Middle Range Theory Critique: Self Efficacy
The problem of nursing personnel self-efficacy requires an application of new concepts and constructs for its solution. The theory of social learning developed by scientists has required an introduction of a new concept corresponding to a new tendency in psychological researches in which a leading role was given to the cognitive processes. Such a concept of the social learning theory was first presented as the “efficacy expectation”, and then by “self-efficiency” (Bandura, 1994, p.871). For the first time, self-efficacy as an expectation construct that influences the functioning and motivation of the nursing staff was presented in the works of Albert Bandura. The scientist showed that the lack of belief in the efficiency of own actions can cause violations of behavior (Williams & Rhodes, 2014, p. 113). However, the self-efficacy theory was proved not only theoretically but also experimentally. The many-aspect impact of self-efficacy on human activity and insufficient study of its applied aspects make this theory important for the nursing practice and appropriate for the profound critique.
Description of Theory
Self-efficacy, together with the surrounding environment, influences the previous behavior. Moreover, other personal characteristics determine human behavior. In the concept of expectations, Bandura differentiates the “efficacy expectation” and “outcome expectation”. The first type of expectation is identical to the belief that some behavior will have certain results. The expectation of self-efficacy means that a person is able to behave in such a way to have desirable results (success) (Bandura, 1994, p.71).
The influence of belief in self-efficacy on human behavior is explained by Bandura as follows: a person is afraid of and avoids those social situations with which he cannot cope. On the contrary, he behaves actively and offensively when he is confident in his powers and believes in the success of his own actions. According to the theory and researches of Bandura (1982), self-efficacy is revealed in the way people feel, think, and work. The researcher discovered that an individual self-efficacy plays an important role in how the purposes, desires, and motives are realized. The low level of self-efficacy is associated with depression, concern, and feeling of helplessness (Bandura, 1982, p.124). Such individuals have a low self-assessment and demonstrate pessimistic thoughts of own achievements. People with a low level of self-efficacy avoid difficult situations, believe that complex challenges and instructions are not for them, learn from own mistakes and failures, lose faith and confidence in own capabilities, etc. On the other hand, people with a high level of self-efficacy believe that there are no insoluble situations, develop a great interest in that field of activity in which they are engaged, quickly recover after they experience failures and stresses (Bandura, 1982, p.126).
Bandura assumed that the ideas of self-efficacy comprise something more than just the belief that efforts determine success. Self-efficacy is understood as a belief of the individual in the capability to deal successfully with the difficulties leading to the achievement of some results (Lunenburg, 2011, p.1). Also, the self-assessment of knowledge, skills and stress management strategies influences the formation of ideas of self-efficacy.
The endured experience of success is the main source of self-efficacy growth. To do everything possible and to reach the desired results means to feel sure in the correctness of personal actions. Beliefs arise and become stronger in the course of vigorous activity directed at the solution of the tasks set by definite situations (Williams & Rhodes, 2014, p. 114).
Self-efficacy, however, is developed in early childhood. Nevertheless, the development of self-efficacy does not finish in youth but continues during the whole human life – gaining new experience, knowledge, and understanding. As stated by Bandura (1982), there are four main resources of self-efficiency:
1. Personal experience. Experience is the most effective method for the development of own self-efficacy. The level of personal self-efficacy increases when a successful solution of problematic situations is found. The achieved success strengthens the feeling of self-efficiency to a lesser extent if a carried-out task was easy than if it was difficult. The feeling of self-efficacy also grows more if success is achieved independently by a person, who overcame the difficulties by means of persistent efforts. Nevertheless, the failures can decrease this level.
2. Social experience. The successful problem solution is an important resource of self-efficacy. The observations of how people around act in difficult situations change the judgments of the observer of own opportunities. The more there are similarities between the individual who successfully solves any problem and the observer, the stronger there is an impact. A person who sees how other people try to achieve success has a strong belief in the possibility to overcome the arising difficulties.
3. Social belief. People are capable of convincing themselves that they have the necessary resources and opportunities to achieve certain objectives. Public encouragement is most effective when it is combined with one’s own successful execution. The belief of other people gives only a short-term and weak effect because its force is limited to the realized status, authority and trust degree for the one who makes a verbal impact. Thus, the words of encouragement and praise told once can help people believe in themselves. Obtaining positive information from society, people are focused on success but not on failures.
4. Emotional lift. Self-efficacy is constantly changing. The development of personal self-efficacy is provided by means of cognitive abilities formation to build some behavioral patterns, gain an indirect experience and to enter the condition of physical or emotional lift providing success. The high self-efficiency connected with the expectation of success usually results in positive outcomes and an increase in self-efficacy (Bandura, 1994, p.72). On the contrary, the low self-efficacy is related to the failure expectations. The mood, emotional condition, and level of stress can also influence the way how a person feels the opportunities under certain circumstances. If a person experiences a pleasant excitement and positive emotions, his or her self-confidence and self-efficacy enhance. Moreover, rough emotions prevent people from the successful completion of the tasks (Bandura, 1982, 134-135).
