An Update to the Middle-Range Theory of Self-Care of Chronic Illness

Self-care is essential in the management of chronic illness. In 2012, we published a middle-range theory addressing self-care as a process of maintaining health through health-promoting practices and managing chronic illness. Three key concepts in the theory were self-care maintenance, self-care monitoring, and self-care management. Self-care maintenance refers to those behaviors performed to improve well-being, preserve health, or maintain physical and emotional stability. Self-care monitoring is the process of routine vigilant surveillance, self-awareness, and body monitoring or body listening. Self-care management involves the response to signs and symptoms when they occur. In 2019, we updated the theory, specifying the important contribution of symptoms to self-care. Assumptions and propositions of the theory were specified in the original publication; both are expanded in this update.

Here, we update the theory to reflect changes in our thinking and what has been learned from published literature and discussions with others. An important addition is a detailed discussion of 6 essential intrapersonal requirements for self-care: experience, knowledge, skills, reflection, decision-making, and motivation. These requirements interact dynamically; the order in which they are presented is not meant to reflect the order in which they are developed.

These factors are particularly important in guiding the development of self-care interventions. Readers can now refer to this version instead of the 2012 publication.