Self Care Routines
Self-care routines involve patterned behaviors related to usual activities of daily living experienced across the life course, behaviors initially guided and strongly reinforced by parents. Routines differ across and often within families depending upon member’s developmental stages and other temporal factors. Health routines related to hygiene practices include such things as cleanliness, dental care, and toileting activities.
Dietary practices are one of the most complex health routines identified and often mentioned first as a key family health factor. Dietary routines seem strongly rooted in family of origin patterns, varied greatly within and between families, and were often modified due to member schedules, events, and family traditions. Family members have described dietary practices in terms of (a) individual and family food selection, (b) food procurement and storage, (c) types of food preparation, (d) meal consumption patterns, (e) snacking patterns, (f) member roles, and (g) resource availability. Families differ in the freedom allowed members regarding selection and consumption of foods that conflicted with the mother’s ideals. Although mothers mostly prepared meals and children in a single family were usually provided the same menu at meals, the nutritional value of foods consumed by members within the same family was different. Even when mothers were consistent in planning and preparing meals, individual eating patterns and members present for meals varied. When work or activity schedules conflicted with meals, mothers were apt to allow family members to consume less healthy or even unhealthy food items. Dietary patterns were largely influenced by (a) mother’s knowledge about nutrition, (b) personal choices and food preferences, (c) dietary beliefs and values, (d) work and school schedules, and (e) member cooperation in caring for one another’s needs. Families had different dietary rules such as eating what is prepared; tasting new foods; ways food should be prepared, served, purchased, and stored; when and where foods could be eaten; and who had to have what for breakfast, lunch, and supper. Most adults said they tried to be consistent about adhering to healthy diets. Several described reasons for dietary inconsistencies tied to observations of ancestors and family friends who had lived to be 80-90 years of age without watching their diets, worrying about exercise, or seeking medical care.
Nutrition has been widely recognized as a key modifiable lifestyle factor with broad health implications. Healthy People 2010 has identified overweight and obesity as a leading health indicator pertinent to broad public health issues (U.S. Department of Health and Human Services, 2000). The intention of leading health indicators is to increase understandings about health promotion, disease prevention, and encourage wide participation in health improvement in the next decade. Nurses have some education about nutrition and understand dietary relationship to diseases, illness, but they most often educate and counsel about nutrition with little emphasis placed upon the lived household experience or routines. Diet histories are often used to assess nutritional intake, but family patterns influencing diet are less likely to be considered. Family-focused care implies a holistic response to nutritional needs that includes things such as member values, family meal patterns, cultural and ethnic influences, personal preferences, family rules about diet, finances, knowledge about nutrition, and special dietary needs. In order to assist families to construct routines they will value and ones beneficial to health needs, families need knowledge and skills to alter behaviors and maintain changes over the life course.
Sleep and rest patterns are affected by time, role demands, work schedules, seasons, and special events, but less often than dietary routines. Preparation for sleep often occurs in close proximity to other routines such as dietary practices and hygiene care, although snacks and baths were often closely aligned to sleep routines they were actually other health routines. Unique variations in sleep and rest patterns are related to (a) bedtime and awake time, (b) sleep or rest time requirements, (c) sleep locations and with whom, and (d) strings of sleep related behaviors. Sleep and rest patterns are influenced by (a) biological rhythms, (b) personal time demands, (c) family patterns, (d) developmental stages, and (e) seasons. Families living with unpredictable life events (e.g., children with special health care needs or developmental delays, terminal illness) might express concerns related to interrupted sleep routines.
Mothers may be the most likely to experience sleep deprivation when members are ill or unpredictable life events occurred. Inordinate stress levels with potential ‘pile-up’ effects can place mothers at risk for depression, lowered self-esteem, and other health risks. In research conducted, several mothers reported stress symptoms due to sleep deprivation. In fact, several parents indicated that when routines were out of sync, personal stress and family discord occurred.s
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