Theory of Planned Behavior

THEORY OF PLANNED BEHAVIOR

INTRODUCTION

The theory of planned behaviour (TPB) is one of the most widely cited and applied behaviour theories. It is one of a closely inter-related family of theories which adopt a cognitive approach to explaining behaviour which centres on individuals attitudes and beliefs. The TPB (!"#en $%&' $%%$ !"#en and *adden $%&+) evolved from the theory of reasoned action (,ishbein and !"#en $%') which posited intention to act as the best predictor of behaviour. Intention is itself an outcome of the combination of attitudes towards a behaviour. That is the positive or negative evaluation of the behaviour and its expected outcomes and sub"ective norms which are the social pressures exerted on an individual resulting from their perceptions of what others thin they should do and their inclination to comply with these. The TPB added a third set of factors as affecting intention (and behaviour) perceived behavioural control. This is the perceived ease or difficulty with which the individual will be able to perform or carry out the behaviour and is very similar to notions of self-efficacy (see Bandura $%&+ $%% Terry Terry et al. $%%/). In addition to attitudes and sub"ective norms (which mae the theory of reasoned action) the theory of planned behavior adds the concept of  perceived  perceived behavioral behavioral contr control ol  which originates from self-efficacy  theory (01T). 0elf-efficacy was proposed by Bandura in $% 2$3 which came from social cognitive theory theory.. !ccording to Bandura expectations such as motivation performance and feelings of frustration associated with repeated failures determine effect and

behavioral reactions. Bandura separated expectations into two distinct types4 self-efficacy and outcome expectancy.253 6e defined self-efficacy as the conviction that one can successfully execute the behavior re7uired to produce the outcomes. The outcome expectancy refers to a person8s estimation that a given behavior will lead to certain outcomes. 6e states that self-efficacy is the most important precondition for behavioral change since it determines the initiation of coping behavior

The TPB has been used successfully to predict and explain a wide range of health behaviors and intentions including smoing drining health services utili#ation breastfeeding and substance use among others. The TPB states that behavioral achievement depends on both motivation (intention) and ability (behavioral control). It distinguishes between three types of beliefs - behavioral normative and control. 9sing the theory of planned behavior in health services for a high 7uality care through patient centered communication4 whereby •

Behavioral belief 4 an individual8s belief about conse7uences of particular behavior. The concept is based on the sub"ective probability that the behavior will produce a given outcome that is through patient centered communication high 7uality care can be achieved.

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Attitude toward behavior 4 an individual8s positive or negative evaluation of self-performance of the particular behavior. The concept is the degree to which performance of the behavior is positively or negatively valued. It is determined by the total set of accessible behavioral beliefs

lining the behavior to various outcomes and other attributes thait is whether health care worers should or should not improve communication sills and how it is valued either positively or negatively with riss and rewards. ,or e.g taen positively improving communication sills through patient centered communication will definitely leads to smooth ongoing of processes wherby patient is informed about their diagnosis and why the given treatment is most appropriate. •

Subjective norm4 an individual8s perception about the particular behavior which is influenced by the "udgment of significant others (e.g. patients collegues other staffs seniors and surrounding). There can be pressure from collegues and other staffs lie assessing one8s way of communicating with patients to improve communication sills because in so doing we will acheive patient centered communication which is our main aim therefore the need to adopt a positive attitude toward the given behavior. :r all staffs are adopting such a behavior and acheiving satisfactory so to fit in the group others should follow.

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Perceived behavioral control 4 an individual8s perceived ease or difficulty of performing the particular behavior. 2/3 It is assumed that perceived behavioral control is determined by the total set of accessible control beliefs and measure the confidence toward the probabiltity feasibility or lielihood of executing a given behavior that is it will be easy to improve health care worers8 communication sills health care worers are in favor for the improvement of the current communication sills.

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Control belief4 an individual8s beliefs about the presence of factors that may facilitate or impede performance of the behavior. 2;3 The concept of perceived behavioral control is conceptually related to self-efficacy. 6owever it can be hindered by constraints such as beliefs that one8s behavior will not have any impact. 6ealth care worers can improve their communication sills due to motivation from the others through performance appraisal that is improving communication sills will increase patient satisfaction and after service has been provided to them patients thans healthcare worers for their oustanding wor (wow effect) or cannot improve because of frustration and stress because a way to assess healthcare worers on how they are applying their communication sills on each process with a patient is observed by their superiors which renders their behavior static due to stress.

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Behavioral intention 4 an indication of an individual8s readiness to perform a given behavior. It is assumed to be an immediate antecedent of behavior .2'3 It is based on attitude toward the behavior sub"ective norm and perceived behavioral control with each predictor weighted for its importance in relation to the behavior and population of interest. The readiness to perform 7uality communication for patient centered care based on attitude4 improving the actual communication sills sub"ective norm4 how it is perceived by others and perceived behavioral control4 whether it will be easy for health care worers to improve it or it is loosing time on something that will have no effect on patients.

Behavior4 an individual8s observable response in a given situation with respect to a given target. !"#en said a behavior is a function of compatible intentions and perceptions of behavioral control in that perceived behavioral control is expected to moderate the effect of intention on behavior such that a favorable intention produces the behavior only when perceived behavioral control is strong. ,avorable intention produce behavior only when perceived behavioral control is strong. Therefore readiness to improve communication sills will depend on how easy health care worers find it to improve and having a positive attitude towards it and implementing this attitude will in turn provide high 7uality care in terms of patient centered communication.

!imitation The theory of planned behavior is based on cognitive processing and level of behavior change. >5 Taylor et al. 5>> ?ebb et al. 5>$>). 9sing the theory to explain and predict liely behaviour may however be a useful method for identifying particular influences on behaviour that could be targeted for change. !s 6ardeman et al. (5>>54 $;%).

R"#"R"NC"S $.Bandura !. ($%). Self-efficacy: toward a unifying theory of behavioral change. Psychological review $% (5)4 $%$. Bandura !. ($%%;). 0elf@efficacy. Aohn ?iley  0ons Inc. 5.Bandura !. !dams C. 1. 6ardy !. B.  6owells D. C. ($%&>). Tests of the generality of selfefficacy theory. >5). Perceived Behavioral . .Hutta-Bergman *. A. (5>>'). Theory and Practice in 6ealth TransportJ5>*odellingTheJ5>Theory

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