Concept Of Self-care Research Articles

‘Self-care without a self’: Alzheimer’s disease and the concept of personal responsibility for health

The article focuses on the impact of the concept of self-care on persons who are understood as incapable of self-care due to their physical and/or mental 'incapacity'. The article challenges the idea of this health care concept as empowerment and highlights the difficulties for persons who do not fit into this concept. To exemplify this, the self-care concept is discussed with regard to persons with Alzheimer's disease (AD). In the case of persons with AD, self-care is interpreted in many different ways-depending on the point of view, for instance as an affected person or a carer. To prevent a marginalisation of the growing group of elderly persons with dementia, the article argues that concepts such as those of personhood, wellbeing, autonomy, rationality and normality have to be re-thought with regard to an increasingly ageing population. Taking into account that AD as a socio-medical construct has to be understood in the context of power relations, the article focuses on the mutual influence between the concepts of self-care and of AD and its possible impact on governing dementia and AD in particular. Michel Foucault's considerations on 'technologies of the self' provide the basis for the discussion of the self-care concept within existing societal power relations.

Montaigne and the Ethics of Skepticism

This book tackles with enjoyable verve and originality questions that continue to occupy Montaigne scholarship: subjectivity, rhetoric, scepticism and ethics. Zalloua's approach is stimulating, and carefully hybrid, drawing on modern critical theory from Foucault to Levinas, and on Renaissance and classical discourses on charity, exemplarity and care of the self. His close attention to this last Hellenic notion supplies the book's most significant contributions: reading Montaigne through Socratic, Platonic and Stoic concepts of self-care and self-knowledge, Zalloua provides a refreshing approach to the Essais. The choice of focus will, of course, be familiar to readers of Montaigne: the emblematic ‘others’ that the book considers are Socrates, La Boétie, and the cannibal, and Zalloua situates his work carefully within the vast scholarship that has grown up around these questions. He successfully adds nuance to the inevitable received critical opinions such as the exclusively literary status of Montaigne and La Boétie's friendship and Montaigne's lack of interest in any other alterity than that he finds within himself. These questions are usefully placed within their historical context in addition to their intellectual and literary background, following the historical turn of recent Montaigne criticism. In his conclusion Zalloua returns to the vexed issue of Montaigne's commitment to politics and behaviour during his mayoralty, arguing that the moderation which Montaigne champions, and which can also be seen in the writing practice of the essayist, constitutes a bridge between his public and private selves; a model for political action therefore seems embedded in the form of the essay. Zalloua argues that it is Montaigne's insistence on the open formula of ‘Que sais-je?’ that renders the Essais more complex and self-critical in their descriptions and relations of the other than the humanist, eurocentric position that Montaigne has occasionally been accused of. Paying close attention to the manner (rhetorical, essayistic, provisional) as well as the matter (the description of the other) of Montaigne's text provides another way in to the discussion of the implementation of sceptical method in the essay form. This approach offers a rich reading of the chosen essays which deftly navigates between intra- and intertextual references. Certain key concepts return as leitmotifs in the study: charity, friendship, good faith and the notion of the ‘esprit genereux’ are all pulled together at the end in a satisfying way that imitates the oblique counterpoint of the essay form. Zalloua argues that it is precisely this essay form that supplies the interpellative function and the ethical force of the questions Montaigne seeks to ask his reader. Drawing on the work of André Tournon, Gisèle Mathieu-Castellani and recent American critics of Montaigne such as Timothy Hampton and David Quint (but not on Emmanuel Naya's groundbreaking work on Renaissance scepticism), Zalloua nevertheless offers stimulating readings that encourage the reader to approach Montaigne's ethical concerns differently and with fresh enthusiasm.

Community matrons: promoting self management (part four)

This is the fourth of six articles which draw on the content of a series of masterclasses organised and funded by the Department of Health for community matrons during summer 2006. It draws on input to the community matrons masterclasses from Keith Strahan and Alf Collins. It opens by reviewing the concepts of self care and self management. The significance of understnading patients' and their carers' health beliefs in person-centred care planning is then highlighted. The importance of capitalising on readiness to change the role of motivational interviewing in successful behaviour change is then presented. Finally, the consequent issues for professionals and services in terms of managing risk are discussed.

