Tools for measuring individual self-care capability: a scoping review

(2023) 23:1312 El‑Osta et al. BMC Public Health https://doi.org/10.1186/s12889-023-16194-6 BMC Public Health Open Access RESEARCH Tools for measuring individual self‑care capability: a scoping review Austen El‑Osta1* , Eva Riboli Sasco1 , Evelina Barbanti1 , Iman Webber1 , Aos Alaa1 , Manisha Karki1 , Marie line El Asmar1 , Haitham Idriss1 , Mashael Almadi1 , Farah Massoud1 , Ahmed Alboksmaty1    and Azeem Majeed1    Abstract Background Our ability to self-care can play a crucial role in the prevention, management and rehabilitation of diverse conditions, including chronic non-communicable diseases. Various tools have been developed to support the measurement of self-care capabilities of healthy individuals, those experiencing everyday self-limiting conditions, or one or more multiple long-term conditions. We sought to characterise the various non-mono-disease specific selfcare measurement tools for adults as such a review was lacking. Objective The aim of the review was to identify and characterise the various non-mono-disease specific self-care measurement tools for adults. Secondary objectives were to characterise these tools in terms of their content, struc‑ ture and psychometric properties. Design Scoping review with content assessment. Methods The search was conducted in Embase, PubMed, PsycINFO and CINAHL databases using a variety of MeSH terms and keywords covering 1 January 1950 to 30 November 2022. Inclusion criteria included tools assessing health literacy, capability and/or performance of general health self-care practices and targeting adults. We excluded tools targeting self-care in the context of disease management only or indicated to a specific medical setting or theme. We used the Seven Pillars of Self-Care framework to inform the qualitative content assessment of each tool. Results We screened 26,304 reports to identify 38 relevant tools which were described in 42 primary reference studies. Descriptive analysis highlighted a temporal shift in the overall emphasis from rehabilitation-focused to pre‑ vention-focused tools. The intended method of administration also transitioned from observe-and-interview style methods to the utilisation of self-reporting tools. Only five tools incorporated questions relevant to the seven pillars of self-care. Conclusions Various tools exist to measure individual self-care capability, but few consider assessing capability against all seven pillars of self-care. There is a need to develop a comprehensive, validated tool and easily accessible tool to measure individual self-care capability including the assessment of a wide range of self-care practices. Such a tool could be used to inform targeted health and social care interventions. Keywords Self-care, Instrument, Measurement, Proxy-measure, Scale, Assessment, Tool *Correspondence: Austen El‑Osta Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecom‑ mons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. El‑Osta et al. BMC Public Health (2023) 23:1312 Background The global burden of chronic non-communicable diseases (NCD) and so-called ‘lifestyle diseases’ including type II diabetes, cardiovascular disease, stroke and some types of cancers result partly from individuals’ inability to self-care [1–3]. There is a growing body of literature regarding the substantial benefits of self-care interventions [4, 5] culminating in the publication of the World Health Organization (WHO) Guideline on Self-Care Interventions in 2019 [6] and 2021 [7]. The WHO working definition of self-care is “the ability of individuals, families and communities to promote health, prevent diseases and maintain health and to cope with illness and disability with or without the support of a healthcare provider” [8]. Self-care necessarily encompasses a wide range of activities related to lifestyle, hygiene, environmental factors and socioeconomic factors [9]. Self-care behaviours refer to the conscious decisions and actions people can make to improve their physical and mental health and wellbeing or to cope with an illness. Webber et al. [1, 10] developed ‘The Seven Pillars of Self-Care’ (7PSC) framework which highlights the importance of (i) knowledge and health literacy, (ii) mental wellbeing, self-awareness and agency, (iii) physical activity, (iv) healthy eating, (v) risk avoidance and mitigation, (vi) good hygiene, and (vii) the rational use of products and services. This framework could be used as a benchmark for comparing self-care practices among the general population and as a tool to support the pragmatic evaluation of self-care initiatives [1, 9–11]. In addition to the generic behaviours indicated in the 7PSC framework, there are also recommended behaviours relating to self-management of specific long-term conditions (e.g., type II diabetes, heart failure) including adherence to medical regimens [12]. Person-level health behaviour is an important determinant of health that significantly affects individual health outcomes and healthcare needs. The individual’s health behaviours play a key role in both disease prevention as well as in the management of chronic conditions [13] and this is reflected by their placement on the Self-Care Continuum, which is a model that describes self-care in the context of resource utilisation [14]. As health systems worldwide struggle to remain solvent, self-care is quickly being recognised as an integral pillar to achieving health for all [15], and policymakers are responding by investing in public health initiatives aimed at promoting self-care among the general population and self-management in patients with NCDs [16]. An important step in assessing the efficacy of these interventions is concerned with measuring an individual’s ability to manage their own health and wellbeing [17]. To date, self-care measurement tools have been used Page 2 of 31 with limited confidence. This is largely due to availability of a vast array (...truncated)