Enhancing adherence to health care providers' instructions: Utilization of self-efficacy theory

Background: Physical inactivity is related to a host of health problems including heart disease, cancer, obesity, diabetes, stroke, as well as a variety of musculoskeletal problems such as osteoarthritis, low back pain, soft tissue pain, and gout. Many inactive people seek medical treatment for these conditions--one important aspect of treatment is physical activity. Lack of adherence to health care providers’ instructions, specifically to recommendations regarding physical activity, is common and detrimental to successful health outcomes. The purpose of this review was to explore studies examining self-efficacy and its relationship to patient adherence to a health care provider’s instructions related to physical rehabilitation.

Methods: A review of the literature was conducted using Scout, PubMed, and Science Direct. Key search terms were: self-efficacy, physical therapy, physical activity, exercise, maintenance, theory, chronic disease, prevention, compliance, and adherence. Studies were selected for analysis if they addressed self-efficacy theory; whether in its entirety or if one or more theory constructs were addressed.

Results: Identified studies indicated that self-efficacy was important in adherence to recommendations. Participants who had higher self-efficacy scores also reported lower perceived barriers and higher perceived benefits associated with prescribed treatments. Mastery experiences, vicarious others and verbal persuasion were useful constructs to enhance maintenance.

Conclusions: Constructs of self-efficacy theory can be utilized to enhance adherence in the physical therapy setting. Encouraging patient involvement in the treatment process, to include goal setting, and problem solving to increase self-efficacy is recommended.