It is more important than ever to stress the importance of taking individual responsibility for health. This includes for example, adopting a healthier lifestyle, staying active, eating healthily, only using alcohol in moderation and not smoking.
Self-care is integral to the governments approach to personalisation, enabling people to be at the heart of decision making about what matters to them. The personalisation agenda can engender resilience and self-care through social prescribing – which is “a means of enabling any healthcare professional to refer patients for support either to a link worker - to provide them with a face to face conversation during which they can learn about the possibilities and design their own personalised care” or even to wider networks for example to leisure centres, or specific programmes such as exercise, arts, gardening or to name but a few to support people to do things to support their wider wellbeing.
Social prescribing has been referred to as a number of things; community referral or asset-based, person-centred approaches, there is no agreed single term used to describe social prescribing. It is, however, a key method to support asset based person centred self-care. Collectively, the UK personalisation agenda, using socially prescribed services such as ‘arts on prescription’, gardening, or exercise, utilises an individual’s strengths to enable them to manage their own conditions. At an even more fundamental level these things level helps people get out, they reduce social isolation and improve community networks. Find out more about social prescribing.
The Self Care forum uses a self-care continuum to illustrate what is meant by self-care. Self-care starts with an individual taking responsibility for making daily choices about their lifestyle, such as brushing their teeth, eating healthily or choosing to exercise. At the opposite end of the continuum is major trauma where responsibility for care is entirely in the hands of the healthcare professionals, until the start of recovery when self-care can begin again. The NHS can support people to self care at any point during the continuum. The realist is that probably around 80% of all care in the UK is self care, from people managing their own minor illness and longer-term chronic conditions and generally how they take care of themselves. The Self Care forum has recently updated it's factsheets.
Self-care and self-management
Many people use the terms self-care and self-management interchangeably. However, there are important distinctions between the two. Self-management will usually be used in relation to long-term, chronic health conditions while self care applies to acute illness or injuries. Self-management is about coping with long-term health conditions, and managing the emotional and practical issues they present. Self-care focuses more on treatment.
Self-management
Around 15 million people in England have one or more long-term conditions, and this is predicted to rise by a third over the next ten years (Department of Health 2011).
Self management UK defines self-management as: “The systematic process of learning and practicing skills which enable individuals to manage their health condition on a day-to-day basis, through practicing and adopting specific behaviours which are central to managing their condition, making informed decisions about care, and engaging in healthy behaviours to reduce the physical and emotional impact of their illness, with or without the collaboration of the health care system.”
Put simply, self-management offers a way for people with long term conditions to create a more sustainable way of living with a health condition.
As a nurse you have a clear role in supporting patients in making healthy choices and in directing people to useful sources of information.
You can also provide advice, education and training to help people manage their condition, to know when to seek medical help and when they can self-manage their symptoms.
The NHS Choices webpage Your health, your way - Your NHS guide to long-term conditions and self care provides some useful information. See also: Self Care Week 2015 Resources – Self care for life
Antimicrobial resistance
Antimicrobial resistance is recognised as a global health and economic threat. At a basic level it is essential that we take prescribed medication as advised and do not take antibiotics unnecessarily. It is also about the supported self-management for people living with long term conditions.
Over use of antibiotics and antibiotic resistance (AMR Antimicrobial resistance) is a major problem, see: World Health Organization - Antimicrobial resistance. It is seen as one of the most significant threats to patients' safety in Europe. Better controls are needed to prevent over use of antibiotics and appropriate education programmes set in place to ensure patients know when to take them properly.
Without effective antibiotics many routine treatments will become increasingly dangerous. To slow resistance we need to cut the unnecessary use of antibiotics. The public, students and educators, farmers, the veterinary and medical communities and professional organisations are being asked to become Antibiotic Guardians. This is a UK wide initiative led by Public Health England.
The Health and Social Care Committee (October 2018) states that Tackling Antimicrobial Resistance needs to be in the 'top five policy priority' for the UK Government.
It is a key area of work for nursing staff and the RCN.
