eSurvey
Demographic profile of respondents
The electronic survey captured full responses from 304 respondents who were either medical or allied health and social care professionals from across England (Table 1). Data from a further 20 respondents were excluded from the analysis due to incomplete survey responses or lack of key demographic data, including occupation.
Table 1
Participant characteristics
| n | (%) |
Age | | |
20–29 | 10 | (3.3) |
30–39 | 42 | (20.0) |
40–49 | 77 | (25.6) |
50–59 | 114 | (37.9) |
60–69 | 51 | (16.9) |
70–79 | 5 | (1.7) |
80+ | 2 | (0.7) |
Gender | | |
Male | 63 | (20.7) |
Female | 235 | (77.3) |
Other | 2 | (0.7) |
Unknown | 4 | (1.3) |
Ethnicity | | |
Asian/Asian British | 40 | (13.2) |
Black/African/Caribbean/Black British | 10 | (3.3) |
Mixed/multiple ethnic groups | 3 | (1.0) |
White | 240 | (78.9) |
Other* | 11 | (3.6) |
Role | | |
Doctor | 47 | (15.7) |
Nurse | 44 | (14.7) |
Services & therapy professionals | 41 | (13.7) |
Pharmacy staff | 119 | (39.7) |
Social prescriber or other (i.e., carer, non-GP doctor, commissioner of health) | 49 | (16.3) |
Seventy eight percent of respondents were female, and the majority were white (79.1%). Nearly two thirds (64.2%) worked in the general practice setting, whereas 7.8%, 6.4%, 5.3% and 4.0% worked in secondary care, social care, voluntary sectors and public health services, respectively. Nearly 40% were pharmacy staff where most (81%) were pharmacists. Although doctors only comprised 15.7% of the total sample, the vast majority (88%) here general practitioners. The results of the survey are shown in Table 2 and S1 Table.
HCP views on the importance of self-care to service users
The percentage of HCPs reporting that self-care was 'very important' to service users rose from 54.3% pre-pandemic to 86.8% during the pandemic reflected across all professional groups (Table 2). Across all professional groups, 'making healthy lifestyle choices' and 'improving general wellbeing' were consistently the two most frequently chosen options for promoting self-care in service users before and during the pandemic. Since the advent of the pandemic, recommending self-care to help 'manage existing mental illness' was the aspect of self-care that increased by the greatest margin followed by 'managing infectious disease' and 'building self-care capacity as part of routine professional care'. Overall, 84.6% of respondents were more likely to recommend self-care during the pandemic compared to before the pandemic.
Barriers to self-care during the pandemic
Across all professional groups, of the 23 potential barriers provided, the three most frequently chosen barriers were related to the service users as follows: 'individual reluctance to engage with health services (74.6%), 'poor understanding of how to selfcare' (71.9%), and 'digital exclusion' (71.6%).
Self-care resources and competencies needed to support self-care during the pandemic
Three quarters (75.6%) of respondents considered that they personally had the resources and proficiency to promote self-care in their practice, but only 25.6% perceived their service users as adequately prepared to self-care. Only 28.5% agreed their service users had the competencies and resources to self-care (Table 2).
Change in use of technology to support self-care during the pandemic
All professional groups reported a significant increase in the use of the technology options listed during the COVID-19 pandemic. Overall, the three greatest increases in technology use were signposting to online self-care resources (86.1%), telephone use (78.9%) and the use of smartphone apps (77.1%) (S1 Table). The majority (86.0%) of HCPs reported that they were more likely to signpost service users to online self-care resources during the pandemic.
Self-care practice after the pandemic
Across all professional groups, 96.7% anticipated that they will continue to actively signpost service users to freely available self-care resources even after the pandemic abates. The majority (87.2%) reported that they will continue to promote more reliance on self-care practices amongst their service users, whereas 75.0% of HCPs felt they were personally more likely to practice self-care. Nearly three quarters (71.6%) of respondents considered that the advent of the pandemic had made the 'absolute case for self-care'. More than half (54.3%) viewed service users as being more likely to adhere to self-care practices as a first option and 58.1% felt that their service users are now better equipped or empowered to self-care since the advent of the pandemic (Table 2).
