Postintervention Self-efficacy Research Articles

Effectiveness of Discharge Education on Self Efficacy among Patients with Coronary Artery Disease

Background: Coronary Artery Disease (CAD) remains a leading cause of morbidity and mortality globally, with effective patient education on self-care post-discharge identified as a crucial component in managing the disease and improving patient outcomes. Despite the recognized importance, there is a gap in understanding the best approaches to discharge education and their impact on patient self-efficacy. Objective: This study aimed to evaluate the effectiveness of a comprehensive discharge education program on enhancing self-efficacy among patients with CAD, compared to standard care. Methods: A randomized control trial was conducted at the Multan Institute of Cardiology over a nine-month period, enrolling 70 participants with ST elevation myocardial infarction (STEMI), aged 30 and above. Participants were randomly allocated to either the intervention group, which received a three-day comprehensive discharge education program, or the control group, which received standard care. The Self-Efficacy Questionnaire, with a content validity index of 0.91 and a Cronbach's Alpha of 0.743, was used to measure outcomes. Data were analyzed using SPSS version 25.0, employing paired sample t-tests and independent sample t-tests to assess within-group and between-group differences, respectively. Results: The intervention group demonstrated a significant increase in self-efficacy post-intervention, with the mean self-efficacy score improving from 31.29 ± 5.571 to 51.69 ± 6.641 (t = -15.197, p < 0.000). In contrast, the control group showed no significant change. The post-intervention self-efficacy scores significantly differed between the intervention and control groups (51.69 ± 6.641 vs. 30.77 ± 4.505, t = -15.42, p < 0.000). Conclusion: The comprehensive discharge education program significantly improved self-efficacy among CAD patients compared to standard care. This suggests that targeted discharge education should be an integral part of patient care to enhance self-management capabilities post-discharge.

Occupational Health Nurses' Self-Efficacy in Implementing Smoking Cessation Interventions for Workers: A Manufacturing Company Quality Improvement Project.

Effective smoking cessation interventions (SCIs) are urgently needed for the working population where smoking continues at high rates. Occupational health nurses (OHNs) could be effective in providing SCI, but self-efficacy was found to be a major barrier. The purpose of this study was to improve the delivery of SCI to those who smoke in the workplace and to explore nurse self-efficacy. Pretest and posttest were conducted on two groups, OHNs (n = 5) and smokers (n = 11) working at U.S. manufacturing facilities. OHNs were trained on motivational interviewing (MI) techniques who then recruited smokers to help them practice their newly acquired skills. The two groups were measured by Likert-type scale for OHN self-efficacy and smoker level of change toward quitting. Paired t-tests detected statistically significant differences in OHN's preintervention and postintervention self-efficacy scores, t(4) = -4.46, p < .001,; d = 2.92) and smokers' preintervention and postintervention stage of change toward quitting scores, t(10) = -9.07, p < .001,; d = 2.09), suggesting that the training and MI intervention were effective in increasing OHN self-efficacy and smokers' motivation to change. This quality improvement (QI) project indicated smokers can be successfully recruited and counseled using MI techniques, while simultaneously improving OHN self-efficacy toward helping patients. Theory-based applications brought OHNs and smokers together in a new paradigm resulting in positive changes for both. Secondary findings in the reverse nurse-patient role revealed success in an innovative recruitment method for smoking cessation.

The implementation and usability of HIRAID, a structured approach to emergency nursing assessment

BackgroundEmergency nurses are responsible for the initial assessment, management and safety of critically ill patients. HIRAID, an evidence-informed emergency nursing assessment framework, is known to improve emergency nursing patient-assessment in the simulated environment however has not been evaluated in the clinical setting. MethodsA pre-post design was used to assess the usability and impact of HIRAID on emergency nurses self-efficacy in the emergency department (ED). Nursing and medical staff from three Australian EDs were surveyed. Descriptive and optimal pooled sample t-tests statistics were conducted. ResultsOne hundred and two emergency nurses completed the pre-intervention self-efficacy survey and 63 completed the post-intervention self-efficacy and satisfaction survey. Forty-two and 17 medical officers completed the pre- and post-intervention satisfaction surveys, respectively. Nursing staff self-efficacy levels were unchanged pre- and post-HIRAID implementation (Mean (SD): 8.8 (0.21) vs. 8.7 (0.20)) as was medical staff satisfaction (Mean (SD):7.5 (1.43) vs. 7.8 (1.07)), although there was a trend towards improved communication. ConclusionThe HIRAID structured approach to patient assessment is acceptable, feasible, practical and appropriate for use in the clinical environment. Further research will demonstrate the direct effects of HIRAID on clinical performance.

