The 'work' of self-care for people with cardiovascular disease and prediabetes: An interpretive description

Cardiovascular disease and sustained high blood glucose (prediabetes) are established concurrent diagnoses. People with these concomitant conditions carry out self-care which is overt (e.g., daily weighing or taking a specific diet), plus there are also concealed facets of self-care (e.g., accessing information about diet or medications). Also of note is the need to 'work' to achieve a self-determined level of self-care. The 'work' put into self-care is currently under-reported when people discuss their progress with health professionals.

Our research aimed to demonstrate that aspects of self-care are typically concealed. A further objective was to reveal the extent of 'work' dedicated to self-care.

Interviews were conducted with 23 participants to reveal their experiences of long-term conditions, cardiovascular disease and prediabetes. Interpretive description underpinned the development of a thematic representation of the data.

Recruitment was from a tertiary hospital coronary care unit in New Zealand. Included participants were those with an acute coronary event, also found to have a high blood glucose. Those people known to have diabetes prior to admission were not included.

Participants were interviewed once, for approximately 60 min, nine months after discharge home. The data is analysed using thematic analysis, organising an interpretation into themes.

Self-care requires 'work', the work itself was frequently understated by participants, they trivialised their important role in their self-care. Participants often required prompting to discuss the responsibilities, choices and behaviours they participated in to support self-care to improve their health and well-being. Participant data showed how the 'work' of self-care aligned to three work themes: solo self-care, teamwork, and constant companion self-care.

Nurses can improve the outcomes for people with long-term conditions by acknowledging and incorporating the often concealed 'work' of self-care when assessing, planning and implementing health care in any clinical setting. A important recommendation for nurses is to support people-as-patients, by encouraging self-determination and working with the preferences patients have for self-care, in order to enhance their quality of life while living with ill-health.