Personal interviews
Nine respondents (4 male, 5 female) consented to an in-depth personal interview. The sample comprised of 5 doctors, 1 nurse, 1 ward sister and 2 pharmacists. Interviews were conducted online and lasted between 25–45 minutes. Four overarching themes were generated from the thematic analysis (S2 Table and S2 File) as follows: (1) professional approaches to self-care, (2) perceived patient/client attitudes to self-care, (3) issues arising since the advent of COVID, and (4) future reliance on self-care following the pandemic.
Professional approaches to self-care
In general, interviewees had a broad view of self-care in covering patient behaviours, in the home and community setting, pre-consultation and post-consultation with HCP. Most interview respondents considered self-care as a fundamental part of healthy living but recognised that pre-pandemic models of care and doctor-patient interactions did not always encourage personal empowerment and individual agency. Respondents expressed a fundamental need for a shared view of self-care that straddled professional and public realms, supported by changes in medical training. One respondent highlighted that in addition to supporting HCPs with training to deliver more person-centred care, patients and service users need to also be able to access quality assured information and resources to help build individual self-care capacity and capability.
"…medical training and professional attitudes tended to place the patient as a helpless victim that needs rescuing by a professional or the NHS. It's really important we change this and empower patients to self-care where suitable.
Perceived patient/client attitudes to self-care
Respondents felt that limited access to routine services during the national lockdowns and prolonged periods of self-isolation meant that patients had to accept self-care as the mainstay of treatment. There was general agreement that certain ethnic groups, and in particular the elderly and those considered as clinically extremely vulnerable, experienced difficulties in access and changes in service delivery. These issues were thought to result from an acceptance of a paternalistic view of the patient's relationship with professionals, reflected in their need to ultimately obtain a doctor's opinion, even for self-manageable illnesses, including COVID.
"…[with] open access to a trusted advisor there is no rational need to self-care. For some people, it's a case of why research things when you can ring the doctor and the lights in the hospital are on 24 hours a day?
Some respondents recognised that because there is not a 'one-size-fits-all' approach to promoting self-care in different patient groups, any lifestyle medicine and self-care recommendations need to be supported by easily accessible and quality assured self-care resources. The HCP interaction with the service user and attempts to signpost may otherwise appear to the patient as a form of 'abandonment' as opposed to 'empowerment'.
"… it's essential we give people the confidence to self-care along with necessary support otherwise there is a danger that people will feel abandoned rather than empowered".
Most respondents felt that the NHS continues to promote itself as a "rescue service for victims" rather than supporting individuals in developing their own power and agency. One respondent suggested that NHS 111 and the use of decision support tools including online symptom checkers could help raise awareness about symptoms red flag conditions that need HCP support or emergent care compared to symptoms commonly experienced in self-limiting conditions. It was acknowledged that the widescale use of digital therapeutics and decision support tools may divert patients from seeking an unnecessary appointment with HCP for non-serious or self-limiting conditions, thus helping to reduce pressure on scarce NHS resources but also that any such reliance on online tools may exacerbate existing digital inequalities, especially with marginalised groups and already at-risk populations.
Issues arising since the advent of COVID
Respondents observed that all government guidance and most of the advice given by NHS 111 centred around getting people to self-care for coronavirus, either by avoiding an infection (prevention) or self-management of COVID-19 symptoms in the home setting. Advice and official guidance since the first national lockdown highlighted personal agency and risk avoidance to help "flatten the curve". This guidance was contemporaneous with various NHS England (NHSE)-led initiatives that saw the widespread acceptance and use of the NHS App, self-testing using rapid antigen test (RAT) kits, voluntary PCR testing for those who tested positive on RAT, and the national launch of the @Home programme. At the same time, self-management of long-term conditions with point-of-care and diagnostic testing at home was quickly becoming the norm.
"During the pandemic, the public moved to becoming totally self-caring by default. People bought their own thermometers, pulse oximeters, blood pressure monitors and personal hygiene products. Simple everyday things like alcohol wipes and hand sanitiser are now part of the mainstay of self-care. Lateral flow tests were a huge success, and their use was often supported with advice from pharmacists. People quickly learnt how to self-test, but this was not routine practice prior to the pandemic. It's just amazing to see how people's attitudes and reliance on self-care increased during the pandemic. I mean, you can argue that most people are now experts at self-care. Who would've thought that nearly everyone would know how to do an antigen test to self-diagnose when this was considered largely the preserve of healthcare professionals before the pandemic."
