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Choi and Ko: The Influence of Self-care Agency and Social Support on Self-care Practice among Spinal Cord Injured Patients
Original Research

Korean J Adult Nurs 2017;29(6):569-578.

Published online: 18 December 2017

DOI: https://doi.org/10.7469/KJAN.2017.29.6.569

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,

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 11 July 20177 September 2017       Accepted 1 December 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.

Abstract

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.

Keywords: Spinal cord injuries, Self care, Social support

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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
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