title: Factors associated with self-efficacy for managing recovery in the trauma intensive care population: a prospective cohort study.
abstract: OBJECTIVE
  The aim of this paper was to identify factors associated with self-efficacy for managing recovery in the trauma intensive care population.
  
  
  BACKGROUND
  Injury accounts for 6.5% of disease burden in Australia, with similar levels being reported in other developed countries. While some studies regarding self-efficacy have identified a relationship to patient recovery post acute injury, others have been inconclusive. This study will identify factors associated with self-efficacy for managing recovery in the trauma intensive care population.
  
  
  METHODS
  A prospective cohort study of patients aged ≥ 18 years, admitted to a metropolitan tertiary hospital in South East Queensland between June 2008 and August 2010 for the acute treatment of injury. Demographic, injury, acute care and psychosocial factors were considered. The primary outcome was self-efficacy measured by the 6-item self-efficacy scale (SES) 1 and 6 months post hospital discharge. All factors significant (p<0.10) on univariate analysis were included in multivariable modelling where p<0.05 was considered significant.
  
  
  RESULTS
  A total of 88 patients were included. The mean self-efficacy score at 1 and 6 months was similar (6.8 vs 6.9 respectively). Self-efficacy at 1 month, psychological distress (K-10) Score and illness perception (K10) Score accounted for 68.4% (adjusted R(2)) of the variance in 6 month self-efficacy (F3,75)=57.17, p<0.001. Illness perception was the strongest contributor to 6 month self-efficacy (beta=-0.516), followed by psychological distress (beta=-0.243) and self-efficacy at 1 month (beta=0.205).
  
  
  CONCLUSIONS
  Significant factors associated with self-efficacy for managing recovery at 6 months included 1 month self-efficacy, illness perception and psychological distress. To promote patient recovery, screening patients at 1 month in order to commence relevant interventions could be beneficial.
authors.affiliation: Clinical Nurse, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Electronic address: fiona_connolly@health.qld.gov.au.
authors.forename: Fiona R
authors.initials: FR
authors.lastname: Connolly
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Aitken
authors.forename: Marion
authors.initials: M
authors.lastname: Tower
authors.forename: Bonnie
authors.initials: B
authors.lastname: Macfarlane
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003422:Critical Care / Q000523:psychology*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010465:Perception; D011446:Prospective Studies; D011584:Psychology; D011788:Quality of Life; D011793:Queensland; D020127:Recovery of Function; D020377:Self Efficacy; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000523:psychology*
keywords: Injury; Intensive care unit; Nurses; Nursing; Patient outcome; Psychosocial factors; Quality of life; Recovery; Self-efficacy; Trauma