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Monday, 18 November 2013
Learning Objective 1: The learner will be able to define self-care and differentiate self-care, self-care maintenance and self-care management.
Learning Objective 2: THe learner will be able to describe
Chronic illnesses impose a tremendous burden on approximately 133 million American adults [1],[2]. In addition, it is predicted that by 2015 more than 1.2 billion children in the world aged 5-14 years will have a significant chronic disease [3]. The economic impact of chronic illness is also tremendous. Self-care is defined as a combination of self-care maintenance and self-care management [8]. Self-care competence can alter the course of the chronic illness by decreasing adverse effects of an illness. The decision-making process underlying self-care is influenced by individuals’ level of confidence that they will succeed (self-care confidence). Delayed pubertal growth and cognitive development may stall self-care confidence [6] thereby influencing the ability to perform self-care. Thus, it is particularly important to understand self-care in this emerging adult patient population. To date, though, few investigators have studied emerging adults exclusively. However, adults typically have different sources of illnesses, different responses to those illnesses and different self-care needs making comparisons across diseases and across populations challenging. The purpose of this presentation is to review self-care in adolescents (ages 14-18 years) and emerging adults (ages 18-24 years) with chronic illness. The literature describing self-care of individuals with the chronic illnesses of asthma, type 1 diabetes mellitus, cystic fibrosis and sickle cell disease was reviewed. When adults aged 18-44 years were included, this introduced another population and different disease processes, therefore only studies with the words “young adults” in the title were included. If data were sorted by age (14-25 years), the studies were included in this review. Since management strategies of chronic illnesses have evolved over time, the literature was limited to the last 10 years.
Themes found included serious chronic illness, self-care needs of adolescents and emerging adults with chronic illness, influences of self-care on outcomes and interventions to improve self-care.