Adolescents are known to strive for autonomy, cope with problems, and gain self-care abilities during developing years. Those with spina bifida are thought to face challenges associated with disability over and above those faced by healthy age-mates. This study was designed to: (a) describe the relationships between autonomy, coping, and self-care agency among healthy adolescents, and (b) compare these behaviors among adolescents with spina bifida to those of matched controls. The conceptual framework for the study included autonomy as described by Erikson and Blos, problem-focused coping as described by Folkman and Lazarus, and self-care agency as described by Orem. Two convenience samples were utilized, one of 250 healthy adolescents and the other of 22 adolescents with spina bifida. The study instruments included the Adjective Check List, the Ways of Coping Checklist, and the Denyes Self-Care Agency Instrument. The responses of the healthy adolescents on the demographic variables of autonomy and problem-focused coping were regressed on self-care agency. A total of 11% of the variance in self-care agency was accounted for by the predictor variables with autonomy explaining 3% and problem-focused coping explaining nearly 8%. Negligible contributions to self-care agency were made by the demographic variables. Partial support for the Orem Self-Care Nursing Model was established among the sample of healthy adolescents.

The Hotelling's T square comparison on the dependent variables of autonomy, problem-focused coping, and self-care agency was carried out using computer-generated nonparametric permutation procedures. No difference between the adolescents with spina bifida and healthy controls was found. Computer-generated univariate comparisons revealed a difference only on autonomy. The absence of differences validates similar therapeutic approaches to both groups. Future investigations were recommended to further explain self-care agency relative to autonomy and coping among similar populations. Further examination of the situation-specific and sociocultural orientation aspects of self-care agency was recommended.