Self-Efficacy and Self-Care: Missing Ingredients in Health and Healthcare among Adults with Serious Mental Illnesses

To help inform the design of a self-management intervention for improving the physical health of adults with serious mental illnesses, we conducted focus groups about their perceived medical care and physical health needs. Adults with serious mental illnesses participated in four semi-structured focus groups conducted at a transitional living facility, a social club, and a Hispanic outpatient mental health clinic. Questions included their recent experiences of seeking medical care, the effect of having a mental illnesses diagnosis, strategies for active self-care, and perceived barriers to better physical health. In addition to various systemic barriers to better medical care, participants articulated limited knowledge and self-efficacy regarding active self-management of their physical health. Despite their interest in learning more about health promotion, most participants expressed a sense of personal futility and powerlessness in improving their health. These data suggest that any effort to improve the wellbeing of these adults will need to address self-efficacy in the hope of improving self-care for their physical health needs.

乳腺癌患者自我效能感培养与焦虑抑郁研究

目的分析培养乳腺癌患者的自我效能感对其焦虑抑郁心理的影响。方法对37例女性乳腺癌患者进行自我效能感培养,并分别在患者入院初期、手术后2周使用汉密顿焦虑量表（HAMA）及汉密顿抑郁量表（HAMD）评估患者的焦虑抑郁症状。结果入院初期乳腺癌患者焦虑、抑郁评分分别为20．04±5．09、22．36±5．51,进行自我效能感培养后焦虑、抑郁评分为13．66±5．02、16．53±5．03,经配对t检验,有显著差异（P〈0．05）。结论对乳腺癌患者进行自我效能感培养,可有效改善乳腺癌患者的焦虑抑郁心理。     

Promoting Self-Efficacy in Minimally Invasive Surgery Training

Many surgeons continue to actively pursue surgical approaches that are less invasive for their patients. This pursuit requires the surgeon to adapt to new instruments, techniques, technologies, knowledge bases, visual perspectives, and motor skills, among other changes. The premise of this paper is that surgeons adopting minimally invasive approaches are particularly obligated to maintain an accurate perception of their own competencies and learning needs in these areas (ie, self-efficacy). The psychological literature on the topic of self-efficacy is vast and provides valuable information that can help assure that an individual develops and maintains accurate self-efficacy beliefs. The current paper briefly summarizes the practical implications of psychological research on self-efficacy for minimally invasive surgery training. Specific approaches to training and the provision of feedback are described in relation to potential types of discrepancies that may exist between perceived and actual efficacy.     

Self-efficacy: A Comparison Between Clinically Anxious and Non-referred Youth

Although diminished self-efficacy has been linked to childhood psychopathology, including depression, it has only recently been studied in relation to childhood anxiety disorders. This study examines the relationship between self-efficacy and self-reported anxiety in children who have been referred for an assessment and possible treatment of anxiety symptoms as well as a comparison group of non-referred children. A self-efficacy questionnaire for children and a childhood anxiety measure were administered to a group of children referred for assessment and treatment of a clinical anxiety disorder (n = 50) and a non-referred control group (n = 50). Results indicate that the two samples differed significantly on measures of emotional self-efficacy, but not in terms of self-reported anxiety or other self-efficacy domains. Potential explanations for observed findings are discussed, including the possibility that self-reports of emotional self-efficacy in children may vary by clinical or referral status, amongst those reporting higher levels of anxiety overall.     

社区中老年2型糖尿病患者自我效能与生活质量的调查

目的：评价社区中老年2型糖尿病患者的自我效能与生活质量的现状。方法：采用糖尿病管理控制自我效能量表和糖尿病患者特异性量表,进行问卷分析。结果：2型糖尿病患者自我效能与生活质量不够理想;不同组别2型糖尿病患者自我效能与生活质量得分比较,差异有显著性;2型糖尿病患者自我效能与生活质量密切相关。结论：社区中老年2型糖尿病患者自我效能和生活质量水平均有待提高,应以自我效能理论为依据,重视并健全社区糖尿病健康教育,采用各种方法调动患者的自身潜能。以增加自我效能,提高患者的生活质量。     

When, why and for whom there is a relationship between physical activity and menopause symptoms

Objectives

The relationship between enhanced physical activity and decreased menopause symptoms is equivocal. In this study we sought to better understand this relationship by examining the association of physical activity to different symptom domains and by examining mediating and moderating variables.

