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Learning Objective 1: The learner will be able to discuss the relationships proposed in the Individual and Family Self-Management Theory and measures used to operationalize the theoretical concepts.
Learning Objective 2: The learner will be able delineate two significant factors associated with self-management identified in this study
A Spina Bifida Transition Program in a large Midwestern US city was developed with a partnership between pediatric and adult providers. A parallel research project was conducted to evaluate the program and the experiences of young adults with spina bifida (YASB) during the transition. This study is guided by The Individual and Family Self-Management Theory (IFSMT) and explored contextual (mobility, bladder management, family factors) and process factors (adolescent self-efficacy, perceived health care competence) related to self-management.
Methods:
A longitudinal descriptive study was conducted for one year from time of transition to adult health care. This analysis uses baseline data from 30 YASB without intellectual disabilities to explore contextual factors related to self-management. Measures collected included the Functional Independence Measure (FIM), Family APGAR, Family Environment Scale (FES), Communication and Problem Solving Self-Efficacy Scale (CPSSES), Perceived Health Competency Scale (PHCS) and the Adolescent/Young Adult Self-Management Scale (AMIS II). The IFSMT guided the hierarchical regression analysis exploring factors associated with self-management.
Results:
The YASB were predominantly Caucasian, the mean age was 22, and 53% were male. Regression analysis revealed that the degree of mobility was a statistically significant (p .05) predictor of AMIS II (B = .04, t = 3.655,R2= .31), but bladder management was not. When CPSSES data was added to the model mobility remained significant but CPSSE was also significant (B = .036, t = 2.775, R2 = .13). PHCS did not add significantly to the prediction. No relationship between the family factors and self-management was noted.
Conclusion:
Transition to adult health care is a global issue for youth with a chronic health condition. Communication and problem solving self-efficacy substantially expanded the amount of self-management variance explained by mobility. Healthcare providers that transition YASB to adult health care need to reinforce the importance of increasing self-efficacy in order to positively influence self-management.