Abstract
Background and objectiveThe number of studies in the area of self-care is growing and international researchers are increasingly developing self-care interventions to improve outcomes of individual patients and communities. However, growth of the evidence is still slow due to challenges with designing and testing self-care interventions. In this article we address major methodological challenges with regard to the definition of self-care, use of theory, and research design, intended to provide guidance to researchers in this field. MethodDuring the inaugural conference of the International Center for Self-Care Research held in Rome, Italy in June 2019 we identified important issues in existing self-care research. Discussion and literature review lead to eight recommendation for future self-care research. ResultsIn preparation, begin with a theoretically sound definition of self-care. In planning the intervention, build on and extend previous studies. Use theory to develop self-care interventions and consider translational models to guide development, evaluation and implementation of complex self-care interventions. Employ a study design that fits the current phase and objectives of the research and measure self-care and related factors carefully. In reporting, describe the sample and setting sufficiently so that others can draw conclusions about generalizability and applicability to their practice and patient population. In interpretation, describe how the intervention is assumed to work (causal assumptions) and its key components. ConclusionOur review of existing self-care research clearly illustrates that the recommendations we provide are needed if we are to substantially grow the evidence base supporting self-care. Embracing a core set of principles will allow us to build on each other's work.Tweetable abstract: A core set of methodological principles is needed to substantially grow the evidence base supporting self-care.
Highlights
There is increasing interest in self-care research and in improving knowledge about the different aspects of self-care (Riegel et al, 2019; Riegel and Jaarsma, 2019)
We identified six specific knowledge gaps to address in future self-care research: the influence of habit formation on behavior change, resilience in the face of stressful life events that interfere with self-care, the effect of culture on self-care decision-making, the difficulty performing self-care for individuals with multiple chronic conditions or severe mental illness, and the influence of others on self-care
The investigators advocated that we focus on the benefits of theory as providing a framework for the design, evaluation, and optimization of interventions, providing a common language for communication, allowing for accumulation of evidence over time, and facilitating predictions in uncertain or new contexts (Michie and Prestwich, 2010; Dalgetty et al, 2019; Prestwich et al, 2014)
Summary
There is increasing interest in self-care research and in improving knowledge about the different aspects of self-care (Riegel et al, 2019; Riegel and Jaarsma, 2019). We identified six specific knowledge gaps to address in future self-care research: the influence of habit formation on behavior change, resilience in the face of stressful life events that interfere with self-care, the effect of culture on self-care decision-making, the difficulty performing self-care for individuals with multiple chronic conditions or severe mental illness, and the influence of others (care partners, family, peer supporters, healthcare professionals) on self-care. To adequately address these knowledge gaps, researchers are challenged to improve the quality of research addressing selfcare and to build on previous work. They give due consideration to the roles of theories and concepts, contexts and samples, interventions, research designs, and measurements of self-care and related factors
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