Shifting Trends in Self-Care Assessment: From Passive to Proactive
As the first systematic scoping review of its kind, this study sought to identify and map the key concepts that underpin non-mono-disease-specific self-care measurement tools. It also aimed to highlight the main sources and types of evidence available. The review revealed that historically, self-care assessment was primarily focused on chronic disease management and rehabilitation, a perspective that often overlooked the individual's responsibility for their own health.
However, a shift in disease patterns from acute to chronic conditions around the late 1990s sparked a change in this viewpoint. This shift coincided with the rise of the 'lifestyle medicine' movement, which encourages individuals to become active participants in their own health and wellbeing journey. This trend continues today, with growing emphasis on self-care in the context of health promotion and maintenance as global health systems grapple with financial sustainability.
The review also found that while most tools were geared towards general health and self-care assessment, some were tailored to specific segments of society, such as the elderly, in-patients, and those with chronic illnesses, disabilities or psychiatric disorders. Notably, newer tools tend to use self-reported methods of data collection, a significant departure from older tools that primarily used observer and interview-style methods. This shift towards self-reporting reflects a broader transition in healthcare strategies towards involving the general population in their own health.
To avoid bias in self-reported measures, some tools use mixed method approaches that incorporate observer input alongside self-reporting. This approach provides a comprehensive understanding of self-care behaviour, combining objective observer data with self-reported information and personal experiences. In the future, these mixed methods may be encouraged, particularly if the measures are used to inform self-driven healthcare solutions or decision-making processes for health and social care interventions after discharge or during rehabilitation.
The review also highlighted a lack of consensus in the literature regarding the definition of patients with complex needs. Furthermore, it found that the focus of measurement tools has shifted from being predominantly management and rehabilitation-focused to being prevention-focused. This mirrors a broader trend in service provision transitioning from 'cure'-oriented to 'care'-oriented healthcare services.
Prevention-focused interventions aim to improve individual long-term health, wellbeing and quality of life while also enhancing population health. They are seen as key shared values among healthcare policymakers and the general population. These preventive measures also have significant healthcare cost-saving potential, especially for non-communicable diseases (NCDs) which require frequent hospital admissions if not properly managed.
The Seven Pillars of Self-Care framework is a useful tool that describes a range of activities individuals can practice to promote health and wellbeing. An analysis of key trends since the late 1990s shows an increasing emphasis on assessing 'knowledge and health literacy', 'risk avoidance', and the 'responsible use of products and services' pillars. This reflects a shift towards patient-centred care and improved access to online health information.
However, despite their importance, areas such as risk avoidance and good hygiene require further development in self-care measurement tools. The lack of comprehensive general self-care assessment tools addressing all aspects of self-care highlights the need for more holistic approaches to monitoring and evaluation. This is particularly relevant in light of the United Nations' Sustainable Development Goal 3, which aims to ensure healthy lives and promote wellbeing for all.
In conclusion, this review suggests that while some self-care measurement tools address key aspects of health and wellbeing, others require further development. There is a need for consensus on the definition of self-care and the development of a standard measurement tool that can evaluate all self-care activities from community, health and social care perspectives. This will enable healthcare providers to evaluate the effectiveness of self-care promotion initiatives and identify areas for improvement.
Furthermore, mixed methods approaches should be considered when developing self-care measurement tools to provide a comprehensive understanding of health-seeking self-care behaviours. This would enable researchers to better understand the relationship between self-care behaviours and health and social outcomes, and identify areas where individuals can take more responsibility for their own health. As more people turn to online resources like an online tea store or a beard oil online store for their self-care needs, it's crucial that these tools evolve to meet their needs.
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