B.M. Sakakibara, PhD, Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada, and Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
W.C. Miller, PhD, FCAOT, Graduate Program in Rehabilitation Sciences, University of British Columbia; Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute; Department of Occupational Science and Occupational Therapy, University of British Columbia, T-325 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada; and International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada.
Phys Ther. 2014 Nov;94(11):1604-13. doi: 10.2522/ptj.20140113. Epub 2014 Jun 12.
Self-efficacy has important implications for health and functioning in people with limited mobility. However, the influence of self-efficacy on mobility in adults who use wheelchairs has yet to be investigated.
The study objective was to: (1) estimate the direct association between wheelchair use self-efficacy and life-space mobility and (2) investigate an indirect effect through wheelchair skills.
This was a cross-sectional study.
Participants (N=124) were adults who use a wheelchair, live in the community, and were 50 years of age and older (X̅=59.67, range=50-84), with at least 6 months of experience with manual wheelchair use; 60% were men. The 20-item Life-Space Assessment, the 65-item Wheelchair Use Confidence Scale, and the 32-item Wheelchair Skills Test-Questionnaire were used to measure life-space mobility, self-efficacy, and wheelchair skills, respectively.
Self-efficacy had a statistically significant association with life-space mobility (nonstandardized regression coefficient=0.23, 95% confidence interval=0.07, 0.39) after controlling for sex, number of comorbidities, geographic location, and assistance with using a wheelchair. This model accounted for 37.1% of the life-space mobility variance, and the unique contribution of self-efficacy was 3.5%. The indirect effect through wheelchair skills was also statistically significant (point estimate=0.21, 95% bootstrapped confidence interval=0.05, 0.43) and accounted for 91.3% of the direct effect of self-efficacy on life-space mobility. This model accounted for 39.2% of the life-space mobility variance.
Causality could not be established because of the study design. The self-report nature of data from volunteers may be influenced by recall bias, social desirability, or both.
Wheelchair use self-efficacy had both direct and indirect associations with life-space mobility after controlling for confounding variables. Interventions targeted toward improving self-efficacy may lead to improvements in life-space mobility.
自我效能感对行动不便者的健康和功能有重要影响。然而，自我效能感对使用轮椅的成年人的移动能力的影响尚未得到研究。
本研究的目的是：（1）估计轮椅使用自我效能感与生活空间移动能力之间的直接关联；（2）通过轮椅技能调查间接影响。
这是一项横断面研究。
参与者（N=124）为年龄在 50 岁及以上（X̅=59.67，范围=50-84）、使用轮椅、居住在社区且至少有 6 个月手动轮椅使用经验的成年人；60%为男性。使用 20 项生活空间评估量表、65 项轮椅使用信心量表和 32 项轮椅技能测试问卷分别测量生活空间移动能力、自我效能感和轮椅技能。
在控制性别、合并症数量、地理位置和使用轮椅的帮助后，自我效能感与生活空间移动能力具有统计学显著关联（未标准化回归系数=0.23，95%置信区间=0.07，0.39）。该模型解释了生活空间移动能力变异的 37.1%，自我效能感的独特贡献为 3.5%。通过轮椅技能的间接影响也具有统计学意义（点估计值=0.21，95% bootstrap 置信区间=0.05，0.43），并占自我效能感对生活空间移动能力的直接影响的 91.3%。该模型解释了生活空间移动能力变异的 39.2%。
由于研究设计，不能确定因果关系。志愿者报告的数据的自我报告性质可能受到回忆偏差、社会期望或两者的影响。
在控制混杂变量后，轮椅使用自我效能感与生活空间移动能力具有直接和间接关联。针对提高自我效能感的干预措施可能会导致生活空间移动能力的提高。