A note of caution was expressed in some interviews with evidence of problems being exacerbated rather than being actively dealt with through self-care.
"… The fear that some people experienced since the advent of COVID-19 meant that there was suddenly a massive demand from people who've been by default self-caring and storing problems rather than dealing with them".
Respondents felt that some groups, notably the elderly, did not- or could not- call or follow-up when appropriate for 'not wanting to bother' doctors and other professionals. A recurrent case study was how the number of cancer referrals had dropped significantly during the pandemic, with most referrals presenting with much later stage disease requiring intensive treatment and with ultimately poorer prognosis.
"Some people felt empowered, but some cancers may well have been missed… presenting later with more extensive disease because of a perception that GP surgeries are closed."
Technology played an important part in accessing healthcare remotely. Modalities including online consultations helped streamline access to HCPs and access to reliable online self-care resources during the pandemic. However, there was concern that the shift to telephone and online delivery, including eConsult may have exacerbated extant inequalities, especially in the elderly or segments of society that are digitally excluded.
"[We] turned increasingly to mobile phone use although some older people did not have access to technology and do not understand it."
… "at times I felt that consultations with people you haven't engaged with before has been a process of alienation between the clinician and patient."
Overall, respondents were sceptical that the benefits of increasing awareness about the importance of self-care would be permanent as some patients may perceive prolonged reliance on self-care as a kind of rationing, whereas other HCPs felt that it was only a matter of time before everyone naturally reverts to the traditional model of care once COVID was firmly in the rear-view mirror.
"[some surgeries say] 'don't come here - go home' leaving patients to deal with their dependence on general practice which was not of their own making."
"There is a danger that encouraging self-care can be seen as rationing with a potential backlash."
In reference to this, two interviewees referred to NHSE recommendation that primary care activity should revert to pre-COVID numbers of face-to-face consultations, even though NHSE did not show the evidence that this could result in better outcomes. It was felt that the numbers of consultations were considered to be more important than the quality.
"The emphasis has been 'excess' not access."
Future reliance on self-care
Despite the tragedies of COVID, all interview participants believed that self-care had become mainstream, with all advice promoting it. Rather than reverting to over-reliance on NHS staff, respondents felt the pandemic was an opportunity to embed some of the learning and the growing realisation that reliance on the self, and self-care, should be a mainstay of how some NHS services are delivered in the future:
"It is an opportunity that needs to be grasped immediately. There has been a strong change in attitudes; self-care has been embraced by both sides".
Respondents highlighted that the learning needs to be consolidated to resist central pressure to revert to a paternalistic system that have already proved difficult to maintain.
"A fundamental change has been to give greater agency and autonomy to individuals to allow them to self-care whilst also providing a level of professional fulfilment by Zoom."
"It is not standard in routine general practice to discuss self-care options."
Widespread access to good quality information, which is understandable, accessible, tailored, and inclusive, was required to ensure care remained optimal, with special attention for those who lack access to care the most.
"There is an absolute need for information to be digestible and comprehensible, to make sense for the individual, and with specific advice on what to do next."
The lack of self-care in the training of professionals, particularly the medical profession, needed to be addressed urgently to establish patient agency as the underpinning of care rather than a doctor centred view. This requires correcting in the postgraduate realm to a person-centred view of medicine. This was of equal importance in training for hospital specialties.
"Self-care has been everybody's job but nobody's responsibility."
"… a change in GP training is needed, otherwise the same attitudes to doctor centrality will continue."
"Self-care does not have its own domain or is even featured in many textbooks... and is not included in examinations.”
