Trajectories Of Self-efficacy Research Articles

Self-efficacy beliefs as key ingredients to healthy and sustainable lifestyles. A five-year longitudinal study on diet and physical activity habits of newly diagnosed patients with acute coronary syndrome.

Cardiovascular diseases represent a significant cause of morbidity and mortality worldwide, and an unhealthy lifestyle notoriously accounts for a large percentage of their risk. Identifying resources to stimulate lifestyle changes is an essential goal of primary and secondary cardiovascular prevention. Self-efficacy beliefs are among the major psychological factors proven to impact health status and lifestyle. This study aimed to confirm the role of self-efficacy beliefs by investigating their associations over 5 years of adherence to healthy lifestyles in terms of diet and physical activity in a sample of 275 newly diagnosed patients with acute coronary syndrome. Longitudinal profiles of lifestyles and self-efficacy beliefs in their improvement were identified through latent class growth analysis. Correlations were then performed to explore the associations between lifestyles and self-efficacy trajectories. Results showed a positive association between virtuous lifestyle profiles and high self-efficacy in implementing behavioural change. Finally, two logistic regressions were performed to test the hypothesis that a high self-efficacy profile would predict better lifestyles 5 years after the coronary event. This hypothesis was confirmed for diet. Overall, current findings confirm the importance of implementing repeated psychological interventions that promote patients' efficacy beliefs in self-regulating their behaviour changes over time.

Self-efficacy and healthcare costs in patients with chronic heart failure or chronic obstructive pulmonary disease.

This study aims to explore possible associations between self-efficacy and healthcare and drug expenditures (i.e. direct costs) in patients with chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) in a study investigating the effects of person-centred care delivered by telephone. This exploratory analysis uses data from an open randomized controlled trial conducted between January 2015 and November 2016, providing remote person-centred care by phone to patients with CHF, COPD, or both. Patients hospitalized due to worsening of CHF or COPD were eligible for the study. Randomization was based on a computer-generated list, stratified for age≥75 and diagnosis. At a 6month follow-up, 118 persons remained in a control group and 103 in an intervention group. The intervention group received person-centred care by phone as an addition to usual care. Trial data were linked to register data on healthcare and drug use. Group-based trajectory modelling was applied to identify trajectories for general self-efficacy and direct costs. Next, associations between self-efficacy trajectories and costs were assessed using regression analysis. Five trajectories were identified for general self-efficacy, of which three indicated different levels of increasing or stable self-efficacy, while two showed a decrease over time in self-efficacy. Three trajectories were identified for costs, indicating a gradient from lower to higher accumulated costs. Increasing or stable self-efficacy was associated with lower direct costs (P=0.0013). The findings show that an increased or sustained self-efficacy is associated with lower direct costs in patients with CHF or COPD. Person-centred phone contacts used as an add-on to usual care could result in lower direct costs for those with stable or increasing self-efficacy.

Self-efficacy trajectories of individuals newly diagnosed with multiple sclerosis.

The first year following a new multiple sclerosis (MS) diagnosis may be a critical time for individuals as they learn to manage their disease. Effective self-management of MS likely requires healthy self-efficacy levels, yet little is known about self-efficacy in the postdiagnosis period. This study aims to improve our understanding of self-efficacy in individuals newly diagnosed with MS by examining self-efficacy trajectories and identifying patient characteristics associated with trajectories in the first postdiagnosis year. Newly diagnosed adults with MS/clinically isolated syndrome (CIS) (N = 230) completed a battery of questionnaires, including the University of Washington Self-Efficacy Scale, at 1, 2, 3, 6, 9, and 12 months, postdiagnosis. Sankey diagrams characterized self-efficacy trajectories and a multiple regression model tested patient characteristics as predictors of self-efficacy change scores. Mean self-efficacy T-scores ranged from 50.79 to 52.04 (SD = 9.40 and 10.12, respectively) across the postdiagnosis year. MS diagnosis (vs. CIS), higher disability levels, and higher MS symptom severity were associated with lower self-efficacy levels at baseline. Baseline symptom severity predicted change in self-efficacy levels from baseline to month 12 (B = -0.05, p = .030). Self-efficacy remains relatively stable in the first year following a MS diagnosis, though high symptom severity is associated with decreased self-efficacy at 12-months postdiagnosis. Clinical characteristics (e.g., MS diagnosis, disability level) also appear to play a role in setting the course of self-efficacy in this postdiagnosis year. Timely interventions that enhance self-efficacy and/or improve certain clinical characteristics may promote healthy self-management of MS that carries forward in disease course. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trajectories of college students' general self-efficacy, the related predictors, and depression: A piecewise growth mixture modeling approach

