"Becoming a Values-Driven Self-Care User”: Development of a Grounded Theory Model and Group Intervention for Health Students
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Self-care is generally understood as a multi-dimensional construct that involves using self-selected strategies in order to achieve a balance between personal and professional life, and to support and promote mental/emotional, physical, spiritual, and professional functioning (Jordan, 2010; Lee & Miller, 2013). Self-care is imperative for health students, as they are at a greater risk for burnout and given their collective responsibility for caring for others (Cecil et al., 2014; Duarte et al., 2016; Salyers et al., 2015). However, there is insufficient focus on self-care in training programs and students’ uptake of self-care is low (Bettney, 2017; El-Ghoroury et al., 2012; Furr & Brown-Rice, 2017). My dissertation aimed to understand this gap between knowledge and action by theorizing how health students who are in undergraduate and graduate programs naturalistically create and maintain self-care, and then by developing a theory-based intervention. In Study 1, I used grounded theory methodology to develop a theory delineating the process of a successful self-care user from the perspective of health students (N = 17). My grounded theory, Becoming a Values-Driven Self-Care User, comprised four phases that participants moved through iteratively: 1) Having a Wake-Up Call, 2) Building Skills, 3) Gaining Confidence, and 4) Building an Identity. In addition, my grounded theory explained why some students were unsuccessful at developing self-care practices and this helped to address the barriers of self-care reported by students. My theory showed that self-care skills are solidified into students’ identities in the context of a values disconnect along with practice and support. This is the first comprehensive theory to explain how health students develop effective self-care habits, and it informs the development of self-care interventions for this population. In Study 2, I used my grounded theory model, as well as previous theoretical work, to develop and evaluate a group self-care intervention, Values-Based Self-Care (VBSC), which comprised of six, 90-minute weekly sessions. I randomly assigned a heterogenous sample of health students (N = 61) into an intervention (VBSC) or waitlist control group. Pre- and post-group data was collected before and after the intervention/wait period and then analyzed for group differences. I also examined within-person changes before and after the intervention using the total sample. My hypotheses were partially supported. There were significant within-person pre-post intervention changes in self-care, emotional distress, valued living, and self-esteem. However, when comparing the intervention and waitlist control groups, meaningful differences were only found for self-care, valued living, and depression. My dissertation shows that values are essential for building and maintaining self-care. In addition, consolidating self-care behaviours into health students’ identities requires support, time, and practice. My dissertation encourages new avenues for future researchers to develop tailored self-care interventions that afford students with social support and feedback, which are necessary for skill mastery. My findings also have implications for how we operationalize self-care and measure it within research studies.
DegreeDoctor of Philosophy (Ph.D.)
CommitteeLawson, Karen; Desjardins, Michel; O’Connell, Megan; D’Eon, Marcel; Martin, Stephanie
Copyright DateMay 2021