Self-efficacy Mediates the Relationship between Balance/Walking Performance, Activity, and Participation after Stroke.
Self-efficacy Mediates the Relationship between Balance/Walking Performance, Activity, and Participation after Stroke.
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DOI：
10.1080/10749357.2015.1110306
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发表时间：
2016-04
影响因子：
2.2
通讯作者：
Reisman D
中科院分区：
文献类型：
--
作者：
French MA;Moore MF;Pohlig R;Reisman D
许多评估个人能力或对其执行任务能力的信念的结果测量（OM）可用于评估中风后的活动和参与；然而，各种 OM 与活动/参与之间的关系尚不清楚。本研究的目的是探讨中风后患者不同的 OM 与活动和参与之间的关系。 59 名中风后受试者参加了评估，包括自选步行速度、6 分钟步行测试、定时“Up and Go”测试、Berg 平衡量表、功能步态评估、Walk 12 和特定活动平衡信心量表。使用阶梯活动监测（SAM）作为活动的衡量标准，使用中风影响量表-参与（SIS-P）作为参与的衡量标准。进行了探索性因素分析，包括除 SAM 和 SIS-P 之外的所有测量。提取了两个因素并称为基于绩效（PB）和自我效能（SE）。路径分析评估了 SE 在 PB 和 SAM/SIS-P 关系中作为中介的作用。在路径分析中，PB 显着预测 SE（p < 0.001，b=0.44），但不能显着预测 SAM 或 SIS-P（分别为 p > 0.05，b=0.25 和 b=0.11）。 SE 显着预测 SAM 和 SIS-P（分别为 p < 0.001，b=0.46 和 b=0.59）。 PB 对 SAM 和 SIS-P 的间接影响显着（p < 0.001；分别为 b=0.20 和 b=0.26）。这些结果表明，SE 介导中风后 PB 与活动和参与之间的关系，强化了改善活动和参与比仅针对表现更复杂。临床医生应实施 SE 和 PB 测量，以确定中风后患者最准确的看法，并寻求通过干预措施改善 SE。
Many outcome measures (OM) that assess individuals’ ability or beliefs in their ability to perform tasks exist to evaluate activity and participation after stroke; however, the relationship between various OM and activity/participation is unclear. The purpose of this study was to explore the relationships between different OM and activity and participation in people after stroke. 59 subjects post-stroke participated in an assessment including self-selected walking speed, 6 minute walk test, Timed “Up and Go” Test, Berg Balance Scale, Functional Gait Assessment, Walk 12, and Activity-specific Balance Confidence Scale. Step Activity Monitoring (SAM) was used as a measure of activity and Stroke Impact Scale-Participation (SIS-P) as a measure of participation. Exploratory Factor Analysis was performed including all measures except SAM and SIS-P. Two factors were extracted and termed performance based (PB) and self-efficacy (SE). A Path Analysis assessed the role of SE as a mediator in the relationships of PB and SAM/SIS-P. In the path analysis, PB significantly predicts SE (p < 0.001, b=0.44), but not SAM or SIS-P (p > 0.05, b=0.25 and b=0.11 respectively). SE significantly predicts both SAM and SIS-P (p < 0.001, b=0.46 and b=0.59 respectively). The Indirect Effects of PB on SAM and SIS-P were significant (p < 0.001; b=0.20 and b=0.26 respectively). These results suggest that SE mediates the relationship between PB and activity and participation after stroke, reinforcing that improving activity and participation is more complicated than only targeting performance. Clinicians should administer SE and PB measures to determine the most accurate view of patients after stroke and seek to improve SE through interventions.