMID 24627628.
  45. ^ Woda, A (2015). "Factors influencing self-care behaviors of African Americans with heart failure: A photovoice project". Heart & Lung: The Journal of Acute and Critical Care. 44 (1): 33–38. doi:10.1016/j.hrtlng.2014.09.001. PMID 25444769.
  46. ^ a b Bayliss, E.A.; Steiner, J.F.; Fernald, D.H.; Crane, L.A.; Main, D.S. (2003). "Descriptions of barriers to self-care by persons with comorbid chronic diseases". Annals of Family Medicine. 1 (1): 15–21. doi:10.1370/afm.4. PMC 1466563. PMID 15043175.
  47. ^ Buck, Harleah G.; Dickson, Victoria Vaughan; Fida, Roberta; Riegel, Barbara; d'Agostino, Fabio; Alvaro, Rosaria; Vellone, Ercole (2015). "Predictors of hospitalization and quality of life in heart failure: A model of comorbidity, self-efficacy and self-care". International Journal of Nursing Studies. 52 (11): 1714–1722. doi:10.1016/j.ijnurstu.2015.06.018. PMID 26234935.
  48. ^ Dickson, Victoria Vaughan; Buck, Harleah; Riegel, Barbara (2013). "Multiple Comorbid Conditions Challenge Heart Failure Self-Care by Decreasing Self-Efficacy". Nursing Research. 62 (1): 2–9. doi:10.1097/NNR.0b013e31827337b3. PMID 23052421. S2CID 6813821.
  49. ^ Dickson, Victoria Vaughan; Buck, Harleah; Riegel, Barbara (2011). "A Qualitative Meta-Analysis of Heart Failure Self-Care Practices Among Individuals with Multiple Comorbid Conditions". Journal of Cardiac Failure. 17 (5): 413–419. doi:10.1016/j.cardfail.2010.11.011. PMID 21549299.
  50. ^ Wilde, Mary H.; Garvin, Suzanne (1 February 2007). "A concept analysis of self-monitoring". Journal of Advanced Nursing. 57 (3): 339–350. doi:10.1111/j.1365-2648.2006.04089.x. ISSN 1365-2648. PMID 17233653.
  51. ^ Gregg, Jennifer A.; Callaghan, Glenn M.; Hayes, Steven C.; Glenn-Lawson, June L. (2007). "Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial". Journal of Consulting and Clinical Psychology. 75 (2): 336–343. doi:10.1037/0022-006x.75.2.336. PMID 17469891. S2CID 11564671.
  52. ^ Bratzke, L (2015). "Self-management priority setting and decision-making in adults with multimorbidity: A narrative review of literature". International Journal of Nursing Studies. 52 (3): 744–55. doi:10.1016/j.ijnurstu.2014.10.010. PMC 4315694. PMID 25468131.
  53. ^ Chen, Aleda M. H.; Yehle, Karen S.; Albert, Nancy M.; Ferraro, Kenneth F.; Mason, Holly L.; Murawski, Matthew M.; Plake, Kimberly S. (1 March 2014). "Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence". Research in Social & Administrative Pharmacy. 10 (2): 378–386. doi:10.1016/j.sapharm.2013.07.001. ISSN 1934-8150. PMC 3923851. PMID 23953756.
  54. ^ Chiauzzi, Emil; Rodarte, Carlos; DasMahapatra, Pronabesh (9 April 2015). "Patient-centered activity monitoring in the self-management of chronic health conditions". BMC Medicine. 13: 77. doi:10.1186/s12916-015-0319-2. ISSN 1741-7015. PMC 4391303. PMID 25889598.
  55. ^ a b c d Lee, KS; Lennie, TA; Dunbar, SB; Pressler, SJ; Heo, S; Song, EK; Biddle, MJ; Moser, DK (2015). "The association between regular symptom monitoring and self-care management in patients with heart failure". Journal of Cardiovascular Nursing. 30 (2): 145–151. doi:10.1097/JCN.0000000000000128. PMC 4098015. PMID 24434828.
  56. ^ "30 Day Self Care Challenge". 4 March 2021.
  57. ^ Kaptein, AA; Fischer, MJ; Scharloo, M (2014). "Self-management in patients with COPD: theoretical context, content, outcomes, and integration into clinical car". International Journal of Chronic Obstructive Pulmonary Disease. 9: 907–917. doi:10.2147/COPD.S49622. PMC 4159069. PMID 25214777.
  58. ^ DeVoe, J.E; Baaez, A; Angier, H; Krois, L; Edlund, C; Carney, P.A (2007). "Insurance + access ≠ health care: typology of barriers to health care access to low-income families". Annals of Family Medicine. 5 (6): 511–518. doi:10.1370/afm.748. PMC 2094032. PMID 18025488.
