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Self‐Efficacy and Pressure Ulcer Prevention After Spinal Cord Injury—Results From a Nationwide Community Survey in Switzerland (SwiSCI)
Author(s) -
Hug Kerstin,
Stumm Caroline,
Debecker Isabelle,
Fellinghauer Carolina Saskia,
Peter Claudio,
HundGeorgiadis Margret
Publication year - 2018
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2017.11.017
Subject(s) - medicine , spinal cord injury , physical therapy , confounding , operationalization , cohort , odds ratio , odds , rehabilitation , gerontology , logistic regression , spinal cord , psychiatry , philosophy , epistemology
Background Pressure ulcers (PUs) are a common and severe health condition in persons with spinal cord injury (SCI). Skin‐care strategies for PU prevention are usually provided during initial rehabilitation. However, individuals with SCI often do not perform these strategies continuously, especially after discharge. The influence of psychological factors such as general self‐efficacy (GSE) on the performance of PU prevention behavior has not yet been sufficiently explored. Objective To investigate whether persons with greater levels of GSE are more likely to perform skin‐care strategies for PU prevention regularly. Design Nationwide cross‐sectional survey within the Swiss Spinal Cord Injury Cohort Study. Setting Community setting, data collection between 2011 and 2013. Participants A total of 456 subjects with a traumatic or nontraumatic SCI living in Switzerland. Methods Associations between GSE and PU prevention behavior were analyzed by multivariate proportional odds regression models, including potential sociodemographic, lesion‐related, and lifestyle‐related confounders without and with interaction terms between GSE and potential effect modifiers. Main Outcome Measurements Self‐efficacy was assessed by the GSE scale comprising 10 items. PU preventive behavior was operationalized using 5 items of an adapted version of the Spinal Cord Injury Lifestyle scale. Both measurements were components of a self‐administered questionnaire. Results Based on the regression model without interaction terms, GSE levels were not associated with skin‐care PU prevention. After we included interaction terms, the final model showed statistically significant associations between GSE and 3 skin‐care items with odds ratios ranging from 1.09 to 1.17 (all P < .001). The slightly positive effect of GSE on PU prevention behavior was restricted to persons who sustained their SCI at a younger age. Conclusions GSE was generally not associated with skin‐care PU prevention behavior among persons with SCI in this study. In further research, it might be of interest to assess SCI‐specific concepts of self‐efficacy. Level of Evidence III