Conceptualizing self-care among nurses: a hybrid concept analysis with potential implications for workforce sustainability and quality of care

Abstract

Self-care is a fundamental concept in nursing theories and a key strategy for maintaining personal health and enhancing the quality of care among nurses. Despite its growing importance, the concept of self-care in nursing remains insufficiently defined and is often overlooked due to challenging working conditions, a culture of self-sacrifice, and lack of targeted education. Given the complexities of the nursing profession and the direct impact of self-care on nurses’ well-being and the quality of healthcare services, a contextual redefinition of this concept appears essential. This study aims to analyze and clarify the concept of self-care among nurses using a hybrid model of concept analysis, exploring its dimensions, antecedents, and consequences within the cultural and professional context of Iran. This study employed a hybrid concept analysis approach based on the Schwartz-Barcott and Kim model, consisting of theoretical, fieldwork, and final analytic phases. In the theoretical phase, a systematic literature review—without time limitation—was conducted across major databases up to June 2023 to extract attributes, dimensions, antecedents, and consequences of self-care among nurses. The fieldwork phase involved a qualitative study using semi-structured interviews with 17 nurses selected through maximum variation sampling. Data were analyzed using directed content analysis. In the final phase, findings from both phases were integrated to develop a comprehensive definition of the concept of self-care in nursing. Nurses’ self-care was conceptualized as a dynamic, intentional, and context-sensitive process comprising six interrelated dimensions: physical, psychological, spiritual, social, professional security, and professionalism. The antecedents identified across the theoretical and fieldwork phases were integrated into four broader areas: individual factors, work-related conditions and multiple role pressure, support systems, and cultural and environmental values. The perceived or reported consequences were organized into three categories: personal, professional, and social. Participants associated self-care with their physical, psychological, and spiritual well-being; professional concentration, behavior, and capacity to provide safe and attentive care; and workplace and family interactions. Nurses’ self-care is a multidimensional and socially embedded process shaped by the interaction of individual, occupational, organizational, and cultural factors. The findings suggest that self-care may be relevant to nurses’ well-being, professional functioning, and interpersonal relationships. However, this concept analysis did not directly assess clinical errors, quality of care, workforce retention, or healthcare-system sustainability; therefore, these relationships should be interpreted as perceived associations and conceptually plausible pathways rather than demonstrated effects. The resulting framework may inform the development and evaluation of contextually appropriate educational and organizational initiatives, but such initiatives should complement rather than substitute for safe working conditions and adequate organizational resources. Not applicable.

The authors' abstract, as published at the source. BMC Health Services Research, 2026 · DOI ↗