title: Influences of wheelchair-related efficacy on life-space mobility in adults who use a wheelchair and live in the community.
abstract: BACKGROUND
  Self-efficacy has important implications for health and functioning in people with limited mobility. However, the influence of self-efficacy on mobility in adults who use wheelchairs has yet to be investigated.
  
  
  OBJECTIVE
  The study objective was to: (1) estimate the direct association between wheelchair use self-efficacy and life-space mobility and (2) investigate an indirect effect through wheelchair skills.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  Participants (N=124) were adults who use a wheelchair, live in the community, and were 50 years of age and older (X̅=59.67, range=50-84), with at least 6 months of experience with manual wheelchair use; 60% were men. The 20-item Life-Space Assessment, the 65-item Wheelchair Use Confidence Scale, and the 32-item Wheelchair Skills Test-Questionnaire were used to measure life-space mobility, self-efficacy, and wheelchair skills, respectively.
  
  
  RESULTS
  Self-efficacy had a statistically significant association with life-space mobility (nonstandardized regression coefficient=0.23, 95% confidence interval=0.07, 0.39) after controlling for sex, number of comorbidities, geographic location, and assistance with using a wheelchair. This model accounted for 37.1% of the life-space mobility variance, and the unique contribution of self-efficacy was 3.5%. The indirect effect through wheelchair skills was also statistically significant (point estimate=0.21, 95% bootstrapped confidence interval=0.05, 0.43) and accounted for 91.3% of the direct effect of self-efficacy on life-space mobility. This model accounted for 39.2% of the life-space mobility variance.
  
  
  CONCLUSIONS
  Causality could not be established because of the study design. The self-report nature of data from volunteers may be influenced by recall bias, social desirability, or both.
  
  
  CONCLUSIONS
  Wheelchair use self-efficacy had both direct and indirect associations with life-space mobility after controlling for confounding variables. Interventions targeted toward improving self-efficacy may lead to improvements in life-space mobility.
authors.affiliation: B.M. Sakakibara, PhD, Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada, and Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Brodie M
authors.initials: BM
authors.lastname: Sakakibara
authors.affiliation: W.C. Miller, PhD, FCAOT, Graduate Program in Rehabilitation Sciences, University of British Columbia; Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute; Department of Occupational Science and Occupational Therapy, University of British Columbia, T-325 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada; and International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada. bill.miller@ubc.ca.
authors.forename: William C
authors.initials: WC
authors.lastname: Miller
authors.affiliation: J.J. Eng, PhD, BSc (PT/OT), Graduate Program in Rehabilitation Sciences, University of British Columbia; Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute; Department of Physical Therapy, University of British Columbia, British Columbia, Canada; and International Collaboration on Repair Discoveries.
authors.forename: Janice J
authors.initials: JJ
authors.lastname: Eng
authors.affiliation: C.L. Backman, PhD, FCAOT, Graduate Program in Rehabilitation Sciences, University of British Columbia, and Department of Occupational Science and Occupational Therapy, University of British Columbia.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Backman
authors.affiliation: F. Routhier, PEng, PhD, Department of Rehabilitation, Université Laval, Quebec City, Quebec, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Routhier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009043:Motor Activity; D012111:Residence Characteristics; D020377:Self Efficacy; D012959:Socioeconomic Factors; D014910:Wheelchairs