The relationships among self-efficacy, social support, resilience, and subjective well-being in persons with spinal cord injuries

Aims To examine the contribution of self-efficacy, social support, and resilience to subjective well-being (SWB), to examine the mediating effect of resilience in the relationship between social support and SWB, and to investigate if marital status moderates the relationship between social support and SWB among people with spinal cord injuries (SCI). Design A descriptive cross-sectional study, conducted from November 2017-January 2018. Methods One hundred and two individuals with SCI were recruited from a rehabilitation center and a community setting in Nepal. SWB, self-efficacy, social support, resilience, demographics and injury-related information was collected using self-reported questionnaires. Hierarchical regression analysis, mediation analysis, and moderation analysis were performed in SPSS and R to test the hypotheses. Results Self-efficacy, social support, and resilience uniquely explained 19% of the variance on SWB after controlling for demographic covariates. In the mediation analysis, resilience partially mediated the relationship between social support and SWB. In the moderation analysis, marital status moderated the relationship between resilience and SWB. Conclusion Subjective well-being of persons with SCI is associated with many factors. Interventions to strengthen self-efficacy, resilience, and social networks can be effective to enhance SWB. A stronger association between resilience and SWB among single participants reflects the need to provide specific considerations for persons with SCI who are single. Longitudinal and/or experimental studies are needed to further validate these findings. Impact This study identified external and internal factors contributing to SWB in persons with SCI. Self-efficacy, social support, and resilience were found to be significantly associated with SWB. Resilience acted as a mediator between social support and SWB. The relationship between resilience and SWB was stronger in single participants than married participants. The findings have potential implications in the field of nursing since nurses are one of the integral members of the SCI rehabilitation team.