Research Reports - Influence of self-efficacy and coping on quality of life and social participation after acquired brain injury

Arch Phys Med Rehabil. 2014 Dec;95(12):2327-34

Brands I(1), Köhler S(2), Stapert S(3), Wade D(4), van Heugten C(5)

OBJECTIVES: To investigate the relations linking self-efficacy and coping to
quality of life (QOL) and social participation and what effect self-efficacy,
changes in self-efficacy, and coping style have on long-term QOL and social
DESIGN: Prospective clinical cohort study.
SETTING: General hospitals, rehabilitation centers.
PARTICIPANTS: Patients with newly acquired brain injury (ABI) (N=148) were
assessed at baseline (start outpatient rehabilitation or discharge
hospital/inpatient rehabilitation; mean time since injury, 15wk) and 1 year later
(mean time since injury, 67wk).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: QOL was measured with the EuroQuol 5D (the EQ-5D index and
the EQ-5D visual analog scale [EQ VAS]) and the 9-item Life Satisfaction
Questionnaire (LiSat-9), social participation with the modified Frenchay
Activities Index, coping with the Coping Inventory for Stressful Situations, and
self-efficacy with the Traumatic Brain Injury Self-efficacy Questionnaire.
RESULTS: At baseline, self-efficacy moderated the effect of emotion-oriented
coping on the EQ-5D index and of avoidance coping on the EQ VAS. Self-efficacy
mediated the relation between emotion-oriented coping and LiSat-9. An increase in
self-efficacy over time predicted better scores on the EQ-5D index (β=.30), the
EQ VAS (β=.49), and LiSat-9 (β=.44) at follow-up. In addition, higher initial
self-efficacy (β=.40) predicted higher LiSat-9 scores at follow-up; higher
initial emotion-oriented coping (β=-.23) predicted lower EQ VAS scores at
follow-up. Higher modified Frenchay Activities Index scores at follow-up were
predicted by higher self-efficacy (β=.19) and higher task-oriented coping (β=.14)
at baseline (combined R(2)=5.1%).
CONCLUSIONS: Self-efficacy and coping predict long-term QOL but seem less
important in long-term social participation. High self-efficacy protects against
the negative effect of emotion-oriented coping. Enhancing self-efficacy in the
early stage after ABI may have beneficial long-term effects.

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