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A Theory of Taking Care of Oneself Grounded in Experiences of Homeless Youth

Rew, Lynn


Background: Homeless adolescents are vulnerable to poor health outcomes owing to the dangerous and stressful environments in which they live. Despite their vulnerability, many of them are motivated to engage in self-care behaviors.

Objective: The specific aim of this study was to explore self-care attitudes and behaviors of homeless adolescents.

Method: Individual interviews were conducted with 15 homeless adolescents. Interviews were audiotaped, transcribed verbatim, and analyzed using the constant comparative method of grounded theory.

Results: Findings revealed a basic social process of taking care of oneself in a high-risk environment. This basic social process was supported by three categories: Becoming Aware of Oneself, Staying Alive With Limited Resources, and Handling One’s Own Health, each including two processes.

Discussion: Findings support Orem’s conceptualizations of self-care and self-care agency and suggest the need for programs to support further healthy growth and development among homeless adolescents.

Homeless adolescents in the United States (US) comprise a population vulnerable to myriad health risks and adverse health outcomes. Numbering nearly two million, these youths include individuals who have run away from home, been removed from their homes by child protective authorities, or who have been thrown out of their homes by their parents (Shane, 1996). Living in the streets, abandoned buildings, cars, trucks, and public parks, these youths encounter environmental conditions that are both stressful and hazardous to their health (van der Ploeg & Scholte, 1997). Despite their early childhood experiences and high-risk lifestyles, many homeless youths are characterized as resilient (Rew, Taylor-Seehafer, Thomas, & Yockey, 2001). Several studies have focused on the health-risk behaviors of homeless adolescents (Rew, Taylor-Seehafer, & Fitzgerald, 2001;Rotheram-Borus, Mahler, Koopman, & Langabeer, 1996;Sullivan, 1996;Yoder, Hoyt, & Whitbeck 1998), yet there is little known about the attitudes and behaviors that reflect their self-care and health-promoting behaviors. The purpose of this study was to develop a descriptive theory of self-care attitudes and practices grounded in the experiences of older youths who are homeless.

Lynn Rew, EdD, RNC, FAAN is Denton and Louise Cooley and Family Centennial Professor in Nursing, The University of Texas at Austin.

Accepted for publication February 10, 2003.

This study was supported by a research award from the American Holistic Nurses’ Association.

The author thanks the staff and clients at Project PHASE, Austin, Texas, for their assistance and David Kahn, PhD, Associate Professor, and Sharon Horner, PhD, Associate Professor, School of Nursing at The University of Texas at Austin, for their invaluable consultations.

Corresponding author: Lynn Rew, EdD, RNC, FAAN, The University of Texas at Austin, 1700 Red River, Austin, TX 78701 (e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.