Self-efficacy, outcome expectations and self-care behaviour in people with type 2 diabetes in Taiwan

Aims. To explore differences in self-care behaviour according to demographic and illness characteristics; and relationships among self-care behaviour and demographic and illness characteristics, efficacy expectations and outcome expectations of people with type 2 diabetes in Taiwan. Background. Most people with diabetes do not control their disease appropriately in Taiwan. Enhanced self-efficacy towards managing diseases can be an effective way of improving disease control as proposed by the self-efficacy model which provides a useful framework for understanding adherence to self-care behaviours. Design and methods. The sample comprised 145 patients with type 2 diabetes aged 30 years or more from diabetes outpatient clinics in Taipei. Data were collected using a self-administered questionnaire for this study. One-way anova, t-tests, Pearson product moment correlation and hierarchical regression were analysed for the study. Results. Significant differences were found: between self-care behaviour and complications (t = −2·52, p < 0·01) and patient education (t = −1·96, p < 0·05). Self-care behaviour was significantly and positively correlated with duration of diabetes (r = 0·36, p < 0·01), efficacy expectations (r = 0·54, p < 0·01) and outcome expectations (r = 0·44, p < 0·01). A total of 39·1% of variance in self-care behaviour can be explained by duration of diabetes, efficacy expectations and outcome expectations. Conclusions. Findings support the use of the self-efficacy model as a framework for understanding adherence to self-care behaviour. Relevance to clinical practice. Using self-efficacy theory when designing patient education interventions for people with type 2 diabetes will enhance self-management routines and assist in reducing major complications in the future.

Parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis in children: Instrument reliability and validity

BACKGROUND: Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change. OBJECTIVES: To develop a suite of valid and reliable research instruments to appraise parents' self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis. METHODS: The Parents' Eczema Management Scale (PEMS) and the Parents' Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales' reliability and validity was conducted. SETTING AND PARTICIPANTS: A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia. RESULTS: Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child's symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of atopic dermatitis by the parent, involving healthcare professionals in management, and involving the child in the management of atopic dermatitis were found. Parents' self-efficacy and outcome expectations had a significant influence on self-reported task performance. CONCLUSIONS: Findings suggest that PEMS and POEEMS are valid and reliable instruments worthy of further psychometric evaluation. Likewise, validity and reliability of PASECI was confirmed.

Evaluating the effect of a patient education brochure on patients’ expectations and satisfaction with emergency department service

Introduction: The purpose of this study was to assess the capacity of a written intervention, in this case a patient information brochure, to improve patient satisfaction during an Emergency Department (ED) visit. For the purpose of measuring the effect of the intervention the ED journey was conceptualised as a series of distinct areas of service comprising waiting time, service by the triage nurse, care from doctors and nurses and information giving Background of study: Research into patient satisfaction has become a widespread activity endorsed by both governments and hospital administrations. The literature on ED patient satisfaction has consistently indicated three primary areas of patient dissatisfaction: waiting time, nursing care and communication. Recent developments in the literature on patient satisfaction studies however have highlighted the relationship between patients. expectations of a service encounter and their consequent assessment of the experience as dissatisfying or satisfying. Disconfirmation theory posits that the degree to which expectations are confirmed will affect subsequent levels of satisfaction. The conceptual framework utilised in this study is Coye.s (2004) model of disconfirmation. Coye while reiterating satisfaction is a consequence of the degree expectations are either confirmed or disconfirmed also posits that expectations can be modified by interventions. Coye.s work conceptualises these interventions as intra encounter experiences (cues) which function to adjust expectations. Coye suggests some cues are unintended and may have a negative impact which also reinforces the value of planned cues intended to meet or exceed consumer expectations. Consequently the brochure can be characterized as a potentially positive cue, encouraging the patient to understand processes and to orient them in what can be a confronting environment. Only a limited number of studies have examined the effect of written interventions within an ED. No studies could be located which have tested the effect of ED interventions using a conceptual framework which relates the effect of the degree to which expectations are confirmed or disconfirmed in terms of satisfaction with services. Method: Two studies were conducted. Study One used qualitative methods to explore patients. expectations of the ED from the perspective of both patients and health care professionals. Study One was used in part to direct the development of the intervention (brochure) in Study Two. The brochure was an intervention designed to modify patients. expectations thus increasing their satisfaction with the provision of ED service. As there was no existing tools to measure ED patients. expectations and satisfaction a new tool was also developed based on the findings and the literature of Study One. Study Two used a non-randomised, quasi-experimental approach using a non-equivalent post-test only comparison group design used to investigate the effect of the patient education brochure (Stommel and Wills, 2004). The brochure was disseminated to one of two study groups (the intervention group). The effect of the brochure was assessed by comparing the data obtained from both the intervention and control group. These two groups consisted of 150 participants each. It was expected that any differences in the relevant domains selected for examination would indicate the effect of the brochure both on expectation and potentially satisfaction. Results: Study One revealed several areas of common ground between patients and nurses in terms of relevant content for the written intervention, including the need for information on the triage system and waiting times. Areas of difference were also found with patients emphasizing communication issues, whereas focus group members expressed concern that patients were often unable to assimilate verbal information. The findings suggested the potential utility of written material to reinforce verbal communication particularly in terms of the triage process and other ED protocols. This material was synthesized within the final version of the written intervention. Overall the results of Study Two indicated no significant differences between the two groups. The intervention group did indicate a significant number of participants who viewed the brochure of having changed their expectations. The effect of the brochure may have been obscured by a lack of parity between the two groups as the control group presented with statistically significantly higher levels of acuity and experienced significantly shorter waiting times. In terms of disconfirmation theory this would suggest expectations that had been met or exceeded. The results confirmed the correlation of expectations with satisfaction. Several domains also indicated age as a significant predictor with older patients tending to score higher satisfaction results. Other significant predictors of satisfaction established were waiting time and care from nurses, reinforcing the combination of efficient service and positive interpersonal experiences as being valued by patients. Conclusions: Information presented in written form appears to benefit a significant number of ED users in terms of orientation and explaining systems and procedures. The degree to which these effects may interact with other dimensions of satisfaction however is likely to be limited. Waiting time and interpersonal behaviours from staff also provide influential cues in determining satisfaction. Written material is likely to be one element in a series of coordinated strategies to improve patient satisfaction during periods of peak demand.

