Article

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
participation. 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
(beta=.30), the EQ VAS (beta=.49), and LiSat-9 (beta=.44) at follow-up. In
addition, higher initial self-efficacy (beta=.40) predicted higher LiSat-9 scores
at follow-up; higher initial emotion-oriented coping (beta=-.23) predicted lower
EQ VAS scores at follow-up. Higher modified Frenchay Activities Index scores at
follow-up were predicted by higher self-efficacy (beta=.19) and higher
task-oriented coping (beta=.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.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS