Background: Self-efficacy, or the perceived ability to perform a certain behaviour often predicts physical activity and walking outcomes after stroke. However, our understanding of how to target self-efficacy after stroke remains unclear.
Objectives: This study aims to explore perspectives of individuals with stroke on self-efficacy for physical activity and walking.
Methods: A qualitative approach was used with semi-structured interviews. Participants discussed their perspectives and experiences of self-efficacy for physical activity and walking. Inductive reflexive thematic analysis was completed. Credibility of the study was ensured through field notes, reflexive journaling and member checking.
Results: Ten adults with stroke participated (mean age: 71 ± 13 years, 60 % female, 8 ± 10 years post stroke). Three main themes were identified: 1. determination and motivation, 2. awareness and planning, and 3. actions and replanning. These main themes were encompassed within an overarching theme of pre- and post-stroke identities. Pre- and post-stroke identities impacted self-efficacy through an influence on determination and motivation, planning, dealing with setbacks and replanning of physical activity and walking after stroke. Awareness of physical limitations helped participants set realistic goals, while support from peers and family positively impacted self-efficacy. The dynamic nature of self-efficacy was evident, as participants adapted to successes and setbacks.
Conclusions: Rehabilitation goals should be tailored to align with individual identities to build self-efficacy for physical activity and walking after stroke. Clinicians may help by identifying goals that are meaningful and relevant to pre- and post-stroke identities, thereby enhancing motivation for physical activity and walking.