Development and Implementation of a Self-Management Program Based On the Five-A Model and Its Impact On the Self-Efficacy of Patients with Traumatic Brain Injury

Introduction: Patients with head injuries are considered the most challenging category of trauma victims, accounting for the second highest mortality rate in the country and the greatest loss of active years of life. The disabilities caused by these injuries have a significant impact on individuals’ self-efficacy. This study aimed to develop and implement a self-management program based on the Five A’s model and to assess its impact on the self-efficacy of patients with head trauma.Method: This randomized controlled trial was conducted at Shohadaye Haftome Tir Hospital, which is affiliated with the Iran University of Medical Sciences. The study employed a pre-test and post-test design. A total of ۷۰ patients who met the inclusion criteria were selected using a convenience sampling method. The self-efficacy questionnaire was completed by both the intervention and control groups prior to the intervention and at the three-month follow-up. Patients in the intervention group participated in eight ۶۰-minute face-to-face self-management training sessions.Result: The patients in the intervention group demonstrated a statistically significant enhancement in self-efficacy and its constituent dimensions following the intervention, compared to the pre-intervention period (p < ۰.۰۰۱). No statistically significant difference was observed in self-efficacy or its dimensions in the control group before and after the intervention. Partial eta-squared values were used to evaluate the magnitude of the intervention’s impact. According to Cohen’s classification, an effect size of ۰.۰۱ is considered small, ۰.۰۶ medium, and ۰.۱۴ large. A statistically significant difference was observed in self-efficacy and its dimensions between the two groups following the intervention, with the mean self-efficacy score in the intervention group being significantly higher than that in the control group (p < ۰.۰۰۱).Conclusion: The implementation of a self-management program based on the Five A’s model has the potential to enhance the self-efficacy of patients with traumatic brain injuries. Interventions such as educational self-management programs can provide support to these patients, thereby improving their self-efficacy, quality of care, and overall quality of life.

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Keywords: self-management ، self-efficacy ، head trauma in patients