Preoperative or postoperative self-efficacy: which is a better predictor of outcome after total hip or knee arthroplasty?

Patient Educ Couns. 2007 Apr;66(1):92-9. doi: 10.1016/j.pec.2006.10.012. Epub 2007 Jan 12.

Abstract

Objective: Self-efficacy is considered an important determinant of outcome after total hip or knee arthroplasty. Aim of this study is to evaluate the contributions of preoperative and short-term postoperative self-efficacy in predicting long-term outcome.

Methods: Self-efficacy was determined in 103 total hip and knee arthroplasty patients preoperatively and 6 weeks postoperatively with the Self-Efficacy for Rehabilitation Outcome Scale (SER). The 6-month outcome was assessed with a disease-specific and a generic self-report questionnaire and an objective measure of function (walking speed). Multiple linear regression analyses were used to examine the value of preoperative and short-term postoperative self-efficacy in predicting 6-month outcomes.

Results: Preoperative self-efficacy was only a significant predictor of long-term postoperative walking speed, with higher self-efficacy resulting in faster walking speed at the long-term measurement (R(2)=0.47). Short-term postoperative self-efficacy was a significant predictor of the long-term postoperative generic outcome measure (physical functioning: R(2)=0.30; mental health: R(2)=0.53) and of walking speed (R(2)=0.66), with higher self-efficacy resulting in a better long-term outcome.

Conclusion: Short-term postoperative self-efficacy seems a better predictor of long-term outcome after total hip or knee arthroplasty than preoperative self-efficacy.

Practice implications: Interventions should focus on enhancing short-term postoperative rather than preoperative self-efficacy.

MeSH terms

  • Activities of Daily Living / psychology
  • Adaptation, Psychological
  • Aged
  • Arthroplasty, Replacement, Hip / psychology*
  • Arthroplasty, Replacement, Hip / rehabilitation
  • Arthroplasty, Replacement, Knee / psychology*
  • Arthroplasty, Replacement, Knee / rehabilitation
  • Attitude to Health*
  • Female
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Male
  • Mental Health
  • Middle Aged
  • Netherlands
  • Nursing Methodology Research
  • Postoperative Care / psychology*
  • Predictive Value of Tests
  • Preoperative Care / psychology*
  • Qualitative Research
  • Self Efficacy*
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Treatment Outcome
  • Walking / psychology