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The Middle Range Theory of Self- and Family Management of Chronic Illness

Providing a framework for understanding the partnerships and processes that influence management of chronic illness among patients, family caregivers, and health care professionals.

As a lead developer of this theory, I support its use to guide study design, intervention development, and interpretation of study results. The Middle Range Theory of Self- and Family Management of Chronic Illness describes how facilitators and barriers influence the processes of self- and family management, ultimately affecting short- and long-term outcomes.

The Theory at a Glance

Diagram of the Middle Range Theory of Self- and Family Management of Chronic Illness: patient and family facilitators and barriers feed into overlapping processes of patient self-management, family management, and health care professionals' support, leading to proximal and then distal outcomes.
Schulman-Green D, Feder SL, David D, Rada L, Tesfai D, Grey M. A Middle Range Theory of Self- and Family Management of Chronic Illness. Nurs Outlook. 2023;71(3):101985.

Foundational Publications

The development of the theory reflects systematic, evidence-based expansion over two decades from original conceptual framework to middle range theory. View the complete developmental bibliography →

An Evolving Theory

The theory continues to evolve as investigators apply, test, refine, and extend it across diverse chronic illness populations. Continued refinement is an essential part of theory development and helps ensure that the theory reflects contemporary science and clinical practice.

How Investigators Use the Theory:

  • Understand the partnerships and processes that influence self- and family management of chronic illness among adults
  • Generate research questions and hypotheses
  • Inform study design and intervention development
  • Interpret and contextualize findings
  • Contribute to the continued development of the theory

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