Associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke

Social isolation, coping efficacy, and social well-being over time in patients with lung cancer

BACKGROUND

Little work has examined how coping efficacy and lung cancer-related social isolation relate to social well-being in the context of a patient's computed tomography (CT) scan. Researchers tested the cross-sectional relationship of social isolation and social well-being, and the longitudinal relationship between coping efficacy and social well-being before CT scans.

METHOD

25 patients with lung cancer, within 6 months of their upcoming CT scan, participated. Baseline surveys collected clinical information, demographics, and social isolation; repeated monthly surveys collected coping efficacy and social well-being every 30 days until one's scan.

RESULTS

[Cross-sectional] High levels of social isolation were associated with low levels of social well-being. [Longitudinal] On months patients reported high coping efficacy, they also reported increases in social well-being.

CONCLUSIONS

Social interventions may improve well-being among those with lung cancer as our work shows that getting and receiving support are strongly related to well-being in the time surrounding a scan.

A scoping review of factors associated with self-management in young adults with stroke

PURPOSE

To synthesize the available evidence on factors associated with self-management behavior in young stroke patients.

METHODS

The methodological guidelines for scoping reviews developed by the Joanna Briggs Institute and the PRISMA-scR-checklist for scoping reviews were used. A total of 5586 studies were identified through bibliographic searches of the scientific databases Medline (OVID), Embase (OVID), CINAHL (EBSCO), and PsycINFO, limited to the period 2000-2023. Studies were independently assessed for inclusion and exclusion criteria by two reviewers. Quantitative observational data and qualitative studies were extracted, mapped, and summarized to provide a descriptive summary of trends and considerations for future research.

RESULTS

Nine papers were finally selected to answer the research question. Young patients' self-management was mainly influenced by demographic factors (age, gender, income, education, and stroke knowledge), disease-related factors (functionality and independence, duration of stroke diagnosis, cognitive function, and poststroke fatigue), and psychosocial factors (hardiness, spiritual self-care, self-efficacy, and social support).

CONCLUSION

Further research is needed to determine the trajectory of poststroke self-management over time and its potential predictors, which should lead to the development of specific stroke rehabilitation and stroke self-management support programs for young people (considering factors that influence return to work in young stroke patients' self-management).

PRACTICE IMPLICATIONS

Healthcare providers can design more efficient interventions to improve the quality of life of young stroke patients after discharge. Gaining an in-depth understanding of the factors that influence self-management can help achieve this.

A cross-sectional study on the moderating effect of self-efficacy on the relationship between sociodemographic variables and nutrition literacy among older adults in rural areas of North Sichuan

Objective

The purpose of this study is to examine the moderating role of self-efficacy among rural elderly individuals in northern Sichuan Province in the relationship between certain sociodemographic variables and nutritional literacy.

Methods

Convenience sampling was used to select 264 elderly individuals aged 60 and above from rural communities in Cangxi County, Guangyuan City, Yilong County, Nanchong City, and Bazhou District, Bazhong City, Sichuan Province. A self-designed questionnaire, including sociodemographic variables, the General Self-Efficacy Scale (GSES), and the Nutrition Literacy Questionnaire for the Elderly (NLQ-E), was administered through face-to-face interviews using a paper-based version. The relationships between sociodemographic variables, self-efficacy, and nutritional literacy in the elderly were analyzed using SPSS 26.0 and the Process plugin to examine the relationships between variables and to test for moderation effects.

Results

(1) There were significant differences in nutrition literacy scores among elderly people of different ages, genders, marital statuses, educational levels, personal monthly living expenses, dental conditions, and number of chronic diseases (p < 0.05). (2) When elderly individuals have lower self-efficacy, their nutritional literacy is lower as they become older, and they have poorer nutritional literacy with a higher number of chronic diseases.

Conclusion

General population demographic data has a significant impact on the nutritional literacy level of elderly people in rural areas of northern Sichuan. Self-efficacy plays a moderating role in the relationship between age and nutritional literacy, as well as the relationship between the number of chronic diseases and nutritional literacy.

Translation and validation of the Persian version of the Stroke Self-Efficacy Questionnaire in stroke survivors

BACKGROUND

The Stroke Self-Efficacy Questionnaire (SSEQ) is a self-report scale that measures stroke survivors' self-efficacy and covers specific domains of functioning after stroke.