International students in Australian universities : gap between student expectations and realities

Australian Universities are very successful in attracting large number of international students. A large proportion of University revenue comes from the full fee paying international students. However, there have been many reports that international students face numerous problems when they arrive in Australia. The common management practice is to provide support staff services to deal with the orientation and welfare of international students. Such service units act as intermediaries between the students and the teaching and learning community of the university. However, the actual experience of international students may be difficult for support staff, counsellors, advisers and academic staff to anticipate. There is little information on the actual experience of students relative to their expectations. This study aimed at securing a deeper understanding of the contextually relevant issues facing by international students in Australian universities in order to develop management strategies aimed at improved teaching and learning outcomes for international students. Using a highly reliable survey questionnaire, a questionnaire survey was conducted among the international students at Queensland University of Technology (QUT), Brisbane, Australia. About 180 engineering students responded in the survey resulting in a response rate of 81%. Results indicate that international students face many difficulties including understanding colloquial language, Australian accent, cost of tuition, feelin isolation, safety, security, health services, accommodation and part time jobs. They also face difficulty in coping with learning methods in Australia, particularly in research report writing. However, they are happy with their lecturers and find them very helpful. Many of the students lacked the information regarding various community groups, recreational and sports facilities in Australia before arriving. Findings of the study show that there is a significant gap between the expectation of the students before coming to Australia and actual experience they experience here. Importantly, there is a lack of coordination between international students, international student services (ISS) and university management and as a consequence there have been little improvement in conditions. There is no direct link between student experience and University management. Many important suggestions arisen from this study and most important suggestion is that the student information system should be integrated with the University enterprise resource planning (ERP) to reduce the huge gap between international student expectation and actual experiences.

Design for inspiration : children, personal connections and educational technology

The project is working towards building an understanding of the personal interests and experiences of children with the aim of designing appropriate, usable and, most importantly, inspirational educational technology. kidprobe, an adaptation of the technology probe concept, has been used as a lightweight method of gaining contextual information about children's interactions with 'fun' technology. kidprobe has produced design inspiration which focuses primarily on the social and emotional connections children made. The use of kidprobe has generated some important ideas for improving the use of probes with children. It is an important first step in understanding how to effectively adapt probing techniques to inspire the design of technology for children.

Personal epistemology and teacher education

A growing body of personal epistemology research shows that personal epistemologies influence student learning, particularly in academic contexts. However, we know little about how personal epistemologies relate to teaching, and even less about teacher education. This introductory chapter sets the stage for this book which brings together a range of international researchers in the field of personal epistemology, teaching, and teacher education. This introductory chapter explores personal epistemology as a construct in the field of teaching and teacher education. In particular, it focuses on teacher education a one contextual influence on personal epistemologies by exploring the nature of teachers' personal epistemologies, teachers' personal epistemologies and learning, teachers' personal epistemologies and teaching, and changing personal epistemology in teacher education programs.

