A Middle-Range Theory of Self-Care of Chronic Illness

Abstract

Nearly 50% of adults have one or more chronic illnesses. Self-care is considered essential in the management of chronic illness, but the elements of self-care in this context have not been specified in a middle-range theory. This article describes a middle-range theory of self-care that addresses the process of maintaining health with health promoting practices within the context of the management required of a chronic illness. The key concepts include self-care maintenance, self-care monitoring, and self-care management. Assumptions and propositions of the theory are specified. Factors influencing self-care including experience, skill, motivation, culture, confidence, habits, functional and cognition and support from others, and access to care are described.

The European Heart Failure Self-care Behaviour Scale: New insights into factorial structure, reliability, precision and scoring procedure

“…weighing every day or exercising) and an adherence based on the provider's "prescription" (e.g., taking medicines). These findings reinforce prior theoretical orientation which states that self-care is a broader dimension and not merely the adherence to treatment [23][24][25]. Interestingly, the SCHFI v.6.2 and the EHFScBS-9, that were seen in prior studies as measuring different constructs [26], resulted in a very similar factorial structure in this study.…”

Comparison of self-care behaviors of heart failure patients in 15 countries worldwide

“…Self-care is a process of maintaining health through health promoting practices, symptom monitoring and managing symptoms when they occur [2]. HF specific self-care includes activities aimed at self-care maintenance (e.g., taking medication, exercising), symptom monitoring (e.g., monitoring weight changes) and symptom management (e.g., calling a health care provider or taking extra diuretics with symptoms of fluid retention) [2][3][4][5]. Self-care is considered important in the comprehensive management of patients with HF and is the focus of HF management programs internationally.…”

Intervenções não farmacológicas para melhor qualidade de vida na insuficiência cardíaca: revisão integrativa

“…Therefore, individualized education focused on disease self-management improves individuals' QoL (40) . This type of monitoring has good results due to low operational costs and easiness obtaining of information (36)(37)(38)(39)(40)(41) .…”

“…Self-care demands self-maintenance, self-monitoring and self-management, which consist of the adoption of behaviors for improving well-being, preserve health or maintain physical and emotional stability (e.g., a lifestyle that includes physical activities and adherence to drug treatment), in addition to routine and continuous monitoring and surveillance of the body to recognize signs and symptoms and the ability to assess them to determine the need for action (37) . Regarding remote health monitoring, studies show a positive impact for telemonitoring of vital signs, weight (15) and cardioverter defibrillator data (16) by nurses and physicians on the QoL of people with HF.…”