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what is self-efficacy
“The extent or strength of one’s belief in the ability to attain goals” (Bandura)
A process of taking control of the results of a task-based effort
Dynamic process
social congnitive theory
personal factors: cognitive? affective? physical?
environment: barriers and facilitators
behavior
concepts of social cognitive theory
Reciprocal determinism
Environment and situation
Behavioral capacity
Observational learning
Reinforcements
expectations
Expectancies
Self-regulation
Self-efficacy
Self-efficacy
A measure of confidence in success; belief in the ability to achieve a goal
Self-regulation
the use of goals and monitoring to control behavior; the target individual’s social network can be used to improve success
Expectancies
The perceived value of behavioral change
expectations
The expected result
Reinforcements
the impact of a positive or negative response on adoption of a new behavior
Observational learning
The concept that an individual can learn to be successful at a new task or skill through observation and modeling
Behavioral capacity
The potential to be successful in behavior change based upon the skills and knowledge of the target individual
Environment and situation
the setting, physical, and social factors surrounding a given behavior
Reciprocal determinism
Relationship between the individual, environment, and behavior; consider positive and negative impacts that previous experience and habits cause, as well physical barriers and facilitators
how do we measure self-efficiacy?
Multiple scales for specific diagnoses or behaviors
Generalizable applicability?
Self-efficacy for exercise scale (SEE)
people who have less chronic pain
have more self-efficacy
Patient/Family Considerations
Self-efficacy of the patient
Addition of caregiver self-efficacy for a pediatric patient
Addition of proxy self-efficacy in the caregiver of a geriatric patient
carfegiver self-efficacy
caregivers belief of their ability to care for the patien
proxy self-efficacy
belief that the patient has in the caregiver to help them
How Do We Build Self-Efficacy?
• Success and mastery
• Vicarious performance
• Verbal encouragement
• Emotional/psychological state
Success and Mastery
• Achievable goals
• Breaking a long-term objective into short-term tasks
Vicarious Performance
• Modeling a task or activity
• Group approach
• Mentoring or identifying a peer
Verbal Encouragement
• Therapist, teacher, peers, family
• Should be valid praise for success as opposed to encouragement for subpar performance
Emotional or Psychological State
• Concept of positive attitude and affect on belief in one’s own abilities
• Detrimental effect of depression, anxiety, poor self-concept
Self-Management
• Patient- and family-centered care
• Enabling independence with disease management
• Shared decision-making
Patient- and Family-Centered Care
• Appropriate and important goals
• Carryover and long-term benefit
• Plan for transition from the onset of the episode of care
Independence With Disease Management
• Empowering, sense of control
• Modulating and altering plan based on new information
• Psychological benefit and psychosocial impact
• State of health care
Shared Decision-Making
• Informed consent
• Balance the extensive web resources
• Ethical practice
• Discussion between the health care provider and patient with informed decision-making
self-mamangement
the tasks that individuals must undertake to live well with one or more chronic conditions
self-management support
the systematic provision of education and supportive interventions by health care or other providers to strengthen patients’ skills and confidence in managing their health problems; incluses regualar assessement of progress and problems, goal-setting, and problem-solving support
self-management education
interactive educational interventions specifically designed to enhance patient self-management