Behavior Change Techniques Associated With Changes in Postintervention and Maintained Changes in Self-Efficacy For Physical Activity: A Systematic Review With Meta-analysis.

Self-efficacy is an important determinant of physical activity but it is unclear how best to increase self-efficacy for physical activity and to maintain these changes. This systematic review aimed to identify which specific behavior change techniques (BCTs), BCT clusters, and number of BCTs were associated with changes in postintervention and maintained changes in self-efficacy for physical activity across all adult populations. A systematic search yielded 180 randomized trials (204 comparisons) which reported changes in self-efficacy. BCTs were coded using the BCT Taxonomy v1. Hierarchical cluster analysis explored the clustering of BCTs. Meta-analyses and moderator analyses examined whether the presence and absence of individual BCTs in interventions were associated with effect-size changes for self-efficacy. Small intervention effects were found for postintervention self-efficacy for physical activity (d = 0.26; 95% CI: [0.21, 0.31]; I2 = 75.8 per cent). "Information about social, environmental, and emotional consequences" was associated with higher effect sizes, whereas "social support (practical)" was associated with lower effect sizes. Small and nonsignificant effects were found for maintained changes in self-efficacy for physical activity (d = 0.08; CI: [-0.05, 0.21]; I2 = 83.8 per cent). Lack of meaningful clustering of BCTs was found. A significant positive relationship was found between number of BCTs and effect sizes for maintained changes in self-efficacy for physical activity. There does not appear to be a single effective approach to change self-efficacy for physical activity in all adults: different approaches are required for different populations. Interventions with more BCTs seem more effective at maintaining changes in self-efficacy for physical activity.

What to expect that you're not expecting: A pilot video education intervention to improve patient self-efficacy surrounding discharge medication barriers.

The objective of this study was to test the feasibility of video discharge education to improve self-efficacy in dealing with medication barriers around hospital discharge. We conducted a single-arm intervention feasibility trial to evaluate the use of video education in participants who were being discharged home from the hospital. The scores of pre- and post-intervention self-efficacy involving medication barriers were measured. We also assessed knowledge retention, patient and nursing feedback, follow-up barrier assessments, and hospital revisits. A total of 40 patients participated in this study. Self-efficacy scores ranged from 5 to 25. Median pre- and post-intervention scores were 21.5 and 23.5, respectively. We observed a median increase of 2.0 points from before to after the intervention (p = 0.046). In total, 95 percent of participants reported knowledge retention and 90 percent found the intervention to be helpful. Video discharge education improved patient self-efficacy surrounding discharge medication challenges among general medicine inpatients. Patients and nurses reported satisfaction with the video discharge education.

Effect of Simulated Patient Practice on the Self-Efficacy of Japanese Undergraduate Dietitians in Nutrition Care Process Skills

