Self-efficacy and self-esteem as predictors of participation in spinal cord injury--an ICF-based study

STUDY DESIGN: A multi-centre cross-sectional study. OBJECTIVE: To examine the relationship of self-efficacy and self-esteem with participation of persons with spinal cord injury (SCI) from a comprehensive bio-psycho-social perspective, based on the conceptual framework of the International Classification of Functioning, Disability and Health (ICF). SETTING: Community-dwelling participants, <5 years post discharge, recruited through three SCI rehabilitation centers in Switzerland. METHODS: Data were collected by means of standardized self-report questionnaires sent to the eligible participants by postal mail. The questionnaires covered the different components of the ICF's bio-psycho-social model, namely health conditions, body functions, participation, environmental and personal factors. Bivariate correlations and multivariate linear regression analyses with participation as the dependent variable have been conducted. RESULTS: In all, 102 persons with SCI answered the survey, response rate 25.9%. Self-esteem (r=0.61) and self-efficacy (r=0.54) correlated highly with participation and were the strongest correlates of participation. They were stronger correlates of participation than symptoms of anxiety, depressive symptoms, pain, health conditions, social support, coping styles or sense of coherence. Participation seemed to be independent of gender, age, level or completeness of injury. Self-efficacy and self-esteem explained together with time since discharge and years of education 48% of the variance in participation adjusting for health condition, depressive symptoms, pain interference and social support. CONCLUSION: Considering self-efficacy and self-esteem within the comprehensive framework of the ICF can contribute to a better understanding of functioning, disability and health in SCI, which in turn may facilitate the development of interventions to support the persons' adjustment and reintegration

Biopsychosocial outcomes in individuals with and without spinal cord injury: a Swiss comparative study

STUDY DESIGN: Multicentre controlled study. OBJECTIVES: To investigate if individuals with and without spinal cord injury (SCI) differ in biopsychosocial variables according to the International Classification of Functioning, Disability and Health (ICF). SETTING: Participants were recruited through three major SCI rehabilitation centres in Switzerland. METHODS: A convenience sample of people with SCI (N=102) and a matched non-SCI sample (N=73) were compared according to secondary conditions, pain, depressive symptoms, participation, social support, self-efficacy, self-esteem, coping and sense of coherence. Difference tests and multivariate logistic regression analyses to predict the likelihood of group membership were calculated. RESULTS: People with SCI reported more health conditions, higher levels of anxiety and depressive symptoms, worse pain and pain interference, lower level of participation and social support, lower self-efficacy, self-esteem and task- and emotion-oriented coping. The two samples did not differ in satisfaction with social support, in use of avoidance-oriented coping and in sense of coherence. Health conditions, pain interference, participation and age were found to be significant predictors of the likelihood of group membership. In the logistic regression models, the number of health conditions, limitations due to health conditions, pain interference, participation, task-oriented coping and age are significant predictors of group membership, accounting for 55% of variation. CONCLUSION: Health conditions, pain interference and participation seemed to be the areas of biopsychosocial functioning that are substantially influenced by SCI. Potential buffering resources seem to be diminished in individuals with SCI. In rehabilitation practice, prevention of secondary conditions, treatment of pain, enhancement of participation and strengthening resources should be addressed

Developing core sets for patients with head and neck cancer based on the International Classification of Functioning, Disability and Health (ICF)

Problems in functioning are frequently seen in survivors of head and neck cancer (HNC) and proof to have increasing impact on their quality of life. With the approval of the International Classification of Functioning, Disability and Health (ICF) by the World Health Assembly in May 2001, we can now rely on a globally accepted framework and classification system based on a bio-psycho-social mode to assess and compare functional outcome. To make the ICF-classification with more than 1.400 categories applicable to every-day clinical practice, ICF core sets are established. The objective of this paper is to outline the proposed development process for the ICF core set for HNC and to invite international experts to participate in this process. The ICF core set will be defined at a Consensus conference, which will integrate evidence from preparatory studies, namely: (a) a systematic literature review regarding the outcome measures of clinical trails and observational studies, (b) semi-structured patient interviews, (c) international experts participating in a internet-based survey and (d) cross-sectional, multi-center studies for clinical applicability. To validate the ICF core set field-testing will follow. The ICF provides useful standards of clinical rehabilitation practice, research and teaching. Its application stimulates comparability of outcome parameters, eventually improving understanding of functioning and disability. The ICF can function as a new language, simplifying communication and cooperation between various professional backgrounds and between health professionals and their patients eventually leading to a more effective and economic rehabilitation. The ICF core set for HNC is designed to translate the benefits of the ICF into clinical routine. The development of ICF core sets is an inclusive and open process. Anyone who wishes to actively participate is invited to contact the project coordinator ([email protected]). Individuals, institutions and associations can be formally associated as partners of the project