Participation self-efficacy plays a mediation role in the association between mobility and social participation among stroke survivors

Chau, Janita Pak Chun; Lo, Suzanne Hoi Shan; Choi, Kai Chow; Butt, Laveeza; Zhao, Jie; Thompson, David R.

doi:10.1016/j.hrtlng.2021.07.002

Cited by 8 publications

(4 citation statements)

References 28 publications

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“…Our findings indicated that iSMART yielded moderate-to-large effects in improving self-efficacy in using participation strategies for home, work, community, and communication management. Future interventions in improving participation outcomes following a stroke should make it a key behavioral target, given its beneficial mediatory effect on mobility and participation [ 52 ]. Participants who completed the iSMART intervention showed moderate-to-large effects of increasing self-efficacy in managing emotions, symptoms, daily activities, and treatments and medications.…”

Section: Discussionmentioning

confidence: 99%

A Digital Intervention to Promote Self-Management Self-Efficacy Among Community-Dwelling Individuals With Stroke: Pilot Randomized Controlled Trial

Li,

Lei,

Bui

et al. 2024

JMIR Rehabil Assist Technol

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Background Digital interventions provided through smartphones or the internet that are guided by a coach have been proposed as promising solutions to support the self-management of chronic conditions. However, digital intervention for poststroke self-management is limited; we developed the interactive Self-Management Augmented by Rehabilitation Technologies (iSMART) intervention to address this gap. Objective This study aimed to examine the feasibility and initial effects of the iSMART intervention to improve self-management self-efficacy in people with stroke. Methods A parallel, 2-arm, nonblinded, randomized controlled trial of 12-week duration was conducted. A total of 24 participants with mild-to-moderate chronic stroke were randomized to receive either the iSMART intervention or a manual of stroke rehabilitation (attention control). iSMART was a coach-guided, technology-supported self-management intervention designed to support people managing chronic conditions and maintaining active participation in daily life after stroke. Feasibility measures included retention and engagement rates in the iSMART group. For both the iSMART intervention and active control groups, we used the Feasibility of Intervention Measure, Acceptability of Intervention Measure, and Intervention Appropriateness Measure to assess the feasibility, acceptability, and appropriateness, respectively. Health measures included the Participation Strategies Self-Efficacy Scale and the Patient-Reported Outcomes Measurement Information System’s Self-Efficacy for Managing Chronic Conditions. Results The retention rate was 82% (9/11), and the engagement (SMS text message response) rate was 78% for the iSMART group. Mean scores of the Feasibility of Intervention Measure, Acceptability of Intervention Measure, and Intervention Appropriateness Measure were 4.11 (SD 0.61), 4.44 (SD 0.73), and 4.36 (SD 0.70), respectively, which exceeded our benchmark (4 out of 5), suggesting high feasibility, acceptability, and appropriateness of iSMART. The iSMART group showed moderate-to-large effects in improving self-efficacy in managing emotions (r=0.494), symptoms (r=0.514), daily activities (r=0.593), and treatments and medications (r=0.870), but the control group showed negligible-to-small effects in decreasing self-efficacy in managing emotions (r=0.252), symptoms (r=0.262), daily activities (r=0.136), and treatments and medications (r=0.049). In addition, the iSMART group showed moderate-to-large effects of increasing the use of participation strategies for management in the home (r=0.554), work (r=0.633), community (r=0.673), and communication activities (r=0.476). In contrast, the control group showed small-to-large effects of decreasing the use of participation strategies for management in the home (r=0.567), work (r=0.342, community (r=0.215), and communication activities (r=0.379). Conclusions Our findings support the idea that iSMART was feasible to improve poststroke self-management self-efficacy. Our results also support using a low-cost solution, such as SMS text messaging, to supplement traditional therapeutic patient education interventions. Further evaluation with a larger sample of participants is still needed. Trial Registration ClinicalTrials.gov 202004137; https://clinicaltrials.gov/study/NCT04743037?id=202004137&rank=1

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Section: Discussionmentioning

confidence: 99%

A Digital Intervention to Promote Self-Management Self-Efficacy Among Community-Dwelling Individuals With Stroke: Pilot Randomized Controlled Trial

Li,

Lei,

Bui

et al. 2024

JMIR Rehabil Assist Technol

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“…2 Thus, the decrease in mobility directly impacts social participation, autonomy, and quality of life in hemiparetic patients, being that it covers aspects such as movement to change the position or location of the body, transporting objects from one place to another, walking, running or going up/down stairs and if you use different forms of transport. [3][4][5][6] Therefore, measuring the mobility of chronic hemiparetic patients after stroke in the real-world environment is an important outcome for rehabilitation, in addition to facilitating personalized management and behavioral change. 7 To measure the mobility of chronic hemiparetic patients after stroke in a real-world environment, physical activity monitors with validity and reliability are used for the continuous recording of the number of steps people with stroke, living in the community, take.…”

