Fostering Patient Self-Care

WHAT IS SELF-CARE IN A COMMUNITY CONTEXT?

“Self-care is the ability of individuals, families and communities to promote and maintain their own health, prevent disease, and to cope with illness – with or without the support of a health or care worker.” (WHO)

SOCIO-ECOLOGICAL FACTORS THAT INFLUENCE SELF-CARE

Individual (Interpersonal) Factors

• Knowledge and Health Literacy

• Skills

• Attitudes and Beliefs

• Demographics

Interpersonal Factors

• Family support

• Peer influence

• Social networks

Community (organizational/Institutional) Factors

• Community Norms & Culture

• Healthcare Access

• Faith Organizations

• Workplaces/ Schools

Societal (Policy/Environmental/Structural) Factors

• Socioeconomic Status

• Policies & Laws

• Physical Environment

• Social Inequality & Discrimination

• Media & Technology

HOW THE COMMUNITY NURSE SUPPORTS SELF- CARE: INDIVIDUAL LEVEL

HOW THE COMMUNITY NURSE SUPPORTS SELF- CARE: INDIVIDUAL LEVEL

▪ Nurses are essential coordinators of care and advocates for patient self- management.

▪ With physicians, pharmacists, and dietitians for coordinated medication management, teaching, and nutrition plans.

▪ With social workers to address barriers such as transportation or housing that affect self-care.

▪ Via case conferences to create unified care plans focused on patient goals.

Examples:

• The CHN co-develops an individualized care plan with a patient following hip replacement, incorporating PT/OT recommendations

• The CHN uses a teach-back method to help a young family learn new parenting skills after the birth of their first child, ensuring consistent health education

• The CHN works with the clinical pharmacist and the patient for medication reconciliation and counseling following diagnoses of T2D

HOW THE COMMUNITY NURSE SUPPORTS SELF- CARE: FAMILY LEVEL

HOW THE COMMUNITY NURSE SUPPORTS SELF- CARE: FAMILY LEVEL

▪ With family therapists and social workers to support caregivers, strengthen family coping, or address family dynamics

▪ With home health aides and visiting nurses ensuring continuity and reinforcement of self-care strategies

▪ With community health workers (CHWs) as cultural liaisons who can bridge communication between families and providers

Examples:

• The CHN organizes multidisciplinary family meetings to set shared self- care goals for a family whose child has been diagnosed with stage IV leukemia

• The CHN coordinates and provides education sessions with dietitians and diabetes educators for family with new onset T2D

• The CHN works with a family support group and counseling for a couple when one spouse seeks treatment for SUD

HOW THE COMMUNITY NURSE SUPPORTS SELF- CARE: COMMUNITY LEVEL

▪ With public health to design and deliver community self-care programs (e.g., chronic disease management, smoking cessation)

▪ With local organizations (e.g., faith groups, cultural centers, fitness programs, schools) to access and promote resources

▪ With social service agencies connecting populations to nutrition programs, housing, or financial aid (e.g., WIC, SNAP, Meals on Wheels)

Examples:

• The CHN leads a community health fairs or screenings with multidisciplinary teams

• The CHN engages with school nurses and teachers to implement wellness and self-care lessons for pre-teens on hygiene

• The CHN builds a local referral network in a small rural community with physical activity programs, food pantries, or transportation services

EVALUATE AND ADVOCATE AN EVIDENCE-BASED STRATEGY

TEACH-BACK METHOD

What is Teach-Back?

• Teach pt then ask pt to explain back to you

How could Teach-Back be implemented in a community setting (e.g., school)?

• hands on in PE

What are potential barriers and how might you overcome them?

• varying literacy levels, intimidating

How would you measure its effectiveness in promoting self-efficacy and health literacy?

GROUP PEER SUPPORT SESSION

▪ How could the CHN implement a group peer support session for patient following bariatric surgery?

▪ What are potential barriers and how might you overcome them?

▪ How would you measure its effectiveness in promoting self-efficacy and health literacy?

Other Evidence-Based Strategies for Self-care

PUT IT INTO PRACTICE: AVOCA

1. Analyze the determinants influencing Avoca’s chronic health condition using the Socio-Ecological Model.

2. Develop culturally sensitive, patient-centered interventions that empower the client and family toward self-care and address system-level health risks.