Self-Care Before Patient-Centered Care

Self-Care is the foundation for Patient-Centered Care.

Patient-centered care should respect each patient and take full account of our values, stories, fears, worries and hopes and respond to our emotional, spiritual, and social needs in addition to our physical needs.[1] Before a provider can do this, the question for each of us as patients is, are we fully aware of our emotional, spiritual, social, and physical needs?  Are we practicing self-care to support ourselves? Are we caring for ourselves as whole-persons? If you are not sure what whole person self-care looks like, read on.

In my work, I have studied the self-care habits of many different people:  patients in all types of settings, healthcare leaders, employees in technology companies, leaders in Fortune 500 companies, patients who have had both good and not-so-good experiences with their providers.  All of these individuals have had one thing in common: those who were happiest, and most satisfied with their lives and their jobs were also most likely to score themselves high on self-care practices.  And, those practices can be somewhat neatly categorized into your 7 sources of health.  I briefly describe these sources of health, all evidence-based, below, but before reading on, you may want to take the 7 Sources of Health Assessment.

 

1. Life Purpose[2]:  Life purpose is the reason we get out of bed in the morning.  It involves knowing why we’re here; finding meaning in our lives; having a sense of passion; having a sense of what you’re trying to accomplish; and/or believing you still have more to do here on earth.[3] Given that there are 1,620,000,000 Google Results and 66,200,000 TED Talks addressing life purpose, it is fair to say that we are obsessed with life purpose. Do you know what your life purpose is or do you at least believe you have a purpose that you are constantly pursuing?  If your answer is yes, then based on the research you are likely to live 7 years longer, have lower healthcare costs and hospital admissions, and even have a lower incidence of several chronic diseases than someone who does not believe in or have a life purpose. For some ideas to help you validate, identify, or at least get closer to your life purpose, check out this life purpose practice I shared during a recent keynote address.

 

2. Body: The 3 activities that you can control to determine your body source of health are eating, sleeping, and moving.  You can optimize each of these by being familiar with the latest research on nutrition, sleep, and exercise. For example, a whole foods, plant-based, low saturated fat diet, that contains most colors of the rainbow has been found to decrease the risk of many chronic diseases.[4]  The American College of Lifestyle Medicine says that for most chronic conditions nutrition should be emphasized as the primary and often most effective treatment.[5]  Something to consider as a baseline for movement: the US Physical Activity Guidelines for Americans recommend 150 minutes (2.5 hours) of moderate intensity exercise per week or 75 minutes (one hour and 15 minutes) of vigorous intensity exercise per week, or a combination of both for adults 18 to 65.  For some ideas on incorporating movement into your daily routine, check out these NEAT [Non-Exercise Activity Thermogenesis] practices. As for sleep, It’s estimated that 62% of people have some kind of sleep disorder. Getting less than 6 ½  hours of sleep per night for three or more consecutive nights creates the same cognitive outcome as having a blood alcohol level of .08.[6] Check out these suggestions for Practices to Improve Your Sleep.  And finally, consider the value of learning more Practices to Change Bad Habits to Good Ones.

 

3. Mind: Your ability to think, focus, remember, learn, and manage moods are all part of your mind source of health. Given our information overloaded existence, the ability to focus may be the most challenging of these. Mindfulness, defined as “paying attention on purpose in the present, letting go of judgment”, has been found to be effective at improving the ability to be aware, focused, and ultimately, to pay attention.[7] Focus is the act of concentrating the mind on the object of attention or the task at hand. Like a muscle, the more you use your mental focus, the stronger it becomes. Other practices that can improve focus include guided imagery, self-hypnosis, and biofeedback. Check out these Focus Practices that combine components of mindfulness and imagery.

 

4. Emotions: Your feelings, often in response to your thoughts, comprise your emotional source of health. Examples of emotions produced by your feelings include happiness, sadness, fear, surprise, anger, pride, shame, embarrassment, and excitement.  Research has found that there are 10 positive emotions that support health, well-being and high performance. Actively being aware of and practicing these emotions can not only improve mood, but may also improve health, chronic disease, and even lifespan.[8] These emotions are gratitude, joy, hope, contentment, amusement, love, inspiration, interest, serenity and pride. In Traditional Chinese Medicine, it is believed that an imbalance of negative or positive emotions is the root cause of chronic disease.  This saying from Jack Kornfield about balancing feelings can give us some perspective:  “Feelings are just visitors.  Let them come and let them go.” Check out these suggestions for Positive Psychology Practices.

 

5. Creativity: Creativity is defined as the ability to either bring something new into existence and/or produce something using your imagination. Positive health benefits are generated when we journal, draw, or engage in art therapy, music therapy, or other expressive arts. Creativity self-care skills can result in improved well-being and self-esteem, a decrease in health care costs, and a stronger immune system resulting in fewer illnesses. The Theory of Transformative Coping states that together, our inherent capacities of creativity and spirituality improve our ability to cope with stress, trauma and other negative exposures. Together creativity and spirituality increase positive emotions and resilience.[9] Check out these suggestions for Drawing and these for Journaling.

 

6. Community: A community is a group of people with something in common. Your community includes the individuals you interact with at work, home and play.  Stronger friendships and community relationships result in improved health, engagement, productivity and longevity.  In fact, people with at least 4 friends are likely to live significantly longer than those with less than 4 friends. The bottom line is your social relationships benefit your health.[10]  Assess your own communities and relationships in Connection or Vital Friendships. In Volunteering strengthen both your community and purpose sources of health.

 

7. Environment: Your environment includes your circumstances, objects or conditions that surround you. Think about the goldfish. Once it reaches the size of the bowl it is in, it will stop growing.  Your environment can impact you similarly[11].  Your immediate environment has a significant impact on your health, mood, behavior and, depending on the built environment can encourage or discourage social interactions. Home and work environment can also impact stress levels. Elevated workplace or environmental noise can cause hearing impairment, hypertension, ischemic heart disease, and sleep disturbance. Check out how Grounding can impact your health or how Simple Environmental Changes can improve your mood and ability to manage stress.

Self-care practices improve your health and allow you to be more aware of what you need from your healthcare provider.  By clearly communicating your needs to your providers they can tailor medical treatment to meet your needs.  It’s a win-win!

 

REFERENCES:

[1] Miles, A., & Mezzich, J. E. (2011). The care of the patient and the soul of the clinic: Person centered medicine as an emergent model of modern clinical practice. The International Journal of Person Centered Medicine, 1, 2, 207 – 222.

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