Abstract P331: Self-Efficacy to Manage Health After Stroke is Related to Quality of Life

Objective: An acute stroke may serve as a major life event that disrupts health-related quality of life. We examined psychosocial and demographic factors related to functioning and well-being after stroke among patients discharged from two health care systems: Veterans Health Administration (VHA) and a Joint Commission Stroke Center. Methods: We enrolled 258 participants into a randomized controlled trial to evaluate a stroke self-management program which targeted functional recovery and risk factor management. All participants completed written consent and a baseline assessment which included demographics, depressive symptoms, self-efficacy, stroke specific, health-related quality of life (SSQoL) and psychosocial factors. We conducted multivariate analyses to evaluate factors related to baseline SSQoL using a social cognitive framework. Results: We enrolled our sample, on average, within 81.5 days after hospital discharge for stroke/TIA. Our sample included 19% women with an average age of 61.7 (10.8) years. The average NIH stroke scale score was 3.0 indicating minor stroke. Across the total and subdomains of SSQoL, self-efficacy to manage stroke health and symptoms was associated with overall better SSQoL (0.16, p<0.0001), social role functioning (0.12, p < 0.01), family role functioning (0.16, p<0.0003), and work role functioning (0.31, p<0.0001). Depressive symptoms were significantly related to poorer SSQoL across all subdomains; however distance walked in a mobility test was not significantly related. Optimism was related to total SSQoL (p<.07) and perceived energy (p<0.02). Demographics were not significantly related to SSQoL in the multivariate models. Conclusions: As social cognitive theory suggests, self-efficacy to manage symptoms and health after stroke and a sense of optimism for recovery are significantly related to greater stroke specific, health-related quality of life shortly after hospital discharge for stroke. Post stroke programs which target building self-efficacy and providing optimism for recovery may enhance SSQoL. Our stroke self-management program targets these concepts and we are currently evaluating our prospective outcomes.