Self-efficacy and self-management after stroke: a systematic review

Area of Science:

• Neurorehabilitation
• Health Psychology
• Evidence-Based Practice

Background:

• Self-efficacy, a core concept in social cognitive theory, plays a crucial role in an individual's belief in their capacity to execute behaviors necessary to produce specific performance attainments.
• Post-stroke recovery is a complex process influenced by numerous factors, including psychological aspects like self-efficacy.

Purpose of the Study:

• To review the influence of self-efficacy on rehabilitation outcomes in stroke survivors.
• To evaluate the evidence supporting self-management interventions grounded in self-efficacy principles for this population.

Main Methods:

• A systematic literature search was conducted across multiple databases (Medline, Embase, Psychlit, Web of Science, AMED, Cochrane) for articles published between 2000 and July 2009.
• Included studies focused on the relationship between self-efficacy and stroke rehabilitation outcomes or the efficacy of self-management interventions based on self-efficacy.
• Methodological quality appraisal and data extraction were performed by two independent reviewers.

Main Results:

• Twenty-two articles met the inclusion criteria from an initial search of 104.
• Self-efficacy is associated with improved quality of life, reduced depression, better activities of daily living (ADL) performance, and to some extent, physical functioning post-stroke.
• Emerging evidence suggests benefits from self-management programs, but optimal intervention delivery for stroke survivors remains unclear, necessitating further research on self-efficacy's predictive value.

Conclusions:

• Further research is needed to develop and test interventions that enhance self-management skills and confidence in stroke survivors.
• Collaborative efforts between researchers and stakeholders are essential to support continued progress and mitigate negative consequences like reduced quality of life and social isolation.