Teachers' personal epistemologies and teacher education : emergent themes and future research

This chapter summarizes the responses to four questions in each of the chapters in this volume. The questions addressed the use of a conceptual framework that guides the chapter, issues of domain-generality, how personal epistemology relates to teaching, and how personal epistemologies change. We concluded that all of the chapters discussed the distinction between constructivist and transmission teaching practices, while suggesting that there are many inconsistencies in understanding the relationship between the nature of beliefs and teachers’ practices regardless of the relative sophistication of teachers’ personal epistemologies. We also summarized a multi-component instructional model for calibrating teaching practices based on suggestions in each of the chapters, and made four suggestions for future research, including the need for an integrated theory that accounts for the development and manifestations of personal pistemology in the classroom, the generalizability of fi ndings across different measurements, a set of guidelines to promote teacher epistemological change, and an explicit instructional model that explains the development and calibration of beliefs and practices. The goal of this volume was to examine the relationship between teachers’ personal epistemologies and teacher education. Sixteen different chapters addressed one or more aspects of this issue. Although each of the chapters addressed different aspects of teachers’ personal epistemologies, a number of common themes are apparent across the chapters. We believe it is useful to articulate these themes in greater detail to provide a better retrospective understanding of this volume, as well as a better prospective framework for future research and changes to teacher training programs. We divide this chapter into two main sections. The fi rst section addresses four key questions about the nature of teachers’ personal epistemologies that were discussed in the introductory chapter as part of a larger set of questions. These questions focus on how to conceptualize these beliefs as explicit models; whether beliefs are domain-specifi c or domain-general; how beliefs are related to teaching; and how beliefs change over time. We provide a summary of each chapter in terms of these four questions. The second section proposes four general suggestions for future research based on the studies reported within this volume.

How can a mentor’s personal attributes and pedagogical knowledge develop a preservice teacher’s behaviour management?

This study presents the importance of a mentor’s (experienced teacher’s) personal attributes and pedagogical knowledge for developing a mentee’s (preservice teacher’s) teaching practices. Specifically, preservice teachers can have difficulties with behaviour management and must learn management strategies that help them to teach more effectively. This paper investigates how mentoring may facilitate the development of a mentee’s behaviour management strategies, in particular what personal attributes and pedagogical knowledge are used in this process.

Retrofitting commercial office buildings for sustainability : tenants’ expectations and experiences

Introduction Buildings, which account for approximately half of all annual energy and greenhouse gas emissions, are an important target area for any strategy addressing climate change. Whilst new commercial buildings increasingly address sustainability considerations, incorporating green technology in the refurbishment process of older buildings is technically, financially and socially challenging. This research explores the expectations and experiences of commercial office building tenants, whose building was under-going green refurbishment. Methodology Semi-structured in-depth interviews with seven residents and neighbours of a large case-study building under-going green refurbishment in Melbourne, Australia. Built in 1979, the 7,008m² ‘B’ grade building consists of 11 upper levels of office accommodation, ground floor retail, and a basement area leased as a licensed restaurant. After refurbishment, which included the installation of chilled water pumps, solar water heating, waterless urinals, insulation, disabled toilets, and automatic dimming lights, it was expected that the environmental performance of the building would move from a non-existent zero ABGR (Australian Building Greenhouse Rating) star rating to 3.5 stars, with a 40% reduction in water consumption and 20% reduction in energy consumption. Interviews were transcribed, with responses analysed using a thematic approach, identifying categories, themes and patterns. Results Commercial property tenants are on a journey to sustainability - they are interested and willing to engage in discussions about sustainability initiatives, but the process, costs and benefits need to be clear. Critically, whilst sustainability was an essential and non-negotiable criterion in building selection for government and larger corporate tenants, sustainability was not yet a core business value for smaller organisations – whilst they could see it as an emerging issue, they wanted detailed cost-benefit analyses, pay-back calculations of proposed technologies and, ideally, wished they could trial the technology first-hand in some way. Although extremely interested in learning more, most participants reported relatively minimal knowledge of specific sustainability features, designs or products. In discussions about different sustainable technologies (e.g., waterless urinals, green-rated carpets), participants frequently commented that they knew little about the technology, had not heard of it or were not sure exactly how it worked. Whilst participants viewed sustainable commercial buildings as the future, they had varied expectations about the fate of existing older buildings – most felt that they would have to be retrofitted at some point to meet market expectations and predicted the emergence of a ‘non-sustainability discount’ for residing in a building without sustainable features. Discussion This research offers a beginning point for understanding the difficulty of integrating green technology in older commercial buildings. Tenants currently have limited understandings of technology and potential building performance outcomes, which ultimately could impede the implementation of sustainable initiatives in older buildings. Whilst the commercial property market is interested in learning about sustainability in the built environment, the findings highlight the importance of developing a strong business case, communication and transition plan for implementing sustainability retrofits in existing commercial buildings.

