Associations between self-efficacy and health-related quality of life in haemorrhagic stroke survivors: a longitudinal study

Background The impact of recovery self-efficacy on health-related quality of life in haemorrhagic stroke survivors remains unclear. This longitudinal study examined this association through a one-year follow-up after discharge. Methods A prospective, longitudinal design was conducted. A total of 184 haemorrhagic stroke survivors in a tertiary hospital in western China from January 2020 to December 2021 were recruited by the convenience sampling method. The three-level EuroQol five-dimension questionnaire (EQ-5D-3 L) and Stoke Self-efficacy Questionnaire (SSEQ) were assessed at four post-discharge time points: 1 month (T1), 3 months (T2), 6 months (T3), and 12 months (T4). The generalized estimating equation analysis was used to evaluate the associations between recovery self-efficacy and health-related quality of life. Results The mean age of included participants were 54.0, with 65.2% of female. Generalized estimating equation analysis revealed significant interactions between time and SSEQ on EQ-5D-3 L (p < 0.001). The simple effects of time showed significant increases in EQ-5D-3 L scores from T3 to T4 in the low SSEQ group (beta = 0.113-0.203, p < 0.001) and from T2 to T4 in the high SSEQ group (beta = 0.038-0.054, p < 0.05). The simple effects of SSEQ showed that patients with higher SSEQ scores had significantly higher EQ-5D-3 L scores at T1 (beta = 0.187, 95%CI: 0.132-0.242, p < 0.001), T2 (beta = 0.154, 95%CI: 0.111-0.196, p < 0.001), and T3 (beta = 0.084, 95%CI: 0.054-0.113, p < 0.001), but not at T4 (p = 0.803). Conclusion Recovery self-efficacy significantly interacted with time in shaping haemorrhagic stroke survivors' health-related quality of life recovery. Higher self-efficacy was associated with earlier improvements, while lower self-efficacy was associated with delayed but larger improvements of health-related quality of life levels, with effects diminishing by one year after stroke.