Self-efficacy, optimism, health competence, and recovery from orthopedic surgery.

Abstract

The authors tested whether self-efficacy for orthopedic rehabilitation tasks accounted for significant variance in rehabilitation outcome, over the variance accounted for by dispositional optimism, health competence, and health value. Whether health value moderated expectancy-outcome relationships also was examined. One hundred five older clients at 2 orthopedic rehabilitation facilities completed a battery of instruments; physical functioning also was assessed. After controlling for physical functioning at admission and for other variables, self-efficacy predicted significant variance in rehabilitation outcome. Health value did not moderate expectancy-outcome relationships. Results suggest that psychologists can improve patients' recovery from serious orthopedic problems by augmenting their self-efficacy beliefs.Orthopedic injury is a major health care concern in the United States for persons 65 years old and older. For example, approximately 250,000 persons are hospitalized each year for treatment of a fractured hip. Risk factors include age, gender, race, medication use, and mental distress (Allegrante, MacKenzie, Robbins, & Cornell, 1991;Forsen et al., 1999). In addition to fall-related orthopedic injuries, elderly persons also require orthopedic surgery for degenerative joint disease of the hip or knee (Orbell, Espley, Johnston, & Rowley, 1998). National health care costs from orthopedic injuries exceed $7 billion per year (Allegrante et al., 1991), and up to 60% of orthopedic patients face postsurgery complications including loss of functional capacity and independence, with many patients requiring long-term institutional care.In an attempt to ameliorate the negative effects of orthopedic surgery and aid rehabilitation, psychologists have begun to focus on psychological factors that affect the disabled patient's condition, including thoughts, beliefs, and attitudes (Bloom, 1988). Broad beliefs such as dispositional optimism (Scheier & Carver, 1985), moderately broad beliefs such as perceived health competence (Wallston, 1991), and more specific beliefs such as selfefficacy expectancies (SE; Bandura, 1997) all have predicted important outcomes among disabled persons or other populations. However, no study has examined these beliefs as predictors of rehabilitation following orthopedic surgery. Studying positive beliefs and their relationship to health-related outcomes is consistent with counseling psychology's emphasis on psychological assets and positive facets of growth (Fretz, 1982;Gelso & Fretz, 1992).

The biopsychosocial approach to chronic pain: Scientific advances and future directions.

“…Moreover, self-efficacy also influences the prognosis after acute physical interventions like surgery. Prospective studies in patients who underwent orthopedic surgery demonstrated that high self-efficacy before the start of rehabilitation and larger increases over the course of a rehabilitation speed recovery and predict better long-term outcome (Dohnke, Knauper, & Muller Fahrnow, 2005;Orbell, Johnston, Rowley, Davey, & Espley, 2001;Waldrop, Lightsey, Ethington, Woemmel, & Coke, 2001). A preoperative intervention (an instruction video demonstrating movement and breathing skills) in hysterectomy patients was able to enhance pre-operative self-efficacy and decrease pain associated with post-operative activities and promote earlier mobilization (Heye, Foster, Bartlett, & Adkins, 2002).…”

Autoeficacia en salud oral: concepto, evaluación y tratamiento

“…La autoeficacia en salud ha sido aplicada a conductas tan diversas como, por ejemplo, el manejo de enfermedades cardíacas (4), osteoporosis (5), artritis (6), adherencia a la medicación (7), el realizar ejercicio (8), el bajar de peso (9), así como también para los resultados de la rehabilitación (10). En relación a las conductas preventivas en salud, los individuos con alta autoeficacia percibida tienen más probabilidad de iniciar cuidados preventivos, buscar tratamientos tempranos y ser más optimistas sobre la eficacia de estos (11).…”

“…A nivel global, la Escala de Autoeficacia General de Schwarzer y Jerusalem es la más utilizada (10). Este instrumento mide autoeficacia desde un punto de vista psicológico global, y se compone de 10 ítems, cuyo formato de respuesta está enumerado del 1 aldos altos en la escala versus los pacientes que no recibieron tratamiento periodontal (26).…”

Return to running following knee osteochondral repair using an anti-gravity treadmill: A case report

“…29,37 The SER was designed specifically for patients undergoing lower limb orthopaedic surgery 45 and has been used in ligament reconstruction 6 and joint replacement 23 but it has not been previously used in a knee osteochondral repair population. The mean SER scores are shown in Figure 2.…”

“…46 Self-efficacy beliefs have been found to influence rehabilitation outcome after total joint arthroplasty. 29,45 Self-efficacy has only been evaluated in anti-gravity treadmill rehabilitation in a single case study where it was found that general self-efficacy was elevated after a 6 week anti-gravity treadmill rehabilitation programme for an amputee. 26 To date, there have been no studies on the role of either, general or domain specific self-efficacy, in rehabilitation after knee osteochondral repair.…”