Self-care as a health resource of elders: an integrative review of the concept

Abstract

Aim: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource.

Background: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance of the concept as a health resource for elders lacks clarity. Before 1989, research focused principally on medical self-care at the expense of health care, and self-care was seen more as supplementary to professional health care rather than as a health-promoting approach in health care.

Method: In this integrative review from 2006, we selected theoretical and empirical articles published between 1990 and 2006, where self-care was related to elders' health promotion. Data were extracted from primary sources and included definitions of self-care, critical attributes, antecedents, goals and outcomes. We interactively compared data and display matrices to describe self-care as a health resource.

Results: Fifty-seven articles addressed health self-care and were integrated into a framework of self-care as a health resource of elders. Self-care was identified as a two-dimensional construct including action capabilities and processes for health in self-care practice. The capabilities consisted of fundamental capabilities, power capabilities and performance capabilities. The action processes included a process of life experience, a learning process and an ecological process.

Conclusion: This review offers insight into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical practice, policy-making and research into health care of frail or robust elders.