Abstract
Introduction
This study aimed to (a) review what theories have been applied to the development of digital self-management interventions for people with neurological disorders; (b) examine their effectiveness to improve depression, anxiety, fatigue and self-efficacy; and (c) identify the optimal mode of intervention delivery.
Methods
Electronic databases (SCOPUS, MEDLINE, EMBASE, CINAHL, Cochrane Library and Clinicaltrials.gov) were searched. Two investigators independently screened studies and extracted data. Study quality and use of theory were also assessed.
Results
A total of 944 studies were screened, and 16 randomised controlled trials were included. Theory-based digital self-management interventions were effective in reducing depression (standardised mean difference (SMD) = –0.77, 95% confidence interval (CI) –1.04 to –0.49), anxiety (SMD = –0.88, 95% CI –1.54 to –0.21) and fatigue (SMD = –0.62, 95% CI –0.96 to –0.27) and in enhancing self-efficacy (SMD = 1.15, 95% CI 0.11–2.18). Cognitive–behavioural theory (CBT)-based interventions were effective in reducing depression (SMD = –0.81, 95% CI –1.22 to –0.39), anxiety (SMD = –1.15, 95% CI –1.85 to –0.44) and fatigue (SMD = –0.75, 95% CI –0.97 to –0.54) and in improving self-efficacy (SMD = 0.84, 95% CI 0.63–1.05), whereas social cognitive theory (SCT)-based interventions were effective in reducing depression (SMD = –0.73, 95% CI –1.17 to –0.28). Partially digital interventions were more effective than fully digital interventions.
Discussion
Our findings support the use of theory to guide the development of digital self-management interventions to increase intervention effectiveness. In particular, CBT-based interventions have a positive impact on depression, anxiety, fatigue and self-efficacy, whereas SCT-based interventions have a positive impact on depression.
Keywords
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
