Self-efficacy and self-management after stroke: a systematic review
Abstract
PURPOSE: The purpose of this review is to examine (1) the influence of self-efficacy on rehabilitation outcomes post-stroke, and (2) the evidence to support self-management interventions based on self-efficacy principals for stroke survivors. METHOD: Medline, Embase, Psychlit, Web of Science, AMED and Cochrane Databases for systematic reviews databases were searched for relevant articles in English between 2000 and ending in July 2009. Articles included (1) primary research testing relationships between self-efficacy and rehabilitation outcomes including the measuring impairment and activity or participation in a stroke population, and (2) research testing efficacy and effectiveness of self-management interventions designed specifically for a stoke population in which the principle theoretical framework is self-efficacy or a similar control cognition. Methodological quality appraisal and data extraction was carried out by two reviewers. RESULTS: Of the 104 articles that were identified by the search, 22 met the criteria to be included in the review. There is evidence that self-efficacy is an important variable associated with various outcomes post-stroke. These outcomes include quality of life or perceived health status, depression, ADL and, to a certain extent, physical functioning. Further empirical evidence is needed to extend these findings, and to determine whether self-efficacy has additional predictive value over and beyond the objective measures of impairment. There is also emerging evidence of benefits to be gained from programmes that target self-management based on self-efficacy principles; however, the optimal format of delivering these interventions for stroke survivors is not clear. CONCLUSIONS: There is a need for researchers, to work together with other stakeholders to develop and test interventions that can support self-management skills and confidence to make continued progress after stroke. This could help to reduce some of the negative consequences of stroke such as reduced quality of life and social isolation.
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Self-efficacy confidence is reinforced through mastery experiences, vicarious learning, persuasion, and performance feedback.
“This confidence is reinforced through mastery experiences, vicarious learning (ie, observing others’ success), persuasion, and performance feedback [40].”
The level of self-efficacy may influence recovery results, depression occurrence, professional performance, quality of life, PA, daily activities, and mobility after stroke.
“The level of self-efficacy may influence the results of recovery [18], the occurrence of depression [19,20,21], improvement of professional performance [22], quality of life, PA, daily activities [23] and mobility [20] after a stroke.”
From Physical Activity, Psychological and Functional Outcomes in Non-Ambulatory Stroke Patients during Rehabilitation—A Pilot Study (2022) · cites this paper as [23]
Cites
The theory of planned behavior
Ajzen, I. (1991) · Organizational Behavior and Human Decision Processes · doi:10.1016/0749-5978(91)90020-t · Cited by 90,587 · see citing works
Self-efficacy: the exercise of control
(1997) · Choice Reviews Online · doi:10.5860/choice.35-1826 · Cited by 24,409 · see citing works
Self-management education: History, definition, outcomes, and mechanisms
Lorig, K. R., & Holman, H. R. (2003) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2601_01 · Cited by 4,094 · see citing works
Encyclopedia of human behavior
(1994) · Choice Reviews Online · doi:10.5860/choice.32-0638 · Cited by 3,250 · see citing works
Falls Efficacy as a Measure of Fear of Falling
Tinetti, M. E., Richman, D., & Powell, L. (1990) · Journal of Gerontology · doi:10.1093/geronj/45.6.p239 · Cited by 2,080 · see citing works
(2001) · PubMed · Cited by 1,506 · see citing works
Frequency of Depression After Stroke: A Systematic Review of Observational Studies
Hackett, M. L., Yapa, C., Parag, V., & Anderson, C. S. (2005) · Stroke · doi:10.1161/01.str.0000165928.19135.35 · Cited by 1,464 · see citing works
Internal versus external control of reinforcement: A case history of a variable.
