The role of the family in supporting the self-management of chronic conditions: A qualitative systematic review
Nursing and Midwifery
Aims and objectives: To explore the contribution of family members in promoting and supporting the self-management of chronic conditions amongst adult family members.
Background: The prevalence of chronic disease continues to grow globally. The role of the family in chronic condition management and support for self-management has received little attention.
Design: A systematic review of qualitative literature using the Joanna Briggs Institute approach for qualitative systematic reviews.
Methods: Ovid (MEDLINE, CINAHL and PsycINFO) were searched for the period of database inception—2016. The QARI (Qualitative Assessment and Review Instrument) critical appraisal instrument was used to assess the quality of each study. Using the Joanna Briggs Institute-QARI data extraction tool, findings related to the family role in the self-management of chronic conditions were extracted and each finding rated according to Joanna Briggs Institute-QARI levels of credibility. Findings were categorised and synthesised to produce a final set of aggregated findings.
Results: Families were key in constructing an environment that was conducive to family engagement and support. Adaptation within the family included maintaining cohesion between family members, normalisation and contextualisation of the chronic condition.
Conclusions: Whilst evidence on the value of the family in promoting positive health outcomes is clear, research on how families can specifically support the self-management of chronic conditions is emerging.
Relevance to clinical practice: Family adaptability has been found to be the most powerful predictor of carer depression. Families may need support to change their home and family organisation to adapt to the challenges they face overtime. Change in roles and subsequent adaptation can be stressful, even for those family members at a distance. Nurses working in hospital and community settings can play an important role in assessing how families are adapting to living with chronic illness and to explore strategies to cope with challenges in the home setting.