1. The correlation between positive, rational problems solving and the frequency of secondary conditions is an artifact of our sample. The study was an RCT of 6 1-hour in-person interventions. This level of commitment may have only drawn the interest of highly motivated individuals with frequent secondary conditions.
A negative outlook on problems, a tendency to avoid problems and the lack of confidence in keeping SCI from living life are expectedly correlated. The inverse may be true as well. A more positively oriented approach to problems may be connected to higher confidence in managing SCI and living life.
Avoiding solving problems is also connected to an increased level of distress from secondary conditions. Behaviors such as procrastination and inaction may not be helpful in managing secondary conditions.
The correlations of BAS Drive and the frequency and distress of secondary conditions may imply that a more active life or pursuit of happiness may mean an increased risk of secondary conditions.
Disability Management Self-Efficacy and its Relationship to Personality,
Problem-Solving, Secondary Conditions and Knowledge among Individuals with SCI.
Bradley Trumpower MS,1 Michelle Meade PhD,1 and Dawn Ehde PhD2
1University of Michigan, 2University of Washington
Objective
Measures Used and Select Subscales
Results and Discussion
BIS / BAS Scales – measures the various aspects of the Behavioral Inhibition System (BIS) and Behavioral Activation System (BAS)
BAS Drive
A scale measuring the component of the BAS that is the pursuit of goals
SCI-SCS – a measure of the frequency and level of distress of secondary conditions in the last 3 months.
SCI-SCS Freq & Distress
Social Problem Solving Inventory – a measure of problem solving style
SPSI Total
A global indicator of the level of a person’s social problem-solving ability2
Positive Problem Orientation (PPO)
Taps into a constructive, problem solving cognitive set2
Rational Problem Solving (RPS)
Assesses the rational, deliberate, and systematic application of effective problem-solving strategies and techniques2
Negative Problem Orientation (NPO)
Measures a dysfunctional or inhibitive cognitive-emotional set2
Avoidance Style (AS)
Assesses another defective problem-solving pattern characterized by procrastination, passivity or inaction, and dependency2
DMSES - Self-reported confidence level in handling the impacts that SCI has on life. It includes the ability to minimize the effect SCI has on social activities, relationships, day-to-day responsibilities, etc.
SCI Knowledge Questionnaire- A questionnaire about SCI and secondary conditions
To examine the significance of self-efficacy in the management of SCI and its relationship to knowledge about expected health behaviors, personality style, secondary conditions and problem-solving ability
For this sample, Disability Management Self-Efficacy was positively related to overall problem-solving ability (r=.565, p=.003) and negatively related both Avoidance Style (r=-.644 ; p<.001) and Negative Problem Orientation (r=-.544; p=.004).
A positive relationship was found between frequency of secondary conditions, as accessed on the SCI-SCS, and Positive Problem Orientation (r=.412; p=.036), Rational Problem Solving (r=.444; p=.023) and the BAS subscale (r=.448; p=.032). While these findings may at first seem counter intuitive, as they note a positive relationship between the presence of secondary conditions and positive, proactive styles of personality and problem-solving; it seems likely that they are a reflection of the sample itself. That is, the research study, overall, seemed to attract individuals who were willing to participate and drive the needed distances, motivated to address health issues and who felt that there were things that they could do to manage their health.
Positive relationships were found between the self-reported distress over secondary conditions and an Avoidance Style of Problem Solving (r=.413; p=.036)and a Personality focused on the pursuit of goals (BAS Drive; r=.456; p=.029)
Knowledge about SCI and management of secondary conditions was not significantly related to any of the other measures.
Problem Statement
Many individuals with SCI develop secondary conditions that can limit health, quality of life and participation.
Many of the common secondary conditions that occur after SCI can be prevented with the performance of recommended health behaviors, including up to 95% of pressure ulcers1.
Higher levels of self-efficacy are often related to a greater likelihood of performing needed health behaviors and achieving positive outcomes.
It seems likely that an individual with SCI’s confidence in managing his or her health and disability will be related to their knowledge of health behaviors, to positive coping styles, and to particular personality characteristics.
Research on this important topic is scant.
Conclusion
Methodology
A negative outlook about problems, a tendency to avoid problems and the lack of confidence in keeping SCI from living life are expectedly correlated. The inverse may be true as well. A more positively oriented approach to problems may be connected to higher confidence in managing SCI and living life.
Avoiding solving problems is also connected to an increased level of distress from secondary conditions. Behaviors such as procrastination and inaction may not be helpful in managing secondary conditions.
The correlations of BAS Drive and the frequency and distress of secondary conditions may imply that a more active life or pursuit of happiness may mean an increased risk of secondary conditions.
Limitations
Small sample size
Individuals volunteering to participate may be representative of only the “highly motivated” individuals with SCI.
The SCI Knowledge scale is under development and so may not have sufficient validity to provide an accurate assessment.
Cross-sectional assessment as part of a RCT of an in-person intervention
26 adults with SCI of at least 24 months duration (Ages Mean age of 44).
Analyses conducted were the Sharpiro-Wilk test for normality and Pearson Product Moment Correlations
Examined data at baseline of study
References
Acknowledgments
1Lindsey L, Klebine P, Oberheu AM. Prevention of Pressure Sores through Skin Care. In: Rehabilitation. UAB PMR, ed. Spinal Cord Injury Information Network. Vol 2000
2Multi-Health Systems Inc. (n.d.) SPSI–R Social Problem -Solving Inventory–Revised
This work was supported with funding from the PVA Research Foundation (Grant #2751)