The influence of social networks on self-management support: a metasynthesis

Abstract

BackgroundThere is increasing recognition that chronic illness management (CIM) is not just an individual but a collective process where social networks can potentially make a considerable contribution to improving health outcomes for people with chronic illness. However, the mechanisms (processes, activities) taking place within social networks are insufficiently understood. The aim of this review was to focus on identifying the mechanisms linking social networks with CIM. Here we consider network mechanisms as located within a broader social context that shapes practices, behaviours, and the multiplicity of functions and roles that network members fulfil.MethodsA systematic search of qualitative studies was undertaken on Medline, Embase, and Web for papers published between 1st January 2002 and 1st December 2013. Eligible for inclusion were studies dealing with diabetes, and with conditions or health behaviours relevant for diabetes management; and studies exploring the relationship between social networks, self-management, and deprivation. 25 papers met the inclusion criteria. A qualitative metasynthesis was undertaken and the review followed a line of argument synthesis.ResultsThe main themes identified were: 1) sharing knowledge and experiences in a personal community; 2) accessing and mediation of resources; 3) self-management support requires awareness of and ability to deal with network relationships. These translated into line of argument synthesis in which three network mechanisms were identified. These were network navigation (identifying and connecting with relevant existing resources in a network), negotiation within networks (re-shaping relationships, roles, expectations, means of engagement and communication between network members), and collective efficacy (developing a shared perception and capacity to successfully perform behaviour through shared effort, beliefs, influence, perseverance, and objectives). These network mechanisms bring to the fore the close interdependence between social and psychological processes in CIM, and the intertwining of practical and moral dilemmas in identifying, offering, accepting, and rejecting support.ConclusionsCIM policy and interventions could be extended towards: raising awareness about the structure and organisation of personal communities; building individual and network capacity for navigating and negotiating relationships and CIM environments; maximising the possibilities for social engagement as a way of increasing the effectiveness of individual and network efforts for CIM.

Social recognition provision patterns in professional Q&A forums in Healthcare and Construction

“…Besides Healthcare and Construction sector we found research papers reporting of similar patterned epistemic practices among other communities of expertise. Vassilev et al (2014) found that professionals in social networks are sharing knowledge and experiences in a personal community and accessing and mediating of resources. They highlighted that professionals' self-management support in social networks requires awareness of and ability to deal with network relationships: network navigation (identifying and connecting with relevant existing resources in a network), negotiation within networks (re-shaping relationships, roles, expectations, means of engagement and communication between network members), and collective efficacy (developing a shared perception and capacity to successfully perform behaviour through shared effort, beliefs, influence, perseverance, and objectives).…”

Conceptualisation of the ‘good’ self-manager: A qualitative investigation of stakeholder views on the self-management of long-term health conditions

“…Compliance, for family care-givers, was important as the individual 460 will "not suffer" (Zoe, family, cancer) if they follow medical advice. The compliant framework, 461 however, assumes behavioural change is easy to achieve and fails to account for the difficulties and 462 complexities around achieving this change (Vassilev et al, 2014 At the core of the notion of the 'active' individual is a recognition that the 'good' self-468 manager is able to exercise agency; that is, to act freely and make their own informed decisions. Patient stakeholders considered the 'good' self-manager to engage in 'strategic non-compliance' 495 (Campbell et al, 2003) or 'rationalised non-adherence' ; that is selectively 496 applying medical advice to either suit lifestyle or minimise treatment burdens respectively.…”

Patient Self-Management In Chronic Heart Failure — Establishing Concordance Between Guidelines And Practice

“…Recent developments point to a role for social networks in self-management support, 42 although efficacy is not yet well-established. Vassilev et al 43 suggest that social networks may effect change in self-management by improving awareness and access to network resources, adjusting social roles, relationships and communication in response to needs and through collective efficacy to achieve behavioural goals. Future research that harnesses a social network perspective to enlist and mobilise collective resources through e-health interventions may improve self-management in chronic disease settings.…”

“…from patient self-efficacy towards collective efficacy. 43 Peer-support programmes have shown improvements in patient self-management in some chronic diseases settings, such as diabetes. For example, the ROMEO trial 27 showed a significant benefit of group education sessions for diabetes patients, scheduled quarterly over a period of two years, on knowledge, health behaviours and quality of life outcomes compared with usual care.…”