Stroke self-management and the role of self-efficacy

Nott, Melissa; Wiseman, Leah; Seymour, Tanya; Pike, Shannon; Cuming, Tana; Wall, Gemma

doi:10.1080/09638288.2019.1666431

Cited by 69 publications

(55 citation statements)

References 23 publications

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“…Four principles could enhance self-efficacy, which include direct mastery of experience, substitution of experience, verbal persuasion, and understanding of physiological states and signals [8]. A previous study found that self-efficacy is a moderator of occupational performance in stroke self-management programs [9].…”

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confidence: 99%

Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke: a randomized controlled trial

Long

Ouyang

Zhang

2020

J NeuroEngineering Rehabil

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Background Virtual reality (VR) has been broadly applied in post-stroke rehabilitation. However, studies on occupational performance and self-efficacy as primary outcomes of stroke rehabilitation using VR are lacking. Thus, this study aims to investigate the effects of VR training on occupational performance and self-efficacy in patients with stroke. Methods This was an assessor-blinded, randomized controlled trial. Sixty participants with first-ever stroke (< 1-year onset) underwent rehabilitation in a single acute hospital. Participants were randomly assigned to either the VR group (n = 30) or control group (n = 30). Both groups received dose-matched conventional rehabilitation (i.e., 45 min, five times per week over 3 weeks). The VR group received additional 45-min VR training for five weekdays over 3 weeks. The primary outcome measures were the Canadian Occupational Performance Measure and Stroke Self-Efficacy Questionnaire. Secondary outcome measures included Modified Barthel Index, Fugl-Meyer Assessment-Upper Extremity, and Functional Test for the Hemiplegic Upper Extremity. The assessment was conducted at baseline and after the 3-week intervention. Results A total of 52 participants (86.7%) completed the trial. Significant between-group differences in Stroke Self-Efficacy Questionnaire (Median Difference = 8, P = 0.043) and Modified Barthel Index (Median Difference = 10, P = 0.030) were found; however, no significant between-group differences in Canadian Occupational Performance Measure, Fugl-Meyer Assessment-Upper Extremity, and Functional Test for the Hemiplegic Upper Extremity were noted. No serious adverse reactions related to the program were reported. Conclusions Additional VR training could help improve the self-efficacy and activities of daily living of patients with stroke; however, it was not superior to conventional training in the improvement of upper limb functions, occupational performance, and satisfaction. Nevertheless, VR could be integrated into conventional rehabilitation programs to enhance self-efficacy of patients after stroke. Trial registration This study was successfully registered under the title “Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke” on October 13 2019 and could be located in https://www.chictr.org with the study identifier ChiCTR1900026550.

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confidence: 99%

Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke: a randomized controlled trial

Long

Ouyang

Zhang

2020

J NeuroEngineering Rehabil

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“…The use of only one format may be monotonous as well, and multiple formats might compensate for the shortcomings of any one format. 28 In terms of the providers, a single provider is mostly specialized in one aspect of the self-management program (e.g., psychotherapists focus on participants' psychological management, physiotherapists focus on teaching them how to improve their mobility), while a single patient may demand or require improvement in many aspects of self-management to be able to manage himself or herself well, and the intervention topic is usually diverse, as argued above. Therefore, multidisciplinary cooperation plays a significant role in supporting stroke survivors' self-management.…”