The phenomenon designated by the “self-efficacy” concept was an object of research in many behavioral theories focused on internal motivation. The term “internal motivation” was introduced in the 1950s by Robert Woodworth in the book “Dynamics of Behavior”, in which he proclaimed the principle of primacy of behavior as opposed to the principle of primacy of motivation (Bandura, 1994, p.73).
Effecting motivation is a force determining the aspiration of a person to competence, the internal motive inducing to the interaction with the surrounding world. According to Williams and Rhodes (2014), while establishing the “effectance” motivation, they determined it as an internal “drive” of the interaction with the environment. The development of “effectance” motivation occurs through the acquisition of knowledge and abilities from the interaction with the environment. This approach served as the basis for the development of Bandura’s self-efficacy theory in the 1990s, grown from the social-cognitive theory (Williams & Rhodes, 2014, p. 117). In agreement with the self-efficacy theory developed by Bandura, people are capable of realizing and estimating the level of their capabilities, building the successful behavior depending on the specific task or situation, as well as estimating their efficiency (Bandura, 1982, 132). Those who realize their self-efficacy make more efforts for accomplishing difficult tasks rather than doubting the opportunities. The powerful source of self-efficacy includes the actively mastered knowledge, actions, previous experience of progress, etc. Also, people can convince themselves that they possess the necessary capabilities and abilities for successful goal achievement, thus increasing their own self-efficacy. They will more likely achieve success if they are not stressed, as emotional condition directly influences a level of self-efficacy (Bandura, 1994, p.80). However, comparing this approach to the concept of Bandura, it should be noted that in the theory of social learning the choice of behavior and persistence of the efforts are determined by self-efficacy rather than by incentive conditions. Hence, self-efficacy arises from the various sources of information, directly and indirectly influencing behavior, through the cognitive structures.
Definition of Concepts
Self-efficacy is a cognitive assessment, or system of representations, regulating the actions directed at the achievement of definite goals. Lee and Ko (2010) state that unlike self-assessment, self-efficacy is a representation not about the personal value but about the ability to take actions. Self-efficacy is connected with the experience of behavioral achievements. The representations about how self-efficacy affects the goal-setting and effective self-assessment were demonstrated by the scientists (Lee & Ko, 2010, p. 842). The achievements in any kind of activity promote the formation of a feeling of self-efficacy, which, in turn, increases the interest in its activity.
Self-efficacy is an assessment of own capability to manage certain specific objectives in this or that specific situation. Self-efficacy implies the capability of an individual to challenge specific and difficult situations and to exert an impact on the efficiency of activities and personality functioning in general (Bandura, 1982, 138). The one who comprehended the level of his/her own self-efficacy does his/her best for the solution of complex challenges than the one who has doubts in his/her own opportunities. A low self-efficacy means a lack of trust to own behavioral capabilities. Contrary to that, a high self-efficacy means that arising problems are perceived by people not as the absolute obstacles but as some challenges giving the opportunity to check and confirm someone’s capabilities (Lee & Ko, 2010, p. 841). Such an assessment of a situation causes the resources mobilization of an organism. Self-efficacy represents the expectation of personal skills in the solution of future tasks.
Perceived self-efficacy is defined as people’s beliefs about their capabilities to produce designated levels of performance that exercise influence over events that affect their lives. Self-efficacy beliefs determine how people feel, think, motivate themselves and behave. Such beliefs produce these diverse effects through four major processes. They include cognitive, motivational, affective and selection processes. (Bandura, 1994, p.72)
Self-efficacy is an important scheme of thinking that influences the behavior of a person and his or her results by means of cognitive, motivational, affective, selective and physiological processes. Self-efficacy does not belong to the ability to realize the main motive functions, such as walking, ability to achieve or be enough (Duggleby, Cooper, & Penz, 2009, p. 2378). All actions of any strategy should be within the limits of the physical abilities of an individual.
Clarity and Consistency
Despite the fact that the self-efficacy theory was based on the psychological social-cognitive theory, abound in the specific terminology and lexis; it is quite clear and consistent. However, if to take into consideration a unified chain of hypotheses, connected into a universal system, allowing nurses to use it in their clinical practice, the theory does not present a systematized and unified theory. At the same time, the theory represents the mix of ideas and concepts, a part of which is a unique contribution to this theory, and the other part is borrowed from other theories than from the uniform integral theory. Sometimes, various concepts are simply gathered, and their contradicting and dubious results are equally present in this theory.
The theory defines the main concepts and ideas. However, Bandura does not include both efficacy expectations and outcome expectations in the self-efficacy theory. The author of the theory considers that the outcome expectations are not consistent with the theory, while self-efficacy composes its major component and is rather unchangeable.
The theory is adequate and clearly states that self-efficacy is important for the forecast of behavioral changes. The unique roles played by individuals result in behavioral changes. The self-efficacy theory takes an important step forward and goes beyond the simplified emphasis on either internal or external determinants of self-efficacy and on cognition, affects or real actions (Lunenburg, 2011, p.2).