General self-efficacy plays a critical role in the development of college students, and mastering the development of students' general self-efficacy is helpful to explain students' behavior and psychological performance. Based on the data from the same cohort of college students for four consecutive years, this study used the piecewise growth mixture model to identify the developmental trajectories of general self-efficacy, built a multinomial logistic regression model to analyze the related predictors on different trajectories, and further compared the differences in depression symptoms in general self-efficacy trajectories. Three trajectories of college students' general self-efficacy were identified: stable-rising (8.7%), stable-decreasing (2.4%), and moderate and stable (88.9%). With the moderate and stable class as the reference, gender and extraversion are the predictors of students in the stable-increasing class; gender, extraversion, mother’s education level, and university tier significantly predict students who fall into the stable-decreasing class. With the stable-increasing class as the reference, gender also has a significant predictive effect on students who belong to the stable-decreasing class. However, age, ethnicity, siblings, hometown location, father’s education level, BMI, sleep, and major were not related predictors. Furthermore, mean differences in depression between latent classes of general self-efficacy trajectories were significant, and the depression scores of the stable-decreasing class were beyond the normal range in the third and fourth years. To promote college students' mental health, we suggest that colleges provide more specific psychological interventions to students based on the classification.

Learning self-efficacies influence on e-servicescapes: rethinking post-pandemic pedagogy

PurposeThe post-pandemic recognises changes are required; universities need to rethink their e-servicescapes strategies by offering different approaches to enhance students’ learning. This study aims to draw on learning self-efficacy trajectories and propose a conceptual model for exploring the predictive validity of satisfaction. In addition, it explores the mediating role of e-servicescapes and the moderating relationship effect of mature and younger students.Design/methodology/approachLearning self-efficacies is incorporated into the design of the model in an attempt to understand student cognition. The influences of e-servicescape on adopting online preferences and satisfaction are also examined. The model was empirically validated by surveying 266 respondents. Structural equation modelling and multi-group analysis were used to analyse the data.FindingsThe results of this study show learning self-efficacies has no significant influence on satisfaction. Yet, they showed a significant influence on e-servicescapes. E-servicescapes positively influenced satisfaction and preference for adopting online learning. E-servicescapes also had a mediating effect between self-efficacy to complete a course and satisfaction, as well as self-efficacy to interact with instructors and satisfaction. It had a negative suppressed effect on social interaction.Originality/valueThe research makes the following contributions. Firstly, the conceptualised model identifies an association between learning self-efficacies and e-servicescapes, suggesting universities as service providers can maximise the value offerings of their customer assets. Secondly, e-servicescapes demonstrate a full mediating effect between self-efficacies and satisfaction, indicating that if universities are to compete successfully in dynamic markets, they should co-create value in their e-servicescapes domain to increase satisfaction. Thirdly, the study recognises the need for a hybrid system of both face-to-face and online delivery because the multi-group analysis shows mature age preference for online learning is required to make this transformation successful.

The four self-efficacy trajectories among people with multiple sclerosis: Clinical associations and implications

BackgroundLongitudinal studies among people with Multiple Sclerosis (pwMS) have shown that self-efficacy is linked to physical, cognitive and psychological functioning. ObjectivesTo determine the distribution of self-efficacy in a large sample of pwMS, examining whether there are distinct groups which show different self-efficacy trajectories over time, and the health status characteristics of any groups identified. MethodsParticipants completed serial questionnaire packs, including Unidimensional Self-efficacy-MS (USE-MS) scale, for the Trajectories of Outcome in Neurological Conditions-MS (TONiC-MS) study over an average 46-month period. The resulting longitudinal data were analysed by a group-based trajectory model. Results5887 pwMS were studied: mean age 50.2 years (SD 12.0); 73.6% female; Relapsing Remitting MS (61.8%), Secondary Progressive (22.9%), Primary Progressive (11.1%), Rapidly Evolving Relapsing Remitting MS (4.2%). Four distinct self-efficacy trajectories emerged, with declining, slightly declining, stable or improving self-efficacy, each showing different patterns of health status indicators such as EQ-5D-5L, disability and depression. USE-MS ≤ 18 at baseline detected all participants in the two declining groups. ConclusionFuture trials on interventions for self-efficacy should assume a priori that those with low levels of self-efficacy (USE-MS ≤ 18 at baseline) are likely to be on a declining trajectory and may need different interventions from those with stable self-efficacy.

