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The Influence of Self-care Agency and Social Support on Self-care Practice among Spinal Cord Injured Patients

Soyoung Choi, MSN, RN1, Il Sun Ko, RN, Ph.D.2
Korean Journal of Adult Nursing 2017;29(6):569-578.
Published online: December 18, 2017

1College of Nursing, Pennsylvania State University, University Park, PA, USA

2College of Nursing, Yonsei University, Seoul, Korea

Corresponding author: Ko, Il Sun College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3255, Fax: +82-2-392-5440, E-mail: isko16@yuhs.ac
This manuscript is based on a part of the first author's master's thesis from the Yonsei University.
• Received: July 11, 2017   • Accepted: December 1, 2017

© 2017 Korean Society of Adult Nursing

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to identify how self-care agency and social support influence self-care prac-tices among spinal cord injured patients.
  • Methods
    106 spinal cord injured patients were recruited from April 12 to May 28, 2016. Structured questionnaires used were the Korean version of the Appraisal of the Self-Care Agency Scale Revised (ASAS-R), the Social Support Scale, and the Spinal Cord Injury Lifestyle Scale (SCILS). Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlations, and Stepwise multiple re-gression analysis with the SPSS/WIN 23.0 program.
  • Results
    Self-care practices had a significant association with self-care agency (β=.30, p=.002), social support (β=.24, p=.010), and monthly income (β=.18, p=.038). A total of 21.5% of the variance explained the self-care practice among spinal cord injured patients and was explained by self-care agency, social support, and monthly income. The self-care agency was the factor most influential on self-care practices among spinal cord injured patients explaining 15.4% of variance.
  • Conclusion
    The result sug-gests that developing strategies enhance spinal cord injured patients’ self-care agency and self-care practices.
  • Key Words: Spinal cord injuries; Self care; Social support
Table 1.
Difference of the Self-care Practice by Characteristics of Participants (N=106)
Variable Categories n (%) M± SD t or F (p)
Age (year) 20~29 9 (8.5) 54.00±6.48 0.36 (.780)
30~39 34 (32.1) 51.03±12.30  
40~49 35 (33.0) 53.34±11.03  
≥50 28 (26.4) 50.96±12.05  
Gender Male 83 (78.3) 52.28±12.51 0.40 (.688)
Female 23 (21.7) 51.13±10.44  
Education level ≤ Junior high school 12 (11.3) 52.33±13.41 0.46 (.636)
High school 43 (40.6) 50.70±13.13  
≥ College 51 (48.1) 53.08±10.86  
Spouse Yes 47 (44.3) 54.33±13.17 2.17 (.032)
No 59 (55.7) 49.80±10.68  
Religion Yes 58 (54.7) 52.84±11.30 2.17 (.052)
No 48 (45.3) 51.04±12.95  
Monthly household income (10,000 won/month)† ＜100 a 39 (36.8) 47.18±11.78 5.41 (.006)
100~＜300 b 41 (38.7) 54.85±9.85 b, c＞ a
300 c 26 (24.5) 54.85±13.64  
Duration of being injured (year) ＜10 33 (31.1) 52.79±14.55 0.17 (.844)
10~＜20 34 (32.1) 51.09±12.65  
≥20 39 (36.8) 52.21±9.10  
Regular health checkups Yes 56 (52.8) 54.55±11.47 2.33 (.022)
No 50 (47.2) 49.20±12.17  
Perceived health status Good 18 (17.0) 54.67±14.99 1.67 (.193)
Fair 52 (49.0) 53.10±8.80  
Bad 36 (34.0) 49.17±14.15  
Smoking Yes 33 (31.3) 51.52±12.17 -0.29 (.770)
No 73 (68.7) 52.26±12.08  
Drinking Yes 68 (64.2) 52.06±11.73 0.04 (.972)
No 38 (35.8) 51.97±12.79  
Level of injury‡ Cervical 38 (38.8) 53.53±12.41 1.42 (.246)
Thoracic 48 (49.0) 53.40±11.42  
Lumbar 12 (12.2) 47.33±11.10  

†Scheffé test;

‡Excluded no response.

