Self-efficacy In People Research Articles

A Nurse-Coached Exercise Program to Increase Muscle Strength, Improve Quality of Life, and Increase Self-Efficacy in People With Tetraplegic Spinal Cord Injuries

A nurse-coached exercise intervention for 10 people with tetraplegic spinal cord injuries was conducted over a period of 2 years at an accessible, community-based YMCA using an equipment especially designed for people with mobility issues and neurological deficits. In this single-subject design study, each participant completed three 3-hour exercise sessions a week for over 6 months. The purpose of the study was to determine what effects the program would have on increasing muscle strength, improving quality of life, and increasing self-efficacy after traditional outpatient therapy sessions were no longer available or affordable. The Sheehy Spinal Cord Injury Functional Improvement via Exercise Model was constructed at the conclusion of an unpublished pilot study and was tested in this study. Expectations of the model were that, if a person with a tetraplegic spinal cord injury participated in a coached program of exercise, muscle strength would increase and functional ability would improve, resulting in greater independence, a higher sense of self-efficacy, and a higher quality of life. Study results using a single-subject design of graph-trend analysis showed upward trajectories in muscle strength, quality of life, and self-efficacy in all study participants regardless of the length of time since his or her original injury. The results support the efficacy of this nurse-coached program for people with tetraplegic spinal cord injuries and validate the Sheehy Spinal Cord Injury Functional Improvement via Exercise Model.

SP0148 Using Mindfulness and Emotion-Focussed Approaches to Support Patients

Rheumatic diseases are associated with increased risk of psychological distress, anxiety and depressed mood. Negative emotional states, such as sorrow, worry, irritability and fatigue are common. Recent studies have shown...

Developing a Model of Associations Between Chronic Pain, Depressive Mood, Chronic Fatigue, and Self-Efficacy in People With Spinal Cord Injury

Chronic pain, chronic fatigue, and depressive mood are prevalent conditions in people with spinal cord injury (SCI). The objective of this research was to investigate the relationship between these conditions in adults with SCI. Multivariate analysis of variance, contingency analyses, and hierarchical regression were used to determine the nature of the relationship, as well as the contribution to this relationship of self-efficacy, a potential mediator variable. Seventy participants with SCI living in the community completed an assessment regimen of demographic and psychometric measures, including validated measures of pain, fatigue, depressive mood, and self-efficacy. Results indicated that participants with high levels of chronic pain had clinically elevated depressive mood, confusion, fatigue, anxiety and anger, low vigor, and poor self-efficacy. Participants with high chronic pain had 8 times the odds of having depressive mood and 9 times the odds of having chronic fatigue. Regression analyses revealed that chronic pain contributed significantly to elevated depressive mood and that self-efficacy mediated (cushioned) the impact of chronic pain on mood. Furthermore, both chronic pain and depressive mood were shown to contribute independently to chronic fatigue. Implications of these results for managing chronic pain in adults with SCI are discussed. PerspectiveThe relationship between pain, negative mood, fatigue, and self-efficacy in adults with SCI was explored. Results support a model that proposes that chronic pain lowers mood, which is mediated (lessened) by self-efficacy, whereas pain and mood independently increase chronic fatigue. Results provide direction for treating chronic pain in SCI.

Abstinence self-efficacy in people with severe mental illness

To validate the Brief Situational Confidence Questionniare (BSCQ) with people diagnosed with severe mental illness (N=129), we examined the associations between abstinence self-efficacy (BSCQ) and alcohol consumption level (within the previous 6months), drug use, and problems related to substance use while controlling for key symptoms of major mental illness and motives for alcohol use (Drinking Motives Questionnaire). Regression models revealed that abstinence self-efficacy was a significant predictor of all three substance use measures suggesting that, even when controlling for psychiatric symptoms and substance use motives, abstinence self-efficacy accounts for unique variance in alcohol use, drug use, and related problems. This study is limited by the cross sectional design and lack of structured diagnostic interviewing.

Evaluation of the criterion and predictive validity of the Alcohol Reduction Strategies—Current Confidence (ARS-CC) in a natural drinking environment

To evaluate several psychometric properties of a questionnaire designed to assess young people's self-efficacy to employ 31 alcohol reduction strategies, we assessed breath alcohol concentration, self-reported drinking, current strategy self-efficacy, and recent past use of these strategies in 100 young adults as they walked to and from the local bar district of a Midwestern college town. In support of criterion and predictive validity of the questionnaire, we found that lower self-efficacy at the initial assessment was significantly correlated with higher scores on a screening measure of consumption, with having engaged in more heavy drinking episodes in the past 30days, and with higher levels of intoxication and use of fewer reduction strategies later that evening. Frequency counts indicate that 10 of the alcohol reduction strategies had been used by at least half of the sample to reduce their drinking earlier that evening.