Home-learning during COVID-19: The psychological adjustment of minority and majority adolescents.

The coronavirus disease (COVID-19) pandemic and the resulting infringements of day-to-day life have affected families through school closures and home-learning. Yet, little research investigated how adolescents and their families could be supported during this time. Our two-wave study had three aims. First, we examined life satisfaction and academic self-efficacy trajectories among ethnic minority and majority adolescents. Second, we considered the role of the home learning environment (learning conditions and parental involvement) in explaining ethnic status group differences. Third, we studied pandemic-related familial factors that contributed to positive home learning environments. The sample comprised 121 ethnic minority (Mage = 14.04; SD = 1.25; 53% female) and 105 ethnic majority adolescents (Mage = 14.36; SD = 1.25; 59% female) in Germany. Results of repeated measures analyses of covariances (ANCOVAs) showed distinct trajectories in adolescents' adjustment (Time × Ethnic status group interaction: ηp² = .02 for academic self-efficacy and ηp² = .03 for life satisfaction). Whereas ethnic minority adolescents reported stable academic self-efficacy and a decrease in life satisfaction, ethnic majority adolescents reported stable life satisfaction and an increase in academic self-efficacy. Accounting for learning conditions reduced the differences between minority and majority adolescents to nonsignificance. Parental involvement did not explain these differences, although it was itself important for adjustment outcomes in both groups. Hierarchical regression analyses showed that good student-teacher communication, a positive family climate and fathers' short-time work contributed to the home learning environment. Findings highlight the decisive role of the family context during home-learning and the importance of learning conditions in overcoming educational disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Differential Impact of a Universal Prevention Program on Academic Self-Efficacy: the Moderating Role of Baseline Self-Control

Self-control (SC) plays a critical role in development across the life course; poor SC is a common antecedent of outcomes with high public health and societal burden including lower educational and occupational attainment, problem substance use, depression, obesity, and antisocial behavior. Further, SC is associated with academic self-efficacy and academic success; therefore, optimizing SC in early childhood could have long-term health and educational implications. However, it remains unknown whether the impact of early childhood prevention programs varies by baseline levels of SC, and whether better SC in early childhood leads to better self-efficacy in adolescence. This study leverages a sample of predominately low-/middle-income Black participants (n = 678) who were part of a randomized universal preventive trial in first grade (1993-1995). Teacher-reported SC was measured at baseline. Utilizing a three-step latent transition analysis, transitions between SC classes and academic self-efficacy trajectories were explored. Intervention status was explored as a predictor of the transition. Results suggest that teacher-rated SC in early childhood predicts academic self-efficacy up to 11 years later. Moderation analyses suggest that there are individual differences in prevention program effectiveness by baseline behavioral regulation skills. Implications for school-based universal prevention programming having an impact on low risk children and methods for exploring moderation within a prevention context are discussed.

Teacher Engagement in Language Teaching: Investigating Self-Efficacy for Teaching Based on the Project "Sino-Greece Online Chinese Language Classrooms".

The support of sustainable learning of foreign languages requires teacher engagement and a high level of self-efficacy, both of which are cornerstones for the persistence of teachers in carrying out teaching activities to help learning. The need for such attributes is even more crucial when online learning platforms as a mode of delivery are becoming increasingly popular. We would argue that keeping students engaged and motivated to attain their academic success online calls for the increased levels of resilience and efforts of teachers. Although self-efficacy of teachers has been widely considered crucial in the professional practices of teachers, there is a paucity of research studies on the self-efficacy of teachers who teach Chinese as a foreign language (CFL) using online platforms. Such a gap becomes prominent after the sudden outbreak of the COVID-19 pandemic, especially in places where there are now numerous calls for online CFL classes. In order to fill in this gap, this study was conducted with a frontline CFL teacher as the participant and aimed to detect thoroughly the trajectories of self-efficacy of a CFL teacher in a completely new teaching context. Embedded in the Project of Sino-Greece Online Chinese Language Classrooms, this study employed narrative inquiry and case study as methodological approaches. Thematic analysis was used to analyze the data that consisted of written narratives (the teacher's teaching journals and reflections, field notes of teaching assistant, and emails of students) and spoken narratives. Three research questions guided this study: What are the teacher's beliefs about (1) the opportunity of teaching CFL online? (2) the management of this online project? (3) her personal capability to foster students' engagement in this project? These three questions focused, respectively, on the three components of the self-efficacy system of a teacher (personal efficacy, efficacy within the organization, and professional efficacy). Findings illustrated that the efficacy beliefs of the teacher in these three aspects were at different levels, which resulted from the interplay of external and internal factors; when external factors appeared to be negative, internal factors seemed to play an essential role.

