Effects of a nurse-led telehealth self-care promotion programmes on the quality of life of community-dwelling older adults: A systematic review and meta-analysis. (Preprint)

Abstract

In recent years, telehealth has become a common channel for healthcare professionals to use to promote health and provide distance care. Coronavirus disease (COVID-19) has further fostered the widespread use of this new technology, which can improve access to care while protecting the community from exposure to infection by direct personal contact, and reduce the time and cost of travelling for both healthcare users and providers. This is especially true for community-dwelling older adults who have multiple chronic diseases and require frequent hospital visits. Nurses are globally recognized as healthcare professionals who provide effective community-based care to older adults, facilitating their desire to age in place. However, to date, it is unclear whether the use of telehealth can facilitate their work of promoting self-care to community-dwelling older adults. Objective: We aimed to summarize findings from randomized controlled trials on the effect of nurse-led telehealth self-care promotion programmes compared to the usual onsite or face-to-face services on the quality of life, self-efficacy, depression, and hospital admissions among community-dwelling older adults.

We aimed to summarize findings from randomized controlled trials on the effect of nurse-led telehealth self-care promotion programmes compared to the usual onsite or face-to-face services on the quality of life, self-efficacy, depression, and hospital admissions among community-dwelling older adults.

A search of six major databases was undertaken of relevant studies published from May 2011 to April 2021. Standardized mean differences (SMDs) and their 95% confidence intervals were calculated from post-intervention outcomes for continuous data, while the odds ratio (ORs) was obtained for dichotomous data using the Mantel-Haenszel test.

From 1173 possible publications, 13 trials involving a total of 4097 participants were included in this meta-analysis. Compared to the control groups, the intervention groups of community-dwelling older adults significantly improved in overall quality of life (SMD=0.12; 95% CI: 0.03 to 0.20; p=.006; I2=21%), self-efficacy (SMD=0.19; 95% CI: 0.08 to 0.30; p=.0005; I2=0%), and depression level (SMD=-0.22; 95% CI: -0.36 to -0.08; p=.003; I2=89%).

This meta-analysis suggests that employing telehealth in nurse-led self-care promotion programmes may have a positive impact on older adults, although more studies are needed to strengthen the evidence base, particularly regarding organization and delivery.

International Prospective Register of Systematic Reviews (PROSPERO) CRD42021257299; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257299.