Table 2
Results of electronic survey
| Doctor | Nurse | Service | Pharmacy | SP/Other | Total | p-value |
N (%) | N (%) | N (%) | N (%) | N (%) | N (%) |
Perceived importance of self-care to patients before the pandemic? | | | | | | | 0.07 |
Very unimportant | 1 (2.1) | 5 (11.4) | 2 (4.8) | 8 (6.7) | 6 (11.8) | 22 (7.2) | |
Unimportant | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.8) | 0 (0.0) | 1 (0.3) | |
Neutral | 1 (2.1) | 2 (4.5) | 1 (2.4) | 9 (7.6) | 7 (13.7) | 20 (6.6) | |
Important | 13 (27.1) | 17 (38.6) | 8 (19.0) | 45 (37.8) | 13 (25.5) | 96 (31.6) | |
Very important | 33 (68.8) | 20 (45.5) | 31 (73.8) | 56 (47.1) | 25 (49.0) | 165 (54.3) | |
TOTAL | 48 (100.0) | 44 (100.0) | 42 (100.0) | 119 (100.0) | 51 (100.0) | 304 (100.0) | |
Perceived capacity and empowerment of patients to self-care before the pandemic | 0.19 |
Very unimportant | 2 (4.2) | 1 (2.3) | 1 (2.4) | 1 (0.8) | 0 (0.0) | 5 (1.6) | |
Unimportant | 14 (29.2) | 6 (13.6) | 5 (11.9) | 13 (10.9) | 9 (17.6) | 47 (15.5) | |
Neutral | 19 (39.6) | 19 (43.2) | 15 (35.7) | 54 (45.4) | 24 (47.1) | 131 (43.1) | |
Important | 11 (22.9) | 13 (29.5) | 16 (38.1) | 46 (38.7) | 14 (27.5) | 100 (32.9) | |
Very important | 2 (4.2) | 5 (11.4) | 5 (11.9) | 5 (4.2) | 4 (7.8) | 21 (6.9) | |
TOTAL | 48 (100.0) | 44 (100.0) | 42 (100.0) | 119 (100.0) | 51 (100.0) | 304 (100.0) | |
HCP personal motivations to support people to self-care before the pandemic | 0.007 |
Empower the client/user | 40 (15.9) | 36 (22.0) | 39 (26.9) | 82 (15.4) | 43 (22.4) | 240 (18.7) | |
It is more convenient to the client/user | 20 (7.9) | 10 (6.1) | 8 (5.5) | 40 (7.5) | 17 (8.9) | 95 (7.4) | |
The option to self-care for some conditions is the superior mode of care | 34 (13.5) | 20 (12.2) | 20 (13.8) | 54 (10.2) | 18 (9.4) | 146 (11.4) | |
Help prevent certain conditions or minimise likelihood of exacerbations | 40 (15.9) | 32 (19.5) | 28 (19.3) | 95 (17.9) | 31 (16.1) | 226 (17.6) | |
To help me reduce my workload | 21 (8.3) | 3 (1.8) | 4 (2.8) | 11 (2.1) | 5 (2.6) | 44 (3.4) | |
To help reduce pressure on scarce NHS resources | 32 (12.7) | 18 (11.0) | 17 (11.7) | 83 (15.6) | 22 (11.5) | 172 (13.4) | |
To promote health literacy | 31 (12.3) | 23 (14.0) | 14 (9.7) | 65 (12.2) | 25 (13.0) | 158 (12.3) | |
To promote the rational use of products & services | 32 (12.7) | 17 (10.4) | 12 (8.3) | 95 (17.9) | 24 (12.5) | 180 (14.0) | |
Other (please specify) | 2 (0.2) | 5 (3.0) | 3 (2.1) | 7 (1.3) | 7 (3.6) | 24 (1.9) | |
TOTAL | 252 (100.0) | 164 (100.0) | 145 (100.0) | 532 (100.0) | 192 (100.0) | 1285 (100.0) | |
Which aspects of self-care did you actively encourage prior to the pandemic? | < 0.001 |
Building self-care capacity as part of routine professional care | 10 (3.5) | 14 (7.7) | 14 (6.6) | 41 (5.9) | 17 (6.2) | 96 (6.2) | |
