title: A theoretical model of efficacy beliefs, functional status and quality of life for older people during rehabilitation: testing causal relationships.
abstract: OBJECTIVE
  Structural equation modelling tested hypothesized causal relationships between age, gender, pain, depression, self-efficacy, outcome expectations, functional status and quality of life in older Australians post-orthopaedics surgery across three stages of their rehabilitation.
  
  
  BACKGROUND
  Self-efficacy is important in forming personal beliefs about capabilities to perform functional activities, which is believed to maintain individual's quality of life. Research examining how efficacy beliefs influence functional status in older people following orthopaedic events is limited.
  
  
  METHODS
  A descriptive, longitudinal method was used for this study.
  
  
  METHODS
  A convenience sample of 101 older people with orthopaedic surgery to lower extremities was recruited from private rehabilitation units in Brisbane, Australia. Data were collected from September 2008-November 2009. Standardized questionnaires were used to measure efficacy beliefs, functional status, and quality of life.
  
  
  RESULTS
  Structural equation modelling revealed that depression, efficacy beliefs, age, and gender significantly influenced quality of life, as self-efficacy and gender have a direct relationship on functional status. Across three stages in the model, outcome expectation at stage 2 was the most significant predictor of functional recovery after discharge. Older men with higher quality of life at admission was positively related to self-efficacy and negatively associated with depression at stage 2: quality of life influenced outcome expectations and pain positively at stage 3.
  
  
  CONCLUSIONS
  Rehabilitation programmes play a significant role in assisting older people in resuming functional activities and quality of life following orthopaedic surgery. Enhancing self-efficacy may facilitate older people's participation and adherence to rehabilitation programmes during hospitalization and following discharge.
authors.affiliation: Central Taiwan University of Science and Technology, Taichung City, Taiwan. 107650@ctust.edu.tw
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Tung
authors.forename: Marie
authors.initials: M
authors.lastname: Cooke
authors.forename: Wendy
authors.initials: W
authors.lastname: Moyle
mesh_terms: D001315:Australia; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008962:Models, Theoretical; D011788:Quality of Life; D012046:Rehabilitation; D011795:Surveys and Questionnaires
keywords: efficacy beliefs; functional status; older people; orthopaedic rehabilitation nursing; quality of life; structural equation modelling