The Effects of Musical Activity on the Self-Esteem and Self-Efficacy of Patients With Schizophrenia: A Cultural Study in West Bengal, India

Studies into the effects of therapeutic music making in the treatment of mental illness have increased dramatically in the last decade, but there still remains a dearth of research into its effects in developing countries such as India. Of particular importance in India, where the stigma associated with mental illness is still prominent, is low self-esteem and self-efficacy in people with disorders such as schizophrenia. Using a qualitative approach, this study explored the views of the participants on the effects of musical activity, at a psychiatric treatment and rehabilitation center in India. Five main themes were interpreted from interview transcripts: therapy, moti- vation, mood, self-efficacy, and self-esteem, suggesting that the patients find the sessions to be therapeutic overall, including in the areas of self-esteem and self-efficacy.

AA and abstinence as prevention techniques

The idea of abstinence as a prevention technique against addiction is a non sequitur. The approach AA takes with confirmed alcoholics makes no sense for children, whose worlds – like adults’ – are strewn with too many potentially addictive involvements to make lifelong abstinence feasible as an answer to all situations for all times. Furthermore, purveying the need for abstinence communicates that various involvements are so fearsome that they can easily topple young people – taking control of their own decision-making out of their hands. Alternative approaches based on affirming young people's self-efficacy are presented.

Health risk appraisal for older people 5: self-efficacy in patient–doctor interactions

Enhancing self-efficacy is central to programmes promoting self-care and self-management. However, little is known about older people's self-efficacy in doctor-patient interactions. This paper investigates lifestyle, medical and demographic factors associated with self-efficacy in doctor-patient interactions in older people in general practice. A cross-sectional analysis of data from a randomised controlled trial of older people was conducted in a health risk appraisal study in London. Self-efficacy was measured using the Perceived Efficacy in Patient-Physician Interactions Questionnaire. Older people with higher self-efficacy were significantly more likely to report having had recent preventive care measures such as recent blood pressure measurement and influenza immunisation. Women were less likely to have higher self-efficacy than men. Older people were significantly less likely to have high self-efficacy if they reported having poor memory, low mood, limited activities due to fear of falling, basic education, difficulties with at least one activity of daily living, reduced physical activity, living alone, or risk of social isolation. A third of people had low self-efficacy in doctor-patient interactions. They appear to be a vulnerable group. Low self-efficacy in interactions with doctors may be a symptom or a characteristic of older people who experience social isolation and depression. Policies that depend on enhancing self-care and self-management need to consider the large number of older people with low self-efficacy in using medical services, and understanding characteristics in older people associated with lower confidence in doctor-patient interactions may be useful in clinical practice and research.

The importance of measuring self-efficacy in patients with diabetes

Self-efficacy is an important factor influencing diabetes self-management behaviours. Previous studies have examined self-efficacy as a general measure in diabetes care for all self-care treatment recommendations together. This current study was designed to examine if low self-efficacy in each of the measured self-care treatment recommendations is related to decreased adherence for each specific recommendation. The self-efficacy was measured in 119 patients for four different treatment recommendations: blood glucose self-monitoring, exercise, diet and oral medication intake and correlated with The Resistance to Treatment Questionnaire. Significant and positive Pearson's correlations were found between the frequency of adherence to treatment recommendations and the self-efficacy regarding different recommendations. The correlation between self-efficacy and diet and physical activity was 0.5 and 0.67, respectively. The higher the resistance to treatment score, the less confident the patient is in his or her ability to adhere with treatment recommendations. This pattern was not present in adherence to medication intake. Self-efficacy impacts adherence to treatment and therefore plays a role in the clinical outcome. The practical implication is that assessment of self-efficacy in people with diabetes may be a first step in the development of individually tailored interventions.

Reliability of a scale of work-related self-efficacy for people with psychiatric disabilities

Work-related self-efficacy at a core task level fits with the social cognitive career theory explaining the career development of people with severe mental illness. The aim of this study was to further investigate the psychometric properties of the 'Work-related Self-Efficacy Scale' for use with people with psychiatric disabilities. Sixty individuals with schizophrenia or schizoaffective disorder participated in repeated telephone interviews conducted 2-5 days apart. Short-cycle test-retest reliability and internal structure were assessed. Face validity, consumer and clinician acceptability and utility were examined qualitatively. Short-cycle test-retest reliability was found to be very good at item and total score levels. The internal structure was consistent with previous investigations. Although face validity, acceptability and utility were adequate, use of face-to-face interviews is preferred over telephone interviews. The construct validity evidence supports wider use for research purposes in community mental health service, supported employment and other psychiatric rehabilitation settings.

