Is self-efficacy after spinal cord injury associated with hospital re-admissions or length of stay in Aotearoa New Zealand? A cross-sectional analysis.

Abstract

Aim: The transition from inpatient care to the community challenges coping strategies in spinal cord injury (SCI), and acute hospital re-admissions may act as profound psychological disruptors. This study compared self-efficacy scores between discharge and 18-month follow-up and examined the association of self-efficacy with hospital re-admissions and length of stay (LOS).

Methods: This repeated cross-sectional study utilised New Zealand Spinal Cord Injury Registry data. One hundred and one participants (35.3% response rate) provided general self-efficacy (GSE) scores at discharge and 18 months. Analysis included paired t-tests, a one-way analysis of covariance comparing readmission groups (controlling for baseline GSE), and linear regression assessing log-transformed LOS.

Results: GSE scores declined significantly from a mean of 34.1 at discharge to 32.2 at 18 months (p=0.0001; Cohen's d=0.4). After adjusting for baseline scores, participants with hospital re-admissions had significantly lower GSE at 18 months (M=31.0) than those without (M=32.9; p=0.036; adjusted Cohen's d=0.43). LOS did not show an association with GSE scores (p=0.778).

Conclusion: Self-efficacy significantly erodes during the transition from rehabilitation to community dwelling. Hospital re-admissions appear to have a significant association with lower self-efficacy at 18 months even when accounting for baseline self-efficacy levels.