Santa pecadora ou execrada santa? O autocuidado em mulheres soropositivas para HIV

Esta pesquisa foi realizada com mulheres portadoras de HIV/Aids, integrantes de uma ONG no Distrito Federal, com o objetivo de conhecer seu processo de adesão ao autocuidado. Teve como objetivos investigar a relação entre o autocuidado e a sua auto-estima e auto-imagem, e como o conceito de autocuidado se relaciona com as suas vivências com o parceiro e com seus familiares. Problema: construção de significados sobre autocuidado por mulheres soropositivas para HIV. Instrumento: entrevista de grupo focal. As construções de sentido foram: histórias de descuido; eu até me cuido, se for para outra pessoa...; desqualificando-se para se relacionar! e profissionais como facilitadoras ou não de sua inclusão social. Os resultados caminharam no sentido de se perceber que a subjetividade dessas mulheres permanece sem alternativa de reedição e, portanto, atrelada à identidade de pecadora por ter o HIV e de santa por sofrer apartada para que os outros não se contaminem.

A concept analysis of self‐monitoring

This paper reports a concept analysis delineating and clarifying the concept of self-monitoring to facilitate development and evaluation of interventions to enhance self-monitoring. The concepts of self-monitoring, self-management, self-care and symptom management are often used in similar or interchangeable ways. Clarification of the concept of self-monitoring is needed for research and theory development. Rodgers and Knafl's evolutionary concept analysis process was used to delineate and clarify the concept. The PubMed and CINAHL databases were searched using keywords 'self-monitoring', 'self-management' and 'self-care' (with and without the hyphen) for the years 1998-2005, to update a previous study (not published). Later, searching was refined and the keyword 'self-monitoring' was paired with 'awareness' and 'self-regulation' was added. Approximately half the papers were from nursing (n = 34) and half from other disciplines (n = 32). The sample from 1998 to 2005 was further stratified by chronic condition. Definition, exemplars, usage, attributes, antecedents/consequences and implications for further study were identified. Self-monitoring was composed of two complementary components (attributes): (1) awareness of bodily symptoms, sensations, daily activities, and cognitive processes and (2) measurements, recordings and observations that inform cognition or provide information for independent action or consultation with care providers. Self-monitoring may be an important concept for understanding how people self-manage chronic conditions. This concept analysis may be useful for researchers who wish to measure this dimension and to develop nursing theory in this area.

The Effect of Self-care on the Renal Transplantation Outcomes

本文从自我护理的概念、病人的基本管理、社会支持、种族/肾移植生存率、社会经济地位、病人的爱好和信念与自我护理实施及对肾移植转归的影响等多方面进行了评述,并针对自我护理存在的问题提出了相应的建议,希望肾移植患者能在公平的前提下得到合理治疗与自我护理方面的支持。

Epidemic of Obesity in African American Communities and the Need for a Culturally Sensitive After School Childhood Obesity Prevention Program

An after-school obesity prevention program for African American children is proposed in this paper. The prevention program is a behavioral education program designed to facilitate healthy behavior changes in obesity self-care and provide culturally sensitive interventions specifically for obese African American children. The self-care concepts addressed involve: knowledge of obesity, exercise, and nutrition. The culturally sensitive interventions address the problems of low self-esteem, communication, and ineffective family coping. The implementation of the after-school obesity program included four phases: needs assessment, planning and goal setting, implementation, and monitoring for progress. This afterschool education program is designed to promote self-care, family support, and improve the quality of life for obese African American children.

Media Literacy: A Critical Role for Dietetic Practice

The mass media, including broadcast, electronic, and print media, have become entrenched in Canadians' daily lives. Spending the majority of their leisure time with mass media puts Canadians at increased health risk. Our review of the research literature shows that television (TV) viewing and content are linked to potential consumer health risks due to developed health attitudes, beliefs, and behaviours. The associated health risks of children and youth are of particular concern. Excessive TV viewing has been associated with obesity development, increased energy consumption, reduced energy expenditure, negative body image development, and reduced concern with the concept of self-care. Media literacy, the ability to view critically and understand mediated messages, is a possible technique to mitigate these adverse effects. The enhanced inclusion of media literacy concepts in health education activities of dietetic practice is advocated. Dietitians could increase their understanding of research findings on the health-related effects of mass media use and the implications of including media literacy in daily practice. Such awareness would further augment available health promotion strategies.