OBJECTIVES

We aimed to determine the validity and reliability of the Persian version of the SSEQ.

METHODS

This descriptive cross-sectional study included 124 stroke patients in the sub-acute phase (between 2 weeks and 3 months of stroke onset). The original SSEQ was translated to Persian and back-translated to English. Demographic, neurologic examination, 'Persian Stroke Self-Efficacy Questionnaire (SSEQ-P)', and 'General Self-Efficacy Scale' (GSE-10) data were collected. The reliability of the questionnaire was evaluated by test-retest assessment among 30 people with stroke at an interval of two weeks. Factor analysis was used to assess the validity of SSEQ-P. Cronbach's alpha assessed internal consistency in all participants. Statistical analysis was performed by SPSS software version 23 and SmartPLS version 3.

RESULTS

In this study, the mean of SSEQ scores was 87.99 ± 37.09. Content Validity Ratio (CVR) and Content Validity Index (CVI) were favorable. Convergent validity of the questionnaire was reported (r = 0.669) using GSE. Factor loadings of items in SSEQ ranged from 0.41 to 0.92. Validity indices (AVE = 0.75, SRMR = 0.07) showed that the single-factor model of the present study owns a favorable fit. Test-retest reliability and Cronbach's alpha values of SSEQ in the present study were calculated at 0.80 and 0.97, respectively.

CONCLUSIONS

The Persian version of the SSEQ depicted acceptable reliability and validity and can be utilized to evaluate the self-efficacy of patients with stroke.HIGHLIGHTSStroke Self-Efficacy Questionnaire (SSEQ) is a self-report scale that measures stroke survivors' self-efficacy.The Persian version of the SSEQ demonstrated acceptable reliability and validity and can be used in stroke patients.

Using Self-Regulation Assessment to Explore Associations between Self-Regulation, Participation and Health-Related Quality of Life in a Rehabilitation Population

OBJECTIVE

Self-regulation, participation and health-related quality of life are important rehabilitation outcomes. The aim of this study was to explore associations between these outcomes in a multi-diagnostic and heterogenic group of former rehabilitation patients.

METHODS

This cross-sectional survey used the Self-Regulation Assessment (SeRA), Utrecht Scale for Evaluation of Rehabilitation-participation (USERParticipation) and the Patient-Reported-Outcome-Measurement-System (PROMIS) ability and PROMIS satisfaction with participation in social roles, and the EuroQol-5L-5D and PROMIS-10 Global Health. Regression analyses, controlling for demographic and condition-related factors, were performed.

RESULTS

Respondents (n = 563) had a mean age of 56.5 (standard deviation (SD) 12.7) years. The largest diagnostic groups were chronic pain disorder and brain injury. In addition to demographic and condition-related factors, self-regulation subscales explained 0-15% of the variance in participation outcome scores, and 0-22% of the variance in HRQoL outcome scores. Self-regulation subscales explained up to 22% of the variance in satisfaction subscales of participation (USER-Participation and PROMIS) and the mental health subscale of the PROMIS-10. Self-regulation subscales explained up to 11% of the restriction and frequency subscales of participation (USER-Participation) and the physical health subscale of the PROMIS-10.

CONCLUSION

Self-regulation is more strongly associated with outcomes such as satisfaction with participation and mental health compared with outcomes such as restrictions in participation and physical health.

Effects of mobile phone App-based continuing nursing care on self-efficacy, quality of life, and motor function of stroke patients in the community