Trajectories of Self-Efficacy, Depressed Mood, and Anxiety From Admission to Spinal Cord Injury Rehabilitation to 1 Year After Discharge

ObjectiveSelf-efficacy (SE) is an important determinant for the psychological adjustment of people with spinal cord injury (SCI). However, little is known about the course of SE during inpatient rehabilitation up to 1 year after discharge. The aim of this study was to determine latent trajectory classes of SE, depressive mood, and anxiety in people with SCI, as well as the interrelationships between these trajectories. DesignLongitudinal inception cohort study. SettingEight specialized SCI rehabilitation centers. ParticipantsThe participants (N=268) were mainly men 183 of 268 (68.3%) with a mean age of 55.6 years. Almost half had a traumatic SCI 135 of 268 (50.4%) and tetraplegia (53.7%), and the minority had a motor complete SCI (32.2%). InterventionsNot applicable. Main Outcome MeasuresSE was measured using the University of Washington Self-Efficacy Scale. In addition, the Hospital Anxiety and Depression Scale was used to asses distress and perform dual trajectory modeling analyses. ResultsThree trajectories of SE, indicating low, middle, and high SE, could be distinguished. Furthermore, a 2-class trajectory solution for depressive mood and a 4-class solution for anxiety were found to be most suitable. All trajectories were stable over time. Developmental connections between SE and depressive mood and between SE and anxiety were revealed. In particular, participants who adjusted well, reporting low scores on depressive mood and anxiety, could be identified by their high SE scores. However, the group of participants with high depressive mood scores and anxiety scores could not always be identified based on their SE trajectory. ConclusionsIn accordance with our hypotheses, distinct trajectories of SE, depressive mood, and anxiety were identified and high probabilities that SE trajectories were interrelated to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening for SE and distress might best detect people at risk for adjustment problems.

Identifying Return to Work Self-Efficacy Trajectories in Employees with Mental Health Problems

Purpose Return to work self-efficacy (RTW-SE) is a strong predictor of return to work (RTW) in employees with mental health problems (MHPs). However, little is known about the development of RTW-SE during the RTW process. In this study, we aimed to identify RTW-SE trajectories in the year following sick leave in employees with MHPs and provided a description of the trajectories in terms of personal and work characteristics, and RTW status. Methods This multi-wave study included 111 employees with MHPs. RTW-SE was measured at baseline, and at 3, 6, and 12 months follow-up with the RTW-SE scale for employees with MHPs. Results Latent class growth analysis revealed six trajectories. In three trajectories employees had increasing RTW-SE scores, namely (class 1) low start, moderate increase, (class 3) moderate start, small increase and (class 5) moderate start, steep increase. The other trajectories were defined by (class 2) persistently high, (class 6) persistently low, and (class 4) decreasing RTW-SE scores over time. Employees across the various trajectories differed significantly with respect to RTW status, and personal and work characteristics measured at baseline, including age, gender, and type of MHP. Less favorable trajectories (class 4 and 6) were characterized by higher age, a higher prevalence of anxiety disorder and lower RTW rates. The most favorable trajectory (class 2) was characterized by a higher proportion of stress-related disorders and less major depression diagnoses. Conclusions Large heterogeneity exists in terms of RTW-SE trajectories in employees with MHPs and significant differences were found across the trajectories regarding personal and work characteristics, and RTW status. Insights into RTW-SE trajectories and their attributes are important to advance more effective and personalized RTW treatment for employees with MHPs.