The evaluation of self‐care and self‐efficacy in patients undergoing hemodialysis

The purpose of this study is to assess patients' self-care ability and self-efficacy, to examine the relationship between them and to determine the factors affecting self-care ability and self-efficacy in people undergoing hemodialysis (HD). This research was conducted as a descriptive survey study by 138 people with ESRD who were patients of HD units service in Sivas. The data were collected with a Personal Information Form, Exercise of Self-Care Agency (ESCA) Scale and Self-Efficacy Assessment Form. Data collected from the study were analysed using percent, mean, Tukey test, significance test of two means, one-way variant analysis and Kruskal-Wallis test. The study results demonstrate that while there is a correlation between self-care ability and education level, work status, income level and frequency of HD application, factors such as age, gender, education level, work status, income level and frequency of HD application determine self-efficacy. Furthermore, a positive correlation was found between patients' self-care ability and self-efficacy. It was determined that as the level of self-care ability increases self-efficacy level also increases. Hemodialysis application affects patients' self-care ability and self-efficacy levels. There is a positive correlation between self-care ability and self-efficacy. In view of this study's results, it is recommended to organize education programmes to increase self-care ability and self-efficacy levels of HD patients and prepare comprehensive plans including patients' families.

Self‐stigma and coming out about one's mental illness

Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mental illness completed measures of coming out (called the Coming Out with Mental Illness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person's quality of life are discussed.

Design and Evaluation of a Computer Game to Promote a Healthy Diet for Young Adults

This article reports the development and evaluation of a computer game (RightWay Café) as a special medium to promote a healthy diet for young adults. Structural features of computer games, such as interactive tailoring, role playing, the element of fun, and narrative, were operationalized in the RightWay Café game to afford behavior rehearsal in a safe and entertaining way. Theories such as the health belief model, social cognitive theory, and theory of reasoned action guided the content design of the game to influence mediators of behavior change, including self-efficacy, perceived benefits, perceived barriers, and behavior change intention. A randomized controlled evaluation study with pretest, posttest, and follow-up design demonstrated that this game was effective in teaching nutrition and weight management knowledge and increasing people's self-efficacy and perceived benefits of healthy eating, as well as their intention to be on a healthy diet. Limited long-term effects were also found: participants in the game-playing group had greater self-efficacy than participants in the control group after 1 month. This study validates the computer game–based approach to health promotion for young adults. Limitations and implications are also discussed.

Pilot study assessing balance in women with fibromyalgia syndrome

The purpose of current study was to assess postural control and balance self-efficacy in people with fibro-myalgia syndrome [FMS]. Thirty-two females with FMS completed the Activity-specific Balance Confidence Scale, Berg Balance test, NeuroCom Balance Master sensory-organization test, and limits of stability. There was a high prevalence of reported falls and a low mean score on the Activity-specific Balance Confidence Scale. A significant number of subjects scored below the population norm fifth percentile score on the sensory-organization test composite, visual, and vestibular sections. Preliminary evidence suggests that women with FMS may present with deficits in postural control, sensory organization, and balance self-efficacy.

A Modeling Intervention in Heart Failure

Peak oxygen uptake (VO(2)) testing is commonly used to assess chronic heart failure (CHF) patients' exercise tolerance. The test requires maximal effort; however, many participants have low confidence (self-efficacy) to perform optimally. This randomized controlled trial examined the effectiveness of a modeling intervention to increase Peak VO(2) (PVO(2)) and self-efficacy in people diagnosed with CHF. Twenty participants with a diagnosis of CHF were randomized to either an intervention (modeling DVD) or a control group. Both groups completed a measure of self-efficacy prior to performing two PVO(2) tests, each separated by 7 days. After completing the first test (T1) the intervention group watched a 10-min coping model DVD. All participants returned 1 week later (T2) to complete identical study procedures. Analysis of covariance results showed that compared with the participants in the control group, those assigned to the modeling intervention had higher PVO(2) at T2, F (1, 19) = 4.38, p = 0.05, eta (2) = 0.21 and self-efficacy, F (1, 19) = 5.80, p < 0.05, eta (2) = 0.25. Only partial support was found for change in self-efficacy mediating treatment outcome (PVO(2)). Watching a modeling video is associated with increased PVO(2) and self-efficacy. These results have implications for testing patients in a clinical setting to maximize exercise tolerance test results.

