The evolution of the concept of self-care in the healthcare system: a narrative literature review

To identify and analyze the definitions of self-care in the healthcare system in the evolution over time as well as to identify the key actors of self-care.

We conducted a narrative review of the literature on the definition of self-care in the CINAHL, PubMed and ILISI databases. The searches ranged from the first year included in each database until May 2013. In addition, a secondary analysis was performed on the references of articles selected to identify additional data sources. The self-care definitions were grouped according to decades and examined in their evolution.

The first self-care definitions date back to the seventies, but only in the eighties self-care has been seen as a key resource for healthcare systems. In the nineties, care activities previously considered the exclusive domain of the health professions were included in this concept; and finally over the 2000s the role of health professionals in self-care is highlighted, extending the self-care activities to the psychological, social and spiritual dimensions. Self-care activities can be carried out directly by the person upon himself, delegated to others, or performed on others.

The review has showed the large body of literature published in different disciplinary and cultural fields, which has led to the proliferation of definitions and interpretations of self-care. Italy has taken part in a marginal way to the international debate. It would be useful that also Italian nurses did research to describe and understand.