Knee performance and self-efficacy trajectory curves after ACL reconstruction: A longitudinal study

ObjectivesTo examine knee flexion range-of-motion, quadriceps strength, and knee self-efficacy trajectory curves over 6 months after anterior cruciate ligament reconstruction (ACLR), stratified by patients’ Month-6 sports activity level. DesignProspective longitudinal study. SettingHospital outpatient physiotherapy department. Participants595 individuals after unilateral ACLR (mean age, 27 years). Main outcome measuresAt 2-, 3-, and 6-months post-surgery, knee flexion range-of-motion, quadriceps strength, and self-efficacy were quantified. Flexion range-of-motion was additionally measured at 2- and 4-weeks post-surgery. Sports activity levels were assessed using the Tegner Activity Score at 6-months post ACLR. ResultsThe various measures improved nonlinearly over time, with substantial improvements observed in the first 2–4 months post-surgery. In multivariable generalized least squares models, greater knee flexion range-of-motion, quadriceps strength, and self-efficacy over time were significantly associated with higher Month-6 Tegner levels (all P values < 0.01). Additionally, receiving a bone-patellar-tendon-bone graft or meniscal repair was associated with lower quadriceps strength trajectories (P-values<0.001) while female sex was associated with lower knee self-efficacy trajectories (P = 0.02). ConclusionsGreater knee flexion range-of-motion, quadriceps strength, and self-efficacy were associated with higher Month-6 Tegner levels. The derived trajectory curves may be useful for effective management decision making and adequate results interpretation during the rehabilitation process.

Trajectories of change in reading self-efficacy: A longitudinal analysis of self-efficacy and its sources

The beliefs children hold about their capabilities as readers are known to influence their reading achievement. The aim of this study was to extend previous work by examining trajectories of change in reading self-efficacy among primary school students (N = 1327) and the relations between the trajectories of self-efficacy and their hypothesized sources over 11 months. Using growth mixture modeling, we identified four trajectories of change in reading self-efficacy, involving increasing, stable, and declining trends. These trajectories of change in reading self-efficacy were associated with students’ varying experiences with the four sources of self-efficacy over time. Higher levels of mastery, verbal persuasion, and vicarious experiences and lower levels of physiological arousal were related to positive developmental trajectories of self-efficacy. Students with declining experiences of social sources of self-efficacy (i.e., verbal persuasions and vicarious experiences) had decreasing self-efficacy trajectories. These findings point to the importance of considering the variability in changes in reading self-efficacy and the interplay between changes in self-efficacy and sources of self-efficacy during primary school years, as well as the importance of monitoring these changes over time.

Mentor's Self-Efficacy Trajectories During a Mentoring Program for At-Risk Adolescents.

The concept of self-efficacy is dynamic and may change over time. Mentors of youth exposed to risk factors are likely to experience shifts in the degree to which they feel confident in their ability to form a positive mentoring bond with their mentee, potentially affecting the quality of the relationship. Based on previous literature, mentors' personality traits, their perceptions of positive mentee behaviors, and youth risk may influence changes in mentor self-efficacy over time. Our study includes 238 adolescents aged 11-18years and their mentors who were recruited for a randomized controlled trial of a mentoring-based intervention for at-risk adolescents, known as Campus Connections. We used latent class growth analysis to identify mentor subgroups with different self-efficacy trajectories. Three subgroups emerged: mentors relatively high in self-efficacy throughout the mentoring relationship, the stable group; those high in self-efficacy at the beginning of the relationship and increasingly so, the increasing group; and those moderately high in self-efficacy and decreasingly so, the decreasing group. Greater mentor conscientiousness, extraversion, and agreeableness were associated with greater likelihood of belonging to the increasing group relative to the decreasing group. Greater mentor emotionality was associated with greater likelihood of belonging to the decreasing relative to the increasing group. Mentors and mentees were also more likely to report having a positive mentoring alliance in the increasing relative to the decreasing group. We found that mentor personality traits play an important role in how mentors perceive their ability to serve as a mentor, which may have implications for mentor recruitment and training in programs designed for at-risk youth.

Longitudinal course and predictors of communication and affect management self-efficacy among women newly diagnosed with gynecological cancers.