  59. ^ Parikh, P.B.; et al. (2014). "The impact of financial barriers on access to care, quality of care and vascular morbidity among patients with diabetes and coronary heart disease". Journal of General Internal Medicine. 29 (1): 76–81. doi:10.1007/s11606-013-2635-6. PMC 3889957. PMID 24078406.
  60. ^ Cramm, J.M; Nieboer, A.P (2012). "Self-management abilities, physical health and depressive symptoms among patients with cardiovascular diseases, chronic obstructive pulmonary disease, and diabetes". Patient Education and Counseling. 87 (3): 411–415. doi:10.1016/j.pec.2011.12.006. PMID 22222024.
  61. ^ Lam, C; Smeltzer, S.C (2013). "Patterns of symptom recognition, interpretation, and response in heart failure patients: An integrative review". Journal of Cardiovascular Nursing. 28 (4): 348–359. doi:10.1097/jcn.0b013e3182531cf7. PMID 22580629. S2CID 24560362.
  62. ^ Lee, Solim; Riegel, Barbara (2018). "State of the Science in Heart Failure Symptom Perception Research". Journal of Cardiovascular Nursing. 33 (3): 204–210. doi:10.1097/JCN.0000000000000445. PMID 28858886. S2CID 4764672.
  63. ^ Jurgens, C. Y.; Hoke, L.; Byrnes, J.; Riegel, B. (2009). "Why do elders delay responding to heart failure symptoms?". Nursing Research. 58 (4): 274–282. doi:10.1097/NNR.0b013e3181ac1581. PMID 19609179.
  64. ^ a b Wallace, A.S; Carlson, J.R; Malone, R.M; Joyner, J; DeWalt, D.A (2010). "The influence of literacy on patient-reported experiences of diabetes self-management support". Nursing Research. 59 (5): 356–363. doi:10.1097/nnr.0b013e3181ef3025. PMC 2946184. PMID 20808193.
  65. ^ a b Bayliss, E.A; Steiner, J.F; Fernald, D.H; Crane, L.A; Main, D.S (2003). "Descriptions of barriers to self-care by persons with comorbid chronic diseases". Annals of Family Medicine. 1 (1): 15–21. doi:10.1370/afm.4. PMC 1466563. PMID 15043175.
  66. ^ Pollack, A. N. (2017). Community health paramedicine. Jones & Bartlett Learning. Retrieved from:
  67. ^ a b c (aafa, n.d.)
  68. ^ (Lung Foundation, n.d.)
  69. ^ Bennett, H. D.; Coleman, E. A.; Parry, C.; Bodenheimer, T.; Chen, E. H. (2010). "Health coaching for patients with chronic illness". Family Practice Management. 17 (5): 24–29. PMID 21121566.
  70. ^ Dickson, Victoria Vaughan; Riegel, Barbara (May 2009). "Are we teaching what patients need to know? Building skills in heart failure self-care". Heart & Lung: The Journal of Acute and Critical Care. 38 (3): 253–261. doi:10.1016/j.hrtlng.2008.12.001. PMID 19486796.
  71. ^ "Seeking Curiosity: How Embracing Uncertainty Strengthens Empathy". 11 July 2017. Retrieved 20 December 2017.
  72. ^ Health in Everyday Living Archived 22 May 2016 at the Portuguese Web Archive Robert Wood Johnson Foundation primer
  73. ^ "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。". Retrieved 20 December 2017.
  74. ^ "Website of the Foundation for Assistive Technology". Retrieved 20 December 2017.
  75. ^ 18.Foucault M: Technologies of the Self. Amherst: University of Massachusetts Press; 1988. As cited by: Thomas J. Papadimos; Joanna E. Manos, Stuart J. Murray (2013). "An extrapolation of Foucault's Technologies of the Self to effect positive transformation in the intensivist as teacher and mentor". Philosophy, Ethics, and Humanities in Medicine. 8 (7): 7. doi:10.1186/1747-5341-8-7. PMC 3717278. PMID 23866101.
  76. ^ M. Foucault: The Hermeneutics of the Subject: Lectures at the College de France 1981–1982
  77. ^ Meltzer, Marisa (10 December 2016). "Soak, Steam, Spritz: It's All Self-Care". The New York Times.
  78. ^ Radical self-care : Performance, activism, and queer people of color (Thesis). May 2014.
  79. ^ Kollack, Ingrid (2006). "The Concept of Self Care". In Kim, Hesook Suzie; Kollak, Ingrid (eds.). Nursing Theories: Conceptual and Philosophical Foundations. Springer Publishing Company. p. 45. ISBN 978-0-8261-4006-7. Retrieved 31 August 2013.
  80. ^ Laurin, Jacqualine (1994). "Commentary". In Kikuchi, June F.; Simmons, Helen (eds.). Developing a Philosophy of Nursing. Sage. p. 27. ISBN 978-0-8039-5423-6. Retrieved 31 August 2013.

External links[edit]