Self-efficacy and self-esteem as predictors of participation in spinal cord injury—an ICF-based study

• Published in: Spinal cord Vol. 50; no. 9; pp. 699 - 706
• Main Authors: Geyh, S, Nick, E, Stirnimann, D, Ehrat, S, Michel, F, Peter, C, Lude, P
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2012; Nature Publishing Group
• Subjects: 631/378/1687/1825; 692/700/228/491; Adult; Age; Aged; Anatomy; Anxiety; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cerebrospinal fluid. Meninges. Spinal cord; Classification; Cross-Sectional Studies; Data processing; Depression; Education; Female; Human Physiology; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; International Classification of Diseases; Inventories; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurochemistry; Neurology; Neuropsychology; Neurosciences; original-article; Pain; Patient Participation - psychology; Predictive Value of Tests; Regression analysis; Rehabilitation; Self Concept; Self Efficacy; Self Report; Social interactions; Spinal Cord Injuries - diagnosis; Spinal Cord Injuries - psychology; Spinal Cord Injuries - therapy; Spinal cord injury; Styles; Surveys and Questionnaires; Traumas. Diseases due to physical agents; participation; self-esteem; spinal cord injuries; psychological adaptation; self-efficacy; Nervous system diseases; Vertebral canal; Spinal cord trauma; Central nervous system disease; Self efficacy; Spinal cord disease; Adaptation
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sc.2012.18

Study design: A multi-centre cross-sectional study. Objective: To examine the relationship of self-efficacy and self-esteem with participation of persons with spinal cord injury (SCI) from a comprehensive bio-psycho-social perspective, based on the conceptual framework of the International Classification of Functioning, Disability and Health (ICF). Setting: Community-dwelling participants, <5 years post discharge, recruited through three SCI rehabilitation centers in Switzerland. Methods: Data were collected by means of standardized self-report questionnaires sent to the eligible participants by postal mail. The questionnaires covered the different components of the ICF's bio-psycho-social model, namely health conditions, body functions, participation, environmental and personal factors. Bivariate correlations and multivariate linear regression analyses with participation as the dependent variable have been conducted. Results: In all, 102 persons with SCI answered the survey, response rate 25.9%. Self-esteem ( r =0.61) and self-efficacy ( r =0.54) correlated highly with participation and were the strongest correlates of participation. They were stronger correlates of participation than symptoms of anxiety, depressive symptoms, pain, health conditions, social support, coping styles or sense of coherence. Participation seemed to be independent of gender, age, level or completeness of injury. Self-efficacy and self-esteem explained together with time since discharge and years of education 48% of the variance in participation adjusting for health condition, depressive symptoms, pain interference and social support. Conclusion: Considering self-efficacy and self-esteem within the comprehensive framework of the ICF can contribute to a better understanding of functioning, disability and health in SCI, which in turn may facilitate the development of interventions to support the persons’ adjustment and reintegration.