Concept of Self-Care Analysis - Research Paper Example

? The Concept of Self Care The Concept of Self care Introduction Self care is an important concept that is frequently used both in nursing theory clinical practice. According to WHO (2003), self care is defined as any activity that individuals can do for themselves to enhance their health, manage symptoms and prevent or deal with illness. Consequently, self care is a broader concept that covers hygiene, nutrition, and physical exercise and life style changes without the assistance of health care professionals. The individuals undertaking self care should however be well informed by the technical skills and knowledge derived from professional medical experience. The theoretical basis of self care as a nursing concept is based on a number of theories that particularly attempt to explain behavior changes associated with self care practices and why some individuals do or do not undertake some of the self care activities. According to Orem’s conceptual theory of self care, individuals have a strong need to achieve maximum level of independence and take care of themselves. On the other hand, the self regulation model of self care developed Leventhal and Robitaille (1998) argues that the individuals’ differences and motivations is a critical factor that determines their ability to initiate and sustain self care practices. This paper critically analyzes the concept of self care with particular focus to the insights, validity and reliability of the contributions of different authors to the development of the concept. Aims of the analysis The primary aim of this concept analysis is to provide an important insight and critical review of the concept of self care using the methodology of (Walker and Avant, 2010). The other important purpose of this critique is to provide an integrated discussion of the importance of self care in nursing practice using the diverse view points and empirical scientific arguments from different authors. Lastly, the findings of this concept analysis will be important in the future scientific studies regarding the varying abilities of individuals to initiate and sustain self care related behaviors. Literature review on the concept of self care and its uses There is considerable variation in the documented theories and conclusions supporting the concept of self care as an important nursing practice. Generally most researchers have based their arguments on the current existing theories of behavior change in their attempt to develop and explain the themes and concept of self care. In their theory of self regulation model of self care, Leventhal and Robitaille (1998) suggests that differences in motivations is one of the primary factors influencing the ability of individuals to initiate and sustain self care related behaviors. The two authors further developed an empirical model that illustrated the interactions between an individual’s reality and his /her emotional reactions. Gantz (1990) also concur that it is through such reactions that the procedures and actions plans for managing symptoms of illnesses and health problems can be generated. On the other hand, Orem (2001), proposed a theory that attempted to explain the concept of self care based on the nature of care environments where nursing interventions are undertaken. According to many authors, self care is one of the most important complements to professional health care that is usually given to persons with chronic illnesses and other health related problems. According to Norburn and Ory (1995), self care behavior is a broader concept that goes beyond simply following the doctor’s advice and incorporates patients learning and using their previous experience to help them restore their health. The potential benefits of self care as a nursing practice include reduced health care costs, enhanced working relationship between patients and health care providers, increased patient experience as well as the overall improvement of the patients perception of his/her own health condition (WHO, 2003).There is however little research on the correlation between self care behaviors and improved physiological outcomes. Defining attributes There are a number of defining contributes for the various uses of the concept of self care such as in personal health practices, consultation and decision making, coping skills as well as using an individuals own resources to manage health related problems. One of the most important defining attributes that currently characterizes the concept of self care is that self care is both situation and culture specific. For example Orem (1991) argues that an individual capacity to initiate and sustain care is dependent on the external environmental factors such as their cultural beliefs and their individual experiences. Another important defining attribute of the concept of self care is that it involves enhancing the capacity of patients and individual’s to act and make choices regarding their health. This is particularly attributed to the current technological advancements which have increasingly resulted in depersonalized healthcare. In the context, the concept of self care is regarded as an important tool for empowering individuals to be able to participate actively in improving and fostering their health as well as shaping the conditions that plays an important role in their own health (Gantz, 1990). The other significant defining attribute of self care concept is that the concept is primarily influenced by values, skills, motivations and confidence of the individuals. Lastly, as opposed to other nursing concepts that are governed by legislations and social policies, self care concept largely focuses only on the health care aspects under individual control. Model cases One of the nursing model cases that best exemplifies the concept of self care is the case of a 27 year old breast cancer patient known as Angeline. Although her condition is quite debilitating, she admits that she is able to follow her treatment plans, attends regular checks and performs her daily tasks. The primary theme of this self care model case is that people tend to require only when their care needs exceed their personal ability to meet such needs (self care deficit). Consequently using this self care model involves assessing the patient’s level of ability to deal with their problems and finally providing them with the necessary support and guidance to help them deal with their health related issues (Orem, 2001). Another model case that attempts to illustrate the concept of self care is the hypothetical case of John, a 20 year old college student who was recently diagnosed with Diabetes type 1. During an interview John admits that he is intending to become more independent and fully responsible for his condition once he finishes college and get a job. According to this hypothetical model case, an individual’s self care behavior often takes place within the context of family resources as well as their individual coping strategies (Aggleton and Chalmers, 2000). Currently, family health nursing model is primarily being used in rural or remote regions. Alternative cases involve a situation where the concept of self care does not include any of the defining attributes of the concept. In this regard, the adjustment of self care behaviors is dependent on the assistance from other people. For example, Tim, who is of the same age as John is also suffering from Diabetes. Tim follows exactly his parent’s advice regarding his daily activities, when to go for checks as well as the kind of activities he should not be involved in. This alternative case exemplifies a case whereby an individual’s ability to initiate and sustain self care behaviors does not involve all the attributes of self care (Gantz, 1990). Lastly, another potential alternative model case is the development of self care behaviors through education. For example, as a student, James has learnt the importance of self care. Consequently when he recently heard a minor accident, James is able to perform his first aid based on the skills that he learnt in school. This is an example of a related case where not all the attributes related to the concept of self care are evident. Antecedents and consequences of the concept of self care Based on this self care concept analysis, the first antecedent that influences an individual’s ability to assume responsibility for self care is the existence of health problems and the treatment regimen given to such individuals. Norburn and Ory (1995) suggests that such conditions often challenge individual’s independence while at the same time increasing their dependence on other people. The next category of antecedents for self care is related to the expectations for responsibility that is often held by patients as well as societal expectations. For example, in some societies, it is a norm for adult individuals to take responsibility of their own health. On the other hand, the consequences of incorporating the concept of self care in nursing practice include better disease and health management, improved psychosocial quality of life. These consequences are particularly attributed to the fact the positive correlation between self care behaviors and physiological outcomes. Empirical Referents There are a number of methods and measures that can be used to measure the attributes of the concept of self care. One of the empirical referents that is commonly used to demonstrate the existence of the concept of self care is Patient self care questionnaire. According to Aggleton and Chalmers (2000), this empirical referent involves the use of patient care task questions that reflect on who performs rather than who makes decisions regarding the daily care tasks. On the other hand, self care responsibility scale can also be used measure both the decision making and self care behaviors for the daily care tasks given to patients. In this regard, the scores can be used to rate the degree of an individual’s independence. Conclusion In conclusion, this concept analysis provides an important insight for health care givers as well as patients on the benefits and challenges of self care. Generally self care behaviors not only improve the quality of life of the patients but also help in the reduction of pain and depression. Health care practitioners should therefore encourage and support patients to develop self care behaviors to enable them effectively participate in their own care and treatment plans. References Aggleton, P., Chalmers, H. (2000). Nursing Models and Nursing Practice.2nd edition. New York: Palgrave. Gantz, S. (1990). Self-Care: Perspectives from Six Disciplines. Holistic Nursing Practice 4, 2, 1-12. Leventhal, E., Robitaille, C. (1998). Enhancing Self Care Research: Exploring the Theoretical Underpinnings of Self Care. New York: Springer. Norburn, J., Ory, M. (1995). Self-Care Assistance from Others in Coping with Functional Status Limitations among a Sample of Older Adults. Journal of Gerontology, 50, 101-109. Orem, D. (2001). Nursing: Concepts of Practice. 6thedition. London: Mosby publishers Walker, L., Avant, K. (2010). Strategies for theory construction in nursing. Boston: Pearson publishers. World Health Organization. (2003). Health Education in Self-care: Possibilities and Limitations. Geneva: WHO Press. Read More