Theories of self-care and self-management of long-term conditions by community-dwelling older adults: A systematic review and meta-ethnography

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dc.contributor.authorLawless, M.T.
dc.contributor.authorTieu, M.
dc.contributor.authorFeo, R.
dc.contributor.authorKitson, A.L.
dc.date.issued2021
dc.description.abstractRationale: The proportion of older adults living with long-term conditions (LTCs) is increasing. Self-care and selfmanagement approaches are seen as valuable in helping older people with LTCs to manage their health and care, yet the theoretical overlaps and divergences are not always clear. Objectives: The objectives of this review were to: (1) systematically identify and appraise studies of self-care or self-management of LTCs by community-dwelling older adults (aged ≥60 years) either informed by, applying, creating, or testing theory; (2) explore similarities or points of convergence between the identified theories; and (3) use a meta-ethnographic approach to synthesise the theories and group related concepts into core constructs. Methods: We conducted a systematic theory synthesis, searching six electronic databases. Three reviewers independently screened titles and abstracts followed by full texts and two reviewers appraised study quality. Theoretical data were synthesised within and across individual theories using meta-ethnographic line-of-argument synthesis. Results: A total of 141 articles (138 studies) and 76 theories were included in the review. Seven core constructs were developed: (1) temporal and spatial context; (2) stressors; (3) personal resources; (4) informal social resources; (5) formal social resources; (6) behavioural adaptations; and (7) quality of life outcomes. A line of argument was developed that conceptualised older adults’ self-care and self-management as a dynamic process of behavioural adaptation, enabled by personal resources and informal and formal social resources, aimed at alleviating the impacts of stressors and maintaining quality of life. Conclusion: This synthesis provides an overview of theories used in research on older adults’ LTC self-care and self-management. Our synthesis describes the complex interplay of intrinsic and extrinsic factors influencing selfcare and self-management behaviours and provides considerations for future research, intervention design, and implementation. The utility of the constructs in research and practice requires further attention and empirical validation.
dc.description.statementofresponsibilityMichael T. Lawless, Matthew Tieu, Rebecca Feo, Alison L. Kitson
dc.identifier.citationSocial Science and Medicine, 2021; 287:114393-1-114393-16
dc.identifier.doi10.1016/j.socscimed.2021.114393
dc.identifier.issn0277-9536
dc.identifier.issn0277-9536
dc.identifier.orcidTieu, M. [0000-0003-3578-6579]
dc.identifier.orcidFeo, R. [0000-0001-9414-2242]
dc.identifier.orcidKitson, A.L. [0000-0003-3053-8381]
dc.identifier.urihttps://hdl.handle.net/2440/146114
dc.language.isoen
dc.publisherElsevier BV
dc.rights© 2021 Elsevier Ltd. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.socscimed.2021.114393
dc.subjectAged; Self-management; Self-care; Chronic illness and disease; Qualitative synthesis; Theory; Systematic review
dc.subject.meshHumans
dc.subject.meshSelf Care
dc.subject.meshAnthropology, Cultural
dc.subject.meshQuality of Life
dc.subject.meshAged
dc.subject.meshIndependent Living
dc.subject.meshSelf-Management
dc.titleTheories of self-care and self-management of long-term conditions by community-dwelling older adults: A systematic review and meta-ethnography
dc.typeJournal article
pubs.publication-statusAccepted

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