Have you ever wondered what influences a person to do what he or she does?
Or what motivates them in the process? Albert Bandura, a psychologist, interpreted this information and formulated a theory to give us a better understanding of this aspect in human nature. The theory he proposed is called “The Social Cognitive Theory”. This theory views a person’s attitude, demeanor and response to the environment. Some important aspects this theory covers include observational learning, reciprocal determinism and self-efficacy (Boyd, S. Wood & E. Wood, 2008). Observational learning is when an individual learns by observing the behavior of another person, which is usually a role model or powerful person.
The result of the behavior, whether the person being observed was rewarded or punished, usually determines whether the behavior learned would be performed or not (Boyd, S. Wood & E. Wood, 2008). In order for observational learning to take place, the observer must go through the process. This process includes attention, retention, reproduction and reinforcement (Boyd, S. Wood & E. Wood, 2008). In other words, the person needs to attend to the model, must store the information, must be physically and cognitively capable of performing the behavior and must be motivated to practice and perform the behavior, respectively. Reciprocal determinism is an interaction of internal, environmental and behavioral variables that influences a person’s personality.
A behavioral variable is the actual behavior of the person. Environmental variables includes consequence of situations, and social source of information. Internal variables are personal variables, which includes beliefs, intelligence, stage of cognitive and social development, etc. (Boyd, S. Wood & E. Wood, 2008). All three aspects, internal, behavioral and environmental are influenced by each other and influence the person’s personality (Boyd, S. Wood & E. Wood, 2008). Lastly is self-efficacy, in which the person has the perception that he or she can efficiently perform or provide what’s needed to succeed in a situation.
According to Cherry (2014), “a person’s attitudes, abilities, and cognitive skills comprise what is known as the self-system”. If a person self esteem is affected then self-efficacy will also be affected. Self-efficacy plays an important role in how an individual tackle everyday situations, goals and responsibility. “People with high efficacy view challenging problems as tasks to be mastered, develop a deeper interest in the activities in which they participate, form a stronger sense of commitment to their interests and activities, and recover quickly from setbacks and disappointments” (Cherry, 2014). Where as people with a “weak sense of self-efficacy avoid challenging tasks, believe that difficult tasks and situations are beyond their capabilities, focus on personal failings and negative outcomes, and quickly lose confidence in personal abilities” (Cherry, 2014). Self- efficacy is a never-ending process that begins during childhood years and continues throughout life. There are 4 ways for person to develop self-efficacy and this includes mastery of experiences (where a person performs task successfully and it builds their confidence), social modeling (in which the person witness others successfully completing their task), social persuasion (in which a person is receiving verbal encouragement from others), and psychological response (which considers a person’s mood and physical and emotional state) (Cherry, 2014). In the Social Cognitive Theory, all of these are important components in understanding human nature.
Out of all the components I will focus more on self- efficacy as it is related to the articles I will speak about. The first research I will speak about is a qualitative, exploratory, descriptive study based on COPD.
This study was done to examine how self-regulation, or self-efficacy in other words, can help an elderly patient with COPD recognize exacerbations based on day-to-day symptoms (Brandt, 2012). COPD is a chronic disease that progressively limits airflow in the lungs and has an increased prevalence in the elderly population (Brandt, 2012). Even though elderly patients are aware of the symptoms, many are unable to monitor, recognize or report symptoms of worsening condition (Brandt, 2012). This leads to an increase in healthcare utilization with increase expenses, a decline in lung function and a decrease in the quality of life experience(Brandt, 2012). The researcher rationalizes the need for this study based on the fact that there is no research on COPD and self-regulation (Brandt, 2012).
The researcher recruited 28 patients through the offices of 4 pulmonary medicine specialists. The inclusion criteria included English-speaking adults, age 50 or older with COPD from the Upper- Midwest community. The researcher obtained approval from the Institutional Review Board (IRB) and also obtained informed consent before performing interviews. The interviews lasted approximately 45 to 90 minutes and was recorded and transcribed verbatim. The subjects were also asked to keep a reflective journal which was a collected and reviewed. The researcher found that the patients all used self-regulation or self-efficacy to some degree (Brandt, 2012).
