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.
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