How self-efficacy can help!

When challenged with dealing with chronic illness or trying to adhere to a weight loss program, a wellness program or a diabetes management regimen, researchers have found that people who have a sense of “self-efficacy” may be more successful in adhering to their plan.
Even if other psychosocial supports - such as family or support group, are not all favorable, a strong sense of self-efficacy can offset these difficulties.

The concept of self-efficacy was proposed by Bandura (1977) and was developed within the framework of what is called “social learning theory.” The self-efficacy model defines self-efficacy as the individual’s perception of his or her ability to carry out a given behavior or group of behaviors.  This sense of self efficacy has an effect on the person’s emotions (feelings), cognitions (thoughts), and motivation in difficult or threatening situations such as facing life-long self management of illness or health maintenance.   In other words, if a person faced with the demands of self-management gains a sense of self-efficacy, then mood, and  thoughts and his/her motivation may be enhanced and in turn, contribute to success in self-care of one’s health.

Are you a Victim?

When you experience a health crisis – whether it’s being newly diagnosed with a disease, experiencing overwhelming stress from dealing with a chronic disability or recovering from an injury, feeling angry may be a normal response.  However, ongoing anger is not a healthy response to the stressor and may keep you from healthy management and feeling better in the long run.   Chronic anger may add to your stress levels, increase the cortisol in your system, which in turn contributes to more inflammation and poorer health. The key is to learn and then act on the knowledge that there are normal and healthy anger responses and there are also unhealthy anger responses.

In addition to denial, what is another common and unhealthy anger response? In addition to denial, which I discussed last week, is a type of anger response that involves seeing yourself as victim of your circumstances, your disease, and even your overall health status. Taking on a role as 'victim' may not seem like an anger response, but it is in essence, blaming externals for your course of illness and treatment and denial of your own agency in the process. This passive denial approach to disease and illness management was in many ways, considered appropriate and a normal adjustment as few as 25 years ago. The older medical model of ‘compliance,’ inferring that the healing professional knows everything and the patient (victim of the disease or accident) must only listen and follow directions in order to heal and become whole again, was a largely accepted viewpoint in medicine for many, many years.  We now know that for most patients, the best approach to disease management involves ‘adherence’ to the treatment plan. 

Adherence involves the patient actively learning, discussing and contributing to decision making with his/her health professional.   As a result, research shows that for most, this leads to higher motivation and better success in managing their disease.   For example, if diabetes management is your issue, then together with the health care professional, you establish your goals, how you’re going to achieve them and how long you will take to meet each objective.  Having this kind of agency and ownership of your treatment plan will help you overcome feelings of anger and be successful in the long run. So then, what is one of the best ways to overcome feeling victimized?   Become an active patient, willing to learn new things, ask questions, speak up about your denial, fears and your hopes and work together with your health care professional to improve your health and your wellbeing.

Adherence leads to success!

Research continues to point patients and health care providers to the awareness that adherence to a weight loss (and if diabetic, better glucose control) program is somewhat complicated.
What actually is adherence?  In simple terms, it’s the patient’s purposeful attitude and behaviors that result in success over time in following the self-management regimen, whether it’s weight loss or glucose control or lowering your blood pressure.  Adherence is a different concept that the older ‘compliance’ model.  Compliance infers an obedience and behavior based on another person's demands. We know now, that if you only follow your doctor’s orders, because he or she said you must, you are more likely to fail in successful self-management of your health challenges.  If you take on some of the responsibility, learn as much as you can about your diagnosis or health problem, ask questions of your health care professionals and make your own personal commitment to health improvements, you will be much more successful in the outcome!  What do you think?  Reply to my blog and let me know if any of this resonates with what you are experiencing!