ObjectiveTo examine the effect of an adapted simulated patient (SP) intervention on self-efficacy in nutrition care process skills. DesignA repeated-measures design using a 25-item survey divided into 7 nutrition professional practice competencies (PPCs) employing a 5-point self-efficacy scale (1 = lowest to 5 = highest) administered immediately before and after the intervention. SettingA private Japanese university. ParticipantsNinety Japanese third-year dietetics undergraduates aged 20–38 years. InterventionAn adapted SP activity practicing nutrition care process skills for the infirm elderly population. Main Outcome MeasuresPre- to postintervention self-efficacy response scores and feedback. AnalysisMean preintervention survey scores were used to divide participants into statistical quartiles (Q1 indicated lowest mean scores and Q3, highest mean scores). Wilcoxon signed-rank tests compared each PPC's pre- and postintervention means. Kruskal-Wallis tests examined changes in quartiles' scores within each PPC. ResultsSelf-efficacy improved significantly in PPCs relating to application of appropriate medical ethics and interpersonal skills (P = .02), appropriate nutrition assessment (P = .04), and creation of a nutrition management plan and nutrition intervention (P = .03). Self-efficacy of Q1 and Q2 rose significantly in most PPCs, although not for acting as a dietitian within a medical care team, whereas that of Q3 decreased for all PPCs. Conclusions and ImplicationsAmong initially low self-efficacy dietetics undergraduates, the SP intervention enhanced self-efficacy in 3 of the 6 PPCs practiced directly and may facilitate more realistic self-views among initially high self-efficacy students. However, further research in the design, implementation, and efficacy of this type of training is recommended to gauge its effects on the quality of related professional practice.

Does Racial/Ethnic Identity Influence the Effectiveness of a Community Health Worker Intervention for African American and Latino Adults With Type 2 Diabetes?

Community health worker (CHW) interventions are known to be an effective strategy to improve health behaviors and outcomes in relation to diabetes, particularly for racial/ethnic communities. Although understanding the function of identity with same race/ethnicity among clients of CHW interventions could contribute to more effective program design, few studies have explored whether levels of racial/ethnic identity among participants can influence the effectiveness of CHW interventions. We tested the relationship between level of racial/ethnic identity and changes in hemoglobin A1c and diabetes self-efficacy among low-income African American and Latino adults with type 2 diabetes who participated in a CHW intervention. Data came from a randomized controlled trial of the CHW intervention with a 6-month delayed control group design for 164 African American and Latino adults in Detroit, Michigan. Racial/ethnic identity was created from two items and classified into high, moderate, and low. We combined the two arms (immediate and delayed) into one because there was no significant difference in baseline characteristics, other than age and postintervention self-efficacy, and multivariable linear regression models were applied in the analysis. Possession of high racial/ethnic identity was associated with greater improvement both in hemoglobin A1c and diabetes self-efficacy at 6 months. Moreover, among those with high hemoglobin A1c at preintervention, higher racial/ethnic identity had a greater impact on hemoglobin A1c improvement, compared with those with lower identity. This study suggests the importance of considering racial/ethnic identity of the participants in designing and operating the CHW intervention for racial/ethnic minority population.

The Effectiveness of Self-Management Programs on Self-Efficacy in Patients With Sickle Cell Disease

Background: Patients with sickle cell disease suffer from various complications during their lifetime. In order to cope with the disease, they must adapt themselves to a complex set of behaviors that promote self-management and prevent complications associated with the disease. Chronic disease self-management programs are a combination of strategies that increase self-efficacy and promote self-management behaviors. Objectives: This study aimed to determine the effectiveness of self-management programs on self-efficacy in patients with sickle cell disease. Patients and Methods: In this quasi-experimental study, 69 patients with sickle cell disease who were referred to the Thalassemia Clinic of Ahvaz Shafa Hospital were entered into the study through the census method. Then, the self-management program was implemented using the 5A method for 12 weeks. The Levels of pre and post intervention self-efficacy were assessed using the sickle cell self-efficacy scale (SCSES), while descriptive statistics, paired t-test and Wilcoxon test were used to analyze the data. Results: Before the intervention, the majority of subjects (50.7%) had moderate self-efficacy, whereas after the intervention, the majority of patients (81.2%) showed high self-efficacy. The overall scores and scores of the post-intervention self-efficacy sub-groups were significantly increased (P < 0.001). Conclusions: The results of this study showed that self-management interventions are effective in promoting self-efficacy in patients with sickle cell disease. Thus, the use of self-management programs is advisable to change behaviors and promote self-efficacy in such patients.

