Theories of self-care and self-management of long-term conditions by community-dwelling older adults: A systematic review and meta-ethnography

Lawless, Michael; Tieu, Matthew; Feo, Rebecca; Kitson, Alison

doi:10.1016/j.socscimed.2021.114393

Cited by 34 publications

(27 citation statements)

References 139 publications

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“…Thus, collaboration, negotiation and shared decision‐making between care provider and care recipient may be minimal or absent. As a result, our understanding of how we ought to provide care for older people, has shifted towards individualistic notions of self‐care and self‐management (Ould Brahim, 2019; Rowe & Kahn, 1998) in which they must be able to effectively draw upon both personal resources (material and psychological) and external resources (informal and formal social support) in the face of ongoing age‐related challenges and adversity (Abdi et al, 2019; Lawless et al, 2021; Meinow et al, 2011; Walsh et al, 2016). As time goes by, they will become increasingly dependent on external sources of social and material support (Cesari et al, 2017; Clegg et al, 2013; Irwin et al, 2018).…”

Section: On Persons As Consumersmentioning

confidence: 99%

The trouble with personhood and person‐centred care

et al. 2022

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The phrase 'person-centred care' (PCC) reminds us that the fundamental philosophical goal of caring for people is to uphold or promote their personhood.However, such an idea has translated into promoting individualist notions of autonomy, empowerment and personal responsibility in the context of consumerism and neoliberalism, which is problematic both conceptually and practically. From a conceptual standpoint, it ignores the fact that humans are social, historical and biographical beings, and instead assumes an essentialist or idealized concept of personhood in which a person is viewed as an individual static object. From a practical standpoint, the application of such a concept of personhood can lead to neglect of a person's fundamental care needs and exacerbate the problems of social inequity, in particular for older people and people with dementia. Therefore, we argue that our understanding of PCC must instead be based on a dynamic concept of personhood that integrates the relevant social, relational, temporal and biographical dimensions. We propose that the correct concept of personhood in PCC is one in which persons are understood as socially embedded, relational and temporally extended subjects rather than merely individual, autonomous, asocial and atemporal objects. We then present a reconceptualization of the fundamental philosophical goal of PCC as promoting selfhood rather than personhood. Such a reconceptualization avoids the problems that beset the concept of personhood and its application in PCC, while also providing a philosophical foundation for the growing body of empirical literature that emphasizes the psychosocial, relational, subjective and biographical dimensions of PCC.

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Section: On Persons As Consumersmentioning

confidence: 99%

The trouble with personhood and person‐centred care

et al. 2022

Self Cite

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“…Providing enhanced self-care support to people with LTCs (e.g., through structured education programs) can increase self-care activity, which is associated with improvements across a range of outcomes, including improved symptom management, clinical indicators, hospital admissions and, in some cases, eventfree survival among patients with hypertension, cardiovascular disease, and diabetes (e.g., da Rocha et al, 2020;Jonkman et al, 2016;Riegel et al, 2017;Toukhsati et al, 2019). A recent review of theories of self-care and selfmanagement of LTCs by community-dwelling older adults emphasized the importance of developing and mobilizing social and environmental resources, which can act as a facilitator or barrier to self-care and disease management (Lawless et al, 2021). In addition to partnerships with HCPs, a supportive environment, enabled by social support and relationships with family, peers, and significant others, is a defining attribute of effective selfcare (Van de Velde et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Several established theories of self-care and selfmanagement identify social networks and relationships as key sources of support enabling chronic disease management (Lawless et al, 2021); Thompson et al, 2022). For example, social learning theory (Bandura & Walters, 1977), which later developed into social cognitive theory, proposes that observational learning can have a powerful effect, and that the effect is greater when the learner perceives that the person demonstrating the behavior is like themselves.…”

Section: Introductionmentioning

confidence: 99%

“You Are By No Means Alone”: A Netnographic Study of Self-Care Support in an Online Community for Older Adults

et al. 2022

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Online peer-to-peer communities provide environments in which people with similar health concerns can interact and exchange information that can support self-care of long-term conditions. However, current theories have not adequately accounted for how self-care support is enacted in online communities. We conducted an observational netnography to identify and analyze posts in a publicly accessible online community (discussion forum boards) designed for older people. A Straussian grounded theory approach was used to examine 659 posts in health-related message boards. Self-care support involved the construction of three interrelated identities: (1) the support seeking self, in which members described problems and requested information; (2) the empathizing self, in which they described similar experiences and offered support; and (3) the influencing self, in which they provided information or advice. Online communities appear to be an important source of peer support and information and may be a cost-effective approach to supplement standard care.

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“…Self-care or self-health management 1 for the older adult population has been called by many in the medical field as the best solution for chronic disease management (Grady & Gough, 2014; Lawless et al, 2021; Park et al, 2015). It is considered critical for better treatment outcomes and optimum healthcare utilization as well as for improving the quality of life of the patient (Holman & Lorig, 2004; McCorkle et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…1Note that self-care and self-health management are often used interchangeably (Lawless et al, 2021; Ryan & Sawin, 2009). While self-care is broader and involves all activities such as preventive measures and includes disease management activities (Grady & Gough, 2014), self-health management is often used for disease/symptom management and was used predominantly in clinical settings and theory development (Ryan & Sawin, 2009).…”

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confidence: 99%

A Comprehensive Digital Self-care Support System for Older Adults With Multiple Chronic Conditions: Development, Feasibility, and Usability Testing of myHESTIA

et al. 2022

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The objective of this mixed methods study is to evaluate the need for a comprehensive digital self-care support system (CDSSS) for older adults with multiple chronic conditions (MCC) and to examine whether such a system can be developed to enable daily capture of self-care data. The 3-phase study involved Phase-1: user needs assessment and prototype development; Phase-2: preliminary user evaluation of the prototype; and Phase-3: 4-week small group usability and feasibility testing of the tracking component of the prototype. Results of Phase-1 show the need for a CDSSS. Phase-2 results demonstrate interest among older adults in using such a CDSSS and Phase-3 findings show that older adults found the tracking component of the system easy to use for capturing daily inputs. Overall, the findings show that it is feasible to design a CDSSS for older adults with MCC in a way that is usable and functional for them.

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Theories of self-care and self-management of long-term conditions by community-dwelling older adults: A systematic review and meta-ethnography

Cited by 34 publications

References 139 publications

The trouble with personhood and person‐centred care

The trouble with personhood and person‐centred care

“You Are By No Means Alone”: A Netnographic Study of Self-Care Support in an Online Community for Older Adults

A Comprehensive Digital Self-care Support System for Older Adults With Multiple Chronic Conditions: Development, Feasibility, and Usability Testing of myHESTIA

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