A Sport Medicine Clinician’s Guide to Improving Patient Adherence through Tenets of Social Cognitive Theory

Abstract

Patient adherence to rehabilitation, whether following an injury or surgery, is crucial for successful clinical outcomes; unfortunately, adherence is often low. Theory-based interventions have been studied to improve the adherence problem, indicating that a more intentional, theoretically-grounded, practical approach may enhance clinicians’ abilities to promote their patients’ holistic well-being. Among the theories applicable to rehabilitation, Social Cognitive Theory (SCT) has demonstrated success in increasing patient adherence to rehabilitation –a variable critical to achieving successful rehabilitation outcomes and maintaining the patient’s overall health. Conceptually nested within SCT, two key frameworks that have been used to influence adherence are A) Triadic Reciprocal Determinism, and B) Self-Efficacy. The purpose of this paper is to review literature related to SCT and these two frameworks to detail their importance in promoting adherence, with an emphasis on practical, theoretically-based strategies. Thus, findings were compiled to create a guide for sports medicine clinicians to incorporate SCT into their practice. Through applying this guidance, improved patient self-efficacy and adherence to rehabilitation can be feasibly accomplished by sports medicine clinicians in an intentional, evidence-based approach (e.g., through goal setting, use of positive role models, avoiding empty praise, and enhancing social support.)