Factors influencing self-care behaviors in persons with spinal cord injuries and disorders

Background: Individuals with spinal cord injury/disorder (SCI/D) must learn to adjust to and manage functional challenges after SCI/D onset. For these individuals, resilience (ie, the adaptive response to stressful events) may be related to their willingness and ability to conduct self-care behaviors. Objective: The study objectives were to examine the relationship between patientreported perceptions of independence in performing self-care behaviors and resilience among Veterans with SCI/D and to examine variables (including resilience) associated with high self-care scores (controlling for confounders). Methods: In this cross-sectional survey, we conducted bivariate analyses to examine differences in demographic, injury, and health characteristics and resilience scores for individuals with SCI/D. We conducted a multivariate block-design linear regression to examine factors associated with ability to perform self-care. Results: Level of injury (β = 7.74, P <.0001), resilience (β = 0.08, P =.0216), marital status (β = 1.75, P =.0445), and living arrangement (β = 4.37, P <.0001) were positively related to higher self-care behaviors. Completeness of injury (β =-2.79, P <.0001), age (β =-0.09, P =.0052), age at injury (β =-0.05, P =.0129), and number of comorbid health conditions (β =-0.72, P <.0001) showed negative relationships with higher self-care. Conclusions: Self-care ability is related to multiple factors, including resilience. The positive relationship between resilience and self-care suggests that greater resilience, independent of injury level/severity, may contribute to improved self-care behaviors in individuals with SCI/D. Other factors that showed a positive relationship with self-care included younger age, living alone, paraplegic level injury, and fewer health conditions. Understanding the profle of persons with SCI/D with regard to self-care behaviors is important to the development of tailored interventions to improve self-care.