Dyadic associations between patient self-efficacy, caregiver preparedness and self-care outcomes after stroke: a cross-sectional actor–partner interdependence model study

Abstract Background Self-care after stroke develops within an interdependent patient–caregiver context. Although patient self-efficacy and caregiver preparedness are recognised as key determinants of post-stroke management, their dyadic associations with self-care-related variables remain insufficiently understood. Methods A cross-sectional study was conducted among 198 patient–caregiver dyads recruited from three tertiary hospitals in China. Patient self-efficacy, caregiver preparedness, patient self-care ability and caregiver contribution were assessed using validated instruments. Dyadic associations were analysed using the actor–partner interdependence model within a distinguishable dyad regression framework. Standardised regression coefficients are reported. Results Significant actor effects were identified for both members of the dyad. Patient self-efficacy was negatively associated with patient self-care ability ( β = −0.242, p < 0.001), whereas caregiver preparedness was positively associated with caregiver contribution ( β = 0.289, p < 0.001). No significant partner effects were observed. Patient self-efficacy and caregiver preparedness were positively correlated ( r = 0.210, p < 0.01). The model explained 19.4% of the variance in patient self-care ability and 29.3% in caregiver contribution. Conclusions In this sample, self-care ability and caregiver contribution were associated with individuals’ own psychological resources rather than cross-partner influences. Given the cross-sectional design and the absence of objective functional status measures, these findings should be interpreted as preliminary and hypothesis-generating rather than confirmatory. Intervention strategies should address patients and caregivers separately but concurrently, while recognising their distinct roles in self-care processes.