title: Preoperative or postoperative self-efficacy: which is a better predictor of outcome after total hip or knee arthroplasty?
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.
  
  
  CONCLUSIONS
  Short-term postoperative self-efficacy seems a better predictor of long-term outcome after total hip or knee arthroplasty than preoperative self-efficacy.
  
  
  CONCLUSIONS
  Interventions should focus on enhancing short-term postoperative rather than preoperative self-efficacy.
authors.affiliation: Department of Orthopaedics, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands. i.scheek@orth.umcg.nl
authors.forename: Inge
authors.initials: I
authors.lastname: van den Akker-Scheek
authors.forename: Martin
authors.initials: M
authors.lastname: Stevens
authors.forename: Johan W
authors.initials: JW
authors.lastname: Groothoff
authors.forename: Sjoerd K
authors.initials: SK
authors.lastname: Bulstra
authors.forename: Wiebren
authors.initials: W
authors.lastname: Zijlstra
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology* / Q000534:rehabilitation; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology* / Q000534:rehabilitation; D001294:Attitude to Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009426:Netherlands; D015404:Nursing Methodology Research; D011182:Postoperative Care / Q000523:psychology*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000523:psychology*; D036301:Qualitative Research; D020377:Self Efficacy; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking / Q000523:psychology