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

    Rights statement: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in The Gerontologist following peer review. Garuth Chalfont, PhD, Céu Mateus, PhD, Sandra Varey, PhD, Christine Milligan, PhD, 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, Volume 61, Issue 6, September 2021, Pages e318–e334, https://doi.org/10.1093/geront/gnaa045 The definitive publisher-authenticated version is available online at: https://academic.oup.com/gerontologist/article-abstract/doi/10.1093/geront/gnaa045/5856419

    Accepted author manuscript, 1.33 MB, PDF document

    Available under license: CC BY-NC: Creative Commons Attribution-NonCommercial 4.0 International License

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

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Published
<mark>Journal publication date</mark>30/09/2021
<mark>Journal</mark>The Gerontologist
Issue number6
Volume61
Number of pages16
Pages (from-to)e318-e334
Publication StatusPublished
Early online date12/06/20
<mark>Original language</mark>English

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.

Bibliographic note

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in The Gerontologist following peer review. Garuth Chalfont, PhD, Céu Mateus, PhD, Sandra Varey, PhD, Christine Milligan, PhD, 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, Volume 61, Issue 6, September 2021, Pages e318–e334, https://doi.org/10.1093/geront/gnaa045 The definitive publisher-authenticated version is available online at: https://academic.oup.com/gerontologist/article-abstract/doi/10.1093/geront/gnaa045/5856419