By AMERICAN HEART ASSOCIATION NEWS
Self-care is more important to your overall health than pretty much anything else, and the term is catching fire. But what does it really mean?
A new scientific statement issued Thursday by the American Heart Association outlines the importance of self-care in the prevention and management of heart disease and stroke. After all, self-care contributes 40 percent to a patient’s health, followed by social circumstances and environment accounting for 20 percent, and inadequate medical care accounting for only about 10 percent, according to the report published in the Journal of the American Heart Association.
This reality highlights the critical need for healthcare providers to tell patients how to take care of themselves and for patients to follow through on tending to their own well-being.
What is self-care?
Self-care is the process heart disease and stroke patients adopt to maintain, monitor and manage their medical conditions. Self-care is also vital for preventing cardiovascular diseases.
It encompasses the basics of having a healthy lifestyle, but also includes more practical things such as adhering to a drug regimen and paying attention to new or worsening symptoms.
Where did the idea of self-care originate?
The concept is as old as time. Before the advent of modern medicine, people only had themselves and their communities to alleviate sickness.
However, during the 1960s and 1970s social changes spurred people to take a more active role in their health, said Barbara Riegel, Ph.D., R.N., a professor of nursing at the University of Pennsylvania. Self-care has become a more integral treatment component as evidence of its effectiveness has mounted.
“There is really strong outcomes data on the effects of self-care, but I don’t think we put as much energy into it as we should,” said Riegel, lead author of the new statement.
Why is it especially important now?
The world’s population is getting older and heavier, and age and weight are major risks for chronic conditions, particularly heart disease and stroke.
By 2050, the global population of those 60 and older will more than double, from 841 million in 2013 to more than 2 billion in 2050, according to a United Nations report. Meanwhile, a recent New England Journal of Medicine study found that 17 percent of the world’s population — nearly 108 million children and 604 million adults — is obese.
The sicker population will further burden the health care system, increasing the need for cost-effective treatments. It’s much less expensive for patients to adopt an exercise program than to wind up in the hospital having a heart attack — and better for them too.
How do self-care and medical care intersect?
They are complementary.
Patients still need to visit their health care providers to ensure their conditions are properly diagnosed and monitored. Doctors or other medical professionals will develop a treatment plan that likely combines elements of traditional medicine such as prescription drugs with self-care measures.
What are the obstacles to self-care?
Not all doctors take time to discuss the importance of self-care and particular strategies with their patients, said Gina Lundberg, M.D., clinical director of the Emory Women’s Heart Center in Atlanta.
She said that sometimes patients won’t heed doctors’ advice even after being presented with the bleak scenarios that are likely to stem from the failure to take medication or follow recommendations to make lifestyle changes such as losing weight.
“Lifestyle is so important that noncompliance here may cause the greatest harm,” said Lundberg.
Another problem is that conditions like high blood pressure or high cholesterol don’t have physical manifestations, making it easier for patients to justify ignoring advice.
And adopting healthy changes like eating a more balanced diet doesn’t immediately show results. It’s easy to get frustrated and resort to old eating habits when the scale doesn’t budge after weeks of forgoing ice cream.
Modifying behavior can be a tougher road if patients lack family and community support. Riegel recalled an instance when a family’s primary cook balked at adapting recipes or preparing special meals to accommodate the patient.
“You want family participation and positive reinforcement,” said Riegel.
There are also environmental barriers to improving health that are beyond the control of patients, their families and doctors. Some neighborhoods lack safe places to exercise or stores that sell healthy, affordable food. Restaurant portions can be enormous.
“Health is a shared responsibility,” said Riegel. “Communities need to put in sidewalks. The media needs to get the word out about health. No one can do this alone.”