Communication Self-Efficacy for People With Parkinson's Disease

Self-efficacy for communication, defined as confidence in one's ability to communicate, is a construct grounded in social cognitive theory and has demonstrated relevance in research on communication disability. Its role in the communicative participation of people with Parkinson's disease (PwPD) has not been explored.

To explore if self-efficacy for communication for PwPD differs across communicative activities, changes over time and following speech therapy, and is associated with communicative participation.

Self-reported data for self-efficacy for communication and communicative participation were collected from 40 community-dwelling PwPD (half who received new speech therapy and half who did not) two times, 6 months apart.

Participants demonstrated higher communication self-efficacy with friends and when ordering food or drinks, and lower confidence when talking in a large group or giving a speech at an informal group. Self-efficacy for communication did not differ between groups who did and did not receive speech therapy, nor did it change after speech therapy; but it significantly declined for participants who did not receive therapy during the study. Self-efficacy for communication was significantly associated with communicative participation.

Self-efficacy for communication varies across some situations but not others. PwPD may be vulnerable to declining self-efficacy in the absence of communication intervention or support.

What is already known on this subject Self-efficacy, or confidence in one's ability to perform a task, is a well-established construct within social cognitive theory. In research on communication disability, particularly in aphasia and stuttering, communicative self-efficacy has been shown to be sensitive to therapy effects and linked to outcomes such as participation, anxiety, and depression. However, little is known about communicative self-efficacy in Parkinson's disease, how it may vary across situations and time, or how it relates to other rehabilitation outcomes. What this paper adds to the existing knowledge This study is the first to examine communicative self-efficacy in PwPD. Self-efficacy varied across situations, with higher ratings in casual, familiar contexts and lower ratings in more demanding contexts such as public speaking. Participants who did not receive speech therapy experienced significant declines in self-efficacy over 6 months, while those who received treatment remained stable. Self-efficacy was strongly associated with communicative participation, suggesting that beliefs about communicative ability may shape real-world participation outcomes in PwPD. What are the potential or actual clinical implications of this work? These findings underscore the importance of routinely addressing communication self-efficacy in the management of PD. Declines in self-efficacy may occur in the absence of intervention, placing individuals at risk for reduced participation. Speech-language pathologists can support clients not only by targeting physical symptoms of speech and voice, but also by promoting self-efficacy as part of intervention. Assessment tools and counselling approaches that capture communicative self-efficacy may help clinicians identify individuals at risk, track progress beyond impairment measures, and tailor interventions that enhance participation in everyday communication contexts.