Aleksandrowicz, AW;
(2016)
Goal setting in neurorehabilitation: development of a patient-centred tool with theoretical underpinnings.
Doctoral thesis , (UCL) University College London.
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Abstract
Aim: This review aimed to evaluate the effects of self-management interventions on self-efficacy in patients with acquired neurological conditions. Method: Four electronic databases (MEDLINE, PsychINFO, CINAHL Plus and PubMed) were systematically searched and papers were assessed against inclusion and exclusion criteria producing 20 eligible articles. Results: Thirteen randomised controlled trials, 2 quasi-experimental controlled design studies, 4 pre-post design studies and 1 multiple participant, two-phase single subject design study were included in the review. There was a variety of neurological diagnoses covered including Multiple Sclerosis (N=8), stroke (N=6), epilepsy (N=5) and acquired brain injury (N=1). The sample sizes varied from 10 to 216 participants. Mean age varied from 29.87 to 67.38 years. Twelve out of 20 studies found some support for the effectiveness of self-management programmes in increasing self-efficacy, although the studies were prone to biases, such as small sample sizes, lack of blinding and low power to detect effects. All but one of the studies involved some incorporation of social cognitive theory or self-efficacy enhancing strategies in their programmes. Conclusion: The review found some evidence for the effectiveness of selfmanagement programmes in increasing levels of self-efficacy in patients with neurological conditions. However, more rigorous studies are needed in order to draw firm conclusions regarding the effectiveness of the programmes and their application in clinical practice.
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