THE MEDIATING ROLE OF SELF-EFFICACY EXPECTATIONS AND SELF-EVALUATION IN THE REHABILITATION PROCESS

Abstract

Bandura (1977) has argued that the consideration of cognitive mechanisms is central to the understanding of behavioral change and the maintenance of these behavioral patterns. More specifically, Bandura (1977, 1982) has proposed two cognitive mechanisms, self-efficacy and self-evaluation, that mediate the initiation of and persistence toward behavioral change. The purpose of the present study was to assess whether the medium through which feedback is presented to patients participating in rehabilitation would have an effect on their future expectations of performance for motor tasks encountered in therapy and the actual performance of strength and endurance tasks. It was hypothesized that knee injury patients who were provided with detailed color graphic feedback intended to facilitate self-evaluation would develop higher self-expectations of performance and subsequently display better motor functioning. The sample consisted of twenty-three patients who had incurred a knee injury. All patients participating were judged capable of regaining 85% of their functional capacity with the injured extremity within 16 therapy sessions. Patients who met selection criterion were randomly assigned to one of two treatment conditions. The experimental condition included color graphic feedback at points throughout the patients\u27 rehabilitation. Patients in the control condition received standard feedback only (i.e., discussion of progress with the therapist). The results showed that the graphic feedback intervention had a significant effect on patients\u27 expectations of performance on a Cybex at 60 and 180 degrees per second but did not have an effect on expectations for weight lifting, performance on an exercise bike, or walking. The graphic feedback intervention did not have an effect on motor performance. Although the intervention did not show a significant effect, the means for each of the five performance tasks were in the hypothesized direction. Finally, the results showed a strong association between patients\u27 expectations of performance and future motor functioning. In general, the results provided support for the predictions of Bandura\u27s (1977) self-efficacy theory. The implications and applications of the principles of efficacy theory for the administration of health services are discussed