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Pensar Enfermagem / v.27 n.01 / December 2023
DOI: 10.56732/pensarenf.v27i1.319
Editorial
How to cite this article: Seabra P. Self-Management of Health Status: Challenges Ahead. Pensar Enf
[Internet]. 2023 Dec; 27(1): 3-4. Available from: https://doi.org/10.56732/pensarenf.v27i1.319
EDITORIAL
Self-Management of Health Status: Challenges
Ahead
The capacity for self-care is recognized by the World Health Organization (WHO) as the
basis of healthcare. Self-care is interconnected with the physical, psychological, emotional,
and spiritual dimensions, and also with self-knowledge and well-being. Self-care is closely
linked to personal balance throughout the life cycle and is at the heart of people's lives.
Acknowledging this, WHO considers interventions to promote self-care as within the
scope of health promotion interventions, since they have the potential to increase choice
and provide more opportunities for individuals to make informed decisions about their
health and healthcare. Those interventions must be accessible and affordable by
indviduals.1
Self-care interventions can be sorted into three levels: Self-knowledge (self-help, self-
education, self-regulation, self-efficacy, self-determination); Self-assessment (self-selection,
self-screening, self-diagnosis, self-collection, self-monitoring); and Self-management (self-
medication, self-treatment, self-examination, self-injection, self-administration, self-use),1
which is recognized as the one having the greatest potential for personal well-being.
Self-management of health in chronic disease encompasses 3 dimensions. The first
concerns the Person, considering that the person must actively participate and take
responsibility in the care process and have a positive way of facing adversity. The second
concerns the Person's Relationship with the Care Environment, recognizing that people
must be informed about their condition and treatment, must be able to express their needs,
priorities, and values, in an environment of partnership and openness to social support, and
its self-management process must be individualized. Finally, the third-dimension states Self-
Management as an Activity, considering that it is a lifelong task that requires personal skills
(namely, decision-making and problem-solving) and covers both management of health
and emotions.2 As chronic disease conditions are related to lifestyles, many times the first
step towards change is often the most difficult, as it includes awareness of the problem,
mobilization of internal resources and decision-making that “may need” the support of a
health provider. This is where Nursing care can be decisive, as self-care interventions or
self-management training, when provided in a safe and supportive environment, offer an
opportunity to increase people's active participation in their own health, increase
functionality and improve quality of life.3,4
Behavior change is one of the most difficult decisions and actions to begin and maintain,
which is why research into self-care and empowerment for self-management of health still
on the international research agenda.5 Now is the time for action and empowerment, and
the world's population expects to rely on all health providers, half of which are 28 million
nurses worldwide. These professionals need to be able to deal with the unpredictability of
the person “with whom” they are caring of, have the ability to accept their choices, even
when they include health-risk behaviors, and to accept that the power lies with each person.
Person-centered care is not real if the person is not truly involved in planning and making
decisions or whenever their wishes and expectations, even if harmful, are not respected. A
lot is asked to these professionals these days, but the potential of their workforce is also
threatened by multiple factors: the shortage of health professionals pointed out by different
international organizations; the attempt to generalize and downgrade the training of nurses
in several countries around the world as a way of reducing costs, depriving people of being
cared by differentiated nurses; the decrease of health training in higher education; and the
disinvestment in national health systems, benefiting private services that do not invest on
health promotion strategies, including self-care interventions.
Research in this area can make a decisive contribution to both people and health
professionals, empowering them to enable and respect rights and choices, but it needs to
integrate both lived experiences into the development of evidence-based and person-
centered interventions.
Paulo Seabra1
orcid.org/0000-0001-8296-1021
1 Editor-in-Chief. Nursing School of Lisbon (ESEL),
Lisbon; Nursing Research, Innovation and
Development Centre of Lisbon (CIDNUR), Lisbon,
Portugal.
Corresponding author:
Paulo Seabra
E-mail: pauloseabra@esel.pt
.2024
4 | Seabra, P.
Editorial
This Journal’s contribution is minor, but Self-Management
of Health was the most published topic on this issue nr. 27.
References
1. World Health Organization. WHO consolidated guideline
on self-care interventions for health: sexual and
reproductive health and rights. Geneva: World health
Organization; 2019
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S, Senn D, De Vriendt P. Delineating the concept of self-
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https://pubmed.ncbi.nlm.nih.gov/31315862/
3. van Schie D, Castelein S, van der Bijl J, Meijburg R,
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Effectiveness of internet-based self-management
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https://onlinelibrary.wiley.com/doi/10.1111/jan.15693
5. Gauthier-Beaupré A., Kuziemsky C., Battistini B.J. et al.
Evolution of public health policy on healthcare self-
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186/s12913-023-09191-3 https://doi.org/10.1186/s12913-
023-09191-3
