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UBC Theses and Dissertations

Towards an understanding of self-efficacy with using a manual wheelchair Sakakibara, Brodie Masaru


Self-efficacy with using a manual wheelchair is the belief individuals have in their ability to use their wheelchair in challenging situations. It is a new construct that may have important implications on the health and well-being of wheelchair users, but has received minimal investigation. There is a need to develop an understanding of this construct in community-dwelling wheelchair users. Purpose: To investigate: the associations between self-efficacy, participation frequency (Chapter 2), and life-space mobility (Chapter 3); the health, personal, and environmental factors that predict self-efficacy (Chapter 4); and the measurement properties of the 65-item Wheelchair Use Confidence Scale (WheelCon) (Chapter 5). Methods: Multiple regression analyses were used to: examine the self-efficacy effects on participation frequency, measured using the Late-Life Disability Instrument, and life-space mobility, measured using the Life-Space Assessment; and develop a predictive model of self-efficacy, measured with the WheelCon, in a sample (n=124) of wheelchair users, ≥50 years old. Principal components analyses were used to evaluate the dimensionality of the WheelCon. Rasch analyses were used to examine the WheelCon’s item reliability in a sample (n=220) of wheelchair users, ≥19 years old. Results: Self-efficacy was a statistically significant predictor of participation frequency and life-space mobility, after controlling for important confounders. The association between self-efficacy and participation frequency was mediated by life-space mobility and perceived participation limitations. The association with life-space mobility was mediated by wheelchair skills. The models accounted for 55.0% and 39.0% of the participation frequency, and life-space mobility variance, respectively. Age, sex, need for a seating intervention, hours of daily wheelchair use, and formal training and assistance with wheelchair use were statistically significant predictors of self-efficacy. The model accounted for 44.0% of the self-efficacy variance. The WheelCon was found to be comprised of two dimensions. Several items were eliminated due to their non-compliance with the Rasch model. The 13-item mobility efficacy, 8-item self-management efficacy subscales, and the combined 21-item short form have good reliability, and provide accurate and precise measurements. Conclusion: Self-efficacy has important implications on the participation frequency and life-space mobility in community-dwelling wheelchair users, ≥50 years old. The construct may be assessed efficiently and precisely.

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