Recovery following stroke: the role of self-management education.

Current stroke rehabilitation tends to focus on the bio-medical course of disability, often responding to psychological and social issues only when they have been implicated in crises. Although this situation is costly, little evidence exists in relation to how psychological and social outcomes can be facilitated or how psychosocial decline can be prevented. In the area of adjustment following traumatic injury, there has been some suggestion that rehabilitation should focus on the expansion of resources, skills and self-efficacy as this will enable individuals to cope more effectively with their medical condition and circumstances. The current study was a longitudinal randomised controlled trial involving 100 people with stroke, 58 of whom were randomly allocated to an intervention based on the notion of psychosocial skill expansion. All were patients of a major hospital in Queensland, Australia. An existing self-management intervention (The Chronic Disease Self-Management Course, Lorig et al., 2001) was used to operationalise the concept of psychosocial skill expansion. The control group reported declines in functioning during the first year following stroke in the areas of family roles, activities of daily living, self-care and work productivity, that were not reported by the intervention group. Although the groups had reached similar levels by one year post-stroke, this intervention may have a protective function, presumably by improving capacity to manage the functional requirements of daily life. However, the intervention did not appear to have its impact through self-efficacy, as was expected, and failed to influence outcomes such as mood or social participation. Nevertheless, the intervention warrants further investigation, given that it appears to improve rehabilitation outcomes, at least in the short-term.

Assessing how much couples work at their relationship: the behavioral self-regulation for effective relationships scale.

It is widely believed that satisfying couple relationships require work by the partners. The authors equated the concept of work to relationship self-regulation and developed a scale to assess this construct. A factor analysis of the scale in a sample of 187 newlywed couples showed it comprised 2 factors of relationship strategies and effort. The factor structure was replicated in an independent sample of 97 newlywed couples. In both samples the scale had good internal consistency and high convergent validity between self- and partner-report forms. Self-regulation accounted for substantial variance in relationship satisfaction in both newlywed samples and in a 3rd sample of 61 long-married couples. The self-regulation and satisfaction association was independent of mood or self-report common method variance.