Self-care, the ability to manage one’s own health and well-being, is increasingly recognized as crucial for preventing and managing chronic diseases. This comprehensive review examines existing Self-care Assessment Tools for adults, analyzing their content, structure, and alignment with established self-care frameworks. Understanding the available tools is essential for researchers, healthcare providers, and policymakers seeking to promote and evaluate self-care practices.
Evolution of Self-Care Assessment
Historically, self-care assessments focused on rehabilitation and disease management, reflecting a paternalistic healthcare model. The late 20th century saw a shift towards prevention-focused tools, emphasizing individual responsibility and aligning with the growing lifestyle medicine movement. This transition is evident in the increasing use of self-reported questionnaires, empowering individuals to actively participate in their health assessment.
Characteristics of Existing Self-Care Assessment Tools
This review identified 38 self-care assessment tools, predominantly originating from North America. These tools vary significantly in:
- Length: Ranging from 5 to 121 items, with an average of 34 items.
- Administration: While earlier tools relied on observer reports, most modern tools are self-administered, reflecting the emphasis on patient empowerment. Some utilize mixed-methods approaches.
- Scoring: Most employ numerical rating scales, though the interpretation of higher scores (better vs. worse self-care) differs across tools.
- Theoretical Framework: While some are explicitly based on established theories like Orem’s Theory of Self-Care, others lack a clear theoretical foundation.
Alignment with the Seven Pillars of Self-Care
The Seven Pillars of Self-Care framework provides a comprehensive model for understanding self-care practices:
- Knowledge and Health Literacy
- Mental Well-being and Self-Awareness
- Physical Activity
- Healthy Eating
- Risk Avoidance
- Good Hygiene
- Responsible Use of Products and Services
Analysis revealed that most tools address physical activity, mental well-being, and knowledge/health literacy. However, fewer comprehensively assess risk avoidance, hygiene, and responsible product use. Notably, only five tools incorporated questions relevant to all seven pillars. This gap highlights the need for more holistic self-care assessment tools.
Implications for Future Development and Research
This review underscores the need for a standardized, validated self-care assessment tool that:
- Comprehensively assesses all seven pillars of self-care.
- Employs a clear and consistent scoring system.
- Is suitable for diverse populations and cultural contexts.
- Includes considerations for digital literacy and psychosocial factors.
Such a tool would facilitate more accurate evaluations of self-care interventions and inform the development of targeted health promotion strategies. The Self-Care CAPabiIity AssessmeNt (CAPITAN) Toolkit, currently under development, aims to address these needs by incorporating the Seven Pillars framework, patient activation measures, and psychosocial domains.
Conclusion
Effective self-care assessment is fundamental to promoting individual and public health. While existing tools provide valuable insights, there is a clear need for a more comprehensive and standardized instrument. Future research and development efforts should prioritize creating a universally applicable self-care assessment tool that captures the multifaceted nature of self-care practices and empowers individuals to take control of their health.