To explore the effects of mobile phone application (App)-based continuing nursing care on the self-efficacy (SE), quality of life (QOF), and motor function (MF) of stroke patients in the community. A total of 101 stroke patients in the community recruited in this study for retrospective analysis were divided into a control group (CG) and an observation group (OG) based on the means of intervention. In total, 50 patients in the CG received routine community health education, based on which a mobile phone App-based continuing nursing mode was applied to the 51 patients in the OG. Changes in physiological indicators, including homocysteine (Hcy), high-density lipoprotein (HDL-C), and total cholesterol (TC), were evaluated before and after intervention. Moreover, MF [determined using the Fugal-Meyer motor function assessment (FMA)], SE (determined using stroke self-efficacy questionnaire), QOF, and satisfaction toward nursing were evaluated. (1) Hcy and TC levels in the OG were lower after intervention; however, HDL-C levels were higher than those in the CG, with statistically significant differences (P < 0.05). (2) The FMA MF of the upper and lower limb (FMA-U and FMA-L) scores and the total scores in the OG after the intervention were significantly improved compared with those in the CG (P < 0.05). (3) Patients in the OG showed significantly higher SE scores than those in the CG (P < 0.05). (4) Scores of emotional health, emotional function, social function, energy, general health status, body pain, physiological function, and physiological features were significantly higher in the OG than those in the CG after the intervention (P < 0.05). (5) Patients in the OG expressed more positive satisfaction toward nursing than those in the CG, with statistically significant differences (P < 0.05). Mobile phone App-based continuing nursing care may significantly improve the SE, quality of life, and satisfaction toward nursing as well as promote the improvement of biological markers and MF of stroke patients.

Investigating the effect of self-management program on stroke's patients' self-efficacy

Background and aim

Stroke patients face various challenges that affect their self-efficacy. The purpose of this study is to evaluate the effect of a self-management program on the self-efficacy of patients with Stroke.

Methods and materials

This study is a clinical trial, in which 72 patients with stroke participated in this study. They were selected based on the convenience sampling method and assigned to either intervention or control group (36 patients in each group) randomly. The intervention group received 5A based self-management program for 6 weeks (in-person and off-site) and the control group received only routine care includes stroke training booklets and post-discharge care training by the ward nurse. Data were collected through demographic and jones self-efficacy questionnaires, before, immediately after, and 3 months after interventions in both groups and were analyzed with descriptive and analytical statistics using SPSS software (with independent t-test, Chi-square, Fisher and analysis of variance with repeated measures with a significance level of 0.05).

Results

Before interventions, the two study groups had no statistically significant difference regarding demographic variables and the mean score of self-efficacy. Immediately and 3 months after interventions, the mean score and mean changes of self-efficacy score in the intervention group were significantly greater than in the control group(p < 0.001).

Conclusion

The results of the present study show the appropriate effect of self-management program on self-efficacy of stroke patients. These results can be used by different members of healthcare teams to improve patients’ self-efficacy.

Trial registration

This study is registered by Iranian Registry of Clinical Trials with decree code: IRCT20190712044181N2 (registration date: 05-11-2019).

Tailoring and Evaluating an Intervention to Support Self-management After Stroke: Protocol for a Multi-case, Mixed Methods Comparison Study

Background

Self-management programs are recognized as a valuable approach to supporting people with long-term conditions, such as stroke, in managing their daily lives. Bridges Self-Management (Bridges) focuses on how practitioners interact and support patients’ confidence, skills, and knowledge, and it is an example of a complex intervention. Bridges has been developed and used across multiple health care pathways in the United Kingdom and is theoretically informed by social cognition theory and self-efficacy principles. Evidence shows that self-management programs based on the construct of self-efficacy can be effective. There is still much to learn about how health care services or pathways should implement support for self-management in a sustainable way and whether this implementation process is different depending on the context or culture of the team or service provided.

Objective

The aim of this study is to tailor and evaluate an intervention (Bridges) to support self-management after stroke in a Swedish context.

Methods

We will use a pretest-posttest design with a case study approach to evaluate the feasibility and implementation of self-management support in two stroke settings. This project includes a complex intervention and depends on the actions of individuals, different contexts, and the adaptation of behavior over time. A mixed methods approach was chosen to understand both outcomes and mechanisms of impact. Data collection will comprise outcome measurements and assessment tools as well as qualitative interviews. Data will be collected concurrently and integrated into a mixed methods design.

Results

Recruitment and data collection for the first site of the project ran from September 1, 2021, to January 17, 2022. The intervention at the first site was conducted from November 1, 2021, to March 5, 2022. The evaluation will start after the implementation phase. The second site has been recruited, and the baseline data collection will start in spring 2022. The intervention will start in early autumn 2022. Data collection will be completed by the end of 2022.

