September 8, 2019
The past months I have been engaged in a lot of conversations about self-care. I sense a self-care zeitgeist arising in communities and healthcare settings. A spirit is gaining momentum to educate and empower individuals, strengthen communities, and also stem the tide of escalating healthcare costs. More so, from the humanistic perspective, self-care offers each individual a path to improve their life-quality and become the best they can be.
Self-care topics beckon researchers to reframe medical science and healthcare studies. I am inspired by excellent work done by my students and colleagues along with a wider proliferation of wellness scholarship. Translating evidence to practice demands inter-professional collaboration and interdisciplinary worldviews, appropriate to an increasing number of scholar-practitioners. My own self-care workshops and presentations have received enthusiastic responses from healthcare professionals as well as people simply wanting more from everyday living. I see this as a further shift, moving healthcare consciousness from providing cures to promoting optimal well-being.
There is no shortage of information. One can hardly log onto the internet without encountering news and products to improve wellness. Myriad educational and commercial offerings flooding inboxes can lead to information overload. Now is a good time to reflect on how the self-care movement is authentic and meaningful both personally and professionally.
Why Self-Care
Self-care is the collection of actions and attitudes intentionally taken to promote and maintain health, prevent disease, and cope with illness and disability when it occurs. It functions at several levels: for each individual, as family, and within community. Self-care practices can be undertaking with or without the support of a healthcare professional. As well, I see opportunities for healthcare settings to engage in quality education.
To borrow from the World Health Organization (2019), “Just as high quality healthcare is important, high quality self-care is too.” Quality self-care is particularly important when healthcare access is limited and, in some cases, not available. Self-care can also be a preferred option in some situations, allowing autonomy and agency, particularly for vulnerable populations. Self-care is equally important for healthcare providers who are experiencing burnout and lack of well-being at unprecedented rates (Kuhn & Flanagan, 2017).
Key ingredient: An Appropriate Framework
As a practical matter, adopting a self-care model or framework is key (WHO, 2019). Plentiful sources are ripe with self-help ideas, possibilities, and solutions, from community programs to self-help articles, from workplace wellness to wellness tourism. The self-care explorer can easily become inundated by the latest research or practice recommendations. From a cognitive as well as an idiosyncratic level, it makes sense to first adopt a framework that considers readiness to change, provides integration of various practices, and is rewarding (Prochaska, Redding, & Evers, 2015). A framework that matches with individual beliefs, preferences, and understanding provides a skeletal structure to support exploring, adopting, and developing practices.
A model is a framework, based on theories and principles, that provides structure. It allows sense-making, in terms of which practices to adopt and when. There are various scholarly-based, thoughtful models available. The best self-care models reach beyond monitoring exercise frequency and whole food eating. Individualization can allow for flexibility according to each individual’s biochemistry, life-style, and preferences.
Here are two models that I find helpful for practice translation as well as suggesting avenues for further research.
The 7 Sources of Health (7SOH)(SoHL7x. com) is an original framework to teach and develop self-care skills and support community health systems. Drawing from seven sources (Life Purpose, Body, Mind, Emotions, Creativity, Community, and Environment), the model’s education component offers evidence-based practices that individuals can adopt based on their needs and preferences (Russo, & Fortune, 2016).
The Pathwaysmodel is a behavioral medicine approach that directs individuals to improve self-care through three levels of engagement: self-care and skills acquisition, use of community resources, and with professionally administered treatments. This model is particularly compatible with complementary-integrative practices and mind-body skills, such as mindfulness, guided imagery, self-hypnosis, and biofeedback (e.g., heart rate variability training) (McGrady & Moss, 2018).
Call for Action
In addition to supporting individual self-actualization, quality self-care is a sustainability issue. Self-care is a need for those who live in communities, who fuel organizations and businesses, and also for the professionals who address healthcare needs. While the path to better well-being is individual, there is a broader opportunity for collaboration. Consider becoming a self-care advocate: because self-care adopted on a community systems level has implications for shifting the future of healthcare.
References
Kuhn, C. M., & Flanagan, E. M. (2017). Self-care as a professional imperative: physician burnout, depression, and suicide. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 64(2), 158-168.
McGrady, A., & Moss, D. (2018). Integrative pathways: Navigating chronic illness with a mind-body-spirit approach. Cham, SZ: Springer.
Moss, D. (2019, August 30). Self care in palliative care — Pathways model. Retrieved from https://www.youtube.com/watch?v=MrYpTUk61_A&list=PLUakTEuPjbFDg-IbovVkI_dRwSCFCSZ3s&index=13&t=0s
Prochaska, J. O., Redding, C. A., & Evers, K. E. (2015). The transtheoretical model and stages of change. Health Behavior: Theory, Research, and Practice, 125-148. Retrieved from https://www.researchgate.net/profile/Daniel_Montano2/publication/233894824_Theory_of_reasoned_action_theory_of_planned_behavior_and_the_integrated_behavior_model/links/0a85e53b67d742bc29000000.pdf#page=135
Russo, R., & Fortune, L. D. (2016). Six evidence-based integrative health practices to manage eight common chronic conditions and promote self-care: A review with findings inspired by a workplace wellness case study. SM J Community Med, 2(2), 1018.
World Health Organization (WHO) (2019, April 2). Self-care can be an effective part of national health systems. Retrieved from https://www.who.int/reproductivehealth/self-care-national-health-systems/en/
Embodied Living: by Luann Fortune, PhD, LMT 