Article

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.
OBJECTIVE: To investigate whether persons with greater levels of GSE are more
likely to perform skin-care strategies for PU prevention regularly. DESIGN:
Nationwide cross-sectional survey within the Swiss Spinal Cord Injury Cohort
Study. SETTING: Community setting, data collection between 2011 and 2013.
PARTICIPANTS: A total of 456 subjects with a traumatic or nontraumatic SCI living
in Switzerland. METHODS: 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. MAIN OUTCOME
MEASUREMENTS: 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. RESULTS: 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. CONCLUSIONS: 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. LEVEL OF
EVIDENCE: III.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS