Associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke

OBJECTIVE: To examine the associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke. DESIGN: Cross-sectional study. Regression analyses were performed. SETTING: Outpatient settings of hospitals and rehabilitation centers in the Netherlands. PARTICIPANTS: Individuals after stroke (n=112; mean age 57.1+/-8.9 y; mean months since stroke 18.9+/-28.5). MAIN OUTCOME MEASURES: Proactive coping was measured using the Utrecht Proactive Coping Competence scale (UPCC), and self-efficacy was measured using the General Self-Efficacy Scale (GSES). Psychosocial outcomes were measured as participation using the restriction and satisfaction subscales of the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation), emotional problems with the Hospital Anxiety and Depression Scale (HADS), life satisfaction with two questions (2LS), and health-related quality of life with the Short Stroke-Specific Quality of Life scale (SSQOL12). RESULTS: Higher UPCC scores were associated with lower HADS scores (beta=-.55; p<.001) and with higher USER-Participation satisfaction (beta=.31; p=.001), 2LS (beta=.34; p<.001), and SSQOL12 scores (beta=.44; p<.001). The influence of UPCC scores on HRQOL was indirect through self-efficacy. Higher GSES scores were associated with higher UPCC scores (beta=.65; p<.001), which in turn were associated with lower HADS scores (beta=-.51; p<.001). GSES scores were directly associated with higher SSQOL12 scores (beta=.32; p=.002). GSES scores did not influence the association between UPCC scores and any of the psychosocial outcomes (all p>.05). CONCLUSIONS: Proactive coping and self-efficacy have different associations with each of the psychosocial outcomes. Therefore, outcome-specific models appear to be necessary to describe these associations.