Preoperative or postoperative self-efficacy: which is a better predictor of outcome after total hip or knee arthroplasty?
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.
van den Akker-Scheek
Inge
I
Department of Orthopaedics, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands. i.scheek@orth.umcg.nl
Stevens
Martin
M
Groothoff
Johan W
JW
Bulstra
Sjoerd K
SK
Zijlstra
Wiebren
W
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