A metasynthesis of factors affecting self-management of chronic illness

Dena Schulman-Green, Sarah S. Jaser, Chorong Park, Robin Whittemore

Research output: Contribution to journalReview articlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)1469-1489
Number of pages21
JournalJournal of Advanced Nursing
Issue number7
StatePublished - 2016


  • chronic illness
  • metasynthesis
  • nursing
  • qualitative
  • review
  • self-management

ASJC Scopus subject areas

  • General Nursing


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