title: Association of depression and pain interference with disease-management self-efficacy in community-dwelling individuals with spinal cord injury.
abstract: OBJECTIVE
  To determine factors influencing disease-management self-efficacy in individuals with spinal cord injury.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Forty-nine community-dwelling individuals with chronic spinal cord injury (mean age 44 years) participated in the study.
  
  
  METHODS
  Each subject was evaluated for disease-management self-efficacy (Self-efficacy for Managing Chronic Disease), depression (10-item Center for Epidemiologic Studies Depression Scale), pain interference (Pain Interference Scale), and availability of support (Interpersonal Support Evaluation List short form). Multiple regression analysis was performed to determine the relative contributions of these factors to disease-management self-efficacy.
  
  
  RESULTS
  The mean disease-management self-efficacy score was 6.5 out of 10 (standard deviation 1.6). Bivariate correlation analysis showed that higher self-efficacy was significantly correlated with longer time since injury (r = 0.367, p = 0.010), better social support (r = 0.434, p = 0.002), lower pain interference (r = -0.589, p <0.001), and less severe depressive symptoms (r=-0.463, p=0.001). In multiple regression analysis, only lower pain interference and less severe depressive symptoms were significantly associated with higher disease-management self-efficacy (F 4,44=10.249, R2=0.482, p<0.001).
  
  
  CONCLUSIONS
  Disease-management self-efficacy is suboptimal in many community-living people with spinal cord injury. This research suggests that rehabilitation of patients with spinal cord injury should include self-efficacy-enhancing strategies. Alleviation of depressive symptoms and pain self-management may be important for improving disease-management self-efficacy in this population, but this requires further study.
authors.affiliation: Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China.
authors.forename: Marco Y C
authors.initials: MY
authors.lastname: Pang
authors.forename: Janice J
authors.initials: JJ
authors.lastname: Eng
authors.forename: Kwan-Hwa
authors.initials: KH
authors.lastname: Lin
authors.forename: Pei-Fang
authors.initials: PF
authors.lastname: Tang
authors.forename: Chihya
authors.initials: C
authors.lastname: Hung
authors.forename: Yen-Ho
authors.initials: YH
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D040561:Assisted Living Facilities; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D059408:Pain Management; D011788:Quality of Life; D020377:Self Efficacy; D012944:Social Support; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D055815:Young Adult