To Thompson D (2004) commentary on Lau-Walker (2004).
Explore the source record for details and available documents.
Attitude of Health Personnel↗
Biomedical subjects
Margaret Lau-Walker
Publications and source records attributed to Margaret Lau-Walker.
A conceptual care model for individualized care approach in cardiac rehabilitation--combining both illness representation and self-efficacy.
PURPOSE: This paper analyses the two prominent psychological theories of patient response--illness representation and self-efficacy--and explore the possibilities of the development of a conceptual individualized care model that would make use of both theories. METHODS: Analysis of the literature established common themes that were used as the basis to form a conceptual framework intended to assist in the joint application of these theories to therapeutic settings. RESULTS: Both theories emphasize personal experience, pre-construction of self, individual response to illness and treatment, and that the patients' beliefs are more influential in their recovery than the severity of the illness. Where the theories are most divergent is their application to therapeutic interventions, which reflects the different sources of influence that each theory emphasizes. Based on their similarities and differences it is possible to integrate the two theories into a conceptual care model. CONCLUSION: The Interactive Care Model combines both theories of patient response and provides an explicit framework for further research into the design of effective therapeutic interventions in rehabilitation care.
Attitude to Health↗
Predicting self-efficacy using illness perception components: a patient survey.
OBJECTIVES: To assess the measures of illness representation components in predicting measures of self-efficacy in patients with coronary heart disease. DESIGN: A longitudinal design was adopted with predictor variables and dependent variables (general self-efficacy, diet self-efficacy and exercise self-efficacy) measured twice while participants were in hospital and 9 months following discharge. Change scores of the predictor variables can be calculated and dependent variables at baseline can be controlled. METHOD: A cohort sample of 300 patients admitted to hospital with coronary heart disease were given the questionnaire measuring their illness perception (illness representation components: identity, consequences, timeline and control/cure and outcome expectation for diet and exercise); self-efficacy (general, diet and exercise self-efficacy measures), demographic and illness characteristics and attendance on a cardiac rehabilitation programme. The patients were asked to complete the questionnaire in hospital before discharge following their cardiac diagnosis, and again, 9 months later, when participants were expected to be functioning independently of any rehabilitation programme. RESULTS: Demographic and illness characteristics were found to have a more significant relationship with illness representation components than with specific self-efficacy. The relationship between illness representation components and specific self-efficacy changes overtime, consequence and timeline were significantly related to self-efficacy measures initially; however, symptom and control/cure were the variables that were significantly related to self-efficacy measures 9 months later. After statistically controlling individuals' baseline self-efficacy measures, demographic and illness characteristic effects, symptom and control/cure were found to make significant contributions to exercise and diet self-efficacy, respectively, 9 months later. CONCLUSION: A significant relationship exists between illness representation and self-efficacy. There is potential to integrate both approaches to the assessment of psychosocial factors to provide effective individualized care in cardiac rehabilitation.
Attitude to Health↗
Cardiac rehabilitation: the importance of patient expectations--a practitioner survey.
BACKGROUND: Numerous cardiac rehabilitation national guidelines consistently endorse the need for psychological support to create effective individualized care. Recent surveys suggest that the psychological factors remain poorly assessed and the measurement of psychological parameters remains patchy. AIM: To examine cardiac rehabilitation practitioners' perception and understanding of the importance of patient expectations and their capacity to assess and utilize these expectations to develop individualized care. METHODS: A survey of cardiac rehabilitation professionals from 10 hospitals in the south-east of England. The questionnaire used in the survey was developed from content analyses of the current cardiac rehabilitation literature and expectancy theory articulated in Bandura's writings. RESULTS: The results of the study show that cardiac rehabilitation practitioners are very aware of the general importance of patient expectations but have little structured support in the development of techniques to either assess these expectations or to utilize them in a therapeutic context. This leaves them unsure about the extent to which patients do receive individualized care and how best to develop their own practice in this regard. RELEVANCE TO CLINICAL PRACTICE: This study suggests that there is a need for the development of a structured assessment tool, which has a sound theoretical basis to assess patients' expectation if good practice is to be established in providing individualized car in cardiac rehabilitation.
Attitude of Health Personnel↗
Relationship between illness representation and self-efficacy.
AIM: This paper reports a patient survey exploring the possible relationship between illness perception and self-efficacy following a cardiac event, and the implications this could have for nursing practice. BACKGROUND: Cardiac rehabilitation guidelines endorse the need to improve psychological care; suggesting that individualized support will improve the effectiveness of cardiac rehabilitation. Surveys, however, continue to identify that psychosocial factors are poorly assessed. Illness representation and self-efficacy are two prominent research approaches that have been developed as separate foci for the treatment of patients. METHOD: A cross-sectional survey with patients diagnosed with either myocardial infarction or angina over an 8-month period in two hospitals. The Illness Perception Questionnaire, General Self-Efficacy Questionnaire, Cardiac Diet Self-efficacy Instrument and Cardiac Exercise Self-efficacy Instrument were used, alongside two specifically-designed scales: the Diet Outcome Expectation and Exercise Outcome Expectation Scales. RESULTS: The results indicate that there is a significant relationship between illness perception and self-efficacy. The greater patients' perceived consequences of the heart condition, the lower was the general self-efficacy available to cope with the condition. Further, the longer the perceived time the condition will affect the patient, the higher the specific self-efficacy to maintain a change of diet or exercise regime. CONCLUSION: The findings identify that, in the initial phase of recovery, nursing practice needs to focus on the key variables of "consequence" and "timeline" in order to increase patients' confidence in their ability to cope (self-efficacy).
Adult↗