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Correlates of self-reported physical function in individuals with spinal cord injuries and disorders: does self-efficacy matter?

Hill JN, Etingen B, Miskevics S, LaVela SL. Correlates of self-reported physical function in individuals with spinal cord injuries and disorders: does self-efficacy matter?. Spinal Cord. 2017 Dec 1; 55(12):1096-1102.

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STUDY DESIGN: Data were collected via a cross-sectional mailed survey with Veterans with spinal cord injury and disorders (SCI/D). OBJECTIVES: To examine self-efficacy in Veterans with SCI/D reporting high versus low perceptions of physical function. SETTING: Department of Veterans Affairs (VA) Spinal Cord Injury System of Care-nation-wide, 24 Spinal Cord Injury (SCI) Centers. METHODS: The survey provided patient-reported data on demographic and injury characteristics, basic mobility and fine motor function, and perceived self-efficacy. Bivariate comparisons were conducted to compare perceptions of self-efficacy between Veterans with SCI/D reporting perceptions of 'high' versus 'low' basic mobility and fine motor function. A multivariate logistic regression was conducted to identify factors independently associated with high physical function when controlling for covariates. RESULTS: Response rate (896/1452 = 61.7%). Multivariate analysis showed that age (odds ratio (OR) = 0.98, 95% confidence interval (CI): 0.96-1.00, P = 0.03), tetraplegia (OR = 0.20, 95% CI: 0.13-0.32, P?0.0001), diabetes (OR = 0.53, 95% CI: 0.31-0.91, P = 0.02), depression (OR = 0.62, 95% CI: 0.39-0.98, P = 0.04) and pressure ulcers (OR = 0.42, 95% CI: 0.25-0.72, P = 0.001) were all independently associated with lower odds of high physical function. When controlling for covariates, persons with high self-efficacy were nearly two times more likely to have high physical function (OR = 1.98, 95% CI: 1.22-3.22, P = 0.01). CONCLUSION: Lower perceptions of basic mobility and fine motor function among individuals with SCI/D were correlated with lower self-efficacy, even when controlling for other covariates. The relationship between physical function and self-efficacy suggests that interventions focused on improving self-efficacy or physical function may also see improvements in the other. Further, studies exploring the impact of interventions on the relationship between self-efficacy and physical function are needed to understand the relationship between the two.

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