School of Health Sciences, Queen Margaret University, Edinburgh, UK.
Gerontologist. 2021 Aug 13;61(6):e302-e317. doi: 10.1093/geront/gnaa036.
General self-efficacy (GSE) encourages health-promoting behaviors in older adults. It is unsurprising then that older adults receiving health care 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 health care services and whether GSE varies based on the setting in which care is received.
In accordance with PRISMA guidelines (PROSPERO registration number CRD42018092191), a systematic search was undertaken across 7 databases. Standardized mean differences (SMD) and mean General Self-Efficacy Scale scores, with 95% confidence intervals (CI), were pooled for meta-analysis.
A total of 40 studies were identified, they consisted of 33 population cohorts that were included in the meta-analysis. Older adults receiving health care 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 health care settings.
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.
一般自我效能感（GSE）鼓励老年人采取促进健康的行为。因此，接受医疗保健服务的老年人被报告比未接受医疗保健服务的老年人更有可能出现 GSE 水平较低的情况也就不足为奇了。尽管如此，目前关于护理环境是否会影响 GSE 效果的证据有限。本综述旨在确定老年人的 GSE 是否受到接受医疗保健服务的影响，以及 GSE 是否因接受护理的环境而异。
根据 PRISMA 指南（PROSPERO 注册号 CRD42018092191），对 7 个数据库进行了系统检索。对荟萃分析进行了标准化均数差（SMD）和一般自我效能感量表评分（95%置信区间[CI]）的汇总。
共确定了 40 项研究，其中包括 33 项人群队列研究被纳入荟萃分析。接受医疗保健服务的老年人比不接受医疗保健服务的老年人更有可能出现 GSE 水平较低的情况（SMD=-0.62；95%CI：-0.96 至-0.27，p<.0001）。在确定了异质性来源后，发现接受急性住院治疗的老年人比在其他医疗保健环境中接受治疗的老年人更有可能出现 GSE 较低的情况。
接受住院治疗的老年人更有可能出现 GSE 较低的情况，进而出现促进健康行为的能力更差。建议进行进一步的研究，重点关注老年人的 GSE 以及从住院治疗中出院后的健康结果。