Dispensing & encouraging appropriate use of medicines | 15 (5.3) | 6 (3.3) | 0 (0.0) | 51 (7.3) | 5 (1.8) | 77 (4.9) | |
Improving general wellbeing | 40 (14.1) | 32 (17.5) | 32 (15.2) | 95 (13.6) | 45 (16.3) | 244 (16.7) | |
Improving mental health | 25 (8.8) | 13 (7.1) | 23 (10.9) | 41 (5.9) | 23 (8.3) | 125 (8.0) | |
Making healthy lifestyle choices | 41 (14.5) | 37 (20.2) | 29 (13.7) | 105 (15.1) | 41 (14.9) | 253 (16.2) | |
Managing cancer care | 4 (1.4) | 0 (0.0) | 0 (0.0) | 7 (1.0) | 0 (0.0) | 11 (0.7) | |
Managing chronic long-term conditions | 16 (5.7) | 11 (6.0) | 11 (5.2) | 38 (5.5) | 18 (6.5) | 94 (6.0) | |
Managing existing mental illness | 15 (5.3) | 5 (2.7) | 11 (5.2) | 30 (4.3) | 12 (4.3) | 73 (4.7) | |
Managing Infectious diseases | 9 (3.2) | 1 (0.5) | 4 (1.9) | 19 (2.7) | 0 (0.0) | 33 (2.1) | |
Managing minor illness & common conditions | 32(11.3) | 25 (13.7) | 14 (6.6) | 92 (13.2) | 26 (9.4) | 189 (12.1) | |
Managing prescribing | 15 (5.4) | 6 (3.3) | 0 (0.0) | 51 (7.3) | 5 (1.8) | 77 (4.9) | |
None of the above | 0 (0.0) | 0 (0.0) | 0 (0.0) | 3 (0.4) | 0 (0.0) | 3 (0.2) | |
Other (please specify) | 3 (1.1) | 1 (0.5) | 1 (0.5) | 2 (0.3) | 3 (1.1) | 10 (0.6) | |
Preventing infectious diseases | 18 (6.4) | 10 (5.5) | 9 (4.3) | 47 (6.8) | 10 (3.6) | 94 (6.0) | |
Preventing mental illness | 21 (7.4) | 10 (5.5) | 11 (5.2) | 24 (3.4) | 13 (4.7) | 79 (5.1) | |
Preventing non-communicable diseases | 19 (6.7) | 12 (6.6) | 6 (2.8) | 50 (7.2) | 14 (5.1) | 101 (6.5) | |
Total | 283 (100.0) | 183 (100.0) | 211 (100.0) | 696 (100.0) | 276 (100.0) | 1559 (100.0) | |
Perceived importance of self-care to patients since the advent of COVID-19 pandemic? | 0.27 |
Very unimportant | 2 (4.2) | 0 (0.0) | 0 (0.0) | 2 (1.7) | 2 (3.9) | 6 (2) | |
Unimportant | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.8) | 0 (0.0) | 1 (0.3) | |
Neutral | 2 (4.2) | 1 (2.3) | 2 (4.8) | 3 (2.5) | 0 (0.0) | 8 (2.6) | |
Important | 1 (2.1) | 2 (4.6) | 2 (4.8) | 10 (8.4) | 9 (17.7) | 24 (7.9) | |
Very Important | 42 (87.5) | 41 (93.2) | 38 (90.5) | 103 (86.6) | 40 (78.4) | 264 (86.8) | |
Unknown | 1 (2.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.3) | |
Perceived capacity/empowerment of service users to self-care since the advent of the pandemic | 0.008 |
Very unimportant | 3 (6.3) | 0 (0.0) | 1 (2.4) | 1 (0.8) | 0 (0.0) | 5 (1.6) | |
Unimportant | 9 (18.8) | 3 (6.8) | 6 (14.3) | 11 (9.2) | 7 (13.7) | 36 (11.8) | |
Neutral | 8 (16.7) | 16 (36.4) | 15 (35.7) | 19 (16.0) | 14 (27.5) | 72 (23.7) | |
Important | 16 (33.3) | 17 (38.6) | 14 (33.3) | 44 (37.0) | 21 (41.2) | 112 (36.8) | |
Very important | 12 (25.0) | 8 (18.2) | 6 (14.3) | 44 (37.0) | 9 (17.6) | 79 (26.0) | |
