Associations between self-efficacy and secondary health conditions in people living with spinal cord injury: a systematic review and meta-analysis

Publication date: Available online 26 April 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Tijn van Diemen, Tim Crul, Ilse van Nes, Jan H.B. Geertzen, Marcel W.M. Post
ObjectiveTo describe the association between self-efficacy and secondary health conditions in people living with spinal cord injury.Data sourcesPubMed, Embase, the Cochrane library and CINAHL were systematically searched from database inception to September 2016.Study selectionStudies describing patients living with spinal cord injury in which self-efficacy was measured by a standardized questionnaire and an association was made with somatic or psychological secondary health conditions.Data extractionAn independent extraction by multiple observers was performed based on the STROBE statements checklist. A meta-analysis concerning the association between self-efficacy and secondary health conditions in people with spinal cord injury was performed if a minimum of 4 comparable studies were available.Data synthesisOut of 670 unique articles screened, 22 met the inclusion criteria. Seven out of these 22 studies investigated associations between self-efficacy and somatic secondary health conditions. Only a trend towards an association between higher self-efficacy with less pain, fatigue, number of secondary health conditions and limitations caused by secondary health conditions was found. Twenty-one studies described the association between self-efficacy and psychological secondary health conditions. All correlations of higher self-efficacy with fewer depressive (18) and anxiety symptoms (7) were significant and meta-analysis showed a strong negative correlation of -0.536 (-0.584 to -0.484) and -0.493 (-0.577 to -0.399) respectively. A small number of studies (2) showed a trend towards a positive correlation between self-efficacy and quality of life.ConclusionSelf-efficacy is negatively associated with depressive and anxiety symptoms in spinal cord injury. Therefore self-efficacy seems an important target in the rehabilitation of patients living with spinal cord injury. More research is necessary to clarify the associations between self-efficacy and somatic secondary health conditions. Future research should also focus on different types of self-efficacy and their association with secondary health conditions.



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