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Participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009884; response rate 50%) met the following criteria: age \u226516 years, ASIA Impairment Scale grades A\u2013D. SE was measured using an adapted version of the PROMIS Short Form v1.0 \u2013 Self-Efficacy for Managing Symptoms 8a; SHCs were assessed with the Spinal Cord Injury Secondary Condition Scale (SCI-SCS). T-scores were calculated via the HealthMeasures Scoring Service. Group differences and SE\u2013SHC associations were analyzed using non-parametric tests and multivariable regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Respondents (mean age 60.7 years; mean time since injury 11.4 years) had a mean SE score of 27.11 (T-score\u2009=\u200948.3; range, 5\u201335). Highest confidence was reported in managing symptoms at home and during personal care; lowest in work-related tasks and information-seeking. SE was higher among participants aged 31 to 45 years and those with \u226516 years since injury. SE was inversely correlated with SHC burden (r\u2009=\u2009\u20130.421,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), particularly with contractures, bowel dysfunction, and chronic pain. In multivariable analysis, SE remained independently associated with SHC burden (\u03b2\u2009=\u2009\u20130.507, 95% CI, \u20130.588 to \u20130.427,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>As SE was associated with SHCs, interventions to strengthen SE could be explored in future studies, but causal relationships cannot be inferred from the present cross-sectional data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41393-026-01246-6","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:33:30Z","timestamp":1792085610000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring self-efficacy \u2013 associations with secondary health conditions in the finnish spinal cord injury population: a national registry-based cross-sectional study"],"prefix":"10.1038","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8059-3423","authenticated-orcid":false,"given":"Vesa-Matti","family":"Kuittinen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eerika","family":"Koskinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Arokoski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7802-5505","authenticated-orcid":false,"given":"Susanna","family":"Tallqvist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1590-2747","authenticated-orcid":false,"given":"Anni","family":"T\u00e4ckman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aki","family":"Vainionp\u00e4\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4087-6889","authenticated-orcid":false,"given":"Markku","family":"Kankaanp\u00e4\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7069-6643","authenticated-orcid":false,"given":"Sinikka","family":"Hiekkala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"1246_CR1","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.3390\/jpm12071178","volume":"12","author":"MA Budd","year":"2022","unstructured":"Budd MA, Gater DR, Channell I. 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