TOTAL | 48 (100.0) | 44 (100.0) | 42 (100.0) | 119 (100.0) | 51 (100.0) | 304 (100.0) | |
Main HCP motivations to support people to self-care since the advent of COVID-19 pandemic | 0.12 |
It can help reduce pressure on scarce NHS resources | 36 (15.4) | 28 (13.8) | 25 (14.5) | 102 (16.9) | 30 (14.7) | 221 (15.6) | |
It is empowering to the client/user | 33 (14.1) | 40 (19.7) | 38 (22.1) | 92 (15.3) | 45 (22.1) | 248 (17.5) | |
It is more convenient to the client/user | 19 (8.1) | 17 (8.4) | 15 (8.7) | 60 (10.0) | 19 (9.3) | 130 (9.2) | |
The option to self-care for some conditions is the superior mode of care | 32 (13.7) | 25 (12.3) | 22 (12.8) | 67 (11.1) | 20 (9.8) | 166 (11.7) | |
Help prevent certain conditions or minimise likelihood of exacerbations | 33 (14.1) | 34 (16.7) | 28 (16.3) | 94 (15.6) | 32 (15.7) | 221 (15.6) | |
To help me reduce my workload | 25 (10.7) | 9 (4.4) | 6 (3.5) | 21 (3.5) | 5 (2.5) | 66 (4.7) | |
To promote of health literacy | 23 (9.8) | 25 (12.3) | 20 (11.6) | 69 (11.4) | 27 (13.2) | 164 (11.6) | |
To promote of the rational use of products & services | 32 (13.7) | 23 (11.3) | 16 (9.3) | 94 (15.6) | 20 (9.8) | 185 (13.1) | |
Other (please specify) | 1 (0.4) | 2 (1.0) | 2 (1.2) | 4 (0.7) | 6 (2.9) | 15 (1.1) | |
Total | 234 (100.0) | 203 (100.0) | 172 (100.0) | 603 (100.0) | 204 (100.0) | 1416 (100.0) | |
Which Aspects of self-care did you actively encourage since the advent of the pandemic? | < 0.001 |
Building self-care capacity as part of routine professional care | 32 (7.8) | 34 (9.7) | 25 (10.6) | 75 (7.4) | 33 (10.6) | 199 (8.6) | |
dispensing & encouraging appropriate use of medicines | 27 (6.6) | 23 (6.6) | 4 (1.7) | 86 (8.5) | 8 (2.6) | 148 (6.4) | |
Improving general wellbeing | 36 (8.7) | 39 (11.1) | 34 (14.5) | 94 (9.3) | 41 (13.2) | 244 (10.5) | |
Improving mental health | 28 (6.8) | 31 (8.9) | 30 (12.8) | 67 (6.7) | 34 (11.0) | 190 (8.2) | |
Making healthy lifestyle choices | 42 (10.2) | 38 (10.9) | 35 (14.9) | 95 (9.4) | 36 (11.6) | 246 (10.6) | |
Managing cancer care | 18 (4.4) | 6 (1.7) | 1 (0.4) | 20 (2.0) | 5 (1.6) | 50 (2.2) | |
Managing chronic long-term conditions | 34 (8.3) | 27 (7.7) | 20 (8.5) | 85 (8.4) | 26 (8.4) | 192 (8.3) | |
Managing existing mental illness | 34 (8.3) | 27 (7.7) | 24 (10.2) | 66 (6.6) | 30 (9.7) | 181 (7.8) | |
Managing Infectious diseases | 27 (6.6) | 12 (3.4) | 8 (3.4) | 49 (4.9) | 10 (3.2) | 106 (4.6) | |
Managing minor illness & common conditions | 31 (7.5) | 24 (6.9) | 12 (5.1) | 93 (9.2) | 21 (6.8) | 181 (7.8) | |
Managing prescribing | 27 (6.6) | 23 (6.6) | 4 (1.7) | 86 (8.5) | 8 (2.6) | 148 (6.4) | |
None of the above | 0 (0.0) | 0 (0.0) | 0 (0.0) | 6 (0.6) | 1 (0.3) | 7 (0.3) | |
Other (please specify) | 2 (0.5) | 2 (0.6) | 0 (0.0) | 4 (0.4) | 5 (1.6) | 13 (0.6) | |
