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

Ivaylo Vassilev,Jan Koetsenruijter,Anne Rogers,Anne Kennedy

doi:10.1186/1471-2458-14-719

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.

Highlights

There 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
Self-management support requires awareness of and ability to deal with network relationships Living with a chronic condition shapes relations with network members at home, work in social situations and the quality of life of oneself and other network members [24,27,31,33,34,42,44]
Our findings indicate that social network involvement with CIM is related to the distribution of illness work that social network members (SNMs) take over or share the burden of

Summary

Introduction

There 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. The literature on the experience of chronic illness consistently points to how people may withdraw from broader social activities and commitments in order to boost or maintain the viability of key domestic relationships. This necessitates shifts overtime in the manner in which people interact with others, leads to changes in contexts, and to renegotiating roles and identities in relations with significant others [4,5,6]. Evidence for the relationship between social networks and SM remains underspecified as do the practices, mechanisms and resources through which social networks may work in providing support [3,10,16]

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