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.
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. Around 80% of all care in the UK is self care.
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.
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-termconditions and self care provides some useful information. See also: SelfCare Week 2015 Resources – Self care for life.
It is important to make sure 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 is of increasing concern 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 Department of Health’s UK 5 YearAntimicrobial Resistance Strategy 2013 to 2018 sets out actions to slow the development and spread of antimicrobial resistance with a focus on antibiotics.
Local pharmacists are increasingly a source of information and advice for people in supporting self-care. The NHS Minor Ailment service is now available through many community pharmacies. See: The Royal College of Pharmacists animation on Minor Ailment Services. The service is very often more convenient and the results for patients just as good as being seen at a GP surgery or in A&E.
A campaign from Pharmacy Voice and PAGB (Proprietary Association of Great Britain) has urged people to self-treat winter ailments such as coughs and colds rather than going to the GP surgery and asking for antibiotics which are ineffective in treating the symptoms of viral infections. The campaign ran until the end of February 2014, see: Treat yourself better withpharmacist advice.
Self Care Forum. This forum aims to further the reach of self-care and embed it into everyday life. 'Empowering people with the confidence and information to look after themselves when they can, and visit the GP when they need to, gives people greater control of their own health and encourages healthy behaviours that help prevent ill health in the long-term.' The Self Care Forum has developed a range of useful resources, including: factsheets; best practice case studies; top tips and a patient portal giving self-care advice to patients.
Self Help UK is a free and non-profit making website which provides information on self-help organisations for specific medical conditions diseases and treatments for patients, carers and their relatives. Self Help UK is provided by Intuition Communication Ltd, specialists in health care publishing on the Internet. The website includes a database of over 1,000 self-help organisations, patient support groups and charities across the UK that provide support, guidance and advice to patients, carers and their relatives.
Self management UK. Self management UK is the leading charity in self management support for people living with long-term health conditions. They work with patients, carers, healthcare professionals, clinicians and commissioners creating sustainable communities where people have the skills and confidence to live better lives.
King's Fund: Supporting people tomanage their health. This resource looks at how to assess whether individuals are ready to engaged or consider life style changes and adopt healthier behaviour. The report looks at the Patient Activation Measure (PAM) tool which is used to gauge patient activation. Patient activation is a widely recognised concept. It describes the knowledge, skills and confidence a person has in managing their own health and health care.
Nesta: Supporting self-management: A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches. This guide outlines how the science of behaviour can help people to self-manage their health and wellbeing.
Nesta. Spreading change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing. This guide outlines how behavioural science can help spread the take-up of person- and community-centred approaches to health and wellbeing.