Building Competency in Diabetes Education THE ESSENTIALS

FOUNDATIONS OF DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT| 2-53

Figure 8. Common concepts in behavioural change theories (155,157,158)

Self-efficacy Self-efficacy refers to the degree of confidence (or efficacy) a person has in performing a set of behaviours which directly correlates with the likelihood that the behaviours will actually be performed (159,160). The extent to which patients engage in behaviours is determined by a judgement they make regarding their ability to accomplish particular tasks in particular circumstances — the “I can”.

Self-efficacy is derived from four sources of information (160): 1. A patient’s own mastery experience with the behaviour.

2. Self-evaluation based on observation of and comparison with performance by others. 3. Verbal persuasion modified by personal confidence in the person attempting to persuade. 4. Self-evaluation of physiologic state/state of arousal. This theory suggests that diabetes SME and SMS should focus on one or more of these sources to increase self-efficacy. An influential source of efficacy for people with diabetes is their own mastery experience; the confidence gained in learning a new health self-care behaviour encourages them to continue in the change process. Facilitating learning in this context involves helping patients identify their behavioural successes in similar situations or previous experiences. However, it is important to remember that self-efficacy is specific to individual