While understanding of asthma has increased in recent years, the morbidity and mortality associated with this chronic condition continue to comprise a major health dilemma. Although new and better treatments for asthma become available each year, the latest information on these new treatments often is not communicated effectively to patients. Even when patients do receive information on new treatments, they often believe communication with their clinicians has been inadequate. These communication problems lead to ineffective management of the disease.
Theoretical Basis of the Program: Application of Self-Regulation Theory
Social cognitive theory provides the theoretical foundation for the PACE program. One principle of this theory, self-regulation, has been studied extensively as a way to improve learning. Research has shown that learning is enhanced by self-regulation, that is, the learner's efforts to observe, evaluate, and react to his or her own responses to a problem.
When learners self-observe, develop strategies to reach goals, and evaluate the success of these strategies, they gain an increased sense of self-confidence (self-efficacy) and higher levels of achievement. The PACE program uses a self-regulation format to present new material to be learned and behaviors to be performed, an approach that works very well for clinicians.
Clinicians make decisions and take action based on previous experiences and the consequences they anticipate. When desired consequences are achieved, behavior is reinforced. This increases the clinician's motivation to use the behavior again. The motivation is experienced as an increased sense of self-efficacy and confidence that the behavior can be used again successfully to achieve similar or better results.
The PACE program enables clinicians to use self-regulation to improve their treatment decisions and delivery of self-management counseling for the family. It provides clinicians with educational strategies and tools that can easily be introduced into their practices, replacing less effective behaviors. Therefore PACE requires no increase in time for a visit but has maximum impact on the patient's ability to retain and use treatment advice and education.
To view a video clip that covers PACE's goals, aims, and theoretical basis, click on the link below:
Training Video for facilitators: PACE Program Theory and Concepts (run time 2:45),
you need RealPlayer on your computer.
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