Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study  

作　　者：Paul E. Plonski Jasmin Vassileva Ryan Shahidi Paul B. Perrin William Carter Lance L. Goetz Amber Brochetti James M. Bjork Paul E. Plonski;Jasmin Vassileva;Ryan Shahidi;Paul B. Perrin;William Carter;Lance L. Goetz;Amber Brochetti;James M. Bjork(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)

机构地区：[1]Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA [2]Richmond Veterans Affairs Medical Center, Richmond, VA, USA [3]Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA [4]Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA [5]Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA [6]Department of Spinal Cord Injury, Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA [7]Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA

出　　处：《Journal of Behavioral and Brain Science》2024年第2期47-63,共17页行为与脑科学期刊（英文）

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.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.

关 键 词：Spinal Cord Injury SELF-CARE DECISION-MAKING PARAPLEGIA Impulsive Behavior Health Care 

分 类 号：R65[医药卫生—外科学]