There is growing recognition and understanding of the importance of the need for people with chronic conditions to take charge of their own health and to actively participate in self-care . 9 Self-care has an essential role as people are becoming increasingly aware of prioritising their health and wellbeing and want to have a greater role in taking care of themselves and improving their health and wellbeing . 10 Individuals perform self-care alone ( independent self-care ) or with support and assistance from their family and / or health professionals . 10 Self-care has the potential to bring advantages to individuals , healthcare systems , and society at large . 52 It not only offers a chance to alleviate the strain and dependency on overwhelmed healthcare systems , 10 , 52 but also gives patients and consumers the ability to take control of their own wellbeing and effectively handle their health conditions , leading to improved health outcomes and overall quality of life . 52 Therefore , self-care is essential for maintaining wellbeing both in times of health and in times of illness 3 and is a lifestyle choice , rather than simply an item on a to-do list or seen as a task or obligation . 15
Self-care is important at all stages of life and health status 3 and is necessary and essential for improving quality of life , 2 , 4-8 restoring and improving health and wellbeing , 2 , 3 , 5 , 7 , 9 , 10 maintenance of health , 2 , 6 , 7 , 12 , 51 , 53 minimising disease complications 2 , 6 , 7 and disease-related conditions , 5 , 15 prevention of disease , 3 prevention and management of chronic diseases , 10 , 13 , 51 along with improving treatment compliance . 7 The positive effects of self-care also encompass decreased morbidity , 8 , 9 decreased hospitalisations , 2 , 3 , 8 reduced mortality , 2 , 3 , 8 , 9 and lower healthcare expenses . 2 , 3 , 7 , 9
Self-care has the potential to significantly alleviate financial burdens on the healthcare system by transferring the responsibility of managing certain conditions from health professionals to patients , thus improving overall healthcare results . 52 Therefore , it is imperative that the healthcare system prioritises the teaching and encouragement of self‐care practices . 51 Implementing self-care strategies can boost patients ’ self-assurance by enhancing their abilities and enabling them to manage specific conditions independently rather than frequently depending on a health professional . 52 Additionally , implementing self-care practices to lower healthcare expenses related to minor ailments has the potential to benefit individuals with chronic and serious health issues by freeing up resources and reallocating them effectively . 54 However , in the case of certain medical conditions , a coordinated care approach involving initial diagnosis and treatment planning by a health professional is the most suitable , especially if symptoms persist or symptom severity increases . 52 A deeper understanding and comprehension of the intricacies of self-care decisionmaking will assist health professionals to effectively educate their patients in selfcare practices , as well as in identifying the shortcomings and limitations of self-care and devising strategies for the enhancement of self-care . 51 It is essential for health professionals to have a comprehensive understanding of the self‐care status of their patients in order to deliver tailored and effective services . 2
Confidence in self-care plays a crucial role in influencing the overall self-care journey . 2 Research demonstrates that an increase in the level of self-care performance has been linked to an improvement in the patient ’ s ability to be active . In contrast , a decrease in self-care performance has been associated with the occurrence of complications . 2 , 5 Efforts to enhance self-care confidence directly influence both self-care maintenance and selfcare management . Conversely , the presence of comorbidities diminishes self-efficacy , subsequently leading to a decrease in self-care behaviours . 2 Health professionals must understand that self-care involves acquiring knowledge and practical skills . It is essential for them to tailor their approach to help patients develop their self-care habits , focusing on the process rather than just the content . Additionally , it is beneficial to establish a supportive environment where patients can openly communicate about their self-care endeavours . 2
Prioritising self-care is essential for optimal health and wellbeing . Selfcare should not be seen as the enemy of performance . Sacrificing and neglecting self-care can have detrimental effects on health and wellbeing . 55 Self-care is not selfish .
Factors and barriers affecting self-care
It is crucial to recognise , acknowledge , and understand that a variety of factors , barriers , and challenges ( both modifiable and unmodifiable ) have a substantial impact on the development of an individual ’ s self-care routines . 3 The presence of multiple chronic health conditions , 11 depression , 1 , 4 , 11-14 anxiety , 1 , 4 distress , 1 , 11 , 14 loneliness , 1 fear of the future , 1 reduced physical capacity , 1 fatalism and fatalistic thinking ( interpreting symptoms as fate ), 5 , 6 low health literacy , 1 , 15 , 52 level of knowledge and awareness about one ’ s health condition , 1 , 4 , 14 , 52 , 54 conflicting health information , 1 collectivism , 6 cultural beliefs and influences , 1 , 5 , 6 faith and religion , 5 , 13 empowerment , 13 emotional support , 5 absence of family support , 1 , 4 , 8 , 14 support groups , 4 lack of social support , 1 , 4-6 , 13-15 independence and autonomy , 1 social norms , 5 , 6 habits , 5 low confidence , 2 , 5 low motivation , 5 selfefficacy , 14 previous self-care experiences , 1 education level , 7 , 13-15 employment status , 13 economic status 1 , 13-15 and economic burden , 7 , 15 and the concurrent use of multiple medications ( polypharmacy ) 11 create opportunities , challenges and barriers for individuals in managing their health , 11 thereby affecting self-care . Poor cognitive function and memory impair the ability to perform many self-care tasks . 1 , 11 , 13 Older individuals exhibit suboptimal levels of self-care when it comes to symptom management , facing challenges in maintaining regular and
146 | vol30 | no3 | JATMS