Development of a measure of skin care belief scales for persons with spinal cord injury

Rosemarie B. King, Victoria L. Champion, David Chen, Michelle S. Gittler, Allen W. Heinemann, Rita K. Bode, Patrick Semik

Research output: Contribution to journalArticle

6 Scopus citations


King RB, Champion VL, Chen D, Gittler MS, Heinemann AW, Bode RK, Semik P. Development of a measure of Skin Care Belief Scales for persons with spinal cord injury. Objectives: To develop and validate a measure of skin care beliefs and to describe the skin care behaviors of persons with spinal cord injury (SCI). Design: A mixed-methods design was used to develop the Skin Care Beliefs Scales (SCBS). The health belief model framed the hypotheses. Phase 1 included item development, content validity testing, and pilot testing. Phase 2 included testing the scale structure (principal components analysis), internal consistency reliability, test-retest reliability, and relationships between the belief scales and care behaviors. Setting: Two acute rehabilitation hospitals and Internet websites. Participants: Patients with SCI (N=462; qualitative/pilot n=56; psychometric study n=406) participated. Interventions: Not applicable. Main Outcome Measures: The pilot and phase 2 studies, respectively, used 146-item and 114-item versions of the SCBS. A skin care activity log was used to record skin care behaviors. Results: Content validity indicated that the items were relevant and clear. The analysis resulted in 11 independent scales reflecting 3 general beliefs (susceptibility, severity, self-efficacy) and barrier and benefit behavior-specific scales for skin checks, wheelchair pressure reliefs, and turning and sitting times. With the exception of skin check barriers (α=.65), Cronbach alphas of the scale ranged from.74 to.94. Test-retest intraclass correlations were fair to excellent (range,.42-.75). Construct validity was supported. Hierarchical linear regression indicated that turning benefits, barriers, susceptibility, and self-efficacy were significant predictors of turning time. Benefits or barriers were correlated significantly with skin check and pressure relief adherence (ρ range, -.17 to -.33). Self-efficacy was correlated with wheelchair pressure relief (ρ=.18). Skin care behavior adherence varied widely (eg, 0%-100%). Conclusions: The scales showed acceptable reliability and validity. Further testing with larger samples is desirable.

Original languageEnglish (US)
Pages (from-to)1814-1821
Number of pages8
JournalArchives of physical medicine and rehabilitation
Issue number10
StatePublished - Oct 1 2012


  • Pressure ulcer
  • Psychometrics
  • Rehabilitation
  • Self care
  • Spinal cord injuries

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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