Health promotion through self-care and community participation: elements of a proposed programme in the developing countries.

BackgroundThe concepts of health promotion, self-care and community participation emerged during 1970s, primarily out of concerns about the limitation of professional health system. Since then there have been rapid growth in these areas in the developed world, and there is evidence of effectiveness of such interventions. These areas are still in infancy in the developing countries. There is a window of opportunity for promoting self care and community participation for health promotion.DiscussionA broad outline is proposed for designing a health promotion programme in developing countries, following key strategies of the Ottawa Charter for health promotion and principles of self care and community participation. Supportive policies may be framed. Self care clearinghouses may be set up at provincial level to co-ordinate the programme activities in consultation with district and national teams. Self care may be promoted in the schools and workplaces. For developing personal skills of individuals, self care information, generated through a participatory process, may be disseminated using a wide range of print and audio-visual tools and information technology based tools. One such potential tool may be a personally held self care manual and health record, to be designed jointly by the community and professionals. Its first part may contain basic self care information and the second part may contain outlines of different personally-held health records to be used to record important health and disease related events of an individual. Periodic monitoring and evaluation of the programme may be done.Studies from different parts of the world indicate the effectiveness and cost-effectiveness of self care interventions. The proposed outline has potential for health promotion and cost reduction of health services in the developing countries, and may be adapted in different situations.SummarySelf care, community participation and health promotion are emerging but dominant areas in the developed countries. Elements of a programme for health promotion in the developing countries following key principles of self care and community participation are proposed. Demonstration programmes may be initiated to assess the feasibility and effectiveness of this programme before large scale implementation.

Self-Care in Elders with Dementia: A Concept Analysis

The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia. The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care. Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs. Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.

An examination of the self-care concept uncovers a new direction for healthcare reform.

The concept of self-care is multidimensional, with many defining elements. This paper describes the origin of this comprehensive concept. It examines the response of the nursing discipline to citizen self-care initiatives and the subsequent effects this response has had on the development of nursing knowledge. The evolution of self-care as a core concept within Canadian health policy is presented; the potential readiness fo citizens to accept self-care as an aspect of healthcare delivery is explored, identifying potential benefits and obstacles. The paper concludes with a proposed self-care approach to healthcare reform in Canada and the subsequent influence this approach may have on the discipline of nursing. The congruency between a self-care healthcare delivery system and the theoretical foundations and perspective of healthcare delivery held by the nursing discipline is discussed. The role nurses might assume in shaping a self-care healthcare delivery system is delineated.

Adequate self-care of dialysed patients: a review of the literature

The purpose of this article is to clarify the concept: ‘adequate self-care of patients treated with hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD)’. This was done by the specification of Orem's general definition of self-care and a review of the literature. Adequate self-care behaviours for preventing and regulating pathological processes and related disabilities e.g. following dialysis and medication prescriptions as well as diet and fluid regimens are well documented. Adequate self-care behaviours aimed to promote personal well-being or development are less well documented. The authors suggest that use of the concept of adequate self-care would enlarge the scope of the disease management of HD and CAPD patients. Further research should focus on systematically investigating self-care activities of dialysed patients and their contribution to health and quality of life outcomes.

Conceptual analysis of self-care agency

The concept of self- care agency was developed by Orem (1980) as a component of Self-Care Defi cit Nursing Theory (SCD-NT). Since its development, self-care agency concept has been applied widely in the discipline of nursing to determine the relationship between self-care agency and other concepts of the Orem SCDNT in various populations. In this paper, the author analyzes the concept of self-care agency using Wilson’s Conceptual Analysis Method as modifi ed by Walker & Avant (1995). In particular, the use of the self-care agency concept is considered as it relates to conditioning factors, self-care actions, and specifi c outcomes in nursing research and practice. Descriptors: Self care.

