title: Development of a measure of skin care belief scales for persons with spinal cord injury.
abstract: OBJECTIVE
  To develop and validate a measure of skin care beliefs and to describe the skin care behaviors of persons with spinal cord injury (SCI).
  
  
  METHODS
  A mixed-methods design was used to develop the Skin Care Beliefs Scales (SCBS). The health belief model framed the hypotheses. Phase 1 included item development, content validity testing, and pilot testing. Phase 2 included testing the scale structure (principal components analysis), internal consistency reliability, test-retest reliability, and relationships between the belief scales and care behaviors.
  
  
  METHODS
  Two acute rehabilitation hospitals and Internet websites.
  
  
  METHODS
  Patients with SCI (N=462; qualitative/pilot n=56; psychometric study n=406) participated.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The pilot and phase 2 studies, respectively, used 146-item and 114-item versions of the SCBS. A skin care activity log was used to record skin care behaviors.
  
  
  RESULTS
  Content validity indicated that the items were relevant and clear. The analysis resulted in 11 independent scales reflecting 3 general beliefs (susceptibility, severity, self-efficacy) and barrier and benefit behavior-specific scales for skin checks, wheelchair pressure reliefs, and turning and sitting times. With the exception of skin check barriers (α=.65), Cronbach alphas of the scale ranged from .74 to .94. Test-retest intraclass correlations were fair to excellent (range, .42-.75). Construct validity was supported. Hierarchical linear regression indicated that turning benefits, barriers, susceptibility, and self-efficacy were significant predictors of turning time. Benefits or barriers were correlated significantly with skin check and pressure relief adherence (ρ range, -.17 to -.33). Self-efficacy was correlated with wheelchair pressure relief (ρ=.18). Skin care behavior adherence varied widely (eg, 0%-100%).
  
  
  CONCLUSIONS
  The scales showed acceptable reliability and validity. Further testing with larger samples is desirable.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. rbking@northwestern.edu
authors.forename: Rosemarie B
authors.initials: RB
authors.lastname: King
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Champion
authors.forename: David
authors.initials: D
authors.lastname: Chen
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Gittler
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: Rita K
authors.initials: RK
authors.lastname: Bode
authors.forename: Patrick
authors.initials: P
authors.lastname: Semik
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010865:Pilot Projects; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control*; D025341:Principal Component Analysis; D011594:Psychometrics; D015203:Reproducibility of Results; D017592:Skin Care / Q000379:methods*; D013119:Spinal Cord Injuries / Q000150:complications*; D011795:Surveys and Questionnaires