REHAB Basel, Clinic for Neurorehabilitation and Paraplegiology, Basel, Switzerland.
REHAB Basel, Clinic for Neurorehabilitation and Paraplegiology, Im Burgfelderhof 40, 4055 Basel, Switzerland.
PM R. 2018 Jun;10(6):573-586. doi: 10.1016/j.pmrj.2017.11.017. Epub 2017 Dec 7.
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.
To investigate whether persons with greater levels of GSE are more likely to perform skin-care strategies for PU prevention regularly.
Nationwide cross-sectional survey within the Swiss Spinal Cord Injury Cohort Study.
Community setting, data collection between 2011 and 2013.
A total of 456 subjects with a traumatic or nontraumatic SCI living in Switzerland.
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.
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.
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.
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.
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压疮（PU）是脊髓损伤（SCI）患者中常见且严重的健康问题。预防 PU 的皮肤护理策略通常在初始康复期间提供。然而，SCI 患者通常不会连续执行这些策略，尤其是在出院后。一般自我效能感（GSE）等心理因素对预防 PU 行为的影响尚未得到充分探讨。
调查自我效能感水平较高的个体是否更有可能定期执行预防 PU 的皮肤护理策略。
瑞士脊髓损伤队列研究中的全国性横断面调查。
社区环境，数据收集于 2011 年至 2013 年之间。
共纳入 456 名居住在瑞士的创伤性或非创伤性 SCI 患者。
使用多元比例优势回归模型分析 GSE 与 PU 预防行为之间的关联，包括潜在的社会人口统计学、损伤相关和生活方式相关的混杂因素，以及 GSE 与潜在效应修饰因子之间的交互项。
GSE 通过包含 10 个项目的 GSE 量表进行评估。PU 预防行为通过改编版脊髓损伤生活方式量表的 5 个项目进行操作化。这两种测量都是自我管理问卷的组成部分。
基于没有交互项的回归模型，GSE 水平与皮肤护理预防 PU 无关。在纳入交互项后，最终模型显示 GSE 与 3 项皮肤护理项目之间存在统计学显著关联，比值比范围为 1.09 至 1.17（均 P <.001）。GSE 对 PU 预防行为的略微积极影响仅限于年龄较小发生 SCI 的个体。
在这项研究中，GSE 通常与 SCI 患者的皮肤护理预防 PU 行为无关。在进一步的研究中，评估 SCI 特异性的自我效能感概念可能会很有趣。
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