Schulman-Green Dena, Jaser Sarah S, Park Chorong, Whittemore Robin
Yale School of Nursing, West Haven, Connecticut, USA.
Vanderbilt University, Nashville, Tennessee, USA.
J Adv Nurs. 2016 Jul;72(7):1469-89. doi: 10.1111/jan.12902. Epub 2016 Jan 19.
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.
Self-management is an individuals' active management of a chronic illness in collaboration with their family members and clinicians.
Qualitative metasynthesis.
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.
Sandelowsi and Barroso approach to qualitative metasynthesis: literature search; quality appraisal; analysis and synthesis of findings.
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).
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.
通过进行定性元综合分析,确定慢性病成年患者描述的自我管理促进因素和障碍因素。
自我管理是个体与家庭成员及临床医生合作对慢性病进行的积极管理。
定性元综合分析。
我们分析了2000年1月至2013年5月期间发表的研究(N = 53),这些研究描述了18岁以上慢性病成年患者报告的影响慢性病自我管理的因素。
采用桑德洛西和巴罗索的定性元综合分析方法:文献检索;质量评估;研究结果的分析与综合。
文章作者总共报告了16种慢性病,最常见的是糖尿病(N = 28)和心血管疾病(N = 20)。参与者包括来自20个国家、代表不同种族和民族的男性和女性(平均年龄 = 57岁,范围18 - 94岁)。我们确定了影响自我管理的五类因素:个人/生活方式特征;健康状况;资源;环境特征;以及医疗保健系统。这些因素可能相互作用影响自我管理,并且可能存在从积极(促进因素)到消极(障碍因素)的连续统一体。
了解影响自我管理的因素可能会改善对慢性病成年患者自我管理的评估,并可为满足个体需求和改善健康结果的干预措施提供依据。