The population to be discussed in this paper is older adults diagnosed with asthma, who need nursing education regarding the use of medication, inhalers, and lifestyle issues. It is essential to take into account that the mentioned population usually has well-established views and habits, and it is critical to explain to them that some change is necessary to improve their health conditions and prevent the deterioration of asthma. In view of the above specifics, one should apply a cognitive learning theory. While studying a particular topic, a patient should receive initial knowledge and skills that would allow him or her to further make a broad transfer and go beyond the immediate knowledge received. In case new information corresponds to existing attitudes, it is assimilated. Even though it does not fit the established norms, the intellect is ready for change, and accommodation takes place in order to connect the new with the previous knowledge. It can be a new way of thinking, concepts, or theory that explains the old and new facts.
Specifically to older adults with asthma, a nurse should be extremely consistent and attentive to their needs. As noted by Butts and Rich (2018), older adults are subjected to an advanced phase of cognitive development, while their reaction to education may be slower than those of children, adolescents, or adults. In this case, the specific intervention is at least one month of education since the patient should not only receive information regarding their health and treatment but also understand and remember it. According to Appel, Wadas, Talley, and Williams (2013), an online classroom for older adults may be an appropriate option. However, this also requires the consideration of the patients’ contextual factors (Appel, Giger, & Davidhizar, 2005). The key to success in applying the cognitive learning theory is to detect and address misperceptions and biases as well as promote social interaction engaging the patients in close collaboration with each other, their families, and nurses.
The social cognitive theory elaborated by Bandura emphasizes the cooperative interaction of the environment, behavior, and personal factors, in which a special place is given to cognitive processes that provide mental self-control and self-efficacy of a person. The above components influence the personality in the same way a person affects them. By means of verbal and imaginative representations, the experience is analyzed by a person, then modeled, and saved to such an extent that serves as a guide for future behavior (Kardong-Edgren, 2013). In the case of older adults with asthma, there is a great stratum of experience, and a nurse should use it to change the patients’ behaviors.
The identified theory may help to change behaviors of the target population by modeling and affecting learning primarily through the informative function of experience. It is assumed that learning occurs only when the determinants of the regulation of individual behavior are included in the form of two types of reinforcement such as indirect reinforcement and self-reinforcement (Heydari, Dashtgard, & Moghadam, 2014). The former involves taking into account the behavior of the chosen model, the observed consequences, and reinforcements from outside for rewarded and effective behavior (Ryan, 2009). Self-reinforcement means that a person awards himself or herself with incentives that can be controlled and are to be provided in case of behavior change. The described system of engagement and stimulation seems to be rather useful to be used to address the stated needs. Thus, the specific intervention is group meetings and personal consultations, which will include both of the mentioned reinforcement options.
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Appel, S.J., Wadas, T.M, Talley, M & Williams, A. (2013). Teaching diagnostic reasoning: Transitioning from a live to a distance accessible online classroom in an adult acute care nurse practitioner program. Journal of Nursing Education and Practice, 3(12), 125-132.
Butts, J.B. & Rich, K.L. (2018). Philosophies and theories for advanced nursing practice. Burlington, MA: Jones & Bartlett Learning.
Heydari, A., Dashtgard, A., & Moghadam, Z. E. (2014). The effect of Bandura’s social cognitive theory implementation on addiction quitting of clients referred to addiction quitting clinics. Iranian Journal of Nursing and Midwifery Research, 19(1), 19-23.
Kardong-Edgren, S. (2013). Bandura’s self-efficacy theory… Something is missing. Clinical Simulation in Nursing, 9(9), 327-328.
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