The effect of self-care management with the look after yourself (LAY) model on self-efficacy and functional status of stroke patients.

BACKGROUND

Stroke is a leading cause of death and long-term disability worldwide. Self-efficacy is a key psychological determinant influencing rehabilitation adherence and functional recovery in stroke survivors. However, structured self-management interventions integrated into early hospital rehabilitation remain limited. This study aimed to analyze the effectiveness of the Look After Yourself (LAY) self-care management model in improving self-efficacy and functional status among post-stroke patients during early rehabilitation.

METHODS

A quasi-experimental pretest-posttest design with a control group was conducted at a stroke center in Indonesia. Ninety-two hospitalized patients with stroke were recruited using purposive sampling and allocated into intervention (n = 46) and control (n = 46) groups. The intervention group received a four-week structured LAY program consisting of group sessions and individualized counseling, while the control group received standard hospital education. Self-efficacy was measured using the Stroke Self-Efficacy Questionnaire (SSEQ), and functional status was assessed using the Modified Barthel Index (MBI). Data were analyzed using paired and independent t-tests and Wilcoxon tests.

RESULTS

A total of 88 participants completed the study (44 in each group). The intervention group showed a significant increase in self-efficacy scores (60.04±11.30 to 77.77±5.56; p < 0.001), with a large effect size (Cohen's d = 1.96). Functional status also significantly improved within the intervention group (59.29±13.46 to 67.02±11.66; p < 0.001). In contrast, the control group demonstrated minimal change in self-efficacy and no significant improvement in functional status. Between-group comparison revealed a significant difference in post-test self-efficacy (p < 0.001), while the difference in functional status was not significant (p = 0.250).

CONCLUSION

The LAY self-care management model is effective in significantly improving self-efficacy and contributing to functional recovery in early post-stroke rehabilitation. Integrating structured self-management interventions into hospital-based rehabilitation may strengthen the psychological determinants of recovery and support long-term functional outcomes.