Section: Discussionmentioning

confidence: 99%

Self‐management interventions for adults with stroke: A scoping review

Ruksakulpiwat

Zhou

2021

Chronic Diseases and Translational Medicine

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Background Stroke is a principal cause of mortality and disability globally. Numerous studies have contributed to the knowledge base regarding self-management interventions among chronic disease patients, but there are few such studies for patients with stroke. Therefore, it is necessary to analyze self-management interventions among stroke patients. This scoping review aimed to systematically identify and describe randomized controlled trials (RCTs) of self-management interventions for adults with stroke. Methods A review team carried out a scoping review on stroke and self-management interventions based on the methodology of Arksey and O'Malley, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). PubMed, Embase, Web of Science, CINAHL Plus Full Text, Medline Plus Full Text, and Cochrane Central Register of Controlled Trials were searched from inception to July 2020. Results Fifty-four RCTs were included. The most popular study design is comparing a self-management intervention to usual care or waitlist control condition. Physical activity is the most common intervention topic, and interventions were mainly delivered face to face. The majority of interventions were located in inpatient and multiple settings. Interventions were conducted by various providers, with nurses the most common provider group. Symptom management was the most frequently reported outcome domain that improved. Conclusions Self-management interventions benefit the symptom management of stroke patients a lot. The reasonable time for intervention is at least 6–12 months. Multifarious intervention topics, delivery formats, and providers are adopted mostly to meet the multiple needs of this population. Physical activity was the most popular topic currently. Studies comparing the effect of different types of self-management interventions are required in the future.

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“…This could be have been caused by individuals who has disability, the positive effect of better knowledge on healthy behavior may be eliminated by the fear or restriction of participation (13). Studies highlighted that patients often feel unprepared do deal with long-term disabilities, self-e cacy has been proposed as important determinant of adaptation process in individuals after stroke (24,42,54). Researches also demonstrated that patients who proactively and willingly participated in exercise had high adherence, even without any supervision (55,56).…”

Section: Discussionmentioning

confidence: 99%

The Influential factors of Adherence to Physical Activity and Exercise among Community-Dwelling Stroke Survivors: A Path Analysis

Lin

Zhang²,

Mei

et al. 2020

Preprint

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Background: Regular physical activity and exercise (PAE) after stroke is essential, but the adherence to PAE and its influential factors is rarely studied and unclear in developed countries. The aim of this study was to investigate the status of PAE adherence, and to identify its influential factors among Chinese community-dwelling stroke survivors.Methods: A cross-sectional study was conducted, 208 stroke survivors were randomly selected from three communities (60.10% men, mean age 70.25 ± 9.08 years). Physical Activity and Exercise Adherence Scale (PAEAS) was used as a measure of compliance, knowledge, attitude, self-efficacy and social support were measured using relevant scales. Influential factors of PAE adherence and associations between those variables were explored using multiple linear regression and path analysis.Results: The mean adherence rate was moderate (62.0%), stroke survivors tended to be more adherent to do PAE than monitoring and seeking advices (70.30% > 53.50% > 48.30%). Regression results revealed that seven factors significantly associated with PAE adherence, including knowledge, attitude, self-efficacy, social support, self-care ability, community rehabilitation experience, and times since stroke (R2 = 75.10%, F = 45.593, p < 0.05). Furthermore, path analysis showed that knowledge had a significant indirect positive influence with self-efficacy as a mediator on adherence (β= 0.16, p < 0.05); while attitude and social support impacted both directly and indirectly on adherence with self-efficacy as the mediator; what’s more, self-efficacy was an important predictor that performed the strongest direct effect on community-dwelling stroke survivors’ PAE adherence (β= 0.44, p < 0.01 ). These four variables accounted for a total of 67.00% of the variance of PAE adherence among community-dwelling stroke survivors.Conclusions: Physical activity and exercise adherence of community stroke survivors is needed to be improved. Attitude and social support presented both direct and indirect impacts on PAE adherence through self-efficacy, while knowledge only exhibited an indirect influencing effect on adherence. Health care professionals should administer a more comprehensive and systematic assessment to seek to improve self-efficacy through the development of effective interventions for promoting adherence to PAE in this population.

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Stroke self-management and the role of self-efficacy

Cited by 69 publications

References 23 publications

Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke: a randomized controlled trial

Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke: a randomized controlled trial

Self‐management interventions for adults with stroke: A scoping review

The Influential factors of Adherence to Physical Activity and Exercise among Community-Dwelling Stroke Survivors: A Path Analysis

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