Patients with more self-confidence make much more progress during rehabilitation than those with low self-confidence. They approach the changes in their circumstances with a positive and calm mindset.

In addition to physical progress, there are potential beneficial effects on the patient’s mental health and quality of life.

In many cases, strokes are the result of high blood pressure. Good self-efficacy can lower blood pressure, even after a stroke has already happened.

Daily life can be a challenge for stroke survivors. Even the simplest everyday tasks, such as getting washed and dressed, can be problematic or impossible due to paralysis. Trying without succeeding can lead to a lack of self-confidence over time.

Also, the other way around is possible: Patients may succeed with certain tasks, but still lack a sense of self-confidence. For example, a patient manages to walk several meters using a cane, but still thinks he or she is not  quite ready yet to walk alone.

Both situations are an example of limited self-efficacy. Several studies have shown that certain measures can help to regain confidence after a stroke.

“Only those who know the destination will find their way.” – Laozi

Goals help us to create a clear and positive idea of the future. They help us to determine what is needed in order to achieve what we desire. Having a clear plan in your mind can make it easier to handle difficulties on the path towards that goal.

It is important to keep your goals realistic when you want to improve self-confidence. Discuss with your therapist what the next realistic goal might look like. The goal should be very precisely defined and may only contain some aspects of a bigger task.

The more realistic the goal, the higher the chance of achieving it. Every goal you achieve will improve your self-confidence. Talk to your family members and therapists about specific and realistic goals to make your daily life more independent.

To improve self-confidence, you must determine your actions and make decisions yourself. It may well be that your family or caregiver is worried and happy to take care of tasks and issues for you.

Start step by step to attempt tasks for yourself. Ask “What part of it can I do?”. Still, ask for help if needed. It may seem difficult or impossible at first, but our brains and bodies have the advantage of neuroplasticity. No matter our age, we can always learn something new and change our neural pathways. Every goal you achieve will give you courage.

For family members and caregivers of patients with stroke – it is important to provide positive and honest feedback to the patient. Encouraging feedback can have a positive impact on rehabilitation and can improve self-efficacy.

Acknowledge and praise the patient when their actions are successful. Support and encourage the patient to complete tasks themselves, even if that takes longer.

Patients can sometimes overlook progress in the form of “small wins”. Actively point out such progress and celebrate success together!

Every patient develops their own solution strategies for everyday challenges. Patients can exchange ideas, motivate each other and work towards goals together. Simply observing other patients with similar symptoms can help you find answers during your rehabilitation.

Therapists must deliberately select group size and the group members’ capabilities when arranging group therapy. Ideally, they are small groups of patients with comparable limitations.

Symptoms such as despondence, lack of motivation, loneliness, or depression are common long-term effects of a stroke. They may affect the patient’s attitude towards the condition and rehabilitation. A positive attitude can reduce physical and mental symptoms and make treatment more effective.

When having difficulties with motivation or finding the energy to do things, talking to your doctor, therapist or family members can be helpful. Sometimes, even just voicing the difficulties is beneficial.

The goal of self-management programs is to support patients in finding solutions for mastering everyday life challenges as independently as possible. Thus, these programs can boost the self-confidence of the patients. Therapists in both inpatient and outpatient settings can utilize self-management program techniques.

A core element of self-management programs is educating the patient concerning their condition and options for rehabilitation. Therapists enable self-help, and only provide enough support to allow the patient to find his or her own solutions.

Author: Hannes Aftenberger

Sources:

Positive Health Beliefs and Blood Pressure Reduction in the DESERVE Study, 2020

Self management programmes for quality of life in people with stroke, 2016

Self-efficacy and its influence on recovery of patients with stroke: a systematic review, 2011

Nedbal, A. (2011). Selbstmanagement nach Schlaganfall—Stark für den Alltag. physiopraxis, 2011; 9(4): 24-26.