Kathryn Dean

Self-care components of lifestyles: The importance of gender, attitudes and the social situation

Self-care practices of individuals are health related elements of lifestyles. In order to understand the influences that shape and maintain the self-care patterns of behaviour that determine health and functional ability, research frameworks for study of the social situations in which people live and the levels of influence among variables are needed. This paper reports on findings from an investigation of self-care practices in a population sample of persons over 45 yr of age in an attempt to study self-care in a lifestyle framework. The findings show the importance of examining patterns of behaviour rather than exclusive focus on the magnitude of differences in discrete behaviours. Gender was the major independent influence on patterns of health maintenance behaviour while social network variables assumed major importance for self-care responses to illness.

Self-care responses to illness: A selected review

Abstract Self-care is the basic level of health care in all societies. Yet, little is known about the range of lay reactions to illness and the forces shaping those reactions. This paper reviews literature concerned with self-care responses to illness. Questions arising from the data are discussed and future research needs are identified. While limited, the literature illustrates the basic role and importance of self-evaluation of symptoms and self-decisions regarding reactions to illness. However, more studies of general populations are needed to chart the dimensions of self-care and to determine the forces which shape reactions to illness in various subgroups of society. It is particularly important at this time to design studies with uniform definitions of variables, especially definitions of self-care and self-medication.

Emerging trends in gerontology and geriatrics: Implications for the self-care of the elderly

Increases in the worlds older population have posed a significant challenge to available health care resources. For many older people, informal initiatives represent a necessary, rather than an optional health care strategy in the absence of alternatives. Those individuals with the greatest health and economic dependencies are often held responsible for their reliance on subsidized long-term care services. This tendency to blame the victim appears to transcend fundamental philosophic differences which have traditionally distinguished some collectivist and individualist societies. Although health care has been viewed traditionally by health professionals as their domain, self-care and lay initiatives have recently been recognized by professionals as important to the health care of different population groups including older people. The concept of self-care has been used in various ways by different people to describe a wide range of personal health behaviors encompassing lay care, self-help, enlightened consumerism, and various preventive measures as antidotes to the impairments of old age. This paper reports some of the outcomes of an international project which reviewed geriatric self-care in different countries and health care systems. Various influences on the evolution of interest in geriatric self-care were identified including: similarities and differences in health care systems: demographic changes; cohort differences; the emergence of professionals with specialized training in geriatric health care; and, the salience of biomedical models in addressing the health problems of aging. The role of professionals, especially those trained in geriatrics, is examined with an acknowledgment of the importance of a self-care strategy that is independent of professional dominance.(ABSTRACT TRUNCATED AT 250 WORDS)

Research on lifestyles and health: Searching for meaning

This paper is based on an alternative approach to standard quantitative analyses in research on behavior and health. Theory and methods focused on the elaboration of complex situational and behavioral influences on health are used in secondary analyses of data from a population health survey in Spain. Findings showing fundamental differences in the relationships among the behavioral and health variables within various age, gender and social groups illustrate the importance of studying interacting influences in relevant subgroups of the population. Quite meaningful findings can be hidden in behavioral research limited to identifying global statistical correlations in cross-sectional and longitudinal data. The impact that statistical methods can have on the findings from analyses that are not guided by theory and logic based on substantive questions derived from the research literature is discussed. The results point to the need to study patterns of behavior in their contexts of occurrence in research on lifestyles and health.

Symptom consultation in lay networks in an elderly population.

Although lay referrals are known to be important as factors affecting the use of professional services, less is known about how individuals use lay consultation in evaluating symptoms. The amount and type of advice given by persons in the social network is especially important with respect to self care of symptoms that never reach the attention of professional caregivers. This article provides information on how often and from whom elderly citizens seek and receive consultation, such as family and friends, when they experience common symptoms. Findings suggest that female relatives are important sources of advice but that neither gender nor living arrangements are closely related to the tendency to seek lay advice for common symptoms. Subjects who consulted lay advisers about arthritic symptoms also were more likely to seek professional consultation.

New directions for health: Towards a knowledge base for public health action

The need for new types of solutions to respond to community health needs, along with the poor fit between research and the knowledge needed for improving the health of populations, have stimulated a renewal process in the field of public health. Growing out of this movement, an international workshop held at the Nuffield Institute for Health, University of Leeds in 1993 took up issues related to the role and limitations of epidemiology as generally practiced today. Concern for creating a relevant and sound knowledge base for public health action was the impetus guiding this project. Some of the major topics taken up in the deliberations of the workshop are reflected in the selection of papers that follow. They are highlighted and supplemented with an overview of other issues taken up by the conferees in this introduction.

Relationships between knowledge and belief variables and health maintenance behaviors in a Danish population over 45 years of age.

The growing body of evidence regarding the importance of self-care behavior for the maintenance of health and functional capacity has stimulated research interest in identifying the factors and processes that influence health-related behavior. This article examines relationships between health knowledge and belief variables and two types of health maintenance behavior: (a) routine habits that affect health and (b) deliberately undertaken health-protective behavior. The findings suggest that generalized health beliefs may have limited influence on behavior. Health locus of control beliefs may be related to behavioral change, but were not related to either current tobacco and alcohol consumption or to conscious health maintenance behaviors. It is concluded that more attention needs to be directed toward cultural influences on health beliefs and behavior.