Table 2.
Descriptive Statistics of Participants' Self-care Agency, Social Support and Self-care Practice (N=106)
Variables Items Min Max M± SD Average M± SD
Self-care agency 15 32 70 50.87±6.83 3.39±0.46
Social support 24 27 120 83.86±15.11 3.49±0.63
Family support 12 14 60 46.66±9.00 3.89±0.75
Medical staff support 12 14 60 37.20±9.91 3.10±0.83
Self-care practices 25 16 87 52.03±12.05 2.07±0.48
Cardiovascular 4 0 14 6.58±2.94 1.64±0.74
Genitourinary 4 2 15 8.38±2.73 2.09±0.68
Neuromusculoskeletal 8 2 32 14.77±5.28 1.85±0.66
Skin 7 1 27 16.40±4.93 2.34±0.70
Psychosocial 2 0 8 5.91±1.99 2.95±0.99
Table 3.
Self-care Practices Assessment Scores of Participants (N=106)
Categories Item M± SD
Cardiovascular I monitor my blood pressure regularly 2.03±1.67
I attempt to reduce my heart disease risk factors 1.57±1.27
I avoid smoking 1.56±1.33
I eat limited amounts of fat and cholesterol 1.42±1.20
Genitourinary I change my catheters as often as recommended 2.28±1.36
I use an intermittent catheterization and stick to the recommended schedule 2.18±1.59
I have episodes of bladder incontinence 2.05±1.57
I use suppository for my regular bowel movement 1.87±1.44
Neuromusculoskeletal If I notice the beginning of a contracture, I would know exactly what to do. 2.52±1.17
I pay attention to my body position while sitting in a wheelchair. 2.25±1.28
I exercise to put weights on my leg bones for increasing bone density about 3 times a week 2.06±1.39
I pay attention to my body position while sleeping 2.06±1.24
I perform range of motion daily for joint flexibility 1.73±1.31
Muscle strengthening exercises are monitored by a therapist at least once a year 1.37±1.13
I rest my shoulder joints when I feel pain from overusing 1.36±1.25
I perform muscle strengthening exercise at least 3 times a week 1.16±1.28
Skin I am knowledgeable of my wheelchair condition and time for repair 3.06±1.15
I am careful with handling of hot liquids by not carrying them in my lap 2.92±1.28
I am aware of the condition of wheelchair cushion 2.75±1.22
I am careful with transfers so that my legs, feet, or buttocks are not injured 2.62±1.55
I check my skin for redness or breakdown 2.33±1.27
I wear something on my feet when out of bed 2.08±1.57
I relieve pressure every 30 minutes while sitting in chair or driving 0.63±1.21
Psychosocial I am able to get around in my house 2.99±1.15
  I am with or talk to others at least once a day 2.92±1.16
Table 4.
Pearson Correlations among Self-care Agency, Social Support, and Self-care Practices (N=106)
Variables Self-care agency Social support -total Social support -family Social support -medical staff
r (p) r (p) r (p) r (p)
Social support-total .36 (＜.001)      
Social support-family .33 (.001) .78 (＜.001)    
Social support-medical staff .25 (.011) .82 (＜.001) .28 (.004)  
Self-care practices .40 (＜.001) .34 (＜.001) .31 (.001) .24 (.015)
Table 5.
Influencing Factors on Self-care Practices
Variables B SE β t R2 Δ R2 p
(Constant) 6.92 8.49   0.82     .420
Self-care agency 0.53 0.17 .30 3.23 .15 .15 .002
Social support 0.20 0.07 .24 2.62 .19 .04 .010
Monthly household income: 100~＜300(10,000 won/month) 4.53 2.15 .18 2.11 .22 .03 .040
  F=10.61, p＜.001
  • 1.Korean Spinal Cord Society (KoSCoS). Disease information [Internet]. Seoul: Korean Spinal Cord Society; [cited 2016 May 10]. Available from.http://www.koscos.kr/sub/sub0401.php.
  • 2.Sezer N, Akkus S, Ugurlu FG. Chronic complications of spinal cord injury. World Journal of Orthopedics.. 2015;6(1):24-33. https://doi.org/10.5312/wjo.v6.i1.24.
  • 3.Hong HS, Lee HY, Cheon MK, Gong HS, Song SE, Lee KD, et alA study on prevention and management plan for chronic diseases of the disabled. Study Report. Seoul: National Reha-bilitation Center; 2012 April. Report No.: 11-1352367-000034-01..
  • 4.Kim JH, Hwang KY, Park JH. Relationship of anger and men-tal health for spinal cord injuries. The Korean Journal of Reha-bilitation Psychology.. 2012;19(2):209-26.
  • 5.Lala D, Dumont FS, Leblond J, Houghton PE, Noreau L. Impact of pressure ulcers on individuals living with a spinal cord injury. Archives of Physical Medicine and Rehabilitation.. 2014;95(12):2312-9. https://doi.org/10.1016/j.apmr.2014.08.003.
  • 6.Jung SJ, Leigh JH, Shin HI. Alcohol use in community-dwelling persons with spinal cord injury. Journal of Korean Acad-emy of Rehabilitation Medicine.. 2010;34(4):424-31.
  • 7.Orem DENursing: concepts of practice. 6th ed.. St. Louis: Mos-by Year Book; 2001. p. 253-287.
  • 8.Bae JM, Shim MS. A study on self-care agency and quality of life in patients with heart valve surgery. Journal of the Korea Academia-Industrial cooperation Society.. 2011;12(9):3975-83. https://doi.org/10.5762/KAIS.2011.12.9.3975.
