In a cross-sectional study of spinal cord injury, Middleton and coworkers looked at the interaction between quality of life in people with spinal cord injury (SCI) and self-efficacy and pain. The home survey included 106 persons with SCI of 12 months or more in duration who lived in the community and who had enrolled from past admission lists in a rehabilitation unit. Participants were asked to complete two questionnaires, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Moorong Self-Efficacy Scale, by postal survey in their post-rehabilitation stage. Persons with SCI were found to have lowered quality of life (QOL) compared with the general population. Low self-efficacy and pain intensity were found to reduce QOL across all SF-36 domains even further. Factors such as completeness of lesion, sex, age at time of injury, and time since injury were not associated with reduced QOL. Tetraplegia was associated with lower QOL in physical functioning and greater limitation due to bodily pain. A combination of low self-efficacy and pain intensity was associated with an increased reduction in QOL compared with reductions seen for these factors by themselves.

VALUE OF STUDY TO READER: The authors concluded that rehabilitation strategies must concentrate on improving QOL by targeting factors like low self-efficacy. Self-efficacy, however, can only occur by patients acquiring competency at performing self-management skills required to control SCI. This performance, over time, could increase self-efficacy.

J Middleton et al. Relationship between quality of life and self-efficacy in persons with spinal cord injuries. Archives of Physical & Medical Rehabilitation, 2007;88:1643-1648.