Conclusions

This study represents a unique, highly relevant, and innovative opportunity to maximize knowledge and minimize practice gaps in rehabilitation stroke care. The study will produce robust data on the intervention and in-depth data on the contextual factors and mechanisms related to the feasibility of the intervention and for whom it is feasible. Bridges has been used in the United Kingdom for more than 10 years, and this study will explore its contextualization and implementation within a Swedish stroke environment. The evaluation will study results at the patient, staff, and organizational levels and provide recommendations for the adoption and refinement of future efforts to support self-management.

International Registered Report Identifier (IRRID)

DERR1-10.2196/37672

Intra- and interpersonal effects of coping style and self-efficacy on anxiety, depression and life satisfaction in patient-partner couples after stroke

Many stroke patients and partners suffer from anxiety, depression, and low life satisfaction. Psychological factors such as coping style and self-efficacy can be protective factors within individuals. The close relationship between stroke patients and partners suggests that there may be interdependence in psychological functioning. The aim of this study was to examine intra- and interpersonal effects of coping style and self-efficacy on anxiety, depression, and life satisfaction in patient-partners couples. In this prospective cohort study, pro-active coping (UPCC), general self-efficacy (GSES), anxiety (HADS-A), depression (HADS-D), and life satisfaction (1-6 scale) were assessed in 215 couples at 2 and 12 months post-stroke. Effects within couples were assessed using structural equation modelling. Several intra- and interpersonal effects of coping style and self-efficacy at 2 months post-stroke were related to emotional health at 12 months post-stroke. Most effects were intrapersonal effects. The interpersonal effects were small but showed that pro-active coping by the patient was associated with lower anxiety of the partner. Higher self-efficacy of the partner was associated with lower depression scores and higher life satisfaction of the patient. This study underscores the importance of a dyadic approach to post-stroke functioning. It supports a family-based approach for treating post-stroke emotional problems.

Teachers' Personality, Perfectionism, and Self-Efficacy as Predictors for Coping Strategies Based on Personal Resources

Many psychological constructs as personality, perfectionism, and self-efficacy have been identified to have a strong contribution to teachers’ coping strategies, but how these variables collectively predict different types of coping has received little attention. The present study aimed to explore the personal resources (personality traits, perfectionistic strivings, and self-efficacy) which predict teachers’ proactive coping strategies. The sample study consisted of 284 pre-service teachers, with ages ranging from 18 to 34years old (M=19.9; SD=2.1). Four hierarchical multiple regression analyses were conducted separately for every proactive coping strategy based on personal resources as criterion variables. Results showed that conscientiousness and openness were predictors for all four coping strategies based on personal resources (proactive, reflective, strategic planning, and preventive coping), extraversion and neuroticism predicted only proactive coping strategies, and agreeableness did not predict any kind of these coping strategies. Planfulness was a predictor for reflective, strategic planning, and preventive coping strategies; striving for excellence predicted only proactive coping, and organization was a predictor only for reflective coping strategies. Self-efficacy predicted the first three proactive coping strategies but preventive coping. Because coping strategies can be learned, knowing what personal resources may help teachers to cope with stressful situations inside and outside the school, could be organized training programs to improve activity and well-being in the teaching profession.

Testing the psychometric properties of the Chinese version of the Neurological Fatigue Index-Stroke

OBJECTIVE

To test the psychometric properties of a Chinese version of the Neurological Fatigue Index-Stroke (C-NFI-Stroke) in stroke survivors.

DESIGN

This was a validation study. Cross-cultural adaptation of the scale was conducted according to standard guidelines. Reliability, validity, responsiveness, and interpretability were measured.

SETTING

Self-help groups and a community center.

SUBJECTS

One hundred and twelve Chinese stroke survivors and 65 healthy Chinese older people living in the community.

INTERVENTIONS

Not applicable.

MAIN MEASURES

The C-NFI-Stroke, Fatigue Severity Scale, Mental Fatigue Scale, General Self-Efficacy Scale, and Geriatric Depression Scale were used.

RESULTS

Cronbach's α coefficients were 0.69-0.88; the item-level agreement was 70.4%-88.9%; the weighted Kappa value was 0.47-0.79; and the intra-class correlation coefficients were 0.88-0.93. The C-NFI-Stroke had no ceiling and floor effects. It had good content validity and had two factors, "lack of energy" and "tiredness/weakness." The confirmatory factor analysis showed a good fit to the model. The C-NFI-Stroke significantly correlated with existing fatigue scales (r_s = 0.55-0.63), self-efficacy (r_s = -0.31 to -0.37), and depressive symptoms (r_s = 0.53-0.60). The C-NFI-Stroke could discern differences between stroke survivors and healthy older people.

