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    THE CHALLENGES IN SELF-CARE

There are many elements in lifestyle disease prevention but at its core is the need for individuals to change their self-care and lifestyle habits. But there are significant system-based challenges with implementing self-care change:
1. Today’s healthcare systems are effectively ‘sickness services’ oriented more towards treating the sick than preventing disease. Worse still, health systems can encourage reliance and complacency towards one’s own health.
2. Self-care is the foundation of healthcare, but it occurs largely outside formal health and social systems, making it harder for governments to engage in and support.
3. Self-care can be supported at many different levels – in the family, in the community, in companies or cities, but currently there is little connection or integration.
4. The individual elements of self-care are simple in concept and some are even common-sense, but they should be approached in an integrated and holistic manner. By contrast, Western approaches tend to target one problem at a time.
5. There is much interest and support in the individual elements of self-care, but no natural champions covering the entire self-care space.
In addition to these system-based externalities, of at least equal significance is the fact that it is difficult for individuals to adopt and sustain good self-care practices. Reasons advanced for not undertaking lifestyle changes include:
· It (lifestyle disease) won’t happen to me /‘they’ exaggerate the risk
· I’ll start tomorrow, I have bigger problems today; anyway we’ve all got to die from something
· Lifestyle modification is hard to keep up; I don’t have time/money/energy for it
· If I get sick I go to the doctor – that’s what I pay my taxes for
Taking all of this together, it is apparent that while the threats of lifestyle diseases are massive, the challenges of adopting self-care are also massive.

自我保健面临的挑战
预防生活方式疾病需要注意方方面面,但最主要的核心就是人们需要改变他们已有的自我保健的方式和生活习惯。但是在改变自我保健方式的过程中有以下几个系统性的挑战:
1. 今天的医疗体制都是以“疾病服务”为导向,更加注重疾病的治疗而非预防。更糟糕的是, 医疗体制竟然鼓励大众仅仅依赖且满足于现有健康。
2. 自我保健是健康医疗体制的基础,但是它却被远远被排除在正规医疗和社会体制之外,因此政府很难参与其中或加以支持。
3. 自我保健在很多不同的层面都可以进行,在家里、在社区、在公司或在城市里,但是目前的情况是各层面的自我保健活动没有任何关联,也不成体系。。
4. 若将个人自我保健所包含的各种因素分开看,在概念上来说还是比较简单的,有一些甚至是常识性的,但仍需将各种因素综合看待。而在西方则相反,个人自我保健的各种因素更应该单独看待。
5. 人们总是更多的关注和支持自我保健的单个活动,同样也没有任何一项活动能够包含自我保健的各个方面。
除了这些以系统为基础的外部挑战,还有一些具不可忽视的重要事实,就是人们很难采取自我保健并坚持不断的自我保健。不愿意改变现有生活方式的原因有以下几点;
· 生活方式疾病不可能发生在我身上/他们夸大了患病风险。
· 明天再开始,今天还有更重要的事要做;人终有一死。
· 改变生活习惯很难坚持;我没时间/没钱/没精力去做。
如果我生病了,会去看医生,这是我缴税应得的。
综合来看,很明显生活方式病的威胁是巨大的,采取自我保健的行动面临的挑战也是巨大的。


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