Self-efficacy of older people using technology to self-manage COPD, hypertension, heart failure or dementia at home : An overview of systematic reviews

Chalfont, Garuth and Mateus, Ceu and Varey, Sandra and Milligan, Christine (2021) Self-efficacy of older people using technology to self-manage COPD, hypertension, heart failure or dementia at home : An overview of systematic reviews. The Gerontologist, 61 (6). e318-e334. ISSN 0016-9013

Text (Self-Efficacy of Older People Using Technology to Self-Manage COPD, Hypertension, Heart Failure or Dementia at Home: An Overview of Systematic Reviews)
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Abstract

Background and Objectives Although telehealth research among the general population is voluminous, study quality is low and results are mixed. Little is known specifically concerning older people and their self-efficacy to engage with and benefit from such technologies. This paper reviews the evidence for which self-care telehealth technology supports the self-efficacy of older people with long-term conditions (LTCs) living at home. Research Design and Methods Following PRISMA guidelines, this overview of systematic reviews focused on four LTCs and the concept of ‘self-efficacy’. Quality was appraised using R-AMSTAR and study evaluation was guided by the PRISMS taxonomy for reporting of self-management support. Heterogeneous data evidencing technology-enhanced self-efficacy were narratively synthesised. Results Five included papers contained 74 primary studies involving 9,004 participants with chronic obstructive pulmonary disease (COPD), hypertension, heart failure or dementia. Evidence for self-care telehealth technology supporting self-efficacy of older people with LTCs living at home was limited. Self-efficacy was rarely an outcome, also attrition and drop-out rates and mediators of support or education. The pathway from telehealth to self-efficacy depended on telehealth modes and techniques promoting healthy lifestyles. Increased self-care and self-monitoring empowered self-efficacy, patient-activation or mastery. Discussion and Implications Future research needs to focus on the process by which the intervention works and the effects of mediating variables and mechanisms through which self-management is achieved. Self-efficacy, patient-activation, and motivation are critical components to telehealth’s adoption by the patient, and hence to the success of self-care in self-management of LTCs. Their invisibility as outcomes is a limitation.