Department of Psychology, Freie Universität Berlin, Berlin, Germany.
Rehabil Psychol. 2011 Aug;56(3):161-70. doi: 10.1037/a0024509.
The present article presents an overview of theoretical constructs and mechanisms of health behavior change that have been found useful in research on people with chronic illness and disability. A self-regulation framework (Health Action Process Approach) serves as a backdrop, making a distinction between goal setting and goal pursuit. Risk perception, outcome expectancies, and task self-efficacy are seen as predisposing factors in the goal-setting (motivational) phase, whereas planning, action control, and maintenance/recovery self-efficacy are regarded as being influential in the subsequent goal-pursuit (volitional) phase. The first phase leads to forming an intention, and the second to actual behavior change. Such a mediator model serves to explain social-cognitive processes in health behavior change. By adding a second layer, a moderator model is provided in which three stages are distinguished to segment the audience for tailored interventions. Identifying persons as preintenders, intenders, or actors offers an opportunity to match theory-based treatments to specific target groups. Numerous research and assessment examples, especially within the physical activity domain, serve to illustrate the application of the model to rehabilitation settings and health promotion for people with chronic illness or disability.
CONCLUSIONS/IMPLICATIONS: The theoretical developments and research evidence for the self-regulation framework explain the cognitive mechanisms of behavior change and adherence to treatment in the rehabilitation setting.
本文概述了在慢性疾病和残疾患者的研究中被证明有用的健康行为改变的理论结构和机制。以自我调节框架（健康行动过程方法）为背景，区分目标设定和目标追求。风险感知、结果预期和任务自我效能被视为目标设定（动机）阶段的前置因素，而计划、行动控制和维持/恢复自我效能被认为在随后的目标追求（意志）阶段具有影响力。第一阶段导致形成意图，第二阶段导致实际行为改变。这种中介模型有助于解释健康行为改变中的社会认知过程。通过添加第二层，提供了一个调节模型，其中区分了三个阶段，以便将针对特定目标群体的量身定制干预措施进行细分。将个体识别为预意向者、意向者或行动者，为基于理论的治疗方法与特定目标群体相匹配提供了机会。许多研究和评估实例，特别是在体育活动领域，说明了该模型在康复环境和慢性病或残疾患者健康促进中的应用。
结论/意义：自我调节框架的理论发展和研究证据解释了康复环境中行为改变和治疗依从性的认知机制。