Rotter, J. B. (1990) · American Psychologist · doi:10.1037/0003-066x.45.4.489 · Cited by 1,256 · see citing works
Schwarzer, R. (2014) · Taylor & Francis eBooks · doi:10.4324/9781315800820-14 · Cited by 889 · see citing works
O’Leary, A. (1985) · Behaviour Research and Therapy · doi:10.1016/0005-7967(85)90172-x · Cited by 802 · see citing works
Stroke incidence and prevalence in Europe: a review of available data
Truelsen, T., Piechowski‐Jóźwiak, B., Bonita, R., Mathers, C. D., Bogousslavsky, J., & Boysen, G. (2006) · European Journal of Neurology · doi:10.1111/j.1468-1331.2006.01138.x · Cited by 661 · see citing works
Self-management education programmes by lay leaders for people with chronic conditions
Foster, G., Taylor, S. J., Eldridge, S. M., Ramsay, J., & Griffiths, C. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005108.pub2 · Cited by 596 · see citing works
Botner, E. M., Miller, W. C., & Eng, J. J. (2005) · Disability and Rehabilitation · doi:10.1080/09638280400008982 · Cited by 332 · see citing works
Kaygısız, B. B., Beninato, M., Sullivan, P. E., & Narielwalla, K. (2006) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2005.12.027 · Cited by 326 · see citing works
Self-care self-efficacy, quality of life, and depression after stroke
Robinson-Smith, G., Johnston, M. V., & Allen, J. (2000) · Archives of Physical Medicine and Rehabilitation · doi:10.1053/mr.2000.3863 · Cited by 293 · see citing works
Qualitative Studies of Stroke: A Systematic Review
McKevitt, C., Redfern, J., Mold, F., & Wolfe, C. (2004) · Stroke · doi:10.1161/01.str.0000127532.64840.36 · Cited by 247 · see citing works
Testing a Model of Post-Stroke Exercise Behavior
Shaughnessy, M., Resnick, B. M., & Macko, R. F. (2006) · Rehabilitation Nursing · doi:10.1002/j.2048-7940.2006.tb00005.x · Cited by 239 · see citing works
Fugl‐Meyer, A. R., Hellström, K., Lindmark, B., & Vahlberg, B. M. (2003) · Journal of Rehabilitation Medicine · doi:10.1080/16501970310000836 · Cited by 211 · see citing works
Chronic illness, expert patients and care transition
Taylor, D. G., & Bury, M. R. (2007) · Sociology of Health & Illness · doi:10.1111/j.1467-9566.2007.00516.x · Cited by 203 · see citing works
Slot, K. B., Berge, E., Dorman, P. J., Lewis, S. C., Dennis, M. S., & Sandercock, P. A. (2008) · BMJ · doi:10.1136/bmj.39456.688333.be · Cited by 198 · see citing works
Perceived control of recovery from physical disability: Measurement and prediction
Partridge, C. J., & Johnston, M. (1989) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1989.tb00811.x · Cited by 184 · see citing works
Cervone, D. (2000) · Behavior Modification · doi:10.1177/0145445500241002 · Cited by 168 · see citing works
Recovery following stroke: The role of self-management education
Kendall, E. A., Catalano, T., Kuipers, P., Posner, N., Buys, N. J., & Charker, J. (2006) · Social Science & Medicine · doi:10.1016/j.socscimed.2006.09.012 · Cited by 167 · see citing works
Motivational Interviewing Early After Acute Stroke: A Randomized, Controlled Trial
Watkins, C. L., Auton, M. F., Deans, C. F., Dickinson, H. A., Jack, C. I. A., Lightbody, C. E., Sutton, C. J., van den Broek, M. D., & Leathley, M. J. (2007) · Stroke · doi:10.1161/01.str.0000258114.28006.d7 · Cited by 166 · see citing works
Pang, M. Y. C., Eng, J. J., & Miller, W. C. (2007) · Physical Therapy · doi:10.2522/ptj.20060142 · Cited by 163 · see citing works
Salbach, N. M., Mayo, N. E., Robichaud‐Ekstrand, S., Hanley, J. A., Richards, C. L., & Wood-Dauphinée, S. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53203.x · Cited by 159 · see citing works
Michael, K. M., Allen, J. K., & Macko, R. F. (2006) · Rehabilitation Nursing · doi:10.1002/j.2048-7940.2006.tb00137.x · Cited by 151 · see citing works
Jones, F., Mandy, A., & Partridge, C. J. (2009) · Clinical Rehabilitation · doi:10.1177/0269215508101749 · Cited by 148 · see citing works