  • 9.Kim HKRelationship of self-care agency and educational needs in lung cancer patients with pulmonary resection [master's thesis]. Seoul: Yonsei University; 2012. p. 1-80.
  • 10.Gharaibeh B, Gajewski BJ, Al-smadi A, Boyle DK. The relation-ships among depression, self-care agency, self-efficacy and dia-betes self-care management. Journal of Research in Nursing.. 2016;21(2):110-22. https://doi.org/10.1177/1744987115621782.
  • 11.Sutton BS, Ottomanelli L, Njoh E, Barnett SD, Goetz LL. The impact of social support at home on health-related quality of life among veterans with spinal cord injury participating in a supported employment program. Quality of Life Research.. 2015;24(7):1741-7. https://doi.org/10.1007/s11136-014-0912-4.
  • 12.Tramonti F, Gerini A, Stampacchia G. Relationship quality and perceived social support in persons with spinal cord injury. Spinal Cord.. 2015;53(2):120-4. https://doi.org/10.1038/sc.2014.229.
  • 13.Munce SE, Webster F, Fehlings MG, Straus SE, Jang E, Jaglal SB. Meaning of self-management from the perspective of individuals with traumatic spinal cord injury, their caregivers, and acute care and rehabilitation managers: an opportunity for improved care delivery. BMC Neurology.. 2016;16(1):1-9. https://doi.org/10.1186/s12883-016-0534-2.
  • 14.Stiens SA, Fawber HL, Yuhas SA. The person with a spinal cord injury: an evolving prototype for life care planning. Physical Medicine and Rehabilitation Clinics of North America.. 2013;24(3):419-44. https://doi.org/10.1016/j.pmr.2013.03.006.
  • 15.Kwak NH, Chang KY, Ahn KH, Woo HS. Study on the application of ICF-based SPG case-management frame with a focus on SCI. The Journal of Korean Society of Occupational Therapy.. 2012;20(4):95-110.
  • 16.Kwak SK, Song YE, Kim BW, Kim CW, Kang EB. The effect of 8 weeks sling exercise program on upper limb muscle strength CUE and SCIM III in spinal cord injury patients. The Korea Journal of Sport.. 2014;12(4):415-26.
  • 17.Evers GC, Isenberg MA, Philipsen H, Brouns G, Halfens R, Smeets H. The appraisal of self-care agency's ASA-Scale: re-search program to test reliability and validity. Paper session presented at: The International Nursing Research Conference "New Frontiers in Nursing Research"; 1986;University of Al-berta, Canada..
  • 18.Sousa VD, Zauszniewski JA, Bergguist-Beringer S, Musil CM, Neese JB, Jaber AF. Reliability, validity and factors structure of the Appraisal of Self-Care Agency Scale Revised (ASAS-R). Journal of Evaluation in Clinical Practice.. 2010;16(6):1031-40. https://doi.org/10.1111/j.1365-2753.2009.01242.x.
  • 19.Kim OSA study on the correlation between perceived social support and the quality of life of hemodialysis patients[master's thesis]. Seoul:. Seoul National University; 1993. p. 1-73.
  • 20.Pruitt SD, Wahlgren DR, Epping-Jordan JE, Rossi AL. Health behavior in persons with spinal cord injury: development and initial validation of an outcome measure. Spinal Cord.. 1998;36:724-31. https://doi.org/10.1038/sj.sc.3100649.
  • 21.Khazaeipour Z, Ahmadipour E, Rahimi-Movaghar V, Ahma-dipour F, Vaccaro AR, Babakhani B. Association of pain, social support and socioeconomic indicators in patients with spinal cord injury in Iran. Spinal Cord.. 2017;55(2):180-6. https://doi.org/10.1038/sc.2016.160.
  • 22.Ghaisas S, Pyatak EA, Blanche E, Blanchard J, Clark F. Lifestyle changes and pressure ulcer prevention in adults with spinal cord injury in the pressure ulcer prevention study lifestyle in-tervention. The American Journal of Occupational Therapy.. 2015;69(1):1-10. https://doi.org/10.5014/ajot.2015.012021.
  • 23.Liu LQ, Moody J, Traynor M, Dyson S, Gall A. A systematic re-view of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries. The Journal of Spinal Cord Medicine.. 2014;37(6):703-18. https://doi.org/10.1179/2045772314y.0000000226.
  • 24.de Groot S, Post MW, Snoek GJ, Schuitemaker M, van der Woude LH. Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury. Spinal Cord.. 2013;51(4):314-8. https://doi.org/10.1038/sc.2012.153.
  • 25.Orem DE, Renpenning KM, Taylor SGSelf care theory in nursing: selected papers of Dorothea Orem. New York: Springer; 2013.
  • 26.Rintala DH. Predictive validity of social support relative to psychological well-being in men with spinal cord injury. Reha-bilitation Psychology.. 2013;58(4):422-8. https://doi.org/10.1037/a0034357.
  • 27.Kim AL. An explanatory model for patient adherence of rehabilitation in patients with spinal cord injury. Korean Journal of Adult Nursing.. 2010;22(1):90-102.