Logical Development and Level of Development
The self-efficacy theory was developed from the social cognitive theory, representing its logical continuation. The main theoretical concepts and definitions are logically presented and explained. The self-efficacy sources have also been logically explained by Bandura. Moreover, the scientist has developed the measurement tools for the theory. However, the only shortcoming in the theory’s logic includes the presentation of some general idea or direction, not a well-developed representation of the system of interrelations.
The self-efficacy theory states that people need such qualities as certain efforts and persistence for definite behavior formation. Facing the difficulties in nursing practice, the nurses with low self-efficacy do not try hard to achieve the desired goal, comparing to those with high self-efficacy who do their best in attaining the desired results. Thus, the theory has a connection with reality and can be successfully applied in nursing practice.
Utility and Significance
Finding themselves into various by content and complex health care settings, nurses use the theory in nursing practice, like, for example, in the process of the patients’ rehabilitation or nursing home care. Within the frameworks of the self-efficacy theory, nurses develop and research the hypotheses.
The self-efficacy theory has significant importance for nursing as it contains the efficacy measurement tool, allowing to apply the theory in clinical practice with the best possible effect. Being based on the own unique efficacy, the nurses, applying the theory in practice, use the individual approach in the provision of health care to patients (Lee & Ko, 2010, p. 841). Moreover, when the level of development and application of the self-efficacy theory was achieved by Bandura, the scientist became involved in global public and nursing problems. It resulted in the formation of collective efficacy, presupposing that common confidence and people’s efforts can cause social changes (Lee & Ko, 2010, p. 847). It roots not in the collective consciousness but in the personal effectiveness of many people working together. Thus, collective efficacy can be applied in nursing practice, allowing the nurses to make positive changes in the nursing process as well as in the health care system as a whole.
Moreover, the self-efficacy theory was organically included in the system of cognitive-oriented social psychology and gave an impetus to numerous psychological researches in many areas. The theory is significant for health maintenance, both mental and somatic, better social integration as well as for high professional achievements. Besides, the self-efficacy theory became one of the key concepts of clinical, social, pedagogical and personal psychology (Lunenburg, 2011, p.2).
The self-efficacy theory is applied in nursing, mostly for the nursing process in the treatment of chronic diseases. It is also effective for the changes in target behavioral patterns.
The scope of the self-efficacy theory in the nursing process is rather narrow. It can be applied, in particular, in the nursing management of chronic diseases or rehabilitation process.
Due to simple descriptions of the main concepts of the theory, it is not considered to be complex. Being the key concept of the theory, self-efficacy is profoundly explained and easily grasped.
In my personal experience, high self-efficacy allows me to change my way of thinking and promoted the growth of self-supporting thoughts. Moreover, it promotes the appearance of motivation to the nursing activity and determines its power. It is revealed in the cases when I face the barriers on the way of nursing management of patients’ diseases. My high self-efficacy helps to reduce my anxiety level and prevents the emergence of negative emotions, which occur when undesired events or failures happen. In my case, the experienced success in the nursing process became the main source of growth for me. I feel a high level of self-efficacy when I can do everything possible for the patients. The development of my self-efficacy occurs due to the mastering of cognitive skills of my behavior construction and experience gain. Thus, my high self-efficacy combined with the expectations of success has positive results and increases my self-efficacy level.
Application of the Theory to the Nursing Practice
Being an important personal factor of the assessment of the stressful situation, self-efficacy is a part of the secondary assessment. It influences the processes of the emotional condition of a person. The belief in own efficiency helps a patient to use own resources in stressful situations. Self-efficacy is not only the predictor of satisfaction with work but it also reduces the level of stress and can substitute the negative impact of the stressful factor for the positive one. Self-efficacy influences a wide range of different areas, like development and training, collective efficacy or teaming, leadership and innovations, as well as goal setting and performance (Lunenburg, 2011, p.5).
According to Duggleby, Cooper, and Penz (2009), an effective application of self-efficacy theory to the practice of nurses includes the possibilities to be successful in the nursing problem solution. The theory can be applied to the nursing management of different chronic diseases, such as diabetes or asthma (Duggleby, Cooper, & Penz, 2009, p. 2381). However, for the more effective application of the self-efficacy theory, it is necessary to consider the environment of the patient.
The self-efficacy theory represents the most important cognitive scheme, which influences the behavior of subjects and its consequences through the cognitive, selective, affective and physiological processes. Due to the many-aspect impact of self-efficacy on human activity and insufficient study of its applied aspects, this theory represents an interest in the nursing practice. The self-efficacy theory critique presented in this paper gives a general background of the theory, analyzes its components as well as its application in nursing practice. Being the main concept of the theory, self-efficacy is the main predictor of efficiency in different spheres of activity, in particular, in nursing management. Moreover, self-efficacy also influences the ability of nursing personnel to adapt and overcome difficult life situations as well as the goals and tasks put in nursing practice. However, at the same time, it is not a systematized and unified theory concerning the uniform network of hypotheses, closely connected with the system which allows doing the definite forecasts. Nevertheless, the attempts of Bandura to explain the mechanism of self-efficacy are very important for the nursing theory and practice.