Predictors of activation among persons with spinal cord injury during hospitalization: A cross-sectional study

To test the contributions of self-efficacy, resilience, social support, and negative moods (i.e., anxiety, depression) to patient activation among persons with spinal cord injury (SCI).

One hundred and twenty-two participants with SCI were recruited from the spinal surgery department at a large general hospital. During the period before discharge after surgery, standardized self-assessment questionnaires were used to collect data on patient activation, self-efficacy, resilience, social support, anxiety, depression, demographics (age, gender, education, marital status), and disease-related information (etiologies, level of injury, American Spinal Injury Association Impairment Scale score). Hierarchical regression analysis, mediation analysis, and moderation analysis were performed in SPSS, Amos, and Jamovi to determine the influencing factors of patient activation.

Self-efficacy, resilience, social support, anxiety, and depression uniquely explained 38.2% (p < .001) of the variance in patient activation after controlling for demographic and disease-related covariates. The full model explained 53.7% (p < .001) of the variance in patient activation. In the mediation analysis, self-efficacy, resilience, and social support had partial mediating effects (p < .05). In the moderation analysis, marital status moderated the relationship between self-efficacy and patient activation (p < .05).

Activation of persons with SCI is a positive psychosocial resource related to higher self-efficacy, resilience, and social support. Marital status may affect activation in persons with SCI. The causal relationship between these psychosocial variables needs to be proved by further intervention studies.