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    The Influence of Self-care Agency and Social Support on Self-care Practice among Spinal Cord Injured Patients
    Korean J Adult Nurs. 2017;29(6):569-578.   Published online December 31, 2017
    DOI: https://doi.org/10.7475/kjan.2017.29.6.569
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    The Influence of Self-care Agency and Social Support on Self-care Practice among Spinal Cord Injured Patients
    Korean J Adult Nurs. 2017;29(6):569-578.   Published online December 31, 2017
    DOI: https://doi.org/10.7475/kjan.2017.29.6.569
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    The Influence of Self-care Agency and Social Support on Self-care Practice among Spinal Cord Injured Patients
    The Influence of Self-care Agency and Social Support on Self-care Practice among Spinal Cord Injured Patients

    Difference of the Self-care Practice by Characteristics of Participants (N=106)

    Variable Categories n (%) M± SD t or F (p)
    Age (year) 20~29 9 (8.5) 54.00±6.48 0.36 (.780)
    30~39 34 (32.1) 51.03±12.30  
    40~49 35 (33.0) 53.34±11.03  
    ≥50 28 (26.4) 50.96±12.05  
    Gender Male 83 (78.3) 52.28±12.51 0.40 (.688)
    Female 23 (21.7) 51.13±10.44  
    Education level ≤ Junior high school 12 (11.3) 52.33±13.41 0.46 (.636)
    High school 43 (40.6) 50.70±13.13  
    ≥ College 51 (48.1) 53.08±10.86  
    Spouse Yes 47 (44.3) 54.33±13.17 2.17 (.032)
    No 59 (55.7) 49.80±10.68  
    Religion Yes 58 (54.7) 52.84±11.30 2.17 (.052)
    No 48 (45.3) 51.04±12.95  
    Monthly household income (10,000 won/month)† ＜100 a 39 (36.8) 47.18±11.78 5.41 (.006)
    100~＜300 b 41 (38.7) 54.85±9.85 b, c＞ a
    300 c 26 (24.5) 54.85±13.64  
    Duration of being injured (year) ＜10 33 (31.1) 52.79±14.55 0.17 (.844)
    10~＜20 34 (32.1) 51.09±12.65  
    ≥20 39 (36.8) 52.21±9.10  
    Regular health checkups Yes 56 (52.8) 54.55±11.47 2.33 (.022)
    No 50 (47.2) 49.20±12.17  
    Perceived health status Good 18 (17.0) 54.67±14.99 1.67 (.193)
    Fair 52 (49.0) 53.10±8.80  
    Bad 36 (34.0) 49.17±14.15  
    Smoking Yes 33 (31.3) 51.52±12.17 -0.29 (.770)
    No 73 (68.7) 52.26±12.08  
    Drinking Yes 68 (64.2) 52.06±11.73 0.04 (.972)
    No 38 (35.8) 51.97±12.79  
    Level of injury‡ Cervical 38 (38.8) 53.53±12.41 1.42 (.246)
    Thoracic 48 (49.0) 53.40±11.42  
    Lumbar 12 (12.2) 47.33±11.10  

    †Scheffé test;

    ‡Excluded no response.

