The importance of self-care in chronic diseases

In recent decades, there has been a significant rise in the prevalence of chronic diseases, which implies an increase in health needs and a greater expenditure of resources. Advances in health care have led to improved management of these conditions, which are becoming increasingly important in public health. At the same time, the focus of care is shifting towards developing methods to control chronic symptoms, with the aim of maintaining the patient’s independence and quality of life over longer periods of time.

In this way, chronic care is changing, giving way to a paradigm in which patients play a central role in their own care, being jointly responsible for their state of health and participating in the process of improving their illness, together with healthcare professionals.

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What do we mean by self-care?

Self-care can be defined as a process of maintaining health status through health promotion and disease management practices and through an active and responsible attitude towards quality of life. It implies the ability to participate in self-care, through actions that enable the person to know, treat and manage their own health problems, in an autonomous way but being supported by the health system.

For this increase in co-responsibility and patient autonomy to take place, especially in those suffering from a chronic illness, a number of factors must be in place. Firstly, the patient must have access to quality, contrasted and sufficient information, which is essential for them to be able to participate in the decision-making process. Secondly, they must have a close, two-way relationship with the healthcare professional, fostering communication and health education for the patient, allowing them to become more aware of their state of health. Finally, it is important that the patient acquires autonomy during the therapeutic process, taking the initiative in improving their lifestyle, knowing their symptoms and managing their medication.

Involving patients in their care results in better disease management, contributing to increased quality of life and increased personal satisfaction. Directly, this reduces the number of visits to the emergency room and health centres, as well as hospital admissions. Therefore, the benefits are not only for the patient, but for the health system in general, which is currently in a complex and highly congested situation.

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Self-care in chronic diseases

Chronic pathologies usually have a slow progression and are of long duration. Therefore, self-care in chronicity requires a set of behaviours to control the disease process, reduce the burden and severity of symptoms and improve survival and quality of life. In chronic care, it is important to emphasise that self-care should incorporate a broad concept of prevention, underlining the idea that patients with chronic diseases still need preventive actions to promote wellbeing and avoid further deterioration of health.

In A Middle-Range Theory of Self-Care of Chronic Illness, self-care is constructed through three concepts:

• Maintenance of self-care. That is to say, to comply on a daily basis with those self-care behaviours, such as regular exercise or taking medication as prescribed by a doctor. Its main objective is to maintain health and prevent exacerbations of symptoms.
• Self-care monitoring. Through routine tests or by regularly measuring certain constants, symptomatology or scales. The aim is to recognise changes in health status in order to act accordingly.
• Self-care management. Making changes in diet, physical activity or medication dosage based on the detection and interpretation of symptoms and following health instructions. The aim is to treat symptoms effectively.

Sufficient self-care encompasses all three behaviours, as they are closely interrelated. For patients with chronic diseases, it is usually necessary to regulate and adapt self-care during the course of the disease, e.g. when decompensation occurs, if a co-morbid disease arises or if advanced treatment is needed.

Proper maintenance, monitoring and management of self-care has a major impact on the patient, the patient’s environment and the entire healthcare system. When patients are able to detect and interpret the symptoms of their disease, they facilitate early intervention by medical teams, contributing to the stability of the pathology. At the same time, patients gain confidence and peace of mind, as they perceive greater control over their decisions and lifestyle habits. Thus, their state of health, well-being and quality of life increase, while their hospital admissions and visits are reduced. This also reduces the use of healthcare resources and mortality, easing the burden on healthcare systems.

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Tucuvi as a promoter of self-care

In Tucuvi we work so patients can have the best quality of life at home, and we are aware of the importance of involving them in decision making and in the care process. The monitoring that chronic patients receive with Tucuvi is carried out by means of conversation protocols, in which our virtual assistant asks a set of questions about their symptoms and general state of health. Thus, answering these questions on a regular basis encourages them to take their blood pressure readings and measure their symptoms more frequently, thus providing a more exhaustive monitoring of their illnesses and, therefore, of their self-care.

On the other hand, these patients receive greater follow-up between consultations, improving communication with their medical teams, who receive data on the health status of their patients on an ongoing basis. In this way, when the healthcare professional is in contact with the patient, he or she has more information and more knowledge about their situation and casuistry, being able to focus on what is really important and promoting a useful and more personal health education, focused on each patient and their disease cycle.

A key aspect of our solution is that the follow-up protocols are customisable, meaning that we can design specific behaviours for the conversations, allowing each patient to express themselves in an open and natural way, and also to receive care focused on their specific pathology.

Furthermore, in order for patients to be able to perform proper self-care, it is imperative that they have quality access to healthcare. Our solution, based on conversational AI, is easily scalable, allowing healthcare professionals to provide healthcare coverage to a greater number of patients more frequently, promoting care to extend beyond the hospital.