Self-Efficacy And Self Management

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