CONCLUSIONS

The C-NFI-Stroke is a reliable and valid tool for clinical and research use on people who have been diagnosed with stroke for a year or more, although its factor structure differs from that of the original English version.

Predictor of self-efficacy in individuals with chronic disease: Stress-coping strategies

AIMS AND OBJECTIVES

This study aims to investigate the relationship between stress-coping strategies of individuals with chronic diseases and their self-efficacy.

BACKGROUND

Self-efficacy and coping with stress in chronic diseases affect the course of the disease.

DESIGN

The sample of this methodological study consisted of 178 patients who were hospitalised in a university hospital between November 2017 and November 2018.

METHODS

Data were collected by the face-to-face interview method using a Patient Information Form, Stress-Coping Styles Scale and Self-Efficacy Scale. This study followed STROBE checklist for cross-sectional studies.

RESULTS

The study found that there was a strong relationship between patients' coping strategies and their self-efficacies and that the variables that predict self-efficacy in order of importance were self-confident approach (β = .41), the helpless approach (β = -0.24) and the submissive approach (β = -0.15), respectively. The study also found that the optimistic approach and the seeking social support approach had no significant contribution to the model.

CONCLUSIONS

The most important predictor of self-efficacy in individuals with chronic disease was the self-confident approach, which was one of the problem-oriented coping strategies. Therefore, patients should be taught to use effective methods to cope with stress to increase their self-efficacy, and their self-confidence should be supported.

RELEVANCE TO CLINICAL PRACTICE

In individuals with chronic disease, self-efficacy has an important role to get better psycho-social adaptation. To determine patients' self-efficacy levels and predictors will guide nursing initiatives.

Impact of stroke on affective well-being: findings from a large longitudinal nationally representative study

OBJECTIVES

To examine whether the incidence of stroke influences affective well-being (positive affect and negative affect), and whether such a relationship is moderated by general self-efficacy.

METHOD

Longitudinal data from 2008, 2011 and 2014 were used from a population-based sample of community-residing individuals ≥ 40 years in Germany (n = 9,659 in regression analysis). Affective well-being was quantified using the established Positive and Negative Affect Schedule (PANAS). A well-established scale by Schwarzer and Jerusalem was used to assess general self-efficacy. General practitioner diagnosed stroke was reported.

RESULTS

Fixed effects regressions showed that the incidence of stroke was associated with a decrease in positive affect in the total sample (β = -.17, p < .001) and in both sexes (men: β = -.16, p < .05; women: β = -.19, p < .01). In contrast to these findings, the incidence of stroke was not associated with changes in negative affect (total sample; stratified by sex). Moreover, general self-efficacy moderated the relation between stroke and positive affect.

CONCLUSION

Panel regression models showed that the incidence of stroke was associated with a decline in positive affect in the total sample and in both sexes. As the general self-efficacy moderated this association, it may be beneficial to enhance self-efficacy and prioritize coping strategies among stroke survivals.

Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke

New reperfusion therapies have improved the clinical recovery rates of acute ischemic stroke patients (AISP), but it is not known whether other factors, such as the ability to cope, might also have an effect. The aim of this study was to evaluate the effect of endovascular treatment (EVT) on coping strategies, quality of life, and neurological and functional outcomes in AISP at 3 months and 1 year post-stroke. A multicenter, prospective, longitudinal, and comparative study of a sub-study of the participants in the Endovascular Revascularization with Solitaire Device versus Best Medical Therapy in Anterior Circulation Stroke within 8 Hours (REVASCAT) clinical trial was conducted after recruiting from two stroke centers in Catalonia, Spain. The cohort consisted of 82 ischemic stroke patients (n = 42 undergoing EVT and n = 40 undergoing standard best medical treatment (BMT) as a control group), enrolled between 2013–2015. We assessed the coping strategies using the Brief Coping Questionnaire (Brief-COPE-28), the health-related quality of life (HRQoL) with the EQ-5D questionnaire, and the neurological and functional status using the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), and Stroke Impact Scale-16 (SIS-16). Bivariate analyses and multivariate linear regression models were used. EVT patients were the ones that showed better neurological and functional outcomes, and more patients presented reporting no pain/discomfort at 3 months; paradoxically, problem-focused coping strategies were found to be significantly higher in patients treated with BMT at 1 year.

