Assessment and enhancement of oral care self-efficacy

Success in achieving good periodontal health depends on whether or not periodontal disease patients can properly adhere to treatment. These patients need effective interventions to improve their adherence to oral hygiene instruction and periodontal treatment. Tentative evidence from low-quality studies indicates that psychological approaches to modifying behavior patterns can improve oral hygiene-related behavior. Accordingly, psychological models should be used in studies aimed at establishing effective interventions to improve oral health-related behavior. Self-efficacy refers to an individual's confidence in determining, "how well they can take necessary action to producing certain results." In clinical practice, self-efficacy refers to "how certain a patient feels about their ability to take necessary action to improve the indicators and maintenance of their health." Medical clinical practice has focused on the function of self-efficacy as a factor antecedent to behavior modification, much as the symptoms of diabetes and other chronic diseases improve through enhanced self-efficacy. Based on these concepts, it is assumed that the prognosis for a patient with periodontitis can be improved by assessing, first the proficiency of their self-efficacy, subsequently providing psycho-educational instruction suitable to each patient, and ultimately promoting behavioral change for oral-care. A task-specific self-efficacy scale for self-care (SESS) for periodontal disease patients was developed. The SESS predicted improvement in self-care and the continuation of consistent and sound periodontal treatment. Self-efficacy belief is constructed from four principal sources of information, performance accomplishment, vicarious experience, verbal persuasion, and physiological and affective states. 'Performance accomplishment' is based on an individual's personal accomplishments. 'Vicarious experience' is gained by observing others perform activities successfully. 'Verbal persuasion' refers to activities in which people are led through suggestion, to believe they can cope successfully with specific tasks. 'Physiological and affective states' are an individual's physiological or emotional states which influence selfefficacy judgment. Self-efficacy can be enhanced by effectively exploiting these four sources. The authors developed a periodontitis patient's education program that employs a six-step method to enhance self-efficacy for improved oral care, and then reported on its effectiveness. This chapter introduces the current study's results concerning the application of the self-efficacy theory in periodontitis patient education, together with findings clarified by other researchers.