title: How technology in care at home affects patient self-care and self-management: a scoping review.
abstract: The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients' role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on patients' self-care and self-management. Using suitable search terms we searched the databases of Pubmed, Embase, Cochrane Library, Cinahl, Picarta and NIVEL dating from 2002 to 2012. Thirty-three studies (six review studies and twenty-seven individual studies) were selected. Effects were extracted from each study and were classified. In almost all the studies, the concepts self-care and self-management are not clearly defined or operationalized. Therefore, based on a meta-analysis, we made a new classification of outcome measures, with hierarchical levels: (1) competence (2) illness-management (3) independence (social participation, autonomy). In general, patient outcomes appear to be positive or promising, but most studies were pilot studies. We did not find strong evidence that technology in care at home has (a positive) effect on patient self-care and self-management according to the above classification. Future research is needed to clarify how technology can be used to maximize its benefits.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, Utrecht 3513 CR, The Netherlands. j.peeters@nivel.nl.
authors.forename: José M
authors.initials: JM
authors.lastname: Peeters
authors.forename: Therese A
authors.initials: TA
authors.lastname: Wiegers
authors.forename: Roland D
authors.initials: RD
authors.lastname: Friele
mesh_terms: D020811:Biomedical Technology / Q000379:methods*; D006699:Home Care Services; D006801:Humans; D012648:Self Care / Q000379:methods*