Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA.
Psychol Health Med. 2019 Dec;24(10):1171-1181. doi: 10.1080/13548506.2019.1612082. Epub 2019 Apr 29.
Self-management of a disability consists of treatment adherence, obtaining information about the disease and treatment options, caring for oneself, participating in decisions, and maintaining social relationships and emotional balance. Understanding and measuring an individual's beliefs about their ability to successfully self-manage and live well with a disability allows researchers and clinicians to better target interventions aimed at increasing disability management self-efficacy (DMSE). The purpose of this study was to examine the associations between demographic and clinical indicators, and self-efficacy for DMSE in individuals with chronic physical conditions. Adults (N = 815) with muscular dystrophy, multiple sclerosis, spinal cord injury, or post-polio syndrome completed a self-report mailed survey assessing DMSE, perceived social support, depression symptoms, resilience, fatigue, pain interference, satisfaction with participation in social roles, physical function, and demographics. A cross-sectional regression model was used to examine the associations between the clinical and demographic factors, and DMSE. The model explained 67% of the variance in DMSE. Satisfaction with participation in social roles, resilience, pain interference, social support, and fatigue were statistically significant. Better social functioning, more resilience, and less pain and fatigue were most strongly associated with DMSE. Interventions aimed at increasing DMSE should include strategies for improving social participation.
自我管理残疾包括治疗依从性、获取疾病和治疗方案信息、自我护理、参与决策以及维持社会关系和情绪平衡。了解和衡量个体对其成功自我管理残疾和生活的能力的信念,使研究人员和临床医生能够更好地针对旨在提高残疾管理自我效能(DMSE)的干预措施。本研究的目的是检验慢性身体状况个体的人口统计学和临床指标与 DMSE 自我效能之间的关联。患有肌肉萎缩症、多发性硬化症、脊髓损伤或小儿麻痹后综合征的成年人(N=815)完成了一项自我报告的邮寄调查,评估 DMSE、感知社会支持、抑郁症状、韧性、疲劳、疼痛干扰、对参与社会角色的满意度、身体功能和人口统计学。使用横截面回归模型来检验临床和人口统计学因素与 DMSE 之间的关联。该模型解释了 DMSE 方差的 67%。对参与社会角色的满意度、韧性、疼痛干扰、社会支持和疲劳具有统计学意义。更好的社会功能、更强的韧性以及更少的疼痛和疲劳与 DMSE 最密切相关。旨在提高 DMSE 的干预措施应包括改善社会参与的策略。