title: Multimedia psychoeducational interventions to support patient self-care in degenerative conditions: A realist review.
abstract: OBJECTIVE
  Multimedia interventions are increasingly used to deliver information in order to promote self-care among patients with degenerative conditions. We carried out a realist review of the literature to investigate how the characteristics of multimedia psychoeducational interventions combine with the contexts in which they are introduced to help or hinder their effectiveness in supporting self-care for patients with degenerative conditions.
  
  
  METHODS
  Electronic databases (Medline, Science Direct, PSYCHinfo, EBSCO, and Embase) were searched in order to identify papers containing information on multimedia psychoeducational interventions. Using a realist review approach, we reviewed all relevant studies to identify theories that explained how the interventions work.
  
  
  RESULTS
  Ten papers were included in the review. All interventions sought to promote self-care behaviors among participants. We examined the development and content of the multimedia interventions and the impact of patient motivation and of the organizational context of implementation. We judged seven studies to be methodologically weak. All completed studies showed small effects in favor of the intervention.
  
  
  CONCLUSIONS
  Multimedia interventions may provide high-quality information in an accessible format, with the potential to promote self-care among patients with degenerative conditions, if the patient perceives the information as important and develops confidence about self-care. The evidence base is weak, so that research is needed to investigate effective modes of delivery at different resource levels. We recommend that developers consider how an intervention will reduce uncertainty and increase confidence in self-care, as well as the impact of the context in which it will be employed.
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast,Belfast,BT9 7BL,United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Halloran
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast,Belfast,BT9 7BL,United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Scott
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast,Belfast,BT9 7BL,United Kingdom.
authors.forename: Joanne
authors.initials: J
authors.lastname: Reid
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast,Belfast,BT9 7BL,United Kingdom.
authors.forename: Sam
authors.initials: S
authors.lastname: Porter
mesh_terms: D002908:Chronic Disease / Q000523:psychology / Q000534:rehabilitation*; D016206:Databases, Bibliographic; D018450:Disease Progression; D006801:Humans; D019212:Multimedia; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000379:methods* / Q000523:psychology
keywords: Degenerative conditions; Multimedia; Palliative care; Psychoeducational; Realist review; Self-care