Description of Theory
In the year 2000 a theory was developed by Dr. Leenerts and Dr. Magilvy concerning the patient’s ability for providing self care. Leenerts and Magilvy describe how the theory developed… “A study was conducted to explore the self-care practices of low income, White women diagnosed with HIV/AIDS. The research question was; Is there a basic social process (BSP) that captures self-care attitudes and behaviors in low-income, White women? The purposes of the study were threefold: (1) identify and describe interactions that characterize self-care, (2) identify and describe interactions that promote and constrain self-care practices, and (3) develop an initial midrange theory of ways low-income women practice self-care while living with HIV/AIDS.” (Leenerts 2000). Even though this theory was developed and researched using a very specific population, the overall definition of the theory is: Investing in Self-Care. Patients today are beginning to understand that the most important key to their health is becoming active in the processes of their treatment or a preventative care method. Meaning the patient is taking responsibility for their own health. The BMA has defined self care as… “Self care is the practices undertaken by individuals towards maintaining health and managing illness. Long term conditions identified as those which could benefit from patient self care include: • arthritis
• chronic bronchitis / asthma
• chronic glaucoma
• chronic heart failure
• manic-depression and chronic depression
• ulcerative colitis.
Self care uses a range of methods and aids to enable people to manage their own health which include: self monitoring, self help and support groups, self management education programmes, patient access to personal medical information, easy access to high quality information on conditions and services and patient-centered tele-care. The diagram below shows some of the options for self care.
Self care is about ‘helping people feel empowered’ rather than ‘making them empowered’. In this respect, the NHS cannot do self care to people but it can create an environment where people feel supported to self care.”(BMA). The significance in developing/helping patient’s to provide self-care would include several factors. To list a few would include overall rising health costs, health care professional shortages, and the simple fact that a patient can provide the best care for them if provided the proper education/information and tools needed. Understanding the application of patients investing in self-care is easily divided into categories as provided below from Leenerts and Magilvy: [pic]
Fig 1. Core category—investing in self-care: Categories, processes, and strategies. Categories in uppercase; processes in italics; and strategies in boxes. (Leenerts, 2000) These four categories as described above are listed and defined as follows: 1) Focusing Self – this describes the social process of investing in self-care. 2) Fitting Resources – this describes the process of finding available resources in self-care. 3) Feeling Emotions – this describes investing emotions into one self-care plan. 4) Finding Meaning – this describing find meaning in living and work with fears of death. Practice Setting
Since this theory was developed in an area that considered mainly lower income white women, a modification or adjustment would be definitely required when using for different patients. With a self-care theory teaching, education, and information would need to be provided to the patient by a health care worker. This could either take place in the hospital setting before discharge, in the Dr’s office for a routine appointment, or during a home health visit.
When a patient becomes involved...
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