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Self-care self-efficacy, religious participation and depression as predictors of poststroke self-care among underserved ethnic minorities

Suzanne M. Robertson, Cashuna Huddleston, Ben Porter, Amber B. Amspoker, Gina L. Evans-Hudnall
  • Suzanne M. Robertson
    Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX, United States | smr1@bcm.edu
  • Cashuna Huddleston
    Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Department of Counseling Psychology, University of Houston, Houston, TX, United States
  • Ben Porter
    Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Department of Psychology, University of Houston, TX, United States
  • Amber B. Amspoker
    Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX, United States
  • Gina L. Evans-Hudnall
    Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Education, Research and Clinical Center, United States

Abstract

Underserved ethnic minorities have multiple chronic disease risk factors, including tobacco, alcohol and substance use, which contribute to increased incidence of stroke. Self-efficacy (self-care self-efficacy), religious participation and depression may directly and indirectly influence engagement in post stroke self-care behaviors. The primary aim of the present study was to investigate the effects of self-care self-efficacy, religious participation and depression, on tobacco, alcohol and substance use in a sample of largely ethnic minority, underserved stroke survivors (n=52). Participants previously recruited for a culturally tailored secondary stroke prevention self-care intervention were included. The treatment group received three stroke self-care sessions. The usual care group completed assessments only. Both groups were included in these analyses. Main outcome measures included tobacco, alcohol and substance use. Self-care self-efficacy, religious participation and depression were also assessed. Logistic regression analyses, using self-efficacy, religious practice and depression as the referents, were used to predict binary outcomes of tobacco, alcohol and substance use at 4-weeks post-stroke. Higher depression and self-care self-efficacy were associated with reduced odds of smoking and substance use. Greater participation in religious activities was associated with lower odds of alcohol use. We can conclude that incorporating depression treatment and techniques to increase self-care self-efficacy, and encouraging religious participation may help to improve stroke self-care behaviors for underserved and low socioeconomic status individuals. Results are discussed in the context of stroke self-management.

Keywords

stroke, self-care, underserved, low socioeconomic status, self-efficacy, alcohol, tobacco, substance, religious participation

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Submitted: 2012-11-13 22:52:04
Published: 2013-04-03 15:11:40
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Copyright (c) 2013 Suzanne M. Robertson, Cashuna Huddleston, Ben Porter, Amber B. Amspoker, Gina L. Evans-Hudnall

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