Self-efficacy is an important psychological resource to assist people in managing chronic illness and has been associated with psychological outcomes among patients coping with cancer. Little is known about the course of self-efficacy among gynecological cancer patients coping with cancer and the sociodemographic, medical, and psychological factors that are associated with the course of self-efficacy among these patients. One hundred twenty-five women recently diagnosed with gynecological cancer completed a measure of communication and affective management self-efficacy at baseline, 5weeks, 9weeks, 6months, 1year, and 18months post-baseline. Participants also completed measures of functional impairment, holding back, perceived unsupportive behaviors of family and friends, emotional expressivity, cancer concerns, depressive symptoms, cancer-specific intrusions and avoidance, problem-solving, and positive reappraisal coping. Growth curve modeling suggested that women varied considerably in their average reports of self-efficacy and varied with regard to their linear trajectories of self-efficacy over time. Average affect management self-efficacy increased significantly over time. Greater functional impairment, more holding back, more unsupportive responses from friends and family, less emotional expressivity, more cancer concerns, depression, intrusions, or avoidance predicted lower average self-efficacy over time. Women who were less emotionally expressive or held back sharing concerns less reported lower self-efficacy which increased over time. It will be important for providers to identify gynecological cancer patients who report low ability to communicate feelings and needs and manage emotional reactions to cancer and offer them interventions which bolster self-efficacy.

Early Breastfeeding Experiences Predict Maternal Self-Efficacy During the Transition to Parenthood.

Objective: Breastfeeding can be challenging for new mothers. Women with high breastfeeding self-efficacy are more likely to breastfeed with confidence and are more likely to succeed in breastfeeding. The aim of this prospective longitudinal study was to test whether breastfeeding self-efficacy and breastfeeding experiences were related to trajectories of self-efficacy in the parenting domain during the transition to parenthood. Materials and Methods: A group of 1,091 primiparous women completed questionnaires at 32 weeks of gestation (maternal self-efficacy) and 3 months after giving birth (maternal self-efficacy, breastfeeding self-efficacy, and breastfeeding experiences). Only the women who started breastfeeding and completed questionnaires at both time points were included in the analyses (N = 817). Results: High breastfeeding self-efficacy significantly predicted increased maternal self-efficacy through the transition to parenthood. A successful breastfeeding experience fully explained this effect. Conclusion: The mediating effect of positive breastfeeding experiences on the relationship of breastfeeding self-efficacy and the change of maternal self-efficacy during the transition to parenthood implies breastfeeding to be an early target to enhance maternal self-efficacy. By pointing out breastfeeding as a genuine challenge during prenatal maternity courses, it might prepare mothers for one of their first experiences of parenthood. As a result, successful breastfeeding could be a steppingstone from positive prenatal expectations to growing confidence as a parent.

Growth Trajectories of Peer Norms, Self-efficacy and Condom Use Behavior Among Sexually Active Chinese Men Who Have Sex with Men: Latent Class Analysis and Growth Mixture Modeling.

Data from a randomized controlled trial in 2015 were used to estimate the growth trajectories of peer norms, self-efficacy, and condom use behavior, and to identify associated sociodemographic and behavioral factors among a sample of 804 Chinese men who have sex with men (MSM). Latent class analysis and growth mixture modeling were conducted using Mplus. Two growth trajectories were estimated for each outcome variable with good model fit. The growth trajectories of peer norms were related to age (β = - 0.066, p < 0.05). The growth trajectories of self-efficacy were related to age (β = 0.057, p < 0.01) and using a condom during first sexual encounter with another man (β = 0.777, p < 0.001). The growth trajectories of condom use behavior were related to income (β = 0.366, p < 0.01) and having casual male partners (β = - 1.016, p < 0.001). Predictors for the growth factors within each latent class were also estimated. For subsets of MSM who are older, richer, used a condom during their first sexual encounter with another man, and do not have a casual male partner, condom videos may not have sufficient efficacy and other interventions may be necessary.

Impact of intensive training on health professionals’ self-efficacy in establishing, running and maintaining a cardiac rehabilitation program

