ปัจจัยที่มีผลต่อความสามารถในการดูแลตนเองของผู้สูงอายุที่มีการบาดเจ็บที่ไขสันหลังระดับเอว Factors Affecting Self-care Ability among Older Persons with Lumbar Spinal Cord Injury

Abstract

Background: As the global population ages, the prevalence of spinal cord injury (SCI) among older adults has increased markedly. Lumbar spinal cord injury (LSCI) leads to loss of sensory and motor function in the lower limbs, significantly impacting activities of daily living. This study aimed to identify the self-care ability and its influencing factors among older adults with LSCI in China remain limited. Methods: A correlational predictive design was used. A total of 161 older adults (aged ≥60 years) with LSCI were recruited from the Second Affiliated Hospital of Wenzhou Medical University using simple random sampling. Data were collected using a demographic questionnaire, the Barthel Index, the Geriatric Anxiety Inventory, the Pittsburgh Sleep Quality Index, the Social Health Scale for the Elderly-short, the In-Patient Satisfaction Questionnaire, and the International Standards for Neurological Classification of Spinal Cord Injury Worksheet. Data were analyzed using descriptive statistics, Pearson's correlation, and multiple linear regression. Results: Most participants (84.5%) exhibited mild dependence, with a mean ADL score of 80.18 (SD = 17.401). Multiple regression analysis revealed that age, anxiety level, sleep quality, and social support were significant predictors of self-care ability, together explaining 53.4% of the variance (R² = 0.534, F (6,154) = 31.612, p < .001). Age (β = -0.458, p < .001), anxiety level (β = -0.422, p < .001), and sleep quality (β = -0.460, p < .001) were negative predictors, while social support (β = 0.116, p = .034) was a positive predictor. SCI level and patient satisfaction did not reach statistical significance. Conclusion: Age, anxiety, sleep quality, and social support are important factors influencing self-care ability in older adults with LSCI. Nursing practice should incorporate routine screening for anxiety and sleep problems and mobilize family and community support resources to help maintain and improve patients' self-care capacity.