title: Self-care in people with long term health problems: a community based survey.
abstract: BACKGROUND
  Self-care is a key component of current policies to manage long term conditions. Although most people with long-term health problems care for themselves within lay networks, consultation rates for long-term undifferentiated illness remain high. Promotion of self-care in these individuals requires an understanding of their own self-care practices and needs to be understood in the context of health care pluralism. The aim was to investigate the extent and nature of self-care practices in patients experiencing long term health problems, sources of information used for self-care, and use of other forms of health care (conventional health care and complementary and alternative medicine).
  
  
  METHODS
  The study involved a cross-sectional community-based survey set in three general practices in South West England: two in urban areas, one in a rural area. Data were collected using a postal questionnaire sent to a random sample of 3,060 registered adult patients. Respondents were asked to indicate which of six long term health problems they were experiencing, and to complete the questionnaire in reference to a single (most bothersome) problem only.
  
  
  RESULTS
  Of the 1,347 (45% unadjusted response rate) who responded, 583 reported having one or more of the six long term health problems and 572 completed the survey questionnaire. Use of self-care was notably more prevalent than other forms of health care. Nearly all respondents reported using self-care (mean of four self-care practices each). Predictors of high self-care reported in regression analysis included the reported number of health problems, bothersomeness of the health problem and having received a diagnosis. Although GPs were the most frequently used and trusted source of information, their advice was not associated with greater use of self-care.
  
  
  CONCLUSIONS
  This study reveals both the high level and wide range of self-care practices undertaken by this population. It also highlights the importance of GPs as a source of trusted information and advice. Our findings suggest that in order to increase self-care without increasing consultation rates, GPs and other health care providers may need more resources to help them to endorse appropriate self-care practices and signpost patients to trusted sources of self-care support.
authors.affiliation: Institite of Health Services Research, Peninsula Medical School, University of Exeter, Exeter EX2 4SG, UK. fiona.mackichan@pms.ac.uk
authors.forename: Fiona
authors.initials: F
authors.lastname: MacKichan
authors.forename: Charlotte
authors.initials: C
authors.lastname: Paterson
authors.forename: William E
authors.initials: WE
authors.lastname: Henley
authors.forename: Nicky
authors.initials: N
authors.lastname: Britten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult