Motivation has been identified as an important variable in recovery. Self-efficacy, which is an individual's judgment of his or her capabilities to organize and execute courses of action to accomplish specific goals, is considered an essential component of motivation. This study used an experimental pretest-posttest design and qualitative design using a grounded theory approach to assess the impact of self-efficacy enhancing interventions on self-efficacy beliefs and functional outcomes of participants in a geriatric rehabilitation program. Participants were randomly assigned to one of two groups: (1) the experimental treatment group; and (2) the usual care control group. In addition to usual care, the treatment group received three self-efficacy enhancing interventions: (1) role modeling; (2) verbal persuasion; and (3) physiological feedback. The study sample consisted of 77 participants, 55 females (71%) and 22 males (29%), with a mean age of 78 (SD = 7.2). Admission performance was the only statistically significant predictor of self-efficacy and outcome expectancy beliefs in this sample. Based on repeated measures analyses there was a statistically significant difference between the two groups in regard to participation, self-efficacy and outcome expectancy for participation, and pain. The treatment group had stronger efficacy beliefs regarding participation, higher participation at discharge, and less pain than the control group. Although not statistically significant, the treatment group had higher self-efficacy for functional ability at discharge than the control group. There was no difference in the groups in regard to length of stay, however stronger efficacy beliefs on admission were correlated with shorter length of stay. Based on themes identified in the interviews, motivation was conceptualized as a wheel that moves. The spokes of the wheel incorporated the variables within the theory of self-efficacy and expanded on these variables to include: (1) personal expectations; (2) physical sensation; (3) individualized care; (4) social support; (5) self-determination; (6) spirituality; (7) goals; and (8) performance behavior. This conceptualization of motivation can be used to assess motivation in the older adult, and use interventions to strengthen motivation and help these individuals obtain and maintain their highest functional level.

Currently, older adults are among the fastest growing online users, and the Internet/e-mail could serve as a new support system for these individuals. The purpose of this study was to test "A Model of Computer-Mediated Social Support Among Older Adults" that explains relationships among a computer-mediated social network (CMSN), functional social support from that network (CMFSS), and psychological well-being of older adults. This was a one-time single group descriptive study employing a Web survey. The questionnaire was posted on the SeniorNet Website from April 5 to June 9, 2002. Participants were eligible if they were: (1) age 55 or older; (2) able to use the Internet/e-mail independently; and (3) currently residing in a community setting. The data were directly populated to an ACCESSRTM database. The data then was imported into SPSS for data screening, and then into AMOS 4.0 for the SEM analysis. A two-step approach (measurement model test first, then full model test) was employed in this model testing. Validity of the overall model was examined employing the cross-validation method. A total of 809 SeniorNet users participated in this study. The majority of participants were white (751, 92.8%) with a mean age of 67.8. About two-thirds of participants (511, 64%) were female. The majority (641, 80.3%) reported at least some college education. Model testing showed that, overall, the proposed model fit the sample data. The fit indices were: chi2/df, 2.86 (chi 2 = 1358.39, df = 475, p < .001), GFI, .90; RMSEA, .05; CFI, .88; NFI, .82. Specific findings demonstrated that computer time, computer knowledge, age, gender, and physical health directly influenced CMSN, and CMSN had a positive impact on CMFSS. Computer-mediated social support, however, did not have a significant impact on psychological well-being. The supported relationships between CMSN and CMFSS suggest that health care professionals may use Internet/e-mail to provide important health-related support (e.g., information and support groups) to older adults. The non-significant relationships could have been due to other confounding variables or measurement issues in psychological well-being; this calls for further research.

Background. Falls are among the most common and serious health problems of older people. Also, falls can have a significant physical and psychosocial impact on the individual, resulting in physical inactivity and subsequent functional decline and social isolation. However, the psychological symptoms of falling have received relatively little attention compared to physical problems. Purpose. The purpose of this study is to test a model to explain the factors that influence FOF among older adults living in a continuing care retirement community (CCRC). Methods. A secondary analysis was conducted using data obtained from a Health Promotion Survey done on 149 older adults living in a CCRC. Data was originally obtained during face to face interviews with each participant. Eligibility for participation included residents living in independent or assisted living apartments with at least 65 years of age. Descriptive statistics and bivariate correlations were used to describe the sample and evaluate simple correlations. A path analysis was done using the AMOS statistical program. Results. Of the 49 hypothesized paths, 13 were statistically significant, and the model accounted for 22% of the variance in fear of falling among the elderly. There was support for the fit of the model to the data with a nonsignificant chi square at 0.478 (df= 2, p=0.79), and the ratio of chi-square to degrees of freedom was 0.24, a CFI of 0.99 and RMSEA of 0.00. In particular, gender, a history of falling, and exercise were significant predictors of fear of falling; Age and mental health influenced fall incidents; and Self-efficacy and outcome expectation played an important role in maintaining exercise behavior in older adults. Conclusions/Implications. This study develops the comprehensive model to explain the predictors of fear of falling. As anticipated, exercise is an important factor to prevent fear of falling. As a modifiable variable, self-efficacy and outcome expectation indirectly influence fear of falling through exercise. This study clearly indicates the need to motivate older adults to engage in exercise. Further research should examine other factors that influence fear of falling with a larger sample size in a heterogeneous setting.