Self-Care in Pediatric Patients with Chronic Conditions: A Systematic Review of Theoretical Models

Int J Environ Res Public Health. 2021 Mar 28;18(7):3513. doi: 10.3390/ijerph18073513.

Abstract

Background: To improve outcomes in children and young adults (CYAs) with chronic conditions, it is important to promote self-care through education and support.

Aims: (1) to retrieve the literature describing theories or conceptual models of self-care in CYAs with chronic conditions and (2) to develop a comprehensive framework.

Methods: A systematic literature search was conducted on nine databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All peer-reviewed papers describing a theory or a conceptual model of self-care in CYAs (0-24 years) with chronic conditions were included.

Results: Of 2674 records, 17 met the inclusion criteria. Six papers included a theory or a model of self-care, self-management, or a similar concept. Six papers developed or revised pre-existing models or theories, while five papers did not directly focus on a specific model or a theory. Patients were CYAs, mainly with type 1 diabetes mellitus and asthma. Some relevant findings about self-care in CYAs with neurocognitive impairment and in those living with cancer may have been missed.

Conclusions: By aggregating the key elements of the 13 self-care conceptual models identified in the review, we developed a new overarching model emphasizing the shift of self-care agency from family to patients as main actors of their self-management process. The model describes influencing factors, self-care behaviors, and outcomes; the more patients engaged in self-care behaviors, the more the outcomes were favorable.

Keywords: chronic diseases; model; pediatric; self-care; young adults.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Child
  • Chronic Disease
  • Diabetes Mellitus, Type 1*
  • Humans
  • Models, Theoretical
  • Self Care
  • Self-Management*