title: A metasynthesis of factors affecting self-management of chronic illness.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Qualitative metasynthesis.
  
  
  METHODS
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Yale School of Nursing, West Haven, Connecticut, USA.
authors.forename: Dena
authors.initials: D
authors.lastname: Schulman-Green
authors.affiliation: Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Jaser
authors.affiliation: Yale School of Nursing, West Haven, Connecticut, USA.
authors.forename: Chorong
authors.initials: C
authors.lastname: Park
authors.affiliation: Yale School of Nursing, West Haven, Connecticut, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Whittemore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D000073278:Self-Management; D055815:Young Adult
keywords: chronic illness; metasynthesis; nursing; qualitative; review; self-management