    Descriptive Statistics of Participants' Self-care Agency, Social Support and Self-care Practice (N=106)

    Variables Items Min Max M± SD Average M± SD
    Self-care agency 15 32 70 50.87±6.83 3.39±0.46
    Social support 24 27 120 83.86±15.11 3.49±0.63
    Family support 12 14 60 46.66±9.00 3.89±0.75
    Medical staff support 12 14 60 37.20±9.91 3.10±0.83
    Self-care practices 25 16 87 52.03±12.05 2.07±0.48
    Cardiovascular 4 0 14 6.58±2.94 1.64±0.74
    Genitourinary 4 2 15 8.38±2.73 2.09±0.68
    Neuromusculoskeletal 8 2 32 14.77±5.28 1.85±0.66
    Skin 7 1 27 16.40±4.93 2.34±0.70
    Psychosocial 2 0 8 5.91±1.99 2.95±0.99

    Self-care Practices Assessment Scores of Participants (N=106)

    Categories Item M± SD
    Cardiovascular I monitor my blood pressure regularly 2.03±1.67
    I attempt to reduce my heart disease risk factors 1.57±1.27
    I avoid smoking 1.56±1.33
    I eat limited amounts of fat and cholesterol 1.42±1.20
    Genitourinary I change my catheters as often as recommended 2.28±1.36
    I use an intermittent catheterization and stick to the recommended schedule 2.18±1.59
    I have episodes of bladder incontinence 2.05±1.57
    I use suppository for my regular bowel movement 1.87±1.44
    Neuromusculoskeletal If I notice the beginning of a contracture, I would know exactly what to do. 2.52±1.17
    I pay attention to my body position while sitting in a wheelchair. 2.25±1.28
    I exercise to put weights on my leg bones for increasing bone density about 3 times a week 2.06±1.39
    I pay attention to my body position while sleeping 2.06±1.24
    I perform range of motion daily for joint flexibility 1.73±1.31
    Muscle strengthening exercises are monitored by a therapist at least once a year 1.37±1.13
    I rest my shoulder joints when I feel pain from overusing 1.36±1.25
    I perform muscle strengthening exercise at least 3 times a week 1.16±1.28
    Skin I am knowledgeable of my wheelchair condition and time for repair 3.06±1.15
    I am careful with handling of hot liquids by not carrying them in my lap 2.92±1.28
    I am aware of the condition of wheelchair cushion 2.75±1.22
    I am careful with transfers so that my legs, feet, or buttocks are not injured 2.62±1.55
    I check my skin for redness or breakdown 2.33±1.27
    I wear something on my feet when out of bed 2.08±1.57
    I relieve pressure every 30 minutes while sitting in chair or driving 0.63±1.21
    Psychosocial I am able to get around in my house 2.99±1.15
      I am with or talk to others at least once a day 2.92±1.16

    Pearson Correlations among Self-care Agency, Social Support, and Self-care Practices (N=106)

    Variables Self-care agency Social support -total Social support -family Social support -medical staff
    r (p) r (p) r (p) r (p)
    Social support-total .36 (＜.001)      
    Social support-family .33 (.001) .78 (＜.001)    
    Social support-medical staff .25 (.011) .82 (＜.001) .28 (.004)  
    Self-care practices .40 (＜.001) .34 (＜.001) .31 (.001) .24 (.015)

    Influencing Factors on Self-care Practices

    Variables B SE β t R2 Δ R2 p
    (Constant) 6.92 8.49   0.82     .420
    Self-care agency 0.53 0.17 .30 3.23 .15 .15 .002
    Social support 0.20 0.07 .24 2.62 .19 .04 .010
    Monthly household income: 100~＜300(10,000 won/month) 4.53 2.15 .18 2.11 .22 .03 .040
      F=10.61, p＜.001
    Table 1. Difference of the Self-care Practice by Characteristics of Participants (N=106)

    Scheffé test;

    Excluded no response.

    Table 2. Descriptive Statistics of Participants' Self-care Agency, Social Support and Self-care Practice (N=106)

    Table 3. Self-care Practices Assessment Scores of Participants (N=106)

    Table 4. Pearson Correlations among Self-care Agency, Social Support, and Self-care Practices (N=106)

    Table 5. Influencing Factors on Self-care Practices

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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