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          MEASURING SELF-CARE

Self-care consists of a wide range of activities that are universal in their importance to health, but which have to be tailored to an individual’s circumstances. Important steps in the development of self-care will be its measurement in individuals, and (in future) in populations. However, the use of self-care metrics by individuals is not widespread, with the notable exception of people who are trying to lose weight or improve their fitness.
A holistic measure of an individual’s self-care status and the identification of priority areas for behavioural modification can provide useful base data and incentives for personal change.  Data derived from measurements of self-care practices would be valuable in addressing these challenges, at an individual and population level.
Fundamentally, self-care is a relatively new concept, and there is a strong opportunity and need to ‘systematise’ it.  Measuring how the different elements of self-care operate independently and interdependently is an important step in a ‘systems approach’.
As the Director-General of the World Health Organisation Dr Margaret Chan said in her accession speech: ‘I believe it is also our job to constantly assess the impact of our activities. One thing I learned from my previous life is this: what gets measured gets done.’

Measuring self-care in individuals
There are three baseline measures and comparators of importance:

Measures which define health norms. These are the normal population ranges of key health norms relevant to self-care (e.g. body mass index or calorie intake), split by gender, age etc. These norms represent the comparators and potentially some goals, for individuals to compare themselves with.
Measuring myself, my own self-care status. This describes the individual’s self-care starting point or ‘balance sheet’ – assets and deficits across the 7 pillars of self-care. It is apparent that while many measures can be self-generated (e.g. weight, smoking status), others require professional input (e.g. cholesterol levels). The individual’s self-care balance sheet represents a self-care health record or passport. A simple example is the World Health Professions Alliance (WHPA) ‘Health Improvement Card.’

Measuring change in myself. The object of self-care is for individuals to make adjustments to their daily practices. In this it will be helpful to record self-care activities, and outcomes.
Each of these measurement areas can be mapped across the 7 pillars to give a consistent overall framework of measures.  The 7 pillars include different types of situation and activity – cognitive, behavioural and physical.

测量自我保健
自我保健包括很多项活动,这些活动对于健康具有普遍重要性,但是个人具体应该采取哪种自我保健活动,因人而异。在自我保健的发展进程中,很重要的一步就是要对个体自我保健行为的测量和未来对人群自我保健行为的测量。然而,除了在那些试图减肥和改善身体健康状况的人当中,自我按标准测量保健状况在个体间并不普遍。
一个全面衡量个人自我保健状况的方法和个人鉴别所需改变的行为习惯的能力将为个人改变提供有效的数据支撑并成为人们改变自身的动力。衡量自我保健实践的数据对于解决这些挑战意义非凡,无论是在个人层面还是人群层面。
从根本上讲,自我保健还是一个相对较新的概念,很有必要将其系统化。探知自我保健的各方面因素如何独立和相互起作用是将其系统化的重要步骤。
世界卫生组织总干事陈冯富珍
博士在她的任职演讲中讲道:“我相信不断的评估我们组织的活动对大众的有何影响也是我们的工作。从我之前的人生阅历中我领悟到一件事:只要是能被标准测量的任务就都可以完成”。
自我保健自测
以下是三个重要的基线测量值和对比标准:
测量方法定义健康标准。我们熟知的有一些与自我保健相关的针对普通大众的健康标准,如按不同性别和年龄等划分的身体质量指数和卡路里摄入量标准等。这些标准可以供个人作为参照,也方便个人依此设定健康目标。
自我保健状况自测。该条描述的是个人的自我保健起点或者说“健康资产负债表”——通过7大要点来看自我保健的资产和负债情况。很明显,虽然很多健康状况人们都有自己的测量法,如体重,吸烟情况等,但是仍有其他一些健康状况需要专业的测量方法,如胆固醇水平。个人的健康资产负债表就相当于一个自我保健记录或护照一样,举例来说就好比世界卫生专业联盟(WHPA)的“健康改善进度卡”。
测量自身的改变。个人自我保健的目的在于让自己每天的行为习惯发生改变。该条有助于记录自我保健的活动情况和结果。
这里的每一个测量标准都能够映射到自我保健的7大要点上去,从而可以看出测量方法的整体框架。7大要点包括了不同类型的情况和活动,包括认知、行为和身体。

 

 



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