We developed an intensive five-day training program for health professionals working in cardiac rehabilitation (CR). The training covers topics related to establishing, running, maintaining and evaluating a CR program. The aim of this study was to assess the impact of the training on health professionals’ self-efficacy regarding the effective delivery of CR. From 2014 to 2018, 167 health professionals participated in one of five training programs. Participants completed a 28-item pre- and post-training self-efficacy scale. For a sub-group, self-efficacy was re-assessed 4 months later. Factor analysis was used to identify self-efficacy domains. Paired sample t-tests compared pre- and post-training self-efficacy scores; repeated measures analysis of variance investigated change over the three time points. Variations in self-efficacy across profession, role in CR, and years of CR practice were investigated. Factor analysis identified three domains: Operational aspects of CR; Medical aspects of heart disease; and Psychosocial aspects of CR. Health professionals’ self-efficacy increased significantly after training participation, across the three domains and for the total score. Effects were sustained in the 4-month follow-up. Few variations in self-efficacy trajectories by participant characteristics were identified. The study demonstrates that our health professional CR training significantly improves health professionals’ confidence in a range of areas related to establishing, running, maintaining and evaluating a CR program, with immediate improvements sustained four months later. The pattern of findings was largely consistent regardless of participants’ role and experience in CR. Findings highlight the benefits of this relatively brief intensive program on enhancing the capacity of the CR workforce.

Trajectories of Self-Efficacy and Depressed Mood and Their Relationship in the First 12 Months Following Spinal Cord Injury

ObjectivesTo establish self-efficacy and depressive mood trajectories in adults with spinal cord injury (SCI), determine their interrelationship over time, and determine the influence that appraisals and comorbid physical conditions have on the development of self-efficacy. DesignA prospective cohort design. SettingInpatient rehabilitation and community settings. ParticipantsAdults (N=88) admitted consecutively into 3 SCI units (mean age, 42.6 years, 70.4% male, 61% paraplegia). InterventionsMultidisciplinary inpatient SCI rehabilitation. Main Outcome MeasuresThe Moorong Self-Efficacy Scale and Hospital Anxiety and Depression Scale were used to model self-efficacy and depressive mood trajectories. Appraisals were assessed using the Appraisals of Disability Scale and frequency/type of secondary conditions using the Secondary Conditions Scale. Growth mixture modeling was used to determine trajectories. Dual trajectory probability analysis was used to determine concurrent changes in self-efficacy and depressive mood. Linear mixed modeling incorporating repeated measures determined the contribution of appraisals and physical complications to self-efficacy trajectories. ResultsModeling identified 4 trajectories of self-efficacy and depressive mood. The majority (around 60%) of the sample was estimated to have moderate to high self-efficacy and low levels of depressive mood. Dual trajectory analysis revealed that robust self-efficacy was strongly connected to low depressive mood over time, while low self-efficacy was strongly linked to clinically elevated depressive mood. Low self-efficacy was related to higher severity of secondary conditions and negative appraisals. ConclusionsFindings highlight the importance of self-efficacy not only as a strategic clinical measure for assessing adjustment following SCI but also in relation to the implications it raises for improving SCI rehabilitation.

Colorectal cancer patient\u2019s self-efficacy for managing illness-related problems in the first 2\xa0years after diagnosis, results from the ColoREctal Well-being (CREW) study

PurposeThere is a growing emphasis on self-management of cancer aftercare. Little is known about patient’s self-efficacy (confidence) to manage illness-related problems and how this changes over time. This paper describes the patterns of self-efficacy for managing illness-related problems amongst colorectal cancer patients in the 2 years following diagnosis.MethodsIn this prospective cohort study, questionnaires were administered at baseline (pre-surgery), 3, 9, 15 and 24 months to 872 colorectal cancer patients. Self-efficacy (confidence to manage illness-related problems), anxiety, social support, affect, socio-demographics, physical symptoms and clinical and treatment characteristics were assessed. Group-based trajectory analysis identified trajectories of self-efficacy up to 24 months and predictors.ResultsFour trajectories of self-efficacy were identified: group 1 (very confident) 16.0% (95% confidence interval (CI) 10.7–21.3%), group 2 (confident) 45.6% (95% CI 40.3–51.0%), group 3 (moderately confident) 29.5% (95% CI 25.1–33.8%) and group 4 (low confidence) 8.9% (95% CI 6.4–11.4%). Greater deprivation, domestic status, more co-morbidities, worse fatigue and pain, lower positivity and greater negativity were significantly associated with lower self-efficacy. There was an increase in mean scores for self-efficacy over time for the whole sample, but this did not reach the cut-off for minimally important differences. At 2 years, the lowest level of confidence to manage was for symptoms or health problems.ConclusionAround 40% of patients had suboptimal levels of confidence to manage illness-related problems with little change from the time of diagnosis across the four groups.Implications for cancer survivorsScreening for self-efficacy at diagnosis would enable targeted, early intervention which could in turn enhance health-related quality of life.