Application of the Theory of Self-Efficacy:

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Presentation transcript:

Application of the Theory of Self-Efficacy: Medication Adherence in the Elderly population

Background The elderly population uses prescription medications three times more than the general population and yet has the lowest rate of compliance (Morgan & Brosi, 2007, p. 420). Non-adherence is related to side effects and lack of understanding of use (Swanlund, Scherck, Metcalfe, & Jesek-Hale, 2008, p. 239). Nurses can help.

Clinical Problem A lack of self-efficacy is a contributing factor to non-adherence to prescribed medication in the elderly population.

Significance of the Problem Self-efficacy decreases with aging (Esposito, Gendolla, & Van der Linden, 2014, p. 522). Non-compliance is prevalent among women (Swanlund et. al., 2008, p. 238) 2 out of 10 patient report adherence is influenced by inner belief of prescribed medications (Gatti, Jacoson, Gazmararian, Schmotzer, & Kripalani, 2009, p. 657).

The theory of Self-Efficacy A person’s judgment of their own abilities (Resnick, 2014, p. 197). Concepts: self-efficacy expectations and outcome expectations. Models: Enactive attainment Vicarious experience Verbal persuasion Emotional arousal

Application of the Theory Function-focused care approach (Resnick, 2014, p. 211): Environment and policy/procedure assessment: a) Accessibility of medication b) Method of storage c) Health literacy/belief about medication 2. Education: a) use, frequency, adverse effects of medication b) use of visual or auditory demonstration c) active participation

Application of the Theory 3. Development of function-focused goals: a) Establish a time of day to take medication b) Integrate into habits and routines c) Eliminate barriers 4. Mentoring and motivating: Provide feedback through phone calls Nurse visit Recognize effort of family members

Conclusion Theory can be used to manage adherence in the elderly population. Ongoing assessment, education, review of goals, and motivation. Higher self-perception, higher self- efficacy.

References Esposito, F., Gendolla, G. E., & Van der Linden, M. (2014). Are self-efficacy beliefs and subjective task demand related to apathy in aging?. Aging & Mental Health, 18(4), 521-530. doi:10.1080/13607863.2013.856865. Gatti, M., Jacobson, K., Gazmararian, J., Schmotzer, B., & Kripalani, S. (2009). Relationships between beliefs about medications and adherence. American Journal of Health-System Pharmacy, 66(7), 657-664. doi:10.2146/ajhp080064. Morgan, M., & Brosi, W. (2007). Prescription drug abuse among older adults: a family ecological case study. Journal of Applied Gerontology, 26(5), 419-432. Resnick, B. (2014). In M.J. Smith & P. R. Lierh (Eds.), Middle range theory for nursing. New York: Springer Publishing Company. Swanlund, S., Scherck, K., Metcalfe, S., & Jesek-Hale, S. (2008). Keys to successful self-management of medications. Nursing Science Quarterly, 21(3), 238-246.