Social Cognitive Theory (SCT) (Nursing)

00:00 This presentation is all about the social cognitive theory.

00:06 When nurses think about reasons that patients change or don't change their behaviors, we often focus on education.

00:13 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.

00:24 The social cognitive theory provides the structure to understand several factors that influence behavior.

00:30 These include environmental, cognitive, and behavioral factors.

00:35 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.

00:45 So, let's first start with an overview.

00:47 There are 3 major constructs to the social cognitive theory, and you see them here.

00:52 We have cognitive in purple, behavioral in blue, environmental in orange.

00:58 And you'll see that all 3 factors interact to influence behavior.

01:02 That's what you see in the middle in green.

01:05 The theory views people as active agents who both influence and are influenced by their environment.

01:12 A major component of the theory is observed learning.

01:16 This is the process of learning about behaviors that are desirable or undesirable simply by observing others.

01:23 Further, with this theory, we understand the individual beliefs and their own self-efficacy influence whether or not they'll reproduce an observed behavior.

01:33 So, let's take a look at each of the 3 components starting first with cognitive factors.

01:40 Cognitive factors are also called personal factors.

01:43 These are knowledge or expectations based on previous experiences and attitude.

01:50 This also includes personal factors that influence behavior such as age or ability.

01:56 Next, we have environmental factors. This includes social norms.

02:01 So, is the behavior considered socially acceptable? This also includes access to resources and the influence of others or support of friends and family.

02:12 And then finally, we have aspects of the behavior itself.

02:16 We understand that in order to perform a behavior, a patient must have the skills to do so.

02:21 They must practice the behavior and see positive results.

02:25 Patients must also have high self-efficacy.

02:28 This means that they believe that they have control over the outcome by engaging in a specific behavior.

02:35 Together, these 3 types of factors influence behavior.

02:40 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.

02:49 We don't necessarily need someone to tell us that a behavior is socially acceptable.

02:54 Rather, we observe reactions around us to determine if it is or not.

02:59 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.

03:10 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.

03:24 Let's take a look at a case study to see how we can apply this theory to our practice.

03:30 Imagine you're working with the patient who's struggling to control their diabetes.

03:34 Let's consider how we can influence each factor of the social cognitive theory to improve outcomes.

03:42 Cognitive factors: Here, you may focus on attitude.

03:47 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.

03:57 Motivational interviewing could be one strategy that you could use to influence attitude.

04:05 Environmental factors: Here, we consider social norms and social supports.

04:10 Let's say you talk to your patient and find out that they have little support at home from family.

04:15 They don't know anyone else who has diabetes.

04:18 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.

04:30 And then finally, we have behavioral factors.

04:33 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.

04:40 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.

04:54 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.