Effectiveness Of Self-efficacy Intervention On Rehabilitation Outcome Of The TKA Patients

Objective：This research was to Chinesize American self-efficacy scale(Self-Efficacyfor Rehabilitation Outcome Scale, SER) as the evaluation scale of the total kneearthroplasty(TKA) patients’ self-efficacy, and to evaluate the effectiveness of self-efficacyintervention on self-efficacy, knee function and the quality of life of the TKA patients.Methods: The study was consisted of two parts. Part I: American SER was selectedand introduced into China through systematical literature review. The draft SER wascreated by translation, back-translation and culture adaption. The formal scale had beenfinished, after revise as the understanding and response of twenty TKA patients. we usedthe revised SER to investigate146TKA patients’ self-efficacy. The items of scale werechosen by the method of extreme group. The reliability and validity were assessed by thedescriptive analysis,factor analysis,correlation analysis and maximum oblique rotation.Part II: The self-efficacy intervention program was determined by systematical literaturereview and experts’ consultation.85patients were chosen in our study, which were underthe unilateral TKA in a3A hospital in shanghai between Mar2013and Jun2013. Theywere divide into intervention group(N=42) and control group(N=43) according toadmitting time. Control group was received usual care, while intervention group wasreceived self-efficacy intervention. The result was evaluated by SER, Hospital for SpecialSurgery and36-Item Short Form. All the statistic analysis were acted by SPSS16.0.Results: Part I: The item analysis demonstrated that12items had a good identifydegree. Factor analysis results showed two factors(task self-efficacy and copingself-efficacy), whose cumulative contribution of variance accounted to75.31%. The finalscale had12items. Cronbach’s α and Guttman split-half coefficients of the scale were0.942and0.827. Part II:①The self-efficacy of TKA patients in the intervention groupsignificantly increased compared with the control group after repeated measurementanalysis of variance（P<0.05）.②Analysis of variance of repeated measure showed the HSSscores of TKA patients in the intervention group significantly enhanced compared with the control group(P<0.05).③The quality of life of TKA patients in the intervention groupimproved compared with the control group in the third month after operation and the sixthmonth after operation (P<0.05).Conclusion: The Chinese version SER has good reliability and validity,can be appliedin Chinese TKA patients and provide an effective evaluation instrument for self-efficacyintervention programs. Self-efficacy intervention programs could increase TKA patients’self-efficacy, and improve patients’HSS scores and quality of life.