Self-citationSalbach, N. M., Mayo, N. E., Robichaud‐Ekstrand, S., Hanley, J. A., Richards, C. L., & Wood-Dauphinée, S. (2006) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2005.11.017 · Cited by 142 · see citing works
Lay-led self-management in chronic illness: a review of the evidence
Newbould, J., Taylor, D. G., & Bury, M. R. (2006) · Chronic Illness · doi:10.1177/17423953060020040401 · Cited by 134 · see citing works
Self-efficacy predicts self-reported health status in multiple sclerosis
Riazi, A., Thompson, A. J., & Hobart, J. C. (2004) · Multiple Sclerosis Journal · doi:10.1191/1352458504ms986oa · Cited by 127 · see citing works
Self-citationFear of falling in stroke patients: relationship with previous falls and functional characteristics
Andersson, Å. G., Kamwendo, K., & Appelros, P. (2008) · International Journal of Rehabilitation Research · doi:10.1097/mrr.0b013e3282fba390 · Cited by 124 · see citing works
Perceived control, coping and recovery from disability following stroke
Johnston, M., Morrison, V., Macwalter, R., & Partridge, C. (1999) · Psychology and Health · doi:10.1080/08870449908407322 · Cited by 117 · see citing works
Perceptions of self-efficacy and rehabilitation among neurologically disabled adults
Dixon, G., Thornton, E. W., & Young, C. A. (2007) · Clinical Rehabilitation · doi:10.1177/0269215506071784 · Cited by 114 · see citing works
Kendall, E. A., & Rogers, A. E. (2007) · Disability & Society · doi:10.1080/09687590601141535 · Cited by 111 · see citing works
Pang, M. Y. C., & Eng, J. J. (2007) · Osteoporosis International · doi:10.1007/s00198-007-0519-5 · Cited by 109 · see citing works
LeBrasseur, N. K., Sayers, S. P., Ouellette, M. M., & Fielding, R. A. (2006) · Physical Therapy · doi:10.2522/ptj.20050162 · Cited by 105 · see citing works
Johnston, M., Bonetti, D. L., Joice, S. A., Pollard, B., Morrison, V. L., Francis, J., & MacWalter, R. (2007) · Disability and Rehabilitation · doi:10.1080/03323310600950411 · Cited by 100 · see citing works
Orbell, S., Johnston, M., ROWLEY, D. I., Davey, P. G., & Espley, A. (2001) · British Journal of Health Psychology · doi:10.1348/135910701169034 · Cited by 80 · see citing works
Barry, L. C., Guo, Z., Kerns, R. D., Duong, B. D., & Reid, M. C. (2003) · Pain · doi:10.1016/s0304-3959(02)00471-2 · Cited by 76 · see citing works
Huijbregts, M. P. J., Myers, A. M., Streiner, D. L., & Teasell, R. W. (2008) · Topics in Stroke Rehabilitation · doi:10.1310/tsr1505-503 · Cited by 74 · see citing works
Fear of falling, balance, and gait velocity in patients with stroke
Rosen, E. B., Sunnerhagen, K. S., & Kreuter, M. (2005) · Physiotherapy Theory and Practice · doi:10.1080/09593980590922299 · Cited by 73 · see citing works
Reasons for recovery after stroke: A perspective based on personal experience
Jones, F., Mandy, A., & Partridge, C. J. (2008) · Disability and Rehabilitation · doi:10.1080/09638280701355561 · Cited by 72 · see citing works
Self-citationStrategies Enhancing Self-Efficacy in Diabetes Education: A Review
van de Laar, K. E. W., & van der Bijl, J. J. (2001) · Research and theory for nursing practice · doi:10.1891/0889-7182.15.3.235 · Cited by 65 · see citing works
Shaughnessy, M., Resnick, B. M., & Macko, R. F. (2004) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2004.07.002 · Cited by 49 · see citing works
Battersby, M., Hoffmann, S., Cadilhac, D. A.-M., et al. (2009) · International Journal of Stroke · doi:10.1111/j.1747-4949.2009.00261.x · Cited by 44 · see citing works
Bonetti, D., & Johnston, M. (2008) · British Journal of Health Psychology · doi:10.1348/135910707x216648 · Cited by 44 · see citing works
Stroke is a chronic disease with acute events
O’Neill, D. J., Horgan, F., Hickey, A., & McGee, H. M. (2008) · BMJ · doi:10.1136/bmj.39500.434086.1f · Cited by 40 · see citing works