Study design

Women participating in a randomized control trial on physical activity were given a menopause symptom measure (MENQOL) at follow-up. Of the 280 women participating, 113 (mean age = 52) reported having symptoms they attributed to menopause. Regression analyses were run to examine if change in physical activity predicted fewer symptoms. Exercise self-efficacy was examined as a mediator and depressive symptoms as a moderator.

Results

An increase in physical activity from baseline was found to be related to reporting fewer total menopause symptoms (β = −0.22, p = .02). When the total menopause symptoms score was examined by domain, increased physical activity was found to be related to reporting fewer general symptoms attributed to menopause (psychosocial (β = −0.18, p = .05) and physical (β = −0.23, p = .01)), but had no effect on specific symptoms of menopause (vasomotor and sexual). Exercise self-efficacy was found to mediate the relationship between increased physical activity and total, physical and psychosocial menopause symptoms. Finally, for individuals with high depressive symptoms, those who increased physical activity the most reported fewer sexual symptoms of menopause.

Conclusion

This study suggests that physical activity participation is associated with lower general symptom reporting as opposed to specifically impacting menopause symptoms. Further, exercise self-efficacy mediates the relationship between physical activity and general menopause symptoms, suggesting a psychological pathway.     

自我效能感与糖尿病患者血糖控制情况的研究

目的探讨糖尿病患者自我效能感对糖尿病控制情况的影响。方法选择我院80例门诊糖尿病患者分为两组,观察组给予临床路径干预,评测两组患者自我效能感和糖尿病控制情况。结果观察组自我效能感、空腹血糖、餐后血糖和糖化血红蛋白控制方面都优于对照组。结论患者自我效能感的提高,改善了患者的糖尿病控制情况,满足了患者的健康需求。     

Development and validation of the Chinese version of the Diabetes Management Self-efficacy Scale

OBJECTIVE: The purpose of this study was to translate the Diabetes Management Self-Efficacy Scale (DMSES) into Chinese and test the validity and reliability of the instrument within a Taiwanese population. RESEARCH DESIGN AND METHODS: A two-stage design was used for this study. Stage I consisted of a multi-stepped process of forward and backward translation, using focus groups and consensus meetings to translate the 20-item Australia/English version DMSES to Chinese and test content validity. Stage II established the psychometric properties of the Chinese version DMSES (C-DMSES) by examining the criterion, convergent and construct validity, internal consistency and stability testing. The sample for Stage II comprised 230 patients with type 2 diabetes aged 30 years or more from a diabetes outpatient clinic in Taiwan. RESULTS: Three items were modified to better reflect Chinese practice. The C-DMSES obtained a total average CVI score of .86.The convergent validity of the C-DMSES correlated well with the validated measure of the General Self-Efficacy Scale in measuring self-efficacy (r=.55; p<.01). Criterion-related validity showed that the C-DMSES was a significant predictor of the Summary of Diabetes Self-Care Activities scores (Beta=.58; t=10.75, p<.01). Factor analysis supported the C-DMSES being composed of four subscales. Good internal consistency (Cronbach's alpha=.77 to .93) and test-retest reliability (Pearson correlation coefficient r=.86, p<.01) were found. CONCLUSIONS: The C-DMSES is a brief and psychometrically sound measure for evaluation of self-efficacy towards management of diabetes by persons with type 2 diabetes in Chinese populations.     

老年人和大学生自我效能感与应付方式的差异

目的 探讨自我效能感和应付方式的年龄差异以及两者之间的特征.方法 以48名老年人和49名在校大学生为被试,进行背景信息问卷、应付方式问卷、一般自我效能感问卷施测.结果 (1)在控制了教育水平差异之后,老年人自我效能感得分[(43.47±11.49)分]高于大学生[(40.82±7.88)分]差异具有显著性( P <0.05);在应付方式上,解决问题和自责2个维度存在显著年龄差异( P <0.05).(2)自我效能感和应付方式部分维度有显著相关( P <0.05),且老年人和大学生的相关模式不同.(3)在应付方式上,大学生的自我效能感高分组和低分组差异有显著性( P <0.05),老年人则没有.结论 老年人和大学生的自我效能感、应付方式以及两者之间的关系模式皆存在显著年龄差异.     

实习医学生的自我效能及其作用的相关研究

目的研究实习医学生的自我效能感水平及其相关因素,探讨自我效能感在医学教育中的作用。方法采用＂人脸量表＂、＂一般自我效能感量表＂、＂特质应付方式量表＂、自编职业压力量表,来进行测量评定。结果实习医学生的自我效能感与主观幸福感、应付方式、职业压力之间存在显著相关性。结论自我效能感与实习医学生的职业满意度下降、离职率升高有关。