The effectiveness of self-care interventions in chronic illness : A meta-analysis of randomized controlled trials
Lee, Christopher, Westland, Heleen, Faulkner, Kenneth, Iovino, Paolo, Thompson, Jessica, Sexton, Jessica, Farry, Elizabeth, Jaarsma, Trijntje and Riegel, Barbara Jean. (2022). The effectiveness of self-care interventions in chronic illness : A meta-analysis of randomized controlled trials. International Journal of Nursing Studies. 134, pp. 1-12. https://doi.org/10.1016/j.ijnurstu.2022.104322
|Authors||Lee, Christopher, Westland, Heleen, Faulkner, Kenneth, Iovino, Paolo, Thompson, Jessica, Sexton, Jessica, Farry, Elizabeth, Jaarsma, Trijntje and Riegel, Barbara Jean|
Objective: To characterize and explain variation in the comparative effectiveness of self-care interventions on relevant outcomes of chronic illness compared with controls.
Design: Meta-analysis and meta-regression.
Methods: Data extraction was framed within the context of a previously-published scoping review of randomized trials designed to enhance self-care in type 2 diabetes mellitus, heart failure, hypertension, asthma, coronary artery disease, and chronic obstructive pulmonary disease (published between 2008 and 2019). Data were pooled using random-effects meta-analyses. Meta-regression was used to test the effect of potential moderators on trial effectiveness.
Results: 145 trials involving 36,853 participants were included. Overall, the effect size of self-care interventions on improving outcomes was small (Hedges' g = 0.29 (95% CI = 0.25-0.33), p < 0.001) with statistically significant heterogeneity across trials (Q = 514.85, p < 0.001, I2 = 72.0%). A majority of trials (n = 83, 57.2%) were rated as having a high risk of bias. There was no statistically significant difference in trial effectiveness based on the use of theory, specific components of self-care addressed, the number of modes of delivery, the number of behavioral change techniques, specific modes of delivery, specific behavioral change techniques, intervention duration, total number of hours of intervention, or either participant age or gender.
Conclusions: Self-care interventions are modestly effective in improving outcomes. Poor trial quality limits the strength of conclusions in this area of science. There is much to be done to enhance the design, conduct and reporting of self-care trials in order to gain more insight into the effectiveness of self-care interventions.
|Keywords||Asthma; Chronic obstructive pulmonary disorder; Chronic disease; Diabetes mellitusType 2; Heart failure; Hypertension; Meta-analysis; Self-care|
|Year||01 Jan 2022|
|Journal||International Journal of Nursing Studies|
|Journal citation||134, pp. 1-12|
|Digital Object Identifier (DOI)||https://doi.org/10.1016/j.ijnurstu.2022.104322|
|Web address (URL)||https://www.sciencedirect.com/science/article/pii/S0020748922001511|
|Open access||Published as green open access|
|Research or scholarly||Research|
File Access Level
|01 Oct 2022|
|Publication process dates|
|Accepted||28 Jun 2022|
|Deposited||06 Jan 2023|
© 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
|Place of publication||United Kingdom|
|License: CC BY-NC-ND 4.0|
|File access level: Open|
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