title: Self-management support from the perspective of patients with a chronic condition: a thematic synthesis of qualitative studies.
abstract: BACKGROUND
  Receiving adequate support seems to be crucial to the success of self-management. Although different empirical studies separately examined patients' preferences for self-management support (SMS), an overview is lacking.
  
  
  OBJECTIVE
  The aim of this qualitative review was to identify patients' needs with respect to SMS and to explore by whom this support is preferably provided.
  
  
  METHODS
  Qualitative studies were identified from Embase, MEDLINE OvidSP, Web of science, PubMed publisher, Cochrane central, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO.
  
  
  METHODS
  Articles needed to meet all of the following criteria: (i) focuses on self-management, (ii) concerns adult patients with rheumatic diseases (rheumatoid arthritis and fibromyalgia), a variant of cancer or chronic kidney disease, (iii) explores support needs from the patients' perspective, (iv) uses qualitative methods and (v) published in English.
  
  
  METHODS
  A thematic synthesis, developed by Thomas and Harden, was conducted of the 37 included studies.
  
  
  RESULTS
  Chronic patients need instrumental support, psychosocial support and relational support from health-care professionals, family/friends and fellow patients to manage the chronic condition. Relational support is at the centre of the support needs and fuels all other types of support.
  
  
  CONCLUSIONS
  Patients do not self-manage on their own. Patients expect health-care professionals to fulfil a comprehensive role. Support needs can be knitted together only when patients and professionals work together on the basis of collaborative partnership. Dynamics in support needs make it important to regularly assess patient needs.
authors.affiliation: Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.|Department of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Dwarswaard
authors.affiliation: Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
authors.forename: Ellen J M
authors.initials: EJ
authors.lastname: Bakker
authors.affiliation: Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.|Department of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: AnneLoes
authors.initials: A
authors.lastname: van Staa
authors.affiliation: Department of Methodology and Statistics, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Hennie R
authors.initials: HR
authors.lastname: Boeije
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy; D019468:Disease Management; D006301:Health Services Needs and Demand; D006801:Humans; D036301:Qualitative Research; D012648:Self Care; D012944:Social Support
keywords: chronic disease; health; health care; lived experiences; patient perspective; qualitative synthesis; review; self-care; self-management support