Adolescents with chronic conditions represent a large population with unique medical and psychosocial needs. During adolescence there is an important shift from a reliance on parents and caregivers for psychosocial support and management of medical needs to relying more on peers for social support and becoming more independent with managing their medical needs. During adolescence, responsibility for managing medical needs typically increases and patterns of self-management behaviors develop. Self-management encompasses the many behaviors an individual living with a chronic condition must regularly engage in to optimize their health and wellbeing (Lozano & Houtrow, 2018). Successful self-management is key to promoting the wellbeing of individuals living with chronic conditions that affect adolescents such as cystic fibrosis, lupus, arthritis, inflammatory bowel disease, and others. While chronic conditions affecting adolescents vary in their symptoms and treatments, many conditions affecting this population share two unifying factors: an unpredictability or fluctuation in disease activity and a need for daily self-management (Schoemaker et al., 2022). Successful self-management is typically characterized in terms of medical management: adherence to a treatment plan, healthy lifestyle behaviors, and effectively responding to changes in one's health and symptoms (Lozano & Houtrow, 2018). However, self-management also encompasses a psychosocial component including social role management and emotional management (Schoemaker et al., 2022). Maintaining effective self-management during adolescence is an ongoing challenge; developmental factors specific to adolescence, as well as social factors, knowledge, and beliefs, have been cited as barriers to effective self-management in this population (Hanghøj & Boisen, 2014; Holley et al., 2017).

In addition to facing challenges with effective self-management, this population is also at risk for experiencing difficulties in social and peer relationships. Existing literature demonstrates that adolescents with chronic conditions are at increased risk for school absenteeism, bullying, decreased social participation, and comorbid depression (Janin et al., 2018; Zheng et al., 2020). Previous quantitative research conducted in the Netherlands also demonstrates that adolescents with chronic conditions are vulnerable to poor psychosocial outcomes which can impact their health outcomes, self-efficacy, and independence (Sattoe et al., 2014). However, the complex relationship between psychosocial factors, peer relationships, and self-management behaviors among adolescents with chronic conditions remains poorly understood. In particular, there is a gap in the qualitative literature which explores the interrelationship of psychosocial factors and self-management behaviors, from the perspectives of adolescents. Therefore, the purpose of this study is to describe the interaction between psychosocial and peer relationship factors and self-management behaviors among adolescents with chronic conditions to identify targets for intervention.