{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:14:14Z","timestamp":1792131254778,"version":"4.4.0"},"reference-count":56,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,12,7]],"date-time":"2017-12-07T00:00:00Z","timestamp":1512604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Swiss Paraplegic Foundation"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pressure ulcers (PUs) are a common and severe health condition in persons with spinal cord injury (SCI). Skin\u2010care strategies for PU prevention are usually provided during initial rehabilitation. However, individuals with SCI often do not perform these strategies continuously, especially after discharge. The influence of psychological factors such as general self\u2010efficacy (GSE) on the performance of PU prevention behavior has not yet been sufficiently explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate whether persons with greater levels of GSE are more likely to perform skin\u2010care strategies for PU prevention regularly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Nationwide cross\u2010sectional survey within the Swiss Spinal Cord Injury Cohort Study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Community setting, data collection between 2011 and 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A total of 456 subjects with a traumatic or nontraumatic SCI living in Switzerland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Associations between GSE and PU prevention behavior were analyzed by multivariate proportional odds regression models, including potential sociodemographic, lesion\u2010related, and lifestyle\u2010related confounders without and with interaction terms between GSE and potential effect modifiers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measurements<\/jats:title><jats:p>Self\u2010efficacy was assessed by the GSE scale comprising 10 items. PU preventive behavior was operationalized using 5 items of an adapted version of the Spinal Cord Injury Lifestyle scale. Both measurements were components of a self\u2010administered questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the regression model without interaction terms, GSE levels were not associated with skin\u2010care PU prevention. After we included interaction terms, the final model showed statistically significant associations between GSE and 3 skin\u2010care items with odds ratios ranging from 1.09 to 1.17 (all <jats:italic>P<\/jats:italic> &lt; .001). The slightly positive effect of GSE on PU prevention behavior was restricted to persons who sustained their SCI at a younger age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>GSE was generally not associated with skin\u2010care PU prevention behavior among persons with SCI in this study. In further research, it might be of interest to assess SCI\u2010specific concepts of self\u2010efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>III<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2017.11.017","type":"journal-article","created":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T17:22:15Z","timestamp":1512753735000},"page":"573-586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Self\u2010Efficacy and Pressure Ulcer Prevention After Spinal Cord Injury\u2014Results From a Nationwide Community Survey in Switzerland 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