Social Cognitive Theory (SCT) (Nursing)

by Heide Cygan, DNP, RN

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    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.

    About the Lecture

    The lecture Social Cognitive Theory (SCT) (Nursing) by Heide Cygan, DNP, RN is from the course Health Promotion Frameworks (Nursing).

    Included Quiz Questions

    1. Cognitive/personal factors
    2. Environmental factors
    3. Behavioral factors
    4. Pre-contemplative factors
    5. Societal factors
    1. Environmental
    2. Behavioral
    3. Cognitive
    4. Societal
    1. Encourage the client to visit the clinic weekly to practice self-administering testosterone in a supportive environment.
    2. Sign the client up for a support group for people who are afraid of needles.
    3. Give the client a pamphlet on the importance of medication adherence.
    4. Ensure the client has access to clean injection supplies.

    Author of lecture Social Cognitive Theory (SCT) (Nursing)

     Heide Cygan, DNP, RN

    Heide Cygan, DNP, RN

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