Modelling Successful Self-Management in Adults With Cystic Fibrosis: Vicarious Self-Efficacy From Videos of ‘People Like Me’

Abstract

BackgroundSelf-efficacy is an important determinant of treatment adherence, and peer modelling of success can provide vicarious self-efficacy. A series of patient stories ('talking heads' videos) were developed with people with cystic fibrosis (CF) as part of the CFHealthHub multi-component adherence intervention, aiming to demonstrate success with daily therapy in 'people like me'. MethodologyOne-to-one semi-structured interviews exploring patients' experiences, barriers and facilitators of nebuliser adherence were audio and video-recorded between October 2015 and August 2016. Interview transcripts were reviewed to identify descriptions of problem-solving and sustained treatment success. Positive stories potentially providing vicarious descriptions of success were selected as video clips. ResultsIn total, 14 adults with CF were recruited from five UK CF centres. Each participant contributed a median of five (interquartile range: 3-6) video clips, and a total of 57 unique clips were uploaded onto the CFHealthHub digital platform. Nine of those clips spanned two categories, hence, there were 66 clips across 16 categories. ConclusionsThe videos were well received though some adults were concerned that comparisons with peers might create anxiety by highlighting the possibility of future decline or current relative underperformance. It is important to sensitively support choice when providing resources aiming to increase vicarious self-efficacy. Our experience may guide the development of similar videos for people with other long-term conditions.

Hope in Every Breath: Navigating the Therapeutic Landscape of Cystic Fibrosis

“…In recent decades, the patient's role in CF care has evolved from passive recipient to active participant, especially with the burden of chronic disease and fragmented healthcare systems, pushing for patient engagement, communication through information and communication systems, and remote monitoring to enhance care coordination and improve treatment adherence [ 74 ]. The use of patient narratives in the form of "talking heads" videos and the positive deviance approach showed promise in inspiring confidence, promoting behavior change, and providing valuable insights into overcoming barriers to treatment adherence for individuals with CF [ 75 ]. Successful integration of an Advanced Healthcare Assistant (AHA) within an adult CF center, resulting in changes to physiotherapy service provision, increased complexity of clinical care, expanded physiotherapist roles, improved patient communication, and no reported safety issues, emphasizing the potential of AHAs to enhance service delivery in other acute respiratory physiotherapy settings [ 76 ].…”