Reflections upon rehabilitation by members of a community based stroke club
Sabari, J. S., Meisler, J., & Silver, E. (2000) · Disability and Rehabilitation · doi:10.1080/096382800296692 · Cited by 40 · see citing works
Memory self-efficacy and psychosocial factors in stroke
Aben, L., Busschbach, J. J. V., Ponds, R., & Ribbers, G. M. (2008) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-0227 · Cited by 30 · see citing works
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Taylor, S. J., Pinnock, H., Epiphaniou, E., Pearce, G., Parke, H. L., Schwappach, A., Purushotham, N., Jacob, S., Griffiths, C. J., Greenhalgh, T., et al. (2014) · Health Services and Delivery Research · doi:10.3310/hsdr02530 · Cited by 431 · see citing works
Laferton, J. A. C., Kube, T., Salzmann, S., Auer, C. J., & Shedden-Mora, M. C. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00233 · Cited by 267 · see citing works
General Self-Efficacy as a Driving Factor of Post-Stroke Depression: A Longitudinal Study
Volz, M., Voelkle, M. C., & Werheid, K. (2019) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2017.1418392 · Cited by 65 · see citing works
Peinado-Rubia, A., Osuna-Pérez, M. C., Rodríguez-Almagro, D., Zagalaz-Anula, N., López-Ruiz, M. C., & Lomas-Vega, R. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17093160 · Cited by 38 · see citing works
Church, G., Ali, A., Smith, C. L., Broom, D., & Sage, K. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031707 · Cited by 20 · see citing works
Stone, J. K., Shafer, L. A., Graff, L. A., Witges, K., Sexton, K., Lix, L. M., Haviva, C., Targownik, L. E., & Bernstein, C. N. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110719 · Cited by 18 · see citing works
Błaszcz, M., Prucnal, N., Wrześniewski, K., Pasiut, S., Mika, P., Kucia, M., Stach, B., Woźniak, M., & Mirek, E. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11247260 · Cited by 12 · see citing works
“General self-efficacy was found to correlate, but not mediate with the post-stroke quality of life level [69] and might influence a change in the intensity of depressive symptoms [21] as well as physical functioning and fulfilling everyday activities [21,23].”
BackgroundResultHarris, P., & Maine, I. (2026) · JMIR Rehabilitation and Assistive Technologies · doi:10.2196/86915 · Cited by 1 · see citing works
“This confidence is reinforced through mastery experiences, vicarious learning (ie, observing others’ success), persuasion, and performance feedback [40].”
- Authors
- Jones, F., & Riazi, A.
- Affiliations
- St George's, University of London (GB)
- Royal Holloway University of London (GB)
- Corresponding author
- Jones, Fiona
- Venue
- Disability and Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2010-08-27
- Volume
- 33
- Issue
- 10
- Pages
- 797-810
- ISSN
- 0963-8288 (ISSN-L)
- 1464-5165
- OpenAlex
- W2111301792
- Cited by
- 421
- References
- 50
- Citations by year
- 2026: 20 · 2025: 25 · 2024: 29 · 2023: 41 · 2022: 39 · 2021: 37 · 2020: 35 · 2019: 24 · 2018: 28 · 2017: 20 · 2016: 29 · 2015: 28 · 2014: 23 · 2013: 20 · 2012: 15
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Disability and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Research Repository (Kingston University London) (submittedVersion)
- Royal Holloway Digital Repository (Royal Holloway University of London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- self-efficacy, stroke, self-management interventions, stroke rehabilitation, stroke survivors, quality of life, depression, activities of daily living, physical function, social isolation
- MeSH terms
- Stroke Rehabilitation, Activities of Daily Living, Health Services Research, Humans, Self Care, Treatment Outcome, Self Efficacy, Stroke
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