Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study
Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study作者机构：Institute for Drug and Alcohol Studies Virginia Commonwealth University Richmond VA USA Richmond Veterans Affairs Medical Center Richmond VA USA Department of Psychiatry Virginia Commonwealth University Richmond VA USA Department of Psychology Virginia Commonwealth University Richmond VA USA Department of Physical Medicine and Rehabilitation Virginia Commonwealth University Richmond VA USA Department of Spinal Cord Injury Cleveland Veterans Affairs Medical Center Cleveland OH USA Department of Pharmacology and Toxicology Virginia Commonwealth University Richmond VA USA
出 版 物：《Journal of Behavioral and Brain Science》 (行为与脑科学期刊（英文）)
年 卷 期：2024年第14卷第2期
页 面：47-63页
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
主 题：Spinal Cord Injury Self-Care Decision-Making Paraplegia Impulsive Behavior Health Care
摘 要：Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.
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