Self-care as a health resource of elders: an integrative review of the concept.
OBJECTIVE
To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource.


BACKGROUND
Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance of the concept as a health resource for elders lacks clarity. Before 1989, research focused principally on medical self-care at the expense of health care, and self-care was seen more as supplementary to professional health care rather than as a health-promoting approach in health care.


METHODS
In this integrative review from 2006, we selected theoretical and empirical articles published between 1990 and 2006, where self-care was related to elders' health promotion. Data were extracted from primary sources and included definitions of self-care, critical attributes, antecedents, goals and outcomes. We interactively compared data and display matrices to describe self-care as a health resource.


RESULTS
Fifty-seven articles addressed health self-care and were integrated into a framework of self-care as a health resource of elders. Self-care was identified as a two-dimensional construct including action capabilities and processes for health in self-care practice. The capabilities consisted of fundamental capabilities, power capabilities and performance capabilities. The action processes included a process of life experience, a learning process and an ecological process.


CONCLUSIONS
This review offers insight into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical practice, policy-making and research into health care of frail or robust elders.
Institute of Public Health, Department of Nursing Science, University of Aarhus, Høgh-Guldbergsgade 6A, Arhus 8000 C, Denmark. bh@sygeplejevid.au.dk
Bente
B
Høy
Lis
L
Wagner
Elisabeth O C
EO
Hall
D000203:Activities of Daily Living; D000368:Aged; D001294:Attitude to Health; D005851:Geriatric Nursing / Q000458:organization & administration; D006040:Goals; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006295:Health Resources / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D016294:Models, Nursing; D024802:Nurse's Role / Q000523:psychology; D015399:Nursing Research / Q000458:organization & administration*; D009742:Nursing Theory; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D010687:Philosophy, Nursing; D011209:Power, Psychological; D012107:Research Design; D012648:Self Care / Q000379:methods / Q000523:psychology