TELEHEALTH-BASED COMMUNITY HEALTH NURSING INTERVENTIONS AND THEIR EFFECTS ON PATIENT SELF EFFICACY, HEALTH BEHAVIORS, AND PSYCHOLOGICAL WELL-BEING IN SAUDI ARABIA: A SYSTEMATIC REVIEW

Abstract

Background: Telehealth has become central to Saudi Arabia’s digitally enabled health-system transformation, but the patient-level evidence most relevant to community health nursing is dispersed across diabetes self management, physical-activity promotion, virtual home care, mental-health support, and national telemedicine services. This review synthesized Saudi evidence on telehealth and digital community-care interventions with particular attention to self-efficacy, health behavior, psychological well-being, acceptability, and chronic-disease self-management. Methods: An updated systematic review approach was used. A 2026 Saudi systematic review of digital chronic disease interventions was used as a verified evidence map, and primary studies were re-checked and supplemented through focused searches and citation chaining for Saudi telehealth, telenursing, mobile health, WhatsApp, virtual home health, remote coaching, self-efficacy, health behavior, and psychological outcomes. Eligible studies involved Saudi patients or community populations, a patient-facing telehealth/digital intervention or service evaluation, and at least one behavioral, self-efficacy, psychological, engagement, or self-management outcome relevant to community health nursing. Sixteen primary studies/evaluations were included. Owing to marked heterogeneity in interventions, designs, populations and outcomes, synthesis was narrative. Results: The 16 studies included randomized trials, quasi-experimental studies, pilot/feasibility studies, qualitative evaluations and cross-sectional service evaluations. Mobile applications, WhatsApp/SMS, telehealth consultations, virtual home care, wearable-supported monitoring and remote health coaching were represented. The most consistent positive findings concerned diabetes self-management, self-efficacy, physical activity, patient education and perceived convenience. A randomized WhatsApp diabetes intervention improved self-efficacy and self-management, while physical-activity trials showed increased activity and daily steps. Telehealth and nurse led education also improved depression, anxiety and pain in ambulatory patients. Older adults and cardiovascular patients reported technical and digital-literacy barriers, and qualitative evidence emphasized Arabic-language communication, trust, family involvement and culturally responsive delivery. Conclusions: Telehealth-based community-care interventions in Saudi Arabia show promising effects on self efficacy, health behavior, psychological outcomes and chronic-disease self-management. The strongest nursing relevant model is hybrid: digital contact combined with human coaching, education, monitoring and escalation. Evidence remains limited by small trials, heterogeneous outcome measures, short follow-up, reliance on self report, and relatively little explicitly nurse-led community research. Future Saudi trials should test standardized nurse-led protocols, report behavioral and psychological outcomes consistently, include rural and older populations, and evaluate sustainability and cost-effectiveness.