Brief report
Prevalence of Low Mobility and Self-Management Self-Efficacy in Manual Wheelchair Users and the Association With Wheelchair Skills

https://doi.org/10.1016/j.apmr.2015.03.002Get rights and content

Highlights

  • The prevalence of low wheelchair-mobility self-efficacy was 28.5%.

  • The prevalence of low self-management self-efficacy was 11.4%.

  • The association with wheelchair skills was .70 (mobility) and .39 (self-management).

  • Of the sample, 16% had discordant mobility self-efficacy and wheelchair skills.

  • Of the sample, 30% had discordant self-management self-efficacy and wheelchair skills.

Abstract

Objective

To estimate the prevalence of low wheelchair-mobility and self-management self-efficacy and to evaluate the association with wheelchair skills.

Design

Cross-sectional.

Setting

Community.

Participants

Community-dwelling manual wheelchair users (N=123) who were ≥50 years of age (mean, 59.7±7.5y) and from British Columbia and Quebec, Canada.

Interventions

None.

Main Outcome Measures

The 13-item mobility and 8-item self-management subscales from the Wheelchair Use Confidence Scale–Short Form (standardized scores range, 0–100) measured self-efficacy, and the 32-item Wheelchair Skills Test, Questionnaire Version (scores range, 0–100) measured wheelchair skills. A score of 50 was used to differentiate individuals with high and low self-efficacy, and a score of 72 differentiated between high and low wheelchair skills.

Results

The prevalence of low wheelchair-mobility and self-management self-efficacy was 28.5% (95% confidence interval [CI], 20.6–36.4) and 11.4% (95% CI, 5.8–17.0), respectively, and their bivariate association with wheelchair skills was r=.70 and r=.39, respectively. Of the sample, 16% reported conflicting mobility self-efficacy and skill scores; 25% reported low self-efficacy and high skills. Of the participants, 30% reported conflicting scores between self-management self-efficacy and wheelchair skills, with 8.1% reporting lower self-efficacy than skill.

Conclusions

Low self-efficacy was relatively high in this sample as was its discordance with wheelchair skills. Interventions to address low self-efficacy and/or offset the discordant self-efficacy/skill profiles are warranted.

Section snippets

Study design and participants

This is a secondary analysis of cross-sectional data from community-dwelling volunteers from British Columbia and Quebec, Canada, who were aged ≥50 years, had at least 6 months of experience with manual wheelchair use on a daily basis, and were able to communicate in either English or French.4 Individuals with a Mini-Mental State Examination score <23 and/or those who were not medically stable were excluded from study. Rehabilitation therapists from various health authorities in British

Results

The mean age of this sample (N=123) of experienced wheelchair users was 59.7±7.5 years; 74 participants (60.2%) were men. Of the participants, 59 (48%) had a spinal cord injury. Sample characteristics are detailed in table 1.

The prevalence of low wheelchair-mobility and self-management self-efficacy (figs 1A,B, quadrants 3 and 4) was 28.5% (95% CI, 20.6–36.4) and 11.4% (95% CI, 5.8–17.0), respectively.

The bivariate association between the wheelchair-mobility self-efficacy and wheelchair skills

Discussion

Approximately 25% of wheelchair users reported both low wheelchair-mobility self-efficacy and wheelchair skills and therefore are at risk for low mobility and low participation frequency.4, 5 Although these individuals may benefit from efficacy and/or skill intervention, it is important for clinicians to be cautious when prescribing treatment because those individuals who may appear to be in greatest need of efficacy enhancements may first require development of their wheelchair skills, and

Conclusions

Prevalence of low self-efficacy is high and in 16.3% to 30% of cases does not match well with level of skill. Both self-efficacy and skills have important implications on rehabilitation outcomes; therefore, research on interventions to improve low mobility self-efficacy and/or offset the discordant mobility self-efficacy skill profile is warranted.

References (10)

There are more references available in the full text version of this article.

Cited by (13)

  • Effect of an mHealth Wheelchair Skills Training Program for Older Adults: A Feasibility Randomized Controlled Trial

    2019, Archives of Physical Medicine and Rehabilitation
    Citation Excerpt :

    Self-efficacy, or confidence, for wheelchair use is a key construct determining MWC mobility patterns.19 Low self-efficacy is particularly prevalent among older MWC users20 and is modifiable through skills training.21 The Wheelchair Use Confidence Scale for Manual Wheelchair Users (WheelCon-M 3.0) asks respondents to rate their self-efficacy on 65 items, producing a composite score from 0 (“not confident”) to 100 (“completely confident”).21

  • Influence of Peer-led Wheelchair Training on Wheelchair Skills and Participation in Older Adults: Clinical Outcomes of a Randomized Controlled Feasibility Trial

    2019, Archives of Physical Medicine and Rehabilitation
    Citation Excerpt :

    First, the intervention group comprised 39% men compared to 77% in the control group. There is some evidence to suggest that females require more time to learn wheelchair skills and may experience lower wheelchair use self-efficacy,16,49 which may explain why the intervention group had lower wheelchair skills and self-efficacy at T1. Furthermore, participants in the control group (who were predominantly men) may have been influenced through measurement of objective wheelchair skills.

  • Rasch Analyses of the Wheelchair Use Confidence Scale for Power Wheelchair Users

    2018, Archives of Physical Medicine and Rehabilitation
View all citing articles on Scopus

Supported by the Canadian Institutes of Health Research with a postdoctoral fellowship and grant (grant no. CIHR IAP-107848).

Disclosures: none.

View full text