LaVela Sherri L, Etingen Bella, Miskevics Scott
Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois.
Center for Healthcare Studies, Institute for Public Health and Medicine, General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Top Spinal Cord Inj Rehabil. 2016 Winter;22(1):27-38. doi: 10.1310/sci2201-27.
Individuals with spinal cord injury/disorder (SCI/D) must learn to adjust to and manage functional challenges after SCI/D onset. For these individuals, resilience (ie, the adaptive response to stressful events) may be related to their willingness and ability to conduct self-care behaviors. The study objectives were to examine the relationship between patient-reported perceptions of independence in performing self-care behaviors and resilience among Veterans with SCI/D and to examine variables (including resilience) associated with high self-care scores (controlling for confounders). In this cross-sectional survey, we conducted bivariate analyses to examine differences in demographic, injury, and health characteristics and resilience scores for individuals with SCI/D. We conducted a multivariate block-design linear regression to examine factors associated with ability to perform self-care. Level of injury (β = 7.74, < .0001), resilience (β = 0.08, = .0216), marital status (β = 1.75, = .0445), and living arrangement (β = 4.37, < .0001) were positively related to higher self-care behaviors. Completeness of injury (β = -2.79, < .0001), age (β = -0.09, = .0052), age at injury (β = -0.05, = .0129), and number of comorbid health conditions (β = -0.72, < .0001) showed negative relationships with higher self-care. Self-care ability is related to multiple factors, including resilience. The positive relationship between resilience and self-care suggests that greater resilience, independent of injury level/severity, may contribute to improved self-care behaviors in individuals with SCI/D. Other factors that showed a positive relationship with self-care included younger age, living alone, paraplegic level injury, and fewer health conditions. Understanding the profile of persons with SCI/D with regard to self-care behaviors is important to the development of tailored interventions to improve self-care.
脊髓损伤/疾病（SCI/D）患者必须学会在SCI/D发病后适应并应对功能挑战。对于这些患者而言，复原力（即对应激事件的适应性反应）可能与他们进行自我护理行为的意愿和能力有关。本研究的目的是探讨脊髓损伤/疾病退伍军人自我报告的自我护理行为独立性认知与复原力之间的关系，并研究与高自我护理得分相关的变量（包括复原力）（控制混杂因素）。在这项横断面调查中，我们进行了双变量分析，以检查脊髓损伤/疾病患者在人口统计学、损伤和健康特征以及复原力得分方面的差异。我们进行了多变量块设计线性回归，以检查与自我护理能力相关的因素。损伤水平（β = 7.74，< .0001）、复原力（β = 0.08，= .0216）、婚姻状况（β = 1.75，= .0445）和居住安排（β = 4.37，< .0001）与更高的自我护理行为呈正相关。损伤完整性（β = -2.79，< .0001）、年龄（β = -0.09，= .0052）、受伤年龄（β = -0.05，= .0129）和合并健康状况数量（β = -0.72，< .0001）与更高的自我护理呈负相关。自我护理能力与多种因素有关，包括复原力。复原力与自我护理之间的正相关表明，更高的复原力，独立于损伤水平/严重程度，可能有助于改善脊髓损伤/疾病患者的自我护理行为。其他与自我护理呈正相关的因素包括年龄较小、独居、截瘫水平损伤和健康状况较少。了解脊髓损伤/疾病患者在自我护理行为方面的特征对于制定改善自我护理的针对性干预措施很重要。
