Predictive value of emergency department patients' self-efficacy and outcome beliefs regarding wound care

Date of Completion

January 2001


Health Sciences, Nursing




The purpose of this predictive study was to explore the relationship between self-efficacy, outcome beliefs and wound healing, as well as the relationship of self-efficacy and outcome beliefs to following wound care discharge instructions after suturing. Bandura's Social Cognitive Theory was the theoretical framework for this study. ^ A sample of 100 participants admitted to the Emergency Department (ED) with a diagnosis of laceration requiring closure with sutures was included in this study. Participants were asked to complete an informed consent form and the Wound Care Questionnaire (WCQ), a questionnaire measuring self-efficacy and outcome beliefs regarding wound care. Additional information was collected on the Biographical Data Form. When patients returned to the ED a nurse researcher assessed the laceration for degree of healing using the Wound Healing Assessment Instrument (WHAI). All patients not returning to the ED for follow-up within fourteen days of suturing were contacted by telephone and asked if stitches were removed and by whom. ^ Analyses of the WCQ indicated a high level of internal consistency (Confidence scale α = .84 and Importance scale α = .87). Interobserver agreement estimates for the WHAI indicated a high level of concordance (wound description κ = 1.00 and wound appearance κ = .79). ^ Logistic regression was the method of analysis used to explore the relationship between self-efficacy and outcome beliefs as predictors of return to the ED to have stitches removed. The logistic model identified self-efficacy beliefs for following wound care instructions (p < .05), self-efficacy beliefs for returning to the ED (p < .01), and age ( p < .01) as significant predictors. ^ Descriptive statistics including chi-square and correlational analyses were used to interpret the relationship between self-efficacy and outcome beliefs and wound healing. Analyses did not identify any significant predictors of wound healing. ^ The research indicated, for the first time, that use of Social Cognitive Theory, specifically self-efficacy, in the ED by nurses could assist health care providers in identifying patients who may not return for follow-up visits to have stitches removed. This study demonstrates that Social Cognitive Theory is applicable for research and practice in the ED. ^