Preventing infectious diseases | 24 (5.8) | 23 (6.6) | 14 (6.0) | 64 (6.4) | 18 (5.8) | 143 (6.2) | |
Preventing mental illness | 24 (5.8) | 21 (6.0) | 17 (7.2) | 51 (5.1) | 20 (6.5) | 133 (5.7) | |
Preventing non-communicable diseases | 26 (6.3) | 20 (5.7) | 7 (3.0) | 66 (6.6) | 14 (4.5) | 133 (5.7) | |
TOTAL | 412 (100.0) | 350 (100.0) | 235 (100.0) | 1007 (100.0) | 310 (100.0) | 2314 (100.0) | |
Are you more or less likely to recommend & support your service users to self-care in your daily work as a result of the pandemic? | 0.22 |
Significantly less likely | 2 (4.2) | 0 (0) | 0 (0) | 2 (1.7) | 0 (0) | 4 (1.3) | |
Slightly less likely | 1 (2.1) | 0 (0) | 0 (0) | 2 (1.7) | 1 (2.0) | 4 (1.3) | |
No change | 3 (6.3) | 3 (6.8) | 6 (14.3) | 17 (14.3) | 9 (17.7) | 38 (12.5) | |
Slightly more likely | 23 (47.9) | 12 (27.3) | 11 (26.2) | 38 (31.9) | 15 (29.4) | 99 (32.6) | |
Significantly more likely | 18 (37.5) | 29 (65.9) | 25 (59.5) | 60 (50.4) | 26 (51.0) | 158 (52) | |
TOTAL | 47 (100.0) | 44 (100.0) | 42 (100.0) | 119 (100.0) | 51 (100.0) | 303 (100.0) | |
Which aspect of self-care did you personally pursue during the pandemic? | < 0.001 |
Building self-care capacity as part of routine professional care | 9 (4.9) | 18 (9.9) | 13 (8.2) | 41 (7.4) | 23 (10.3) | 103 (7.9) | |
dispensing & encouraging appropriate use of medicines | 4 (2.2) | 6 (3.3) | 1 (0.6) | 32 (5.8) | 6 (2.7) | 49 (3.8) | |
Improving general wellbeing | 31 (17.0) | 35 (19.2) | 28 (17.7) | 76 (13.7) | 33 (14.8) | 203 (15.6) | |
Improving mental health | 20 (11.0) | 17 (9.3) | 19 (12.0) | 51 (9.2) | 25 (11.2) | 132 (10.1) | |
Making healthy lifestyle choices | 33 (18.1) | 34 (16.7) | 30 (19.0) | 89 (16.1) | 38 (17.0) | 224 (17.3) | |
Managing cancer care | 2 (1.1) | 0 (0.0) | 0 (0.0) | 6 (1.1) | 2 (0.9) | 10 (0.8) | |
Managing chronic long-term conditions | 7 (3.8) | 7 (3.8) | 13 (8.2) | 17 (3.1) | 14 (6.3) | 58 (4.5) | |
Managing existing mental illness | 6 (3.3) | 1 (0.5) | 10 (6.3) | 28 (5.1) | 11 (4.9) | 56 (4.3) | |
Managing Infectious diseases | 6 (3.3) | 2 (1.1) | 4 (2.5) | 19 (3.4) | 4 (1.8) | 35 (2.7) | |
Managing minor illness & common conditions | 14 (7.7) | 13 (7.1) | 8 (5.1) | 53 (9.6) | 14 (6.3) | 102 (7.9) | |
Managing prescribing | 4 (2.2) | 6 (3.3) | 1 (0.6) | 32 (5.8) | 6 (2.7) | 49 (3.8) | |
None of the above | 4 (2.2) | 3 (1.6) | 2 (1.3) | 5 (0.9) | 2 (0.8) | 16 (1.2) | |
Other (please specify) | 2 (1.1) | 4 (2.2) | 1 (0.6) | 2 (0.4) | 4 (1.8) | 13 (1.0) | |
Preventing infectious diseases | 19 (10.4) | 15 (8.2) | 16 (10.1) | 46 (8.3) | 19 (8.5) | 115 (8.9) | |
Preventing mental illness | 12 (6.6) | 14 (7.7) | 8 (5.1) | 27 (4.9) | 15 (6.7) | 76 (5.9) | |
Preventing non-communicable diseases | 9 (4.9) | 7 (3.8) | 5 (3.2) | 29 (5.3) | 7 (3.1) | 57 (4.4) | |
