Relationships Among Perceived Functional Capacity, Self-Efficacy, and Disability After Dysvascular Amputation
Relationships Among Perceived Functional Capacity, Self-Efficacy, and Disability After Dysvascular Amputation
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DOI：
10.1016/j.pmrj.2018.03.014
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发表时间：
2018-10-01
期刊：
影响因子：
2.1
通讯作者：
Christiansen, Cory L.
中科院分区：
文献类型：
--
作者：
Miller, Matthew J.;Magnusson, Dawn M.;Christiansen, Cory L.
背景资料：血管障碍性经胫骨截肢（TTA）后的假体康复侧重于优化功能能力，对促进健康自我效能的强调有限。自我效能干预可降低慢性病患者的残疾，但对于血管障碍性TTA患者，自我效能对残疾的影响尚不清楚。目的：确定自我效能是否介导血管障碍性TTA后自我报告的功能能力与残疾之间的关系。设计：横断面，二级数据分析。设置：门诊康复设施。参与者：38名男性（63.6 +/- 9.1岁）与dysvascular TTA.Methods：参与者已经生活了不到6个月的截肢，并使用步行作为他们的主要运动形式使用假肢。使用假体评价量表-活动度量表（PEQ-MS）测量自变量功能能力。结果：自我效能感部分介导了自我报告的功能能力与残疾之间的关系。WHODAS 2.0与PEQ-MS（r = -0.61）、WHODAS 2.0与SEMCD（r = -0.51）、PEQ-MS与SEMCD（r = 0.44）之间的相关性均显著（P <0.01）。控制SEMCD（P = 0.04），PEQ-MS和WHODAS 2.0之间的关系仍然显着（P <0.01）。统计学显着的调解确定的bootstrap方法的产品的系数（95%置信区间：-2.23，-7.39）。结论：本研究提供了初步证据，自我报告的功能能力和残疾之间的关系是部分介导的自我效能后血管病变TTA。自我效能的纵向效应应进一步研究，以确定血管离断性截肢后残疾的因果通路。此外，需要确定有助于自我报告的功能能力和残疾之间关系的其他因素。
Background: Prosthesis rehabilitation after dysvascular transtibial amputation (TTA) is focused on optimizing functional capacity with limited emphasis on promoting health self-efficacy. Self-efficacy interventions decrease disability for people living with chronic disease, but the influence of self-efficacy on disability is unknown for people with dysvascular TTA.Objectives: To identify if self-efficacy mediates the relationship between self-reported functional capacity and disability after dysvascular TTA.Design: Cross-sectional, secondary data analysis.Setting: Outpatient rehabilitation facilities.Participants: Thirty-eight men (63.6 +/- 9.1 years old) with dysvascular TTA.Methods: Participants had been living with an amputation for less than 6 months and using walking as their primary form of locomotion using a prosthesis. The independent variable, functional capacity, was measured using the Prosthesis Evaluation Questionnaire-Mobility Scale (PEQ-MS). The proposed mediator, self-efficacy, was measured with the Self-Efficacy of Managing Chronic Disease questionnaire (SEMCD).Main Outcome Measure: Disability was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaire.Results: The relationship between self-reported functional capacity and disability is partially mediated by self-efficacy. Relationships between WHODAS 2.0 and PEQ-MS (r = -0.61), WHODAS 2.0 and SEMCD (r = -0.51), and PEQ-MS and SEMCD (r = 0.44) were significant (P < .01). Controlling for SEMCD (P = .04), the relationship between PEQ-MS and WHODAS 2.0 remained significant (P < .01). Statistically significant mediation was determined by a bootstrap method for the product of coefficients (95% confidence interval: -2.23, -7.39).Conclusions: This study provides initial evidence that the relationship between self-reported functional capacity and disability is partially mediated by self-efficacy after dysvascular TTA. The longitudinal effect of self-efficacy should be further examined to identify causal pathways of disability after dysvascular amputation. Furthermore, additional factors contributing to the relationship between self-reported functional capacity and disability need to be identified.