Empowering health: how self-care transforms chronic disease management

Despite the continuous development of national healthcare systems, the number of chronic diseases is increasing at an even faster rate. Conditions such as diabetes, cardiovascular and oncological diseases, chronic respiratory diseases, and orthopaedic disorders have long become commonplace. With increasing life expectancy and population ageing, chronic and often incurable diseases require innovative strategies for diagnosis, treatment, monitoring, and management.

An interesting fact is that the time patients spend with healthcare professionals accounts for an average of only 0.01% of the year. The rest of the time, patients with chronic diseases spend with caregivers or within their family environment.

In this context, the concept of SELF-CARE is of particular interest. This new approach enables patients, their families, and the surrounding community to take responsibility for health, helping to reduce the burden on healthcare systems while narrowing the gap between professional medical care and the daily management of personal health.

How can people organize the process of caring for their own health?
How can chronic disease management be organized?

What concepts for health management does modern science offer?

The answers to these questions are presented in this review.

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WHAT IS SELF-CARE

The World Health Organization (WHO) defines SELF-CARE as the ability of individuals, families, and communities to maintain health, prevent disease, and cope with disability with or without the support of a healthcare professional. SELF-CARE is more than a fashionable term. It is a comprehensive strategy for maintaining health and managing disease. This concept identifies three principal aspects:

• SELF-CARE maintenance – activities aimed at stabilizing health status, such as taking medications, maintaining a balanced diet, and engaging in regular physical exercise;
• SELF-CARE monitoring – continuous observation of symptoms and health indicators such as blood glucose or blood pressure;
• SELF-CARE management – rapid responses to deterioration, including consultation with a physician and adjustments to the treatment plan.

RESILIENCE AS A SELF-CARE TOOL

Resilience is the ability to adapt, recover, and “return to normal” after adversity and difficult experiences. In this context, resilience is the process of successful adaptation when life events interfere with our ability to care for ourselves. These life events include trauma and stressful situations such as job loss or a new diagnosis of a serious disease. Resilience depends on an individual’s internal resources and protective factors such as high self-awareness, self-esteem, cognitive and social skills, optimism, and a sense of humour. Internal strength is reduced by low health literacy, cognitive dysfunction, and other psychological factors that may affect the ability to care for oneself. Resilience may also depend on the social environment, cultural factors, and the healthcare system itself.

PARTNERSHIP IN SELF-CARE

Caregiver is a relatively new term describing a person who provides care. Caregiver implies a linear relationship from the person providing care to the patient. Another term found in some literature is care partners, which emphasises the concept of the patient and partner functioning as a single unit in confronting disease.

Both terms emphasise that the patient is uniquely connected with their caregiver, while the caregiver in turn depends on the patient’s behaviour and attitude. Patients and caregivers influence one another. In the context of chronic disease, both approach health as a unified whole and become interdependent members of one team, ultimately enabling successful management of the process of coping with disease.

THE HUMAN FACTOR IN SELF-CARE

Various factors influence lifestyle. Many unhealthy habits, such as food choices, are acquired at an early age. Habits are difficult to change. In addition, environmental factors can hinder healthy behaviour. Lack of motivation to change, habits, and goals also influence behaviour. Habits provide a default response, while goals provide energy and direct action by defining a desired state. Initially, goals influence habit formation by motivating action, but once a habit has formed, contextual cues automatically activate it. Through activation or inhibition, people act according to their habits and prevailing goals.

In addition to the complexity of human behaviour, there are high expectations regarding the use of information and communication technologies, known as electronic or digital health, which may facilitate behavioural change by helping people perform SELF-CARE and simplifying access to healthcare and social support.

Although technology plays an important role, the human aspect of SELF-CARE should not be underestimated. Family members and close friends are indispensable in supporting people with chronic diseases. The role of the patient’s close social environment encompasses three aspects of SELF-CARE:

• supporting healthy habits and adherence to medication;
• monitoring symptoms to enable subsequent interpretation of health data;
• providing emotional and logistical support during crises.

Nevertheless, caregiving involves numerous challenges. Physical and emotional burnout, financial strain, and limited resources often place a heavy burden on those around the patient.

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BENEFITS OF SELF-CARE

Scientific research clearly supports the value of SELF-CARE. A recent meta-analysis of 145 randomized controlled trials involving more than 36,000 people showed that SELF-CARE interventions have a moderate but significant effect on improving outcomes in chronic diseases such as diabetes, hypertension, and heart failure. For example:

• type 2 diabetes: SELF-CARE improved glucose control (HbA1c);
• hypertension: blood pressure management improved through self-monitoring and adjustments in lifestyle and diet;
• asthma and COPD (chronic obstructive pulmonary disease): improvements in lung function and quality of life were observed among participants who used recommended SELF-CARE methods.

Despite the positive results, several unresolved issues remain. Many studies identify problems with the presentation of data, increasing the risk of incorrect interpretation. In addition, cultural differences, low health literacy, and multiple chronic diseases often complicate SELF-CARE efforts.

INNOVATIONS IN SELF-CARE

Technology has begun to play a key role in SELF-CARE. From wearable fitness trackers to applications using AI (artificial intelligence), innovations in digital health are simplifying complex aspects of SELF-CARE. For example:

• digital health tools: mobile applications allow patients to track symptoms, set medication reminders, and consult healthcare professionals remotely;
• virtual reality (VR): experimental interventions using VR increase patient engagement and confidence in their abilities;
• artificial intelligence (AI): analysis of a patient’s personal data helps formulate predictions, prevent complications, and take preventive measures.

Research highlights the potential of these tools, particularly for monitoring medication adherence and improving patient health literacy. However, integrating these innovations into routine practice requires addressing issues of accessibility, cost, and user training.

THE FUTURE OF SELF-CARE

For the concept of SELF-CARE to reach its full potential, attention must be given to several key areas:

• improving research quality and standardisation will increase the reliability of findings;
• behavioural economics, through incentives and habit formation, will support sustainable SELF-CARE practices;
• policy support will promote SELF-CARE through funding, educational programmes, and public campaigns;
• use of AI will help personalise SELF-CARE by adapting it to individual needs and cultural contexts.

CONCLUSION

SELF-CARE represents a fundamental mechanism in chronic disease management, enabling people to take responsibility for their health while simultaneously reducing the burden on healthcare systems. The benefits of the approach are evident: improved quality of life, fewer hospitalisations, and better treatment outcomes. However, realising the full potential of SELF-CARE requires coordinated efforts: integration of technological innovations, patient support, and robust public policy. The need for chronic disease monitoring positions SELF-CARE as a reliable and sustainable tool for modern healthcare.

References

Iovino, P., Uchmanowicz, I., & Vellone, E. (2024). Self-care: An effective strategy to manage chronic diseases. Advances in clinical and experimental medicine : official organ Wroclaw Medical University, 33(8), 767–771. https://doi.org/10.17219/acem/191102

Riegel, B., Dunbar, S. B., Fitzsimons, D., Freedland, K. E., Lee, C. S., Middleton, S., Stromberg, A., Vellone, E., Webber, D. E., & Jaarsma, T. (2021). Self-care research: Where are we now? Where are we going?. International journal of nursing studies, 116, 103402. https://doi.org/10.1016/j.ijnurstu.2019.103402

Lee, C. S., Westland, H., Faulkner, K. M., Iovino, P., Thompson, J. H., Sexton, J., Farry, E., Jaarsma, T., & Riegel, B. (2022). The effectiveness of self-care interventions in chronic illness: A meta-analysis of randomized controlled trials. International journal of nursing studies, 134, 104322. https://doi.org/10.1016/j.ijnurstu.2022.104322