The general self-efficacy of older adults receiving care: A systematic review and meta-analysis

Abstract

Background and Objectives: General self-efficacy (GSE) encourages health-promoting behaviors in older adults. It is unsurprising then, that older adults receiving healthcare services are reported to have a greater risk of low GSE than older adults who are not. Despite this, there is currently limited evidence investigating whether the effect differs based on the environment in which care is received. This review aims to determine whether the GSE of older adults is affected by the receipt of healthcare services, and whether GSE varies based on the setting in which care is received.

Research Design and Methods: In accordance with PRISMA guidelines (PROSPERO registration number CRD42018092191); a systematic search was undertaken across seven databases. Standardized mean differences (SMD) and mean General Self-Efficacy Scale scores, with 95% confidence intervals, were pooled for meta-analysis.

Results: A total of 40 studies were identified, they consisted of 33 different population cohorts that were included in the meta-analysis. Older adults receiving healthcare services were found to be at greater risk of having lower GSE than those who do not (SMD = -0.62; 95% CI: -0.96 to -0.27, p<.0001). Following identification of sources of heterogeneity, older adults receiving acute inpatient care were more likely to have lower GSE than those receiving care in other healthcare settings.

Discussion and Implications: Older adults receiving inpatient care have a greater risk of lower GSE, and consequently poorer health-promoting behaviors. Further research is recommended that focuses on the GSE of older adults and health outcomes following discharge from inpatient care.