SELF-C ARE AND C AM
Self-care and CAM: defining the differences, recognising the similarities Karen Pilkington Senior Research Fellow, School of Life Sciences, University of Westminster
Summary Self-care is promoted as an integral part of a ‘patientcentred health service’. But how is self-care defined? And when is CAM considered self-care? Some of the basic tenets of self-care and of CAM are compared to highlight similarities. CAM appears to have a primary role in chronic, poorly defined and difficult to manage conditions. Patients with these conditions seek selfcare options and frequently choose to use CAM. Choice is affected by cost and accessibility. Feasibility in practice and personal recommendation also play important roles in decisionmaking.
© Journal of holistic healthcare
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Volume 6 Issue 2 Aug 2009
Starting my career as a clinical pharmacist, I first worked at the ‘high-tech’ end of healthcare with paediatric patients undergoing cardiac and transplant surgery. Following this, I moved into an educational role supporting health professionals in their quest to apply relevant research in practice. Initially focused on drug therapy, many of the questions arising later focused on complementary therapies. In 2003 I moved from the NHS into academia to develop my interest in CAM and to begin to answer some of the questions that had arisen.
Introduction Self-care has been highlighted as an integral part of a ‘patient-centred health service’ and is defined as: ‘the actions people take for themselves, their children and their families to stay fit and maintain good physical and mental health; meet social and psychological needs; prevent illness or accidents; care for minor ailments and long-term conditions; and maintain health and wellbeing after an acute illness or discharge from hospital’.1 Complementary and alternative medicine (CAM) comprises a diverse range of approaches, philosophies and individual therapies. But there are certain common features that are particularly relevant to self-care. For example, one of the attitudes said to be shared by CAM approaches is that they place ‘as much emphasis on psychological and preventive care as on the treatment of pathologies’.2 Emphasis is also placed on the individual’s choices and preferences: access to the majority of CAM therapies
is self-sought while during treatment there is considerable effort to develop an effective and ongoing ‘therapeutic relationship’ or partnership between the patient and practitioner.3 In many cases, the patient is introduced to a range of possible actions including lifestyle changes to manage or improve their condition and general wellbeing. For example, for individualised self-help acupuncturists see advice as an integral part of treatment and it is embedded in the acupuncture diagnosis.4 In fact, patients expect to receive self-help advice as part of a CAM intervention and this expectation is an important factor in the decision to seek CAM treatment.5
Common features of CAM and self-care • Focus on a range of needs (not solely health).
• Emphasis on prevention of illhealth and promoting wellbeing.
• Dependent on patient preferences and choices.
• Takes place mainly outside the conventional health care context.
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