requires the ability to label and interpret changes in the body as normal or abnormal. Recognizing bodily signs and symptoms, understanding disease progression, and their respective treatments allow competency in knowing when to seek further medical help. Self-care monitoring consists of both the perception and measurement of symptoms. Symptom perception is the process of monitoring one's body for signs of changing health. This includes body awareness or body listening, and the recognition of symptoms relevant to health. Changes in health status or body function can be monitored with various tools and technologies. The range and complexity of medical devices used in both hospital and home care settings are increasing. Certain devices are specific to a common need of a disease process such as glucose monitors for tracking blood sugar levels in diabetic patients. Other devices can provide a more general set of information, such as a weight scale, blood pressure cuff, pulse oximeter, etc. Less technological tools include organizers, charts, and diagrams to trend or keep track of progress such as the number of calories, mood, vital sign measurements, etc. Barriers to monitoring The ability to engage in self-care monitoring impacts disease progression. Barriers to monitoring can go unrecognized and interfere with effective self-care. Barriers include knowledge deficits, undesirable self-care regimens, different instructions from multiple providers, and limitations to access related to income or disability. Psychosocial factors such as motivation, anxiety, depression, confidence can also serve as barriers. High costs may prevent some individuals from acquiring monitoring equipment to keep track of symptoms. Lack of knowledge on the implications of physiological symptoms such as high blood glucose levels may reduce an individual's motivation to practice self-care monitoring. Fear of outcomes/fear of using equipment such as needles may deter patients from practicing self-care monitoring due to the resulting anxiety, or avoidant behaviors. Lack of family support may affect consistency in monitoring self-care due to the lack of reminders or encouragement. The presence of co-morbid conditions makes performing self-care monitoring particularly difficult. For example, the shortness of breath from COPD can prevent a diabetic patient from physical exercise. Symptoms of chronic illnesses should be considered when performing self-care maintenance behaviors. Interventions to improve monitoring behaviors Because self-care monitoring is conducted primarily by patients, with input from caregivers, it is necessary to work with patients closely on this topic. Providers should assess the current self-care monitoring regimen and build off this to create