Self-efficacy and its influence on recovery of patients with stroke: a systematic review

Aims. To provide an overview of the literature focusing on the influence of self-efficacy and self-efficacy enhancing interventions on mobility, activities of daily living, depression and quality of life of patients with stroke. Background. There is growing evidence for the importance of self-efficacy in the care of people with enduring illness. Therefore, it is important to describe the association of self-efficacy and patient outcomes and the evidence for the effects of self-efficacy interventions for stroke patients. Data sources. Studies were retrieved from a systematic search of published studies over the period of 1996-2009, indexed in the Cumulative Index to Nursing and Allied Health Literature, Medline, Psychinfo and Embase and focusing on stroke, the influence of self-efficacy and self-efficacy enhancing interventions. Methods. A systematic review was carried out. Studies were critically appraised and important characteristics and outcomes were extracted and summarized. Results. Seventeen articles were included in the review. Self-efficacy was positively associated with mobility, activities of daily living and quality of life and negatively associated with depression. Four self-efficacy interventions were identified. The evidence for the effects of these interventions was inconclusive. Conclusions. Patients with high self-efficacy are functioning better in daily activities than patients with low self-efficacy. The evidence concerning the determinants influencing self-efficacy and the self-efficacy interventions makes clear how nurses can develop and tailor self-efficacy interventions for the clinical practice of people with stroke. Therefore, it is necessary to further emphasize the role of self-efficacy in the care for stroke patients in the nursing curriculum.