Section: Introductionmentioning

confidence: 99%

Reliability and validity of remote Life Space Assessment: LSA in persons with chronic stroke

Oliveira,

Santos,

Reis

et al. 2024

Arq Neuropsiquiatr

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Background StepWatch Activity Monitor (SAM) is used to measure the mobility of chronic hemiparetic patients and the Life Space Assessment (LSA) scale was developed to assess the displacement of hemiparetic patients in different contexts through self-reporting. Studies that apply the LSA remotely and correlate it with the number of steps measured by the SAM were not found. Objective To evaluate the measurement properties of the LSA applied remotely and to evaluate the correlation between the LSA scale score and the number of steps measured by the SAM in post-stroke chronic hemiparetic patients. Methods Nineteen patients participated in the study. The LSA scale was applied remotely and later, face to face. The SAM measured the steps taken by the participants over a period of three consecutive days. The correlation between the LSA and the SAM was performed using Pearson's correlation. The measurement properties calculated of remote LSA were the intraclass correlation coefficient (ICC), Cronbrach's alpha, standard error of measurement (SEM), and smallest real difference (SRD). Results The reproducibility of the LSA scale between remote and face-to-face applications was considered excellent with ICC = 0.85 (IC 95% 0.62-0.94); SEM = 8.4; SRD = 23.2, and Cronbach's alpha = 0.85. The correlation between SAM and LSA was positive, considered moderate (r = 0.51) and significant (p = 0.025). Conclusion The LSA is a reproducible measure for post-stroke chronic hemiparetic patients even if applied remotely and can be used as a remote measurement for mobility in a real-world environment for people with chronic hemiparesis after stroke.

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“…Self-efficacy refers to a person’s belief in his or her abilities in performing a behavior successfully [ 18 ]. Its pivotal role in promoting recovery outcomes after stroke such as balance and social participation has been substantially supported in literature [ 19 , 20 ]. It is also important to note that outcome expectation is believed to be closely related to self-efficacy in affecting health behaviors.…”

Section: Introductionmentioning

confidence: 99%

Health Professional- and Volunteer-partnered Self-management Support (COMBO-KEY) to Promote Self-efficacy and Self-management Behaviors in People with Stroke: A Randomized Controlled Trial

Chau

Choi

et al. 2023

Annals of Behavioral Medicine

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Background Multiple systematic reviews have reported that self-management interventions are associated with positive impacts on self-efficacy and health-related quality of life (HRQoL) of people with stroke. Purpose This article reports the effects of an enhanced stroke self-management program. Methods Eligible adults with stroke were recruited from community-based organizations and a support group for a two-arm, assessor-blinded randomized controlled trial. Participants in the control group received usual care, while those in the intervention group also received the 8-week self-management program, Coaching Ongoing Momentum Building On stroKe rEcovery journeY (COMBO-KEY), consisting of four individual home visits and five follow-up phone calls, delivered by healthcare professionals and trained volunteers. Assessments were conducted at baseline and after the intervention, for outcomes of self-efficacy, satisfaction with the performance of self-management behaviors, HRQoL, and community reintegration, which were analyzed using generalized estimating equations (GEEs). Results 134 Participants were recruited [mean age = 64.1 years, standard deviation (SD) = 12.7]. Over 80% of the participants had a first-ever stroke [mean years after first stroke: 4.2 (SD = 5.1)]. The GEE analysis revealed that the intervention group participants showed significantly greater improvements in self-efficacy, satisfaction with their performance of self-management behaviors, HRQoL, and community reintegration at 8-week follow-up with respect to their baseline levels. Conclusions The COMBO-KEY program showed effective improvements in recovery outcomes of people with stroke. Future research should explore the inclusion of virtual/hybrid sessions, strategies to assess health conditions of people with stroke via online modes, and assessment of goal attainment and actual performance of self-management behaviors.

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Participation self-efficacy plays a mediation role in the association between mobility and social participation among stroke survivors

Cited by 8 publications

References 28 publications

A Digital Intervention to Promote Self-Management Self-Efficacy Among Community-Dwelling Individuals With Stroke: Pilot Randomized Controlled Trial

A Digital Intervention to Promote Self-Management Self-Efficacy Among Community-Dwelling Individuals With Stroke: Pilot Randomized Controlled Trial

Reliability and validity of remote Life Space Assessment: LSA in persons with chronic stroke

Health Professional- and Volunteer-partnered Self-management Support (COMBO-KEY) to Promote Self-efficacy and Self-management Behaviors in People with Stroke: A Randomized Controlled Trial

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