The Index of ADOH: concept of measuring oral self‐care functioning in the elderly

Measures of ability, or function, are used in the health field to determine the level of performance of a specific task, assess the loss of function, and to measure the return to function as a result of rehabilitation or interventions. While these measures are important to all age groups, it is the elderly and chronically ill who are at most risk for adverse changes in their health and functional status. The Index of the Activities of Daily Oral Hygiene (ADOH) is an instrument to assess and monitor functional dependency in manipulating aids used in oral self-care. It is part of the overall concept of oral self-care which subsumes function, education and training, and compliance in achieving and maintaining oral health. The purpose of the Index of ADOH is two-fold: to assess a subject for the progressive loss of the physical ability to manipulate the aids used in oral self-care, and to measure the return to function in response to care intervention and rehabilitative services. These manipulative tasks are associated with flossing, brushing, topical fluoride application, and the use of oral rinses. Aside from changes in function, the Index of ADOH can be used by health care providers and administrators to project the need for services or support for home care.

Self-care Activity as a Structure: A Phenomenological Approach

Self-care activity is traditionally viewed as a goal directed activity with the aim to maintain, restore or improve health and well-being. However, it should be possible to situate the phenomenon of self-care within an alternative paradigm and get a new understanding of it in terms of phenomenological knowledge. The purpose of this article was to analyse the notion of self-care activity and elaborate it within a phenomenological frame of reference based on the philosophy of Merleau-Ponty. Using arguments from analytical philosophy, especially action theory, and Orem's self-care deficit theory, some self-care related concepts have first been elucidated. In order to get another understanding of self-care activity, certain parts of the writings of Merleau-Ponty were then applied to the phenomenon. It was stated that there is a dialectical relation between self-care ability as potentiality for self-care activity and self-care activity itself. Both may be regarded as structures given only to perception. Self-care ability is not in-itself a necessary means to maintain, restore or improve health and well-being but rather the potentiality for self-care activity as an integral part of the lived body. The actualization of the ability for self-care may possibly come about through a certain meaning.

Key concepts of self-care in the home: implications for home care nurses.

Key concepts of self-care in the home: implications for home care nurses.

Achievement of appropriate self-care. Does care delivery system make a difference?

The purpose of this article is to review the evidence linking variations in care delivery system with achievement of appropriate self-care. This synthetic review of the research literature used the Outcomes Model for Health Care Research. The concept of self-care was reviewed from several theoretical perspectives, as was the quality of instruments used to measure aspects of self-care. Finally, studies examining the linkage between care delivery system and self-care were critically analyzed. Reliable and valid instruments exist to measure self-care agency and self-care performance, and these data elements are collected routinely in many care settings. Only a few studies, however, have examined the relation between achievement of self-care and variations in delivery systems. Achievement of appropriate self-care may be an outcome measure better suited to nonacute care settings or across the continuum of care. Additionally, work is needed in applying risk-adjustment strategies to the measurement of achievement of appropriate self-care.

Health related behavior in health promotion: utilizing the concept of self care

SUMMARY The concepts of health promotion and self care have common origins. Both represent new thinking about the. roles of the professional and lay sectors in health protection. The two concepts developed quite differently however. The concept of self care did not attain the same level of legitimacy and stability as health promotion, which has evolved from an alternative approach to the dominance of traditional disease prevention into a rapidly developing health field The emergence of the concept of self care and the reasons for its relative lack of acceptance are discussed It is concluded that the concept of self care is logically allied with the field of health promotion and serves an important function in optimizing health related behavior.

Defining the concept of self-care.

Self-care is a concept frequently referred to in both the theory and the clinical practice of nursing. This article presents an overview of self-care theory as described by Henderson, Hall, and Orem. Self-care theory operates on the assumption that all individuals have a need to care for themselves. While this premise may be true, it poses difficult questions for the nurse who must intervene with patients who refuse to achieve their maximum level of independence. When a disease process occurs that alters self-image, some patients (particularly elderly females who have cared for others most of their adult lives) may consciously opt to become the ones cared for. This choice gives them a temporary sense of control over a situation in which they feel helpless. When nursing care is directed toward returning control of the situation to the patient, the process of self-care and healing can begin.

Using Orem's model in psychiatric nursing.

While Orem's model has not been extensively applied to psychiatric nursing, there is some evidence (1, 2) of its use in psychiatric hospital settings in the UK. Anticipating that the concept of self-care may well become more readily incorporated into our changing health care system, this article sets out to examine some key aspects which psychiatric nurses may need to take into account when considering the use of the model in practice.