Anticipatory coping: how women deal with the hassles of living with multiple sclerosis

Background: People living with MS confront a variety of changes and challenges that need to cope with. The aim of this study was to explore the coping patterns related to the impact of MS on people's lives including; daily, family, and social functions.Methods: A constructivist grounded theory approach was taken. A purposive sample of 16 women living with MS were recruited from a MS clinic at a teaching hospital in the north of Iran. Participants completed 22 semi-structured interviews. The interviews were digitally recorded, transcribed and analyzed using initial, focused and theoretical coding.Results: Participants described coping with a certain pattern that reflected direction and orientation of coping. Anticipating outcomes related to disease, self or others led the participants to plan ahead to deal with the challenges of living with MS. Indeed, they develop and employed anticipatory coping in disease-directed, self-directed and other-directed. Then they focused on the orientation of coping patterns, which involved actions, reactions, and interactions in order to manage anticipated outcomes.Conclusion: The majority of participants used coping pattern that were anticipatory rather than a reactionary to past or present challenges. The results highlight the value of engaging with people with MS in order to identify ways that they cope with the impact of this condition. This is an important distinction and one that health professionals not only need to be aware of but highlights the value of engaging with people with MS in this frame to develop informed and positive approaches to anticipated outcomes and in responding to anticipated changes and challenges.IMPLICATIONS FOR REHABILITATIONPeople develop the pattern of anticipatory coping in order to deal with issues related to the disease, self and others that they anticipate will happen in order to manage potential dysfunctions related to living with multiple sclerosis.People living with MS employ anticipatory coping based on existing and anticipated abilities and disabilities in order to maintain normality for as long as possible in daily, family and social activities.Proactive approaches to dealing with MS can be promoted in a number of ways, for example through support groups, social media or the development of networks with the aim of providing peer support and education.Developing rehabilitation programmes that reflect individual responses to living with MS would improve the ability of healthcare systems to meet clients' needs related to adjusting to living with a chronic condition.

Resilience and its correlates among first ischemic stroke survivors at acute stage of hospitalization from a tertiary hospital in China：a cross-sectional study

Objectives: To measure the resilience of elderly patients with first ischemic stroke in mainland China and to identify variables that may be correlated with resilience at the acute stage of hospitalization.Methods: A cross-sectional survey was carried out in departments of neurology of two tertiary hospitals, where a convenience sample of one hundred and forty-seven elderly patients with first ischemic stroke voluntarily participated in our study. Resilience was assessed using the Chinese version of Connor-Davidson Resilience Scale with three dimensions (tenacity, strength, and optimism). The General Self-Efficacy Scale and Medical Coping Modes Questionnaire were applied to evaluate the respondents' general self-efficacy and coping style. Functional independency was also measured using the Functional Independency Measure.Results: The mean score of the 147 respondents' resilience was 62.51 ± 14.69. Together, general self-efficacy, resignation, confrontation, per capital monthly income, and being main source of family income explained 68.1% of the variance in resilience. General self-efficacy, resignation, and confrontation were the strongest explanatory factors. Specifically, 63.4% of the variance in tenacity was explained for general self-efficacy, resignation, being main source of family income, surgical history, and per capital monthly income. 63.2% of the variance in strength was ascribed to general self-efficacy, resignation, per capital monthly income and avoidance. 32.5% of the variance in optimism was attributed to general self-efficacy, religion, and resignation.Conclusion: General self-efficacy and coping style may be implied orientation in enhancing resilience of elderly patients with first ischemic stroke at acute hospitalization. Moreover, economic status may predict level of resilience.HighlightsResilience was measured in 147 older first-episode ischemic stroke survivors at acute hospitalization.General-efficacy was the strongest predictor of resilience.Resilience was significantly influenced by resignation.Coping strategy should be emphasized early after stroke.

