ABSTRACT
The role of self-efficacy in the rehabilitation of adult patients with chronic obstructive pulmonary disease (COPD) was examined. One hundred and nineteen COPD patients were randomly assigned to either a comprehensive rehabilitation program or to an education control group. Each program lasted two months. Patients were evaluated on pulmonary function, exercise, treadmill endurance, and psychosocial measures. These tests were administered prior to the intervention, immediately following the intervention, and one year after the start of the program. The treadmill endurance walk and the psychosocial measures were also administered six months after the start of the program. Self-efficacy was measured using a questionnaire that evaluated expectancies to engage in specific activities that reflect the functional disabilities often associated with COPD. Validity of the self-efficacy construct was demonstrated through systematic correlations with both pulmonary function and exercise variables. Although rehabilitation patients demonstrated significant improvements in treadmill performance, a trend toward improved self-efficacy for walking was non-significant. Further, the modest improvement in self-efficacy for walking did not generalize to similar behaviors. Patients with high initial self-efficacy scores for walking demonstrated the greatest endurance on the treadmill. However self-efficacy expectancies did not predict other health status outcomes. We conclude that physiological feedback is a strong source of self-efficacy expectation. These expectancies might be modified by performance accomplishment. However, continuing physiologic feedback provides a significant obstacle for modifying self-efficacy in chronically ill patients.