Total | 182 (100.0) | 182 (100.0) | 158 (100.0) | 553 (100.0) | 223 (100.0) | 1236 (100.0) | |
Perceived general barriers to self-care | | | | | | | 0.98 |
Barriers caused by new digital or telephone interactions | 20 (4.0) | 28 (5.6) | 24 (6.0) | 65 (4.8) | 29 (5.5) | 166 (5.1) | |
Communication barriers due to hearing difficulties | 9 (1.8) | 19 (3.8) | 10 (2.5) | 51 (3.8) | 17 (3.2) | 106 (3.2) | |
Dependency on professional role | 36 (7.1) | 23 (4.6) | 19 (4.7) | 66 (4.9) | 28 (5.3) | 172 (5.2) | |
Difficulties in access to services & professionals | 27 (5.3) | 29 (5.8) | 28 (7.0) | 81 (6.0) | 27 (5.1) | 192 (5.9) | |
Digital exclusion | 29 (5.7) | 35 (7.0) | 29 (7.2) | 83 (6.2) | 41 (7.8) | 217 (6.6) | |
Health inequalities | 29 (5.7) | 35 (7.0) | 21 (5.2) | 74 (5.5) | 28 (5.3) | 187 (5.7) | |
Health literacy | 26 (5.1) | 26 (5.2) | 15 (3.7) | 71 (5.3) | 26 (5.0) | 164 (5.0) | |
Individual reluctance to engage or take responsibility | 37 (7.3) | 33 (6.6) | 29 (7.2) | 95 (7.1) | 32 (6.1) | 226 (6.9) | |
Insufficient IT skills | 31 (6.1) | 34 (6.8) | 27 (6.7) | 81 (6.0) | 40 (7.6) | 213 (6.5) | |
Interprofessional communication | 13 (2.6) | 17 (3.4) | 12 (3.0) | 54 (4.0) | 20 (3.8) | 116 (3.5) | |
Lack of appropriate information to share with people | 20 (4.0) | 15 (3.0) | 15 (3.7) | 38 (2.8) | 9 (1.7) | 97 (3.0) | |
Lack of consistency in approach or messages amongst professionals | 27 (5.3) | 25 (5.0) | 16 (4.0) | 81 (6.0) | 27 (5.1) | 176 (5.4) | |
Lack of evidence of effectiveness of self-care interventions | 8 (1.6) | 7 (1.4) | 6 (1.5) | 17 (1.3) | 9 (1.7) | 47 (1.4) | |
Lack of funding | 20 (4.0) | 12 (2.4) | 14 (3.5) | 51 (3.8) | 22 (4.2) | 119 (3.6) | |
Lack of IT training | 12 (2.4) | 22 (4.4) | 6 (1.5) | 35 (2.6) | 15 (2.9) | 90 (2.7) | |
Language barriers | 21 (4.2) | 22 (4.4) | 12 (3.0) | 47 (3.5) | 19 (3.6) | 121 (3.7) | |
Other (please specify) | 8 (1.6) | 2 (0.4) | 3 (0.7) | 7 (0.5) | 4 (0.8) | 24 (0.7) | |
Patient/client understanding of self-care | 36 (7.1) | 29 (5.8) | 27 (6.7) | 95 (7.1) | 31 (5.9) | 218 (6.7) | |
Professional resistance to sharing responsibility | 12 (2.4) | 12 (2.4) | 11 (2.7) | 29 (2.2) | 11 (2.1) | 75 (2.3) | |
Professional understanding of alternatives to face-to-face interactions | 16 (3.2) | 13 (2.6) | 12 (3.0) | 36 (2.7) | 16 (3.0) | 93 (2.8) | |
Professional understanding of self-care | 12 (2.4) | 7 (1.4) | 13 (3.2) | 26 (1.9) | 11 (2.1) | 69 (2.1) | |
Time constraints | 35 (6.9) | 28 (5.6) | 23 (5.7) | 81 (6.0) | 31 (5.9) | 198 (6.0) | |
Transition of services from face-to-face to other formats | 22 (4.3) | 30 (6.0) | 29 (7.2) | 78 (5.8) | 32 (6.1) | 191 (5.8) | |
Total | 506 (100.0) | 503 (100.0) | 401 (100.0) | 1342 (100.0) | 525 (100.0) | 3277 (100.0) | |