title: Barriers and facilitators to asthma self-management in adolescents: A systematic review of qualitative and quantitative studies.
abstract: Many adolescents have poor asthma control and impaired quality of life despite the availability of modern pharmacotherapy. Research suggests that poor adherence to treatment and limited engagement in self-management could be contributing factors.
  
  
  
  To conduct a systematic review of the barriers and facilitators to self-management of asthma reported by adolescents using a narrative synthesis approach to integrate the findings.
  
  
  
  MEDLINE, EMBASE, CINAHL, and PsycINFO were searched for all types of study design. Full papers were retrieved for study abstracts that included data from participants aged 12-18 years referring to barriers or facilitators of asthma self-management behaviors.
  
  
  
  Sixteen studies (5 quantitative and 11 qualitative) underwent data extraction, quality appraisal, and thematic analysis. Six key themes were generated that encompassed barriers and/or facilitators to self-management of asthma in adolescents: Knowledge, Lifestyle, Beliefs and Attitudes, Relationships, Intrapersonal Characteristics, and Communication.
  
  
  
  There is a pressing need to prepare adolescents for self-management, using age-appropriate strategies that draw on the evidence we have synthesized. Current clinical practice should focus on ensuring adolescents have the correct knowledge, beliefs, and positive attitude to self-manage their illness. This needs to be delivered in a supportive environment that facilitates two-way communication, fosters adolescents' self-efficacy to manage their disease, and considers the wider social influences that impinge on self-management. Pediatr Pulmonol. 2017;52:430-442. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton Faculty of Medicine, Southampton, United Kingdom.
authors.forename: Simone
authors.initials: S
authors.lastname: Holley
authors.affiliation: NIHR/Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
authors.forename: Ruth
authors.initials: R
authors.lastname: Morris
authors.affiliation: Aston University, Birmingham, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Knibb
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom.
authors.forename: Sue
authors.initials: S
authors.lastname: Latter
authors.affiliation: School of Psychology, University of Southampton, United Kingdom.|Department of Paediatric Psychology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
authors.forename: Christina
authors.initials: C
authors.lastname: Liossi
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, United Kingdom.
authors.forename: Frances
authors.initials: F
authors.lastname: Mitchell
authors.affiliation: Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton Faculty of Medicine, Southampton, United Kingdom.|The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, United Kingdom.|NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
authors.forename: Graham
authors.initials: G
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001249:Asthma / Q000523:psychology / Q000628:therapy*; D002648:Child; D006801:Humans; D007407:Interviews as Topic; D011788:Quality of Life; D012648:Self Care
keywords: patient compliance; pediatrics; self care