Translation and validation of the stroke self-efficacy questionnaire to a Portuguese version in stroke survivors

BACKGROUND

Stroke Self-efficacy Questionnaire (SSEQ) is not available to Portuguese-Brazil.Objective: To translate, perform cross-cultural adaptation, and validate the Stroke Self-efficacy Questionnaire (SSEQ) to Portuguese-Brazil (SSEQ-B).Methods: It is a cross sectional study: 1) translation and cross-cultural adaptation of SSEQ - a five stage process, 2) validation and reliability study with 40 chronic stroke survivors. The outcomes were: Content Validity Index (CVI), Face validity index, Reliability, Internal consistency, Stability, Ceiling and floor effects Concurrent validity, Measurement error using Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). Results: There was high agreement for the English to Portuguese-Brazil translation. Adjustments were made to improve semantic equivalence. Intra-examiner reliability was high (ICC 0.86) as was inter-examiner reliability (ICC 0.91). Internal consistency was acceptable for the total score, the activity subscale and self-management domain, Cronbach alphas are 0.82, 0.77, 0.68, respectively. The stability of the SSEQ-B was high and good (r = 0.77 p < .001). Ceiling effects were evident in 7.5% of the sample. For concurrent validity, there was an inverse relationship between BDI and SSEQ-B (r = -0.43 p = .006), and a positive relationship between FIM (r = 0.52 p < .001), SIS (r = 0.64 p < .001) and SSEQ-B. SEM was 1.58 points of the SSEQ-B and the MDC was 4.38 points of SSEQ-B. Conclusion: SSEQ-B is a valid, reliable, and stable patient-reported outcome. It has concurrent validity with self-reported measures of depression, functional independence and a multi-dimensional measure of health status in chronic stroke survivors in Brazil.

The nature of self-esteem and its relationship to anxiety and depression in adult acquired brain injury

Acquired brain injury (ABI) has a negative impact on self-esteem, which is in turn associated with mood disorders, maladaptive coping and reduced community participation. The aim of the current research was to explore self-esteem as a multi-dimensional construct and identify which factors are associated with symptoms of anxiety or depression. Eighty adults with ABI aged 17-56 years completed the Robson Self-Esteem Scale (RSES), of whom 65 also completed the Hospital Anxiety and Depression Scale; 57.5% of the sample had clinically low self-esteem. The RSES had good internal consistency (α =   .89), and factor analysis identified four factors, which differed from those found previously in other populations. Multiple regression analysis revealed anxiety was differentially predicted by "Self-Worth" and "Self-Efficacy", R² =   .44, F(4, 58) =   9, p <   .001, and depression by "Self-Regard", R² =   .38, F(4, 58) =   9, p <   .001. A fourth factor, "Confidence", did not predict depression or anxiety. In conclusion, the RSES is a reliable measure of self-esteem after ABI. Self-esteem after ABI is multidimensional and differs in structure from self-esteem in the general population. A multidimensional model of self-esteem may be helpful in development of transdiagnostic cognitive behavioural accounts of adjustment.

Assessment of Self-Efficacy and its Relationship with Frailty in the Elderly

Objective It has been increasingly recognized in various clinical areas that self-efficacy promotes the level of competence in patients. The validity, applicability and potential usefulness of a new, simple model for assessing self-efficacy in the elderly with special reference to frailty were investigated for improving elderly patients' accomplishments. Methods The subjects of the present study comprised 257 elderly people who were members of the New Elder Citizen Movement in Japan and their mean age was 82.3±3.8 years. Interview materials including self-efficacy questionnaires were sent to all participants in advance and all other physical examinations were performed at the Life Planning Center Clinic. Results The internal consistency and close relation among a set of items used as a measure of self-efficacy were evaluated by Cronbach's alpha index, which was 0.79. Although no age-dependent difference was identified in either sex, gender-related differences in some factors were noted. Regarding several parametric parameters, Beck's inventory alone revealed a significant relationship to self-efficacy in both sexes. Additionally, non-parametric items such as stamina, power and memory were strongly correlated with self-efficacy in both sexes. Frailty showed a significant independent relationship with self-efficacy in a multiple linear regression model analysis and using Beck's inventory, stamina, power and memory were identified to be independent factors for self-efficacy. Conclusion The simple assessment of self-efficacy described in this study may be a useful tool for successful aging of elderly people.