Barrier self-efficacy and physical activity over a 12-month period in men and women who do and do not attend cardiac rehabilitation.

Objectives: Two primary objectives were to examine (a) changes in physical activity (PA) over a 12-month period in people living with cardiac disease who did not attend cardiac rehabilitation (CR), and (b) the role of barrier self-efficacy in explaining these changes from a gender perspective. A secondary objective was to examine whether attending CR (or not) moderated the gender‐barrier self-efficacy relationship with PA. Design and Setting: Participants (N 801) completed a questionnaire in the hospital and at 2, 6, and 12 months after hospitalization, as well as a telephone-administered 7-day PA recall at 2, 6, and 12 months. Main Outcome Measures: PA and barrier self-efficacy. Results: Hierarchical linear modeling showed significant declines in PA over time, which were especially pronounced for women. Moreover, the association between barrier self-efficacy and PA became significantly weaker over time, especially for women. This trend was similar for participants who did and did not attend CR. Conclusion: Interventions that focus on increasing barrier self-efficacy in people living with heart disease after hospitalization will likely equally benefit men and women in the short term but may disproportionately benefit men in the longer term regardless of participation in CR.

Effects of Treatment on Two Types of Self-Efficacy in People with Chronic Obstructive Pulmonary Disease

Self-management is crucial in people with chronic diseases, and self-efficacy has been shown to impact patients' self-management. The purposes of this study were to 1) determine the effect of intervention on self-efficacy and 2) determine the relationship between domain-specific self-efficacy, walking performance, and symptom severity in patients with chronic obstructive pulmonary disease (COPD). Subjects ( n = 102, forced expiratory volume in 1 second % predicted 44.8 ± 14) received one of three self-management interventions. Self-efficacy for walking and managing shortness of breath, walking performance, and shortness of breath severity were measured at baseline and after intervention. Self-efficacy increased after intervention ( P < 0.01). Self-efficacy for walking was positively related to walking performance ( P < 0.05). Self-efficacy for managing shortness of breath was positively related to symptom severity ( P < 0.05). This study examined two types of disease-specific self-efficacy in patients with COPD and demonstrated that improving self-efficacy is an important outcome of self-management interventions. Studies in other domains of self-efficacy are needed.

A six-month, supervised, aerobic and resistance exercise program improves self-efficacy in people with human immunodeficiency virus: A randomised controlled trial

What is the effect of a six-month, supervised, aerobic and resistance exercise program on self-efficacy in men living with human immunodeficiency virus (HIV)? Randomised, controlled trial. 40 (5 dropouts) men living with HIV, aged 18 years or older. The experimental group participated in a twice-weekly supervised aerobic and resistance exercise program for six months and the control group participated in a twice-weekly unsupervised walking program and attended a monthly group forum. The primary outcome measure was self-efficacy using the General Self-Efficacy Scale. Secondary outcome measures were cardiovascular fitness using the Kasch Pulse Recovery test, and health-related quality of life using the Medical Outcomes Study HIV Health Survey. Measures were taken by an assessor blinded to group allocation. By six months, the experimental group had improved their self-efficacy by 6.8 points (95% CI 3.9 to 9.7, p < 0.001) and improved their cardiovascular fitness by reducing their heart rate by 20.2 bpm (95% CI -25.8 to -14.6, p < 0.001) more than the control group. Health-related quality of life improved in only two out of the eleven dimensions: the experimental group improved their overall health by 20.8 points (95% CI 2.0 to 39.7, p = 0.03) and their cognitive function by 14 points (95% CI 0.7 to 27.3, p = 0.04) more than the control group. The findings of this study add to the known benefits of exercise for the HIV-infected population.

P135 Self-efficacy in people with knee osteoarthritis: A mediator of physical performance?

P135 Self-efficacy in people with knee osteoarthritis: A mediator of physical performance?

Measuring self-efficacy in people with multiple scleoris: a validation study

Objective: To assess the psychometric properties of a measure of self-efficacy in people with multiple sclerosis (MS). Design: Cross-sectional study by mail with retest. Setting: MS Clinic registry of a large Boston teaching hospital. Patients: 141 MS patients reprensenting a broad range of disability. Main Outcome Measures: The MS Self-Efficacy Scale (MSSE), the Expanded Disability Status Scale, the Sickness Impact Profile, and the mastery subscale of the Ryff Happiness Scale. Results: The MSSE has high internal consistency and test-retest reliability, both for the overall scale and for the SE Function and SE Control subscales. Results of convergent and divergent validity analyses suggest that the scale is both sensitive and specific. Conclusions: We conclude that the MSSE is appropriate for assessing self-efficacy in the MS population.