Associations between self-efficacy, social support, and learned helplessness in stroke survivors and caregivers: Using actor-partner interdependence modeling

Background Stroke survivors and their caregivers often experience psychological challenges, including learned helplessness, which may be influenced by self-efficacy and social support. However, little is known about stroke survivors and caregivers' learned helplessness and whether it is interdependent. This study aimed to explore their dyadic relationships. Methods A cross-sectional study was conducted with 266 stroke survivor-caregiver dyads recruited from three inpatient rehabilitation departments in China. Participants completed validated scales measuring self-efficacy (General Self-Efficacy Scale), social support (Chinese Mandarin version of the Medical Outcomes Study Social Support Survey), and learned helplessness (Learned Helplessness Scale). Dyadic analyses using the actor-partner interdependence model within a structural equation modeling framework. And all analyses were carried out using IBM SPSS version 26. Dyadic data were analyzed using Mplus 8.3. Results Stroke survivors’ learned helplessness was higher than caregivers’. APIMs identified actor and partner effects in Dyads. For the actor effects, survivors' and caregivers' social support and self-efficacy directly influenced their own learned helplessness (all P <0.001). In terms of partner effects, survivors' self-efficacy was negatively associated with caregivers’ learned helplessness ( B = -0.502, P  < 0.001), and caregivers’ social support was negatively associated with survivors’ learned helplessness ( B = -0.393, P  < 0.01). However, no significant partner effects were observed for caregivers’ self-efficacy on stroke survivors’ learned helplessness. Similarly, stroke survivors’ social support did not exhibit significant partner effects on caregivers’ learned helplessness. Conclusions The results highlight a reciprocal interdependent influence between stroke survivors and caregivers. Stroke survivors and caregivers’ learned helplessness is associated with their own self-efficacy and social support. This dyadic study also provides evidence suggesting that learned helplessness in both stroke survivors and caregivers is associated with self-efficacy in stroke survivors and social support in caregivers. It is helpful for clinical care to making intervention to stroke survivors and caregivers. Enhancing survivors' self-efficacy and caregivers' social support can help the dyads’ mental health.