Evaluation of a self-efficacy enhancement program to prevent pressure ulcers in patients with a spinal cord injury

Aim: This study developed a self-efficacy enhancement program and evaluated its effects on the self-care behaviors, self-care knowledge, and self-efficacy regarding pressure ulcer prevention in patients with a spinal cord injury. Methods: This was a multicenter randomized controlled trial. Six hospitals were invited to recruit patients with a spinal cord injury who were undergoing rehabilitation after receiving acute treatment. These hospitals were randomly allocated into experimental (three hospitals) or control (three hospitals) groups and 47 patients participated (24 in the experimental group and 23 in the control group). The experimental group was given an 8 week self-efficacy enhancement program for pressure ulcer prevention. The self-efficacy enhancement program consisted of small-group face-to-face intervention (education and skills training), education with computer animation, phone counseling, face-to-face counseling, and self-management records. The control group only received a pressure ulcer prevention information booklet. Self-care knowledge, self-efficacy, self-care behaviors, and pressure ulcer incidence were measured at baseline and after the 8 week self-efficacy enhancement program. Results: The experimental group showed a significantly greater improvement in self-care knowledge, self-efficacy, and self-care behaviors for pressure ulcer prevention than did the control group. One participant in the control group developed a pressure ulcer, while none of the participants in the experimental group developed a pressure ulcer; this difference was not statistically significant. Conclusions: The self-efficacy enhancement program enabled patients with a spinal cord injury to engage in continued self-care behaviors and helped them to improve their knowledge and self-efficacy concerning pressure ulcer prevention.