Motivations, expectations and experiences of Australian rural and regional planners

Despite playing an extremely important role in shaping communities, the role and contribution of planners is not widely understood or acknowledged. At the same time, there is a shortage of planners in Australia, especially in non-urban areas. Thus, though an online survey of 185 rural and regional planners, this research explores their motivations, expectations and experiences. Most enjoyed and felt confident in their role, explaining that they valued the relaxed family orientated rural lifestyle and the varied nature of the planning work. Although they sometimes felt isolated, the non-urban location provided quicker progression to senior roles, the ability to engage directly with the community and to see the consequences of their decisions. Only half felt their education had prepared them well for their role, citing gaps in terms of computerised modelling, team leadership and conflict resolution skills. Their feedback centred on providing a more practical course, focussing more on regional planning, and encouraging urban and rural experience placements. As the first study to quantifiably explore rural and regional Australian planners perceptions of their role and challenges, the findings illustrate current experiences, key planning challenges, perceived educational gaps and future priorities.

Speeding by young novice drivers : what can personal characteristics and psychosocial theory add to our understanding?

Purpose: Young novice drivers continue to be overrepresented in fatalities and injuries arising from crashes even with the introduction of countermeasures such as graduated driver licensing (GDL). Enhancing countermeasures requires a better understanding of the variables influencing risky driving. One of the most common risky behaviours performed by drivers of all ages is speeding, which is particularly risky for young novice drivers who, due to their driving inexperience, have difficulty in identifying and responding appropriately to road hazards. Psychosocial theory can improve our understanding of contributors to speeding, thereby informing countermeasure development and evaluation. This paper reports an application of Akers’ social learning theory (SLT), augmented by Gerrard and Gibbons’ prototype/willingness model (PWM), in addition to personal characteristics of age, gender, car ownership, and psychological traits/states of anxiety, depression, sensation seeking propensity and reward sensitivity, to examine the influences on self-reported speeding of young novice drivers with a Provisional (intermediate) licence in Queensland, Australia. Method: Young drivers (n = 378) recruited in 2010 for longitudinal research completed two surveys containing the Behaviour of Young Novice Drivers Scale, and reported their attitudes and behaviours as pre-Licence/Learner (Survey 1) and Provisional (Survey 2) drivers and their sociodemographic characteristics. Results: An Akers’ measurement model was created. Hierarchical multiple regressions revealed that (1) personal characteristics (PC) explained 20.3%; (2) the combination of PC and SLT explained 41.1%; and (3) the combination of PC, SLT and PWM explained 53.7% of variance in self-reported speeding. Whilst there appeared to be considerable shared variance, the significant predictors in the final model included gender, car ownership, reward sensitivity, depression, personal attitudes, and Learner speeding. Conclusions: These results highlight the capacity for psychosocial theory to improve our understanding of speeding by young novice drivers, revealing relationships between previous behaviour, attitudes, psychosocial characteristics and speeding. The findings suggest multi-faceted countermeasures should target the risky behaviour of Learners, and Learner supervisors should be encouraged to monitor their Learners’ driving speed. Novice drivers should be discouraged from developing risky attitudes towards speeding.

ACE research briefing paper 003 : international perceptions and aspirations

2010 marked the completion of data collection for year three (Wave 3) of the CAUSEE study. This report uses data from the first three years. Australia's population is noted for its mixed international background. The ABS 2006 census reports showed that almost a quarter of Australian population were born overseas, contributing to a high degree of cultural diversity. This report examines the international background and experience of Australian business founders as well as their aspired and actual participation in international markets. In this research briefing paper, we compare Nascent Firm (NF) and Young Firm (YF) groups and also 'Regular' start-ups in both categories with their High Potential counterparts. When we compare characteristics at one point in time and we compare developments over time. Unless otherwise stated the findings we comment on are 'statistically significant'. That is, there is less than 5 per cent risk that they would appear by chance if there is no true difference in the population form which the samples were drawn.

‘Personal Response’ and English Teaching

A case study relating to secondary education, examining the teacher student relationship as it operates within the English classroom is the topic of this paper. It describes how a certain conception of 'personal response' to literature provided a means for the teacher/counsellor to form the ethical capacities of children. 'Personal response' is usually associated with the moment in which the child is freed to be most natural. But for all the emphasis upon the irreducibly individual nature of the 'genuinely felt response', this pedagogic exercise finds its place within a series of strategies designed both to cherish and correct the child, to nurture and to scrutinise, to guide and to reconstruct.