Observational Learning/Modeling

Question 1

Bandura’s Model

Answer 1

Modeled Act –> Attention –> Retention –> Production –> Motivation –> Response

Question 2

Mastery Models

Answer 2

• demonstrate errorless performance
• verbalize confidence
• demonstrate positive attitude
• verbalize low task difficulty

Question 3

Coping Models

Answer 3

• display decreasing distress as they struggle with difficulties or threats
• demonstrate strategies for dealing with different situations
• voice progressively self-efficacious beliefs
  approach or achieve mastery

Question 4

Outcome Measures

Answer 4

Performance
- adherence
- outcome
- effort
- form/errors
Cognitive and Affective Psychological Responses
- anxiety
- self-efficacy
- mood
- RPE

Question 5

Study: A modeling Intervention in heart Failure

Answer 5

Purpose:
- to investigate the effectiveness of a peer coping model intervention to increase self-efficacy and exercise tolerance during a cardiopulmonary exercise stress test, in patients with heart failure
Measures:
Peak VO2-oxygen consumption at peak exercise:
- ability to transport oxygen to working muscles
- utilization of oxygen by muscles during exercise
Self efficacy-self-reported confidence to walk during a peak VO2 test for increasing periods of time (i.e 2, 4, 6, 8 minutes) at three intensities.
Intervention: DVD
- edited interviews and various action shots of the models demonstrating and verbalizing increased confidence to perform the VO2 test and overcome the associated discomfort during the VO2 test.
Procedure:
- Each participant attended two one hour sessions
at the hospital for Peak VO2 tests one week
apart (T1 and T2)
- A cardiopulmonary medical technician
conducted each Peak VO2 test
- Following testing at T1 those in the intervention
group were administered the peer modeling
DVD.
- A trained research assistant administered
measures of self-efficacy prior to T1 and T2
Peak VO2 testing
Results: Peak VO2 change
- Intervention: 6.3% improvement
- Control: -1.26% decrement
Results: Self-efficacy change
- intervention: improved by 12.6%
- Control: improved by 1.5%

Question 6

Benefits of PA

Answer 6

• the benefits of exercise and physical activity in compensated stable chronic heart failure patients have been well documented
• these benefits are associated with a constellation of improvement in peripheral vascular, muscular and metabolic function, including lipid profile, insulin sensitivity, body weight, and endothelial function

Question 7

Adherence Issues

Answer 7

• if the benefits of exercise and PA are to be realized, then people need to adhere long term
• unfortunately, adherence to exercise/physical activity recommendations continues to be low
• between 10% and 36% of individuals drop out of Phase II cardiac rehabilitation
• long term adherence to exercise is also poor with between 26% and 50% dropping out at 6 and 18-months respectively

Question 8

Self-efficacy

Answer 8

• most frequently identified psychosocial determinant of adherence to physical activity is self-efficacy
• refers to an individuals confidence in his/her capabilities to execute the necessary course of action to satisfy situational demands
• self-efficacy is theorized to influence the activities that individuals choose, the effort expended, and the degree of persistence demonstrated in the fact of adverse stimuli

Question 9

Self-efficacy and adherence

Answer 9

• self-efficacy is implicated in exercise adherence in diseased and asymptomatic populations, large scale community studies, and training studies
• exercise related self-efficacy has been shown to act as both, a determinant, and consequence of cardiac rehabilitation

Question 10

Stress testing-adherence

Answer 10

• peak oxygen consumption provides reliable information of exercise tolerance and prognosis in individuals with CHF
• PVO2 has been shown to be related to measured functional performance (6-minute walk test) and well as health-related quality of life and survival
• PVO2 is important for exercise prescription

Question 11

Stress Testing:

Answer 11

• adequate data may not be recorded because CHF patients are apprehensive, unfamiliar with the procedures, and anxious about producing symptoms, which result in them performing to their maximum capability