A metasynthesis of factors affecting self management of chronic illness.
AIM To identify factors that may serve as facilitators and barriers to self management described by adults living with chronic illness by conducting a qualitative metasynthesis. BACKGROUND Self management is an individuals' active management of a chronic illness in collaboration with their family members and clinicians. DESIGN Qualitative metasynthesis. DATA SOURCES We analysed studies (N 53) published between January 2000 May 2013 that described factors affecting self management in chronic illness as reported by adults aged over 18 years with chronic illness. REVIEW METHODS Sandelowsi and Barroso approach to qualitative metasynthesis: literature search; quality appraisal; analysis and synthesis of findings. RESULTS Collectively, article authors reported on sixteen chronic illnesses, most commonly diabetes (N 28) and cardiovascular disease (N 20) Participants included men and women (mean age 57, range 18 94) from 20 countries representing diverse races and ethnicities. We identified five categories of factors affecting self management: Personal/Lifestyle Characteristics; Health Status; Resources; Environmental Characteristics; and Health Care System. Factors may interact to affect self management and may exist on a continuum of positive (facilitator) to negative (barrier) CONCLUSION Understanding factors that influence self management may improve assessment of self management among adults with chronic illness and may inform interventions tailored to meet individuals' needs and improve health outcomes.
Journal of advanced nursing