Self-efficacy in relation to impairments and activities of daily living disability in elderly patients with stroke: a prospective investigation

The objectives of this prospective study, undertaken in elderly patients with stroke undergoing rehabilitation, were to determine to what extent fall-related self-efficacy changes over time, its relationships to objectively assessed functions and activities, and the predictive capacity of self-efficacy at discharge for activities of daily living 10 months after stroke. The study comprised 37 patients, aged 66-89 years. Main outcome measurement instruments were the Falls Efficacy Scale (Swedish version), Berg Balance Scale and Functional Independence Measure. Significant improvements occurred in all these measures from admission to discharge, but patients with low self-efficacy at discharge showed less pronounced improvements than those with high self-efficacy. Falls Efficacy Scale (Swedish version) was closely associated with all other measures and was a more powerful predictor of activities of daily living than the observer-based measures of balance. To minimize dependence in activities of daily living, rehabilitation interventions should incorporate self-efficacy enhancement.