This presentation is all about
the social cognitive theory.
When nurses think about reasons that patients change or
don't change their behaviors, we often focus on education.
You'll hear nurses say "If they only
knew better, they'd do better."
But, the reality is that there are several factors that
determine behavior change and education is just one.
The social cognitive theory provides the structure to
understand several factors that influence behavior.
These include environmental,
cognitive, and behavioral factors.
During this presentation, I'll walk you
through the social cognitive theory
and provide examples of how nurses can use
this model to improve health outcomes.
So, let's first start
with an overview.
There are 3 major constructs to the social
cognitive theory, and you see them here.
We have cognitive in purple, behavioral
in blue, environmental in orange.
And you'll see that all 3 factors
interact to influence behavior.
That's what you see in
the middle in green.
The theory views people as active agents who both
influence and are influenced by their environment.
A major component of the
theory is observed learning.
This is the process of learning about behaviors that are
desirable or undesirable simply by observing others.
Further, with this theory, we
understand the individual beliefs
and their own self-efficacy influence whether
or not they'll reproduce an observed behavior.
So, let's take a look at each of the 3 components
starting first with cognitive factors.
Cognitive factors are also
called personal factors.
These are knowledge or expectations based
on previous experiences and attitude.
This also includes personal factors that
influence behavior such as age or ability.
Next, we have environmental factors.
This includes social norms.
So, is the behavior considered
This also includes access to resources and the
influence of others or support of friends and family.
And then finally, we have
aspects of the behavior itself.
We understand that in order to perform a behavior,
a patient must have the skills to do so.
They must practice the behavior
and see positive results.
Patients must also have
This means that they believe that they have control
over the outcome by engaging in a specific behavior.
Together, these 3 types of
factors influence behavior.
And remember, since a major component of
the theory is observational learning,
we recognize that all 3 of these
factors are influenced by what we see.
We don't necessarily need someone to tell
us that a behavior is socially acceptable.
Rather, we observe reactions around
us to determine if it is or not.
It's also important to recognize that
successful efforts to change behaviors
depend on identification of positive supports
and the detractors of each of the 3 constructs.
For example, if it's socially accepted
among a group of peers to use drugs,
one way to decrease drug use
maybe to find a new peer group
that finds drug use to be undesirable
or not socially accepted.
Let's take a look at a case study to see how
we can apply this theory to our practice.
Imagine you're working with the patient
who's struggling to control their diabetes.
Let's consider how we can influence each factor of
the social cognitive theory to improve outcomes.
Cognitive factors: Here,
you may focus on attitude.
What is the nursing intervention that
you could use to influence attitude?
Think about the need to meet a patient where
they are to really understand their perspective.
Motivational interviewing could be one strategy
that you could use to influence attitude.
Environmental factors: Here, we consider
social norms and social supports.
Let's say you talk to your patient and find out
that they have little support at home from family.
They don't know anyone
else who has diabetes.
What might you do here to influence
their environmental factors?
Maybe, you refer them to a diabetes support group where they
meet others who can help support them in their challenges.
And then finally, we
have behavioral factors.
Remember that not only does the patient
need knowledge, they also need skills
and they need to believe that they
have the power over their behaviors.
What might you do here to help a
patient build skills and confidence?
You could demonstrate, have
them return demonstrate,
and we always encourage small changes
and reward that skill building process.
By using the social cognitive theory to
understand cognitive, environmental,
and behavioral factors that
influence our patients,
we're able to collaborate with them to
improve outcomes through behavior change.