Associations of Proactive Coping and Self-Efficacy with Psychosocial Outcomes in Individuals after Stroke

Abstract

Objective To examine the associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke. Design Cross-sectional study. Regression analyses were performed. Setting Outpatient settings of hospitals and rehabilitation centers. Participants Individuals after stroke (N=112; mean age ± SD, 57.1±8.9y; mean time ± SD since stroke, 18.9±28.5mo). Interventions Not applicable. Main Outcome Measures Proactive coping was measured using the Utrecht Proactive Coping Competence scale (UPCC), and self-efficacy was measured using the General Self-Efficacy Scale (GSES). Psychosocial outcomes were measured as (1) participation with the use of the restriction and satisfaction subscales of the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation); (2) emotional problems with the use of the Hospital Anxiety and Depression Scale (HADS); (3) life satisfaction with the use of 2 questions (2LS); and (4) health-related quality of life (HRQOL) with the use of the Short Stroke-Specific Quality of Life scale (SS-QOL-12). Results Higher UPCC scores were associated with lower HADS scores (β=-.55, P<.001) and with higher USER-Participation satisfaction (β=.31, P=.001), 2LS (β=.34, P<.001), and SS-QOL-12 scores (β=.44, P<.001). The influence of UPCC scores on HRQOL was indirect through self-efficacy. Higher GSES scores were associated with higher UPCC scores (β=.65, P<.001), which in turn were associated with lower HADS scores (β=-.51, P<.001). GSES scores were directly associated with higher SS-QOL-12 scores (β=.32, P=.002). GSES scores did not influence the association between UPCC scores and any of the psychosocial outcomes (all P>.0025). Conclusions Proactive coping and self-efficacy have different associations with each of the psychosocial outcomes. Therefore, outcome-specific models appear to be necessary to describe these associations.