Abstract:
:Purpose: This study explored the impact of a 12-week stroke self-management program on occupational performance, the role of self-efficacy on improving occupational performance and the potential barriers and facilitators to self-efficacy as reported by clients and careers. Materials and methods: Participants (n = 40) were recruited to participate in a self-management program after admission to hospital with diagnosis of stroke. A pre-post study was conducted and data were obtained from participants using: the Canadian Occupational Performance Measure, Stroke Self-efficacy Questionnaire, and semi-structured interviews with five participants and two careers. Data analysis was conducted using parametric statistics and thematic analysis. Results: Significant improvements were observed in occupational performance (t = 11.2; p = 0.001) and satisfaction (t = 9.7; p = 0.001). Self-efficacy was shown to be a significant mediator to improvements in occupational performance (F = 7.08; p < 0.01) and satisfaction (F = 6.52; p = 0.02). Three key barriers and facilitators emerged from the thematic analysis: "Support in making the transition home," "Getting back to normal," and "Reflecting on shared experiences." Conclusions: Engagement in a stroke-specific self-management program can improve client-perceived occupational performance and satisfaction. Self-efficacy was shown to be a mediating variable to occupational performance improvements. Future research should explore further the facilitatory strategies of self-efficacy during stroke self-management programs to maximize rehabilitation outcomes. Implications for rehabilitation Multi-modal self-management programs are recommended as effective for improving client-perceived occupational performance of people who have experienced stroke. Returning to valued occupations, goal setting, shared experiences, and local support are recommended components of a self-management program for stroke survivors. Focusing on enhancing client confidence, competence, and self-efficacy is recommended to achieve occupational performance gains through self-management. Occupational therapy coaching is recommended to guide participants through the self-management processes of goal-setting, shared problem-solving, performance evaluation, and reflection.
journal_name
Disabil Rehabiljournal_title
Disability and rehabilitationauthors
Nott M,Wiseman L,Seymour T,Pike S,Cuming T,Wall Gdoi
10.1080/09638288.2019.1666431subject
Has Abstractpub_date
2019-09-27 00:00:00pages
1-10eissn
0963-8288issn
1464-5165pub_type
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journal_title:Disability and rehabilitation
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