Self-care
Self-care refers to the actions and decisions individuals take to manage their health and address various health issues independently, often with the support of educational resources or professional guidance. Common self-care practices include using natural products, engaging in therapies like yoga and meditation, and adopting dietary changes. The growing trend towards self-care has been influenced by factors such as the rising costs of conventional health care, skepticism toward mainstream medical practices, and an increasing familiarity with complementary and alternative medicine (CAM). The COVID-19 pandemic further highlighted the importance of self-care, as many individuals found themselves isolated from traditional medical services and sought ways to maintain their health at home. While studies indicate that self-care can be effective for conditions like chronic pain, insomnia, and anxiety, the research often faces challenges related to methodology and the accuracy of self-reported data. Additionally, the safety of self-care practices, especially those involving herbal remedies, raises concerns about potential interactions with prescribed medications. Overall, self-care encompasses a diverse range of approaches that empower individuals to take control of their health, though it is essential to remain informed about both the benefits and risks associated with these practices.
Self-care
- DEFINITION: A type of therapy that can be performed by persons themselves, often aided by training from a practitioner or by educational materials.
- PRINCIPAL PROPOSED USES: Arthritis, chronic low back pain, coronary artery disease, headaches, hypertension, incontinence, insomnia, postsurgical symptoms, treatment- and disease-related symptoms of cancer
Overview
A person undertakes self-care decisions and actions to address a health problem or to improve their health. Popular self-care therapies include natural products and herbal medications, deep breathing, meditation, osteopathic manipulation and chiropractic treatment, massage, yoga, diet-based therapies, progressive relaxation, guided imagery, and homeopathy therapy. In 2016, the National Center for Complementary and Integrative Health (NCCIH) announced that 59 million Americans had spent an estimated $30.2 billion on complementary medicine defined as self-care.
Mechanism of Action
It is difficult to evaluate the action of self-care therapy because in most situations, it is not feasible to use placebo controls. For example, in one of the better-documented modalities, the Arthritis Self-Management Program, retrospective analysis shows that pain reduction was maintained four years after therapy began and that physician visits decreased by 40 percent. The program used education, cognitive restructuring, relaxation, and physical activity, but it is impossible to show what treatment was responsible for what result; also, no control group was included for comparison.
Uses and Applications
Several health care trends favor the use of self-care therapies. Some persons see conventional health care as effective but also unaffordable for many. Studies have shown that those who have delayed or skipped medical care for financial reasons are highly likely to try self-care, particularly self-medication.
At the other end of the spectrum are those who distrust mainstream health care and want instead a type of care that promotes empowerment and personal control. Another factor leading people to try self-care is having learned about and becoming comfortable with complementary and alternative medicine (CAM) therapies over time. In addition, CAM therapies that previously could be found only through nontraditional outlets have become widely available. Likely CAM users include older people, those who are well educated, and those with conditions such as severe depression and panic attacks. Studies have also shown that people between the ages of thirty-five and fifty years are part of a fast-growing group of CAM users. The coronavirus 2019 (COVID-19) pandemic that began with an outbreak of a novel coronavirus in China in late 2019 sparked further discussion about the potential for implementing self-care. Many people around the world, including in the United States, were isolated from conventional medical care due to efforts to limit physical contact, and some expressed concern over going to medical facilities as the spread of the virus was still not under control. Therefore, some experts recommended practicing more habitual, reasonable self-care as a means of potentially maintaining physical and mental health.
Another study indicated that twice as many people read self-help literature as see a CAM practitioner to learn relaxation techniques. This followed a general trend showing that the use of self-care therapies increased while consultation with CAM providers decreased. An analysis of persons on Medicare showed that the most frequently sought forms of CAM were those for back problems, chronic pain, general health improvement, and arthritis. Research has demonstrated the efficacy of relaxation, biofeedback therapy, cognitive strategies, and education in treating chronic pain conditions such as osteoarthritis, rheumatoid arthritis, and fibromyalgia. Persons using self-care engaged in health-affirming practices such as exercise, smoking reduction, and limiting alcohol consumption.
Scientific Evidence
Some of the studies used to measure self-care are flawed because the research questions depend on a person’s ability to report CAM use accurately or to remember his or her use of CAM. Typically, information is collected once, so there is no opportunity to study CAM use over time.
Flawed methodology can occur if researchers do not spell out distinctions between complementary and alternative therapies versus more radical alternatives. Peer-reviewed studies of self-care have shown improvements in cancer-related pain, headache pain, and cardiovascular disease as a result of relaxation techniques, behavior modification, imagery, hypnosis, stress management, and health education.
One study looked at changes in health status longitudinally and found no difference in health status when researchers compared therapies such as chiropractic, massage, acupuncture, and herbs with conventional medicine. However, the results of CAM therapies in general, and of self-care specifically, may take longer to manifest. Researchers have called for controlled clinical trials, including large-scale surveys, and in-depth studies of specific populations.
Safety Issues
A lack of relevant scientific studies makes it difficult to determine the safety and efficacy of self-care. Herbal remedies may interact with prescription medicines in harmful ways, with both the person seeking care and the prescribing physician unaware of the risks. Scientific literature on interactions is scarce. Existing information may be skewed because many people do not tell their physicians that they are using a self-care modality of CAM.
Bibliography
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