A Follow-up Study Of Self-efficacy And Quality Of Life In Stroke Patients With The First Attack

Objectives:To investigate the levels of self-efficacy and quality of life at different stages, in the outset and the3rd month post in stroke patients with the first attack. To discuss influencing factors that affect self-efficacy or quality of life. And to analyze the relevance between self-efficacy and quality of life, which will provide theoretical bases for clinical interventions.Methods:Using a convenient sampling, a cross-sectional survey and longitudinal study design,162inpatients with first stroke were recruited from two tertiary-care hospital in Shandong province and a follow-up telephone survey or a door interview was given after3months. The General Information Questionnaire, Follow-up Questionnaire of Social Information after3months, Barthel Index Scale(BI), Self-efficacy for Chronic Disease6-Item Scale (Secd6), Stroke-specific Quality of Life Scale(SS-QOL) were used, and data were analyzed by SPSS16.0.Results:l.Mean score of self-efficacy of162patients with first stroke was6.16+2.25in the outset, and6.55±2.24in the3rd month post. The difference between them was statistically significant, but both of them were in low level(<7).2. Self-efficacy of patients with first stroke was influenced by many factors, higher school education, mental work, public health services or medical insurance, the richer ones had higher scores in self-efficacy than elementary education, physical work, rural cooperative medical treatment or at one’s own expenses, the cheaper ones. The scores of body mass index (BMI) and activities of daily life (ADL) were positively correlated with self-efficacy (rs=0.270,0.431, P<0.01.). Multiple regression was used to analyze factors that influencing self-efficay. Types of medical insurance and AD can explain the variable of31.2%.3. Mean score of SS-QOL of patients with first stroke was166.60-34.22in the outset, and191.45±29.53in the3rd month post. The difference between them was statistically significant, but both of them were lower than total scores.4. SS-QOL of patients with first stroke was influenced by many factors, higher school education, mental work, the relatively rich ones had higher scores in SS-QOL than junior or lower education, physical work, the cheaper ones. The scores of BMI and ADL were positively correlated with SS-QOL (r=0.156, P<0.05, r=0.624, P<0.01). Multiple regression was used to analyze factors that influencing SS-QOL. ADL and self-efficacy can explain the variable of57.4%.5. The scores of self-efficacy are positively correlated with that of SS-QOL in different stages (rs=0.681,0.724, P<0.01). Each term of secd6was correlated with SS-QOL, which remained in0.565-0.714, and self-efficacy was correlated with every term of SS-QOL, which remained in0.074-0.728.Conclusions:1. The levels of self-efficacy were low both in the outset and in the3d month post, which was largely influenced by types of medical insurance and ADL. Therefore, the patients’earlier regular physical activity exercise and the states’perfect and effective medical insurance system are important to improve self-efficacy. In addition, it also suggests that nurses should make timely and effective health education according to patients’different education levels, professions and financial conditions, control patients’primary disease positively and help them to build confidence in exercise and rehabilitation in order to improve their self-efficacy.2. The scores of SS-QOLwere low, and in the outset were lower. The quality was largely influenced by ADL and self-efficacy. Therefore, nurses should adjust their training programs and exercises, and at the same time, focuse on enchancing self-efficacy in their rehabilitation. They can achieve both physical and mental rehabilitation. In addition, different educations, professions, financial conditions may have different influences in quality of life. So Choose the right measures and then improve their life quality. 3. The scores of self-efficacy are positively correlated with that of SS-QOL in different stages, we can carry out measures in behavior achievements, vicarious experience, persuasive speech, personal physiological and psychological status. For one thing, they can help patients to establish the faith to overcome diseases and do rehabilitation exercises. For another thing, they can lessen the financial burden on their families. We might start from enhancing self-efficacy in order to improve their quality of life.