Interventions for improving self-efficacy in patients after stroke based on self-efficacy-related principles of Bandura’s cognition theory: a systematic review and meta-analysis

Background: Interventional approaches based on Bandura’s cognition theory are effective in improving self-efficacy poststroke. However, a systematical investigation for identifying effectives therapeutic components of the intervention has not yet been conducted. Objective: This meta-analysis was conducted to systematically investigated the effects of interventions with different principles on improving self-efficacy after stroke. Methods: Searches were conducted in PubMed, EMBASE, CINAHL, PsycINFO, MEDLINE, Cochrane Library, and two randomized controlled trials registration websites for randomized controlled trials from inception to 18th January 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The meta-analysis was performed using Review Manager and Stata software. Results: In total, 36 RCTs were included. Interventions using any one of the self-efficacy principles–principle 1 (Mastery), principle 2 (Modeling), principle 3 (Social persuasion), and principle 4 (Understanding), were more effective in improving self-efficacy in patients with stroke at post-training and follow-up, compared with the control group. Psycho-educational interventions might significantly improve self-efficacy in both post-intervention and follow-up stages, compared with control group. Meta-regression revealed time since stroke onset was significantly associated with effect sizes. Conclusion: Interventions developed based on Bandura’s cognition theory are beneficial to the improvement of self-efficacy. This review highlights principles of Bandura’s cognition theory are worth considering to be integrated to interventions targeted at improving self-efficacy. The application of self-efficacy principles with Bandura’s cognitive theory could be encouraged in clinical practice in the future. Protocol registration number: PROSPERO CRD42020154984.