Article

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. 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. DESIGN: 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 (X=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. LIMITATIONS:
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.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS