What does confidence mean to people who have had a stroke? A qualitative interview study.
OBJECTIVE
To explore the meaning of confidence to stroke patients after stroke in order to inform the development of a measurement tool.


METHODS
Qualitative interview study using interpretative phenomenological analysis (IPA).


METHODS
Ten stroke survivors were purposively selected from those participating in a multi-centre randomised trial of outdoor mobility rehabilitation. Interviews about confidence were conducted in participants' homes, audio recorded and transcribed verbatim.


RESULTS
Six themes emerged from the analysis. These were loss of identity, fear, social confidence, role confidence, mastering skill and attitudes and beliefs. Loss of identity was particularly evident in the early stages of stroke recovery. Fear was a barrier to regaining confidence and was associated with avoidance behaviours. Lack of social confidence was a common problem which appeared difficult to resolve. Life roles motivated participants to re-engage in daily life activities. Personal attitudes and beliefs, combined with the attitudes of significant others, contributed to personal feelings of competence.


CONCLUSIONS
This study provides a coherent definition of the meaning of confidence through the experiences of stroke survivors. Being successful in gradually re-engaging in activities, including social activities and life roles helped to establish a positive self-belief. The influence of others, such as family and friends reinforce self-beliefs. Confidence and self-efficacy appear to be a similar construct. However, participants in this study also identified a relationship between confidence and self-esteem. The findings indicate that all six themes need to be included in a confidence measure to encompass the meaning of confidence as described by participants with stroke.
University of Nottingham, UK jane.horne@nottingham.ac.uk.
Jane
J
Horne
University of Nottingham, UK.
Nadina Berrice
NB
Lincoln
Glasgow Caledonian University, UK.
Jenny
J
Preston
University of Nottingham, UK.
Pip
P
Logan
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D036301:Qualitative Research; D011788:Quality of Life; D012649:Self Concept; D020377:Self Efficacy; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D017741:Survivors; D016896:Treatment Outcome
Stroke; confidence; qualitative study; self-efficacy; self-esteem