Self-efficacy and resilience in severe aphasia – an exploratory cross-sectional study of two psychosocial factors and their relation to functional communication

Abstract

Purpose Self-efficacy and resilience are important for various aspects of rehabilitation outcome after stroke. However, little is known about how these factors are affected and related to communication outcome in stroke survivors with aphasia. The purpose was to investigate self-efficacy and resilience, and associations to language and functional communication, in people with severe post-stroke aphasia. Materials and methods 37 participants with severe aphasia rated their self-efficacy and resilience, using adapted versions of the existing instruments DLSES and CD-RISC. In addition, linguistic ability, executive function and functional communication were assessed. Results Participants rated their self-efficacy and resilience as expected based on reports in the literature; somewhat lower than general populations and at similar levels as clinical populations. There were no association between self-efficacy, resilience and linguistic ability. In the sample as a whole, there were no associations between self-efficacy, resilience and functional communication. However, when results were stratified by executive function, associations emerged in the group with stronger executive function. Conclusions People with severe aphasia have decreased self-efficacy and resilience compared to general populations, but not necessarily in proportion to their language impairment. Among participants with relatively spared executive functions there were indications of an association between self-efficacy, resilience and functional communication.