Assessing Student Learning in Academic Advising Using Social Cognitive Theory

We investigated whether the social cognitive theory constructs of self-efficacy and self-regulated learning apply to academic advising for measuring student learning outcomes. Community college students (N = 120) participated in an individual academic-advising session. We assessed students' post-intervention self-efficacy in academic planning and their retrospective pre-intervention self-efficacy as well as pre and post self-regulated learning-strategy levels in academic planning. We used 2 hypotheses to verify that students experienced increased levels of self-efficacy and self-regulated learning through academic planning strategies. The 3rd hypothesis verified a positive, reciprocal relationship between self-efficacy and self-regulated learning in academic planning. We discuss results regarding the theoretical usefulness for applying social cognitive theory to assess student learning outcomes in academic advising.

The Development of a Community and Home‐Based Chronic Care Management Program for Older Adults

The objective of this paper was to evaluate a chronic care management program piloted by a visiting nurses association. Desired outcomes were to increase nurses' knowledge of self-management of chronic conditions and improve patient self-efficacy and clinical measures. The program provided educational development for nurses and piloted encounters with patients with chronic conditions targeting community health nurses for a chronic care professional (CCP) certification and invited 300 faith community nurses to an education program on chronic condition(s). Thirteen patients with chronic condition(s) were enrolled. Chronic care professional modules were used to increase nurses' knowledge and were measured by successful completion of a certification exam. Faith community nurses participated in an education program and completed a posttest to measure knowledge of content. Patient improvement in self-management was measured by pre- and postintervention self-efficacy scores and clinical measures. Seventeen nurses successfully completed the exam, and 38 faith community nurses participated in the program and completed the posttest. Three patients showed improvement in self-efficacy scores and eight in clinical measures. The educational development of community nurses prepared them to provide effective encounters to improve self-efficacy and clinical outcomes for older adults with chronic conditions.

Assessing Academic Advising Outcomes Using Social Cognitive Theory: A Validity and Reliability Study

The validity and reliability of three instruments, the Counselor Rubric for Gauging Student Understanding of Academic Planning, micro-analytic questions, and the Student Survey for Understanding Academic Planning, all based on social cognitive theory, were tested as means to assess self-efficacy and self-regulated learning in college academic planning. The rubric assessed pre- and post-intervention self-regulated learning of academic-planning strategy levels. The micro-analytic questions assessed self-regulated learning during forethought and self-reflection phases. Post-intervention self-efficacy in academic planning and retrospectively evaluated pre-intervention self-efficacy were measured by the survey. All three instruments showed strong validity and reliability, but the survey did not distinguish between different self-efficacy challenge levels.

Reactance to a Tailored Multimedia Intervention Encouraging Teachers to Promote Cover-the-Cough

Teachers were presented tailored multimedia messages encouraging them to offer cover-the-cough instruction to their students. Messages were tailored by grade level (elementary, higher grade) and stage of change (preaction, action). Among teachers in the action stages, message tailoring did not make a difference. Among teachers in the preaction stages, tailored messages were rated lower than were nontailored messages. The lower ratings of the tailored messages, seemingly a reactance response, did not carry over to postintervention self-efficacy. The intervention was effective in improving self-efficacy in elementary school teachers, particularly among those in the preaction stages.

Increased Self-Efficacy for Vegetable Preparation following an Online, Skill-Based Intervention and In-Class Tasting Experience as a Part of a General Education College Nutrition Course

Assess the effectiveness of the integration of vegetable demonstration videos and tasting experiences into a college nutrition course to influence students' readiness to change vegetable intake, self-efficacy for vegetable preparation, and usual vegetable intake. Quasiexperimental, preintervention-postintervention comparisons. College nutrition course. Of the 376 students enrolled in the course, 186 completed the online assessments (145 female, 41 male; mean age, 20 years). Participants viewed online vegetable preparation videos and participated in vegetable tasting experiences that featured four target vegetables, one vegetable each month for 4 months. Preintervention and postintervention online surveys determined usual vegetable intake, readiness to change vegetable consumption, and self-efficacy of vegetable preparation. Chi-square distribution and paired sample t-tests were used to examine differences preintervention and postintervention. Stage of readiness to change vegetable intake shifted from contemplation toward preparation (p < .001). Self-efficacy of vegetable preparation increased and postintervention self-efficacy was associated with total and target vegetable consumption (p = .001 and p = .005, respectively). The average intake of asparagus, one of four target vegetables, increased (p = .016); similar changes were not observed for target or total vegetable consumption. Online vegetable demonstration videos may be an effective and cost-efficient intervention for increasing self-efficacy of vegetable preparation and readiness to increase vegetable consumption among college students. More research is needed to determine long-term effects on vegetable consumption.

