Exploring self-efficacy – associations with secondary health conditions in the finnish spinal cord injury population: a national registry-based cross-sectional study

Study design Registry-based cross-sectional survey. Objectives To assess self-efficacy (SE) for managing symptoms and examine the association between SE and secondary health conditions (SHCs) among individuals with spinal cord injury (SCI) in Finland. Setting Three specialized SCI outpatient clinics providing lifelong follow-up care. Methods Data were drawn from the Finnish Spinal Cord Injury Study (FinSCI). Participants ( n = 884; response rate 50%) met the following criteria: age ≥16 years, ASIA Impairment Scale grades A–D. SE was measured using an adapted version of the PROMIS Short Form v1.0 – 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–SHC associations were analyzed using non-parametric tests and multivariable regression. Results Respondents (mean age 60.7 years; mean time since injury 11.4 years) had a mean SE score of 27.11 (T-score = 48.3; range, 5–35). 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 ≥16 years since injury. SE was inversely correlated with SHC burden (r = –0.421, p < 0.001), particularly with contractures, bowel dysfunction, and chronic pain. In multivariable analysis, SE remained independently associated with SHC burden (β = –0.507, 95% CI, –0.588 to –0.427, p < 0.001). Conclusions 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.