Self efficacy measurement and goal attainment after pulmonary rehabilitation

Rachel Garrod, Johanna Marshall, Fiona Jones

School of Physiotherapy, St George’s, University of London and Kingston University Faculty of Health and Social Care Sciences, UK

Background: Little is known about self-efficacy in COPD and its role as a mediator of goal attainment after rehabilitation. We hypothesized that higher baseline self efficacy may facilitate goal attainment.

Methods: 48 COPD patients completed pulmonary rehabilitation, self-efficacy was measured using the COPD Self Efficacy Scale (CSES). Personal goals were used as self reported outcome. Relationships were evaluated between CSES and St George’s Hospital Respiratory Questionnaire (SGRQ); depression; using Brief Assessment Schedule Cards (BASDEC), London Chest Activity of Daily Living Scale (LCADL) and exercise tolerance; using Six-Minute Walking Distance (6MWD) and muscle strength.

Results: 74 Stable COPD patients, mean FEV₁ 1.2 (0.6) l, age 68.1 (10.2) years were recruited. 51 patients completed rehabilitation and 48 of those CSES and reported goal attainment. 94 goals were documented. Baseline self efficacy did not differ according to whether goal was achieved or not. Relationships were evident between CSES and SGRQ (r = –0.53), 6MWD (r = 0.36), BASDEC (r = –0.31), LCADL (r = –0.33) (all p ≤ 0.01), but not FEV₁, pack years or muscle strength. There was a significant improvement in CSES scores pre to post rehabilitation, mean difference (95% CI) 0. 27 (0.04 to 0.51).

Conclusions: Self efficacy, using the CSES, improves with rehabilitation but baseline self efficacy does not appear to influence goal attainment.

Keywords: self-efficacy, COPD, pulmonary rehabilitation, goal