Effect of Adding a Values Clarification Exercise to a Decision Aid on Heart Disease Prevention: A Randomized Trial

Experts have called for the inclusion of values clarification (VC) exercises in decision aids (DAs) as a means of improving their effectiveness, but little research has examined the effects of such exercises. To determine whether adding a VC exercise to a DA on heart disease prevention improves decision-making outcomes. Randomized trial. UNC Decision Support Laboratory. Adults ages 40 to 80 with no history of cardiovascular disease. A Web-based heart disease prevention DA with or without a VC exercise. Pre- and postintervention decisional conflict and intent to reduce coronary heart disease (CHD) risk and postintervention self-efficacy and perceived values concordance. The authors enrolled 137 participants (62 in DA; 75 in DA + VC with moderate decisional conflict (DA 2.4; DA + VC 2.5) and no baseline differences among groups. After the interventions, they found no clinically or statistically significant differences between groups in decisional conflict (DA 1.8; DA + VC 1.9; absolute difference VC-DA 0.1, 95% confidence interval [CI]: -0.1 to 0.3), intent to reduce CHD risk (DA 98%; DA + VC 100%; absolute difference VC-DA: 2%, 95% CI: -0.02% to 5%), perceived values concordance (DA 95%; DA + VC 92%; absolute difference VC-DA -3%, 95% CI: -11% to +5%), or self-efficacy for risk reduction (DA 97%; DA + VC 92%; absolute difference VC-DA -5%, 95% CI: -13% to +3%). However, DA + VC tended to change some decisions about risk reduction strategies. Use of a hypothetical scenario; ceiling effects for some outcomes. Adding a VC intervention to a DA did not further improve decision-making outcomes in a population of highly educated and motivated adults responding to scenario-based questions. Work is needed to determine the effects of VC on more diverse populations and more distal outcomes.

From Weight Training to ADL Performance

1937 An inherent assumption of traditional weight-training (WT) programs is that a direct relationship exists between strength gains derived from WT and increased perceptions of ability to perform activities of daily living (ADL) requiring strength. This approach assumes that exercisers implicitly “make the connection” between WT and ADL (i.e., participants generalize their mastery experiences). However, the inconsistent effects of WT on ADL self-efficacy suggest that older adults may not make this connection. PURPOSE: Our intervention compared the effects of WT alone versus WT plus education about training-related strength gains and the use of that strength when performing ADL (WT+ED) on ADL self-efficacy. METHOD: We conducted a two-arm randomized trial in which 23 men and 41 women (M age = 74.4 + 3.7) were randomly assigned to WT or WT+ED. Both groups performed 12 weeks (2 sessions/week) of WT targeting 8 major muscle groups. WT+ED received individualized behavioral training and associated written materials emphasizing the link between WT and ADL. WT received a parallel intervention on proper WT technique only. Self-efficacy for performing 8 valued ADL tasks in our lab (e.g., climbing stairs, carrying groceries, opening heavy doors) was measured at habituation baseline and post-intervention, along with self-efficacy for performing ADL at home. RESULTS: ANCOVAs controlling for baseline efficacy showed that WT+ED had greater postintervention self-efficacy than WT for performing 5/8 ADL lab tasks (ps < .08, ES ranged from .36 to .49). Greater self-efficacy for the 8 ADL tasks was associated with greater self-efficacy for performing ADL at home (R2adj = .18, p < .01). CONCLUSION: The WT+ED treatment lead to greater gains in ADL self-efficacy than WT alone. These findings emphasize the need for interventionist collaboration and behavior change practice to help older adults generalize the benefits and confidence obtained through WT to the performance of valued ADL. Supported by SSHRC grant 410–00–1380