Under self-regulation each person showed some degree of self observation (by being able to identify symptoms, and associating emotions, such as anxiety to dyspnea), self judgment (by using past experiences or baseline to compare current exacerbations) and self reaction (by seeking medical care or choosing not to) (Brandt, 2012). These 3 aspects mentioned are related to the self efficacy theory. In order for one to be self efficient, a person must have the ability and cognitive skill to know that something isn’t right and take action on it. This information reinforces that elderly patients with COPD need education about the disease, its progression, management, medications and a plan that states when a person should see a health care provider (Brandt, 2012).
As mentioned in the study, none of the 28 participants had a action plan of when to seek medical attention based on the symptoms the person was experiencing. This increased their risk of dying and having a poor quality of life. These patients also need knowledge on how to prevent complications such as respiratory infections by getting the influenza vaccine. The second research, is a quantitative, experimental, RCT using a between subject with a pretest and post test design.
This purpose of this study was to report findings of self efficacy in patient with breast cancer, using Bandura’s theory as a framework, based on the interventions that were performed (Lev & Owen, 2000). The researcher rationalized the need for this study because even though previous research suggested the need for patients to have a active coping strategy during treatment to increase self efficacy, no research have ever measured the patients self efficacy (Lev & Owen, 2000). This study did not convey how human subjects were protected. The inclusion criteria included that the person had to be a female, receiving chemotherapy for breast cancer, ranging from ages 32 to 72.
The researchers randomly selected 18 females undergoing chemotherapy for breast cancer and placed 10 in the experimental group and 8 in the control group. The experimental group had 5 interventions deliver monthly whereas the control had usual care. The interventions that were done included viewing videos on survivors of breast cancer who used self care behaviors to prevent side effects, a booklet that describes strategies such as guided imagery and self encouragement and 5 counseling sessions at monthly intervals(Lev & Owen, 2000). Data was collected on 3 intervals, before the treatment or baseline, at 4 months and then at 8 months.
The result of the study was based on size effect. (eta[n]^2).It concluded that the quality of life measured by the “Functional Assessment of Cancer Treatment (FACT) to be medium (n^2=.096), for symptom distress measured by the Symptom Distress Scale (SDS) was large (n^2= .140)” (Lev & Owen, 2000). Also, for “self-care self-efficacy measured by Strategies Used by Patients to Promote Health (SUPPH) the results ranged from small (n^2=.01) for enjoying life and stress reduction, medium (n^2= .089) for coping, and large (n^2 =.141) for making decisions” (Lev & Owen, 2000). In other words the results implied the intervention promoted self efficacy, increased quality of life and decreased symptoms distress. This study makes us aware that it is very important for health care providers to understand cancer, its treatment, as well as complications and issues a person might have.
In addition to this it’s most important to provide guidance, using interventions mentioned in the study to promote healthy and increased quality of life for patient (Lev & Owen, 2000). This theory was used as a framework to show what is needed to improve self efficacy. Overall, in both studies, self efficacy is an important component is a person’s life.
In order for one to be self efficient they must have the attitude, ability and cognition to succeed. By having this knowledge of information, it allows a person to grow, be the best they can be and have a increased quality of life. In both studies, whether the degree of self efficacy was strong or not, it was still important. Therefore, what I learned is that knowledge is power. And as a health care provider it is critical for us to promote self efficacy by utilizing the interventions mentioned in the studies. Using interventions will promote a person self esteem making them self efficient and independent.
References:
Brandt, C.L. (2013). Study of older adults use of self regulation for COPD self management informs and evidence based patient teaching plan. Rehabilitation nursing, 38, 11-13. Boyd,
D., Wood, S.E., & Wood, E.G. (2008). Mastering the world of psychology (3rd edition). Boston: Pearson.
Cherry, K. (2014). What is self- efficacy? Retrieved from http://psychology.about.com/od/theoriesofpersonality/a/self_efficacy.htm
Lev, E.L., Owen, S.V. (2000). Counseling women with breast cancer using principles developed by Albert Bandura. Perspectives in psychiatric care, 36,131-138.
