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Using a self-efficacy framework in the management of inducible laryngeal obstruction (ILO): A tutorial with
Sarah A Schils1, Andrew D Palmer1
1NW Center for Voice and Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, Portland, OR, USA.
Purpose:
Self-efficacy (SE), a concept from health promotion, is known to be associated with numerous positive health outcomes but has not been formally described for the management of individuals with inducible laryngeal obstruction (ILO). The purpose of this article is to describe how a SE framework can be used to promote optimal outcomes for individuals with ILO.
Method:
The SE framework uses a variety of methods to enhance self-management and achieve therapeutic goals. Key elements include mastery experiences, vicarious experience, verbal persuasion, and an understanding of physiological and affective states, all of which are relevant to the optimal treatment of ILO. Data from our clinic support the use of a SE approach and two case scenarios are presented which illustrate its use in clinical practice.
Results:
In a study of adults with ILO treated at our institution, there were significant associations between feelings of control of symptoms, activity limitations, and psychological symptoms. These findings highlight the utility of using the concept of control as a way of goal-setting at diagnosis, tracking progress in therapy, and as a metric of treatment success. At our institution, simple numeric rating scales provide a useful means of assessing control and are used for the management of ILO at every visit.
Conclusions:
SE is a powerful predictor of behavior change and has been widely used to successfully treat a wide variety of medical conditions. Further investigation of the application of this framework to the treatment of ILO is recommended.
Learning Outcomes:
As a result of this activity, readers will: 1. Describe the findings from previous research and the measures that have been used to document improvement after ILO treatment. 2. Define the concept of self-efficacy and its component parts and summarize its previous use in the literature. 3. Apply that model to the field of rehabilitation, with particular reference to a comprehensive treatment model for ILO as a way of promoting optimal outcomes.
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