Self-care Behaviors and Technology Used During COVID-19: Systematic Review

Abstract

Background Self-care behaviors are essential for people living with chronic conditions; however, the outbreak of the COVID-19 pandemic has imposed additional complications on their daily routines. Few studies have analyzed how self-care behaviors have changed during COVID-19 and the role of digital technology, especially among people with chronic conditions. Objective This study aims to review how self-care behaviors have changed for people with chronic conditions during the COVID-19 pandemic, and what technology they have adopted to manage their conditions during that period. Methods A systematic review was conducted using narrative synthesis. Data were extracted from PubMed, MEDLINE, EMBASE, PsycINFO, CINAHL, and Google Scholar, including articles from December 2019 onward. Eligible studies focused on adults diagnosed with chronic conditions undertaking any self-care tasks in line with the middle-range theory of self-care of chronic illness (ie, self-care maintenance, monitoring, and management). The methodological quality of the included articles was assessed with the McMaster Critical Review Forms for Quantitative or Qualitative Studies. Results In total, 36 primary research articles were included. Changes to self-care behaviors during COVID-19 among people with chronic conditions were organized according to the middle-range theory of self-care of chronic illness focusing on self-care maintenance (ie, medication adherence, physical activity, and diet control), self-care monitoring (ie, monitoring signs and symptoms), and self-care management (ie, consultations with health care providers). Positive self-care behaviors observed include the following: individuals trying to maintain good glycemic control during COVID-19 increased their medication adherence in 27% (10/36) of studies; and diet control improved in 50% (18/36) of studies. Negative self-care behaviors observed include the following: decline in physical activities and increased sedentariness were observed in 65% (23/36) of studies; poor diet control was observed in 57% (21/36) of studies; and self-monitoring of health status dropped in 43% (15/36) of studies. The use of technology to support self-care of chronic conditions during COVID-19 was reported in 72% (26/36) of studies. The actual use of telehealth in place of physical consultations during COVID-19 was observed in 50% (18/36) of studies, and other digital technologies (eg, social media apps, smartphone apps, web-based platforms, and web browsing) were used in 50% (18/36) of studies. Telehealth was discussed and recommended as the default technology in delivering future health care services during COVID-19 and beyond in 77% (28/36) of studies. Conclusions This review highlighted the necessity to rethink how models of self-care should continue to address the demands of chronic conditions while being responsive to the imminent threats of infectious diseases. Perhaps the silver lining of COVID-19 is that adoption of digital technology (especially telehealth) among a vast cross-section of people with chronic conditions is possible. Future research should investigate effective ways to incorporate evidence-based digital health tools into these new models of self-care that address the challenges of chronic and infectious conditions.

Patient-Perceived Impact of the COVID-19 Pandemic on Medication Adherence and Access to Care for Long-Term Diseases: A Cross-Sectional Online Survey

“…During the lockdown period, patient associations were forced to suspend their activities, which increased isolation for patients with long-term diseases. Finally, our study shows the impact of the pandemic on recommended diet and physical activities, which is consistent with other studies reporting on self-care measures [64,65]. Lockdown measures such as stay-at-home orders and quarantine often limited opportunities for physical exercise and increased sedentary behavior, as well as changes in dietary patterns such as increases in overeating [66,67].…”

COVID-19 pandemic has disrupted the continuity of care for chronic patients: evidence from a cross-sectional retrospective study in a developing country

“…According to their findings, in a developing country with the restricted resources, the condition can be worsened and significant loss of visits and increase in the number of postponed, cancelled, and delayed visits can be intensified mainly due to higher frequency and prevalence of positive or suspected cases of COVID-19, higher rate of out-of-pocket payments and lack of medical record systems [39]. Other studies such as Sumner et al 2022) also reported similar findings from the negative effects of the pandemic on the COC for chronic patients and emphasized the necessity of appropriate actions by health systems to ensure the routine care of these patients during health disasters [40][41][42][43][44][45][46][47][48].…”

Self-care for health and wellbeing – a literature review

“…Several studies also showed that during the COVID-19 pandemic, the need and vital role of self-care behaviors in saving lives was more important. Using some life-saving self-care interventions with patients such as wearing masks, social distancing, have been an asset during COVID-19 periods of lockdown [3,8,25,26,27].…”