Barbara Resnick is among the theorists whom people acknowledge based on their significant contributions to the nursing field. Resnick’s middle-range hypothesis of self-efficacy, which forms the basis of this paper, determines the extent to which people believe in their capacity to realize certain goals in their life. This paper analyzes the theory’s main concepts and philosophical underpinnings. Besides, it also presents a practical application of the theory.
Self-efficacy can be defined as the measure of people’s belief in their ability to attain specific goals. The concept of self-efficacy has been studied and analyzed by psychologists from various perspectives. Following its significance in many behavioral and health sciences, self-efficacy has become a major aspect of training in fields such as nursing, education, and human resource development. Barbara Resnick, the founder of the theory, claims that a person who demonstrates a high self-efficacy can persist and/or succeed in a certain task. On the contrary, people who have low self-efficacy are likely to give up and fail to accomplish a particular task since they believe in their limited capacity to achieve certain tasks. In the long run, self-efficacy affects all aspects of a health practitioner’s life. The degree of people’s self-efficacy to verify their viewpoints concerning their talents directly influences the choices they make. The choices that individual nurses make in the context of their job have consequences. Such beliefs are apparently influential in determining whether such individuals (patients) can face challenging tasks such as dieting, exercising, and persevering painful health processes. This paper will focus on this theory. It will analyze and evaluate it with an inclination to the field of nursing.
Main Concepts and Philosophical Underpinnings of the Theory
According to Chism (2013), Barbara Resnick’s theory of self-efficacy holds it that a person’s expectation of his or her capacity to accomplish a particular task is a function of his or her behavior, verbal encouragement, physiological sensations, and exposure to role models. This school of thought originated from the social cognitive theory that was earlier put across by Albert Bandura. Self-efficacy theory (SET) puts an individual in a position to believe that he or she holds the power to accomplish a particular job, program, or activity that is required to attain a certain goal. According to Resnick, individuals hold a strong belief that they can work in a particular manner and attain a stipulated goal. In the nursing field, Resnick presents self-efficacy as a practitioner’s belief that he or she can master a particular nursing concept or situation and develop positive results in the end. Self-efficacy is important in the practice of nursing since it regulates and determines the psychological stability of an individual nurse. Bevans, Reley, and Forrest (2012) assert that low self-efficacy implies an easily distracted nurse who easily gives up on tasks. Such a nurse believes in failure and inability to accomplish tasks. Since the overall goal in the nursing field is to save the lives of ailing people, a selfish practitioner is associated with poor goal attainment, reluctance, and death of patients.
This theory is built on three major aspects that influence the level of an individual’s selflessness. As the figure below shows, these factors include behaviors, personal or cognitive factors, and the environment.
Chism (2013) asserts that individuals’ behavior is a strong foundation of self-efficacy. Employees who believe in hard work and persistence are likely to have a higher level of self-efficacy compared to those who give up on tasks easily. Behavior forms the character, which in turn determines individuals’ will to stay or surrender to a certain activity. Since goals are attained when individuals work in a certain way, the behavior is a key concept in self-efficacy. Personal cognitive factors are also important in determining the level of self-efficacy in an individual nurse. Jongen et al. (2014) assert that cognitive ability determines the ability of a person’s mind to think well and to solve problems. Individuals who have good cognitive skills have a high self-efficacy than their counterparts who have low cognitive skills. The ability to solve problems makes individual nurses believe in themselves and their determination to achieve goals. According to Chan (2014), cognitive ability is also considered a source of self-esteem and self-belief, which mold people’s self-efficacy. In addition, cognitive ability empowers individuals to believe that they can handle challenges not only in their jobs, but also in their day-to-day lives.
Environmental predisposition also influences self-efficacy. Every individual learns how to behave either by modeling or observing. The characteristics of people’s environment not only teach them how to behave, but also specify what a morally upright or acceptable behavior implies. When a nurse observes another nurse achieving great results in his or her job, the observant health official is likely to model his or her behavior and work persistently to achieve similar results. This strategy enhances the level of self-efficacy of an individual health practitioner. Human beings are social. They learn through interaction with each other. People who live amidst lowly motivated people are also likely to be lowly motivated. Our environment can teach us not only to be persistent and determined, but also to believe in ourselves to achieve our goals. Chism (2013) asserts that a nurse who is inducted by a lowly motivated matron is likely to observe and model the same behavior. This situation results in employees who are associated with poor goal attainment. Hence, according to Clarke et al. (2014), environmental predisposition is a powerful factor in the development of strong or low self-efficacy. Therefore, it follows that self-efficacy can be nurtured through experience where goals are achieved through perseverance. When one observes others go through a challenging task until they finally achieve, they are also likely to learn. It is also important to distinguish between self-efficacy and self-esteem. According to Chao-Wen, Shieunt-Han, Ying-Ying, and Wei-Lun (2014), a nurse can have a high self-esteem and a low self-efficacy level. Self-esteem is the overall personal evaluation of one’s worth. Individuals may place a high value on their lives but have low achievement morale. Self-efficacy is goal-oriented while self-esteem addresses the feeling of self-worth. In self-efficacy, persistence and determination are geared towards task accomplishment. Perception is also a major driving force in self-efficacy since it determines one’s belief in doing or not being able to do certain things.
The Heuristic Value of the Theory
According to Flannery et al. (2012), the heuristic value of this theory is found in the way it enhances skill mastery, modeling, and social persuasion of a patient. The value of skill mastery is brought out through the breaking of complex skills into small and easy-to-understand concepts. This strategy ensures that the small tasks are manageable and achievable within time. For example, patients are likely to adapt to a certain behavior when they know that they will benefit from it at the end. In fact, patients show interest in some behaviors when know that they will be successful in small tasks that finally add up to a major goal. Patients need to be taken through various small successes in the process of attaining a major goal. A small success enhances patients’ self-worth. In fact, according to Clarke et al. (2014), behavior change can be learned through these insignificant successful efforts. For example, anti-smoking television and radio programs may persuade addicts to declare smoking a vice that is counterproductive to their health. The small steps of promising not to smoke for a day culminate in quitting.
The second value of this theory is found in its modeling element. According to Shoji et al. (2014), modeling involves exposing a patient to another one who has similar conditions. Flannery et al. (2012) uphold this concept by showing how health foundations and programs such as those that campaign against cancer have adopted modeling as a value. Such foundations use a model case. For example, they use a patient who has gone through cancer successfully to reach those who fear tests and/or those who seem to give up the fight. In the same case, Bevans et al. (2012) affirm that nurses use modeling in treating various conditions. In the modeling process, nurses identify models that match the patient’s aspects, for example, sex, conditions, age, color, race, education level, and status. While selecting these models, especially with reference to health behavior, nurses and other medical practitioners avoid super-achievers, i.e. people who seem to achieve success over a particular health condition within an unrealistic time or using unexplainable means. Under the concept of self-efficacy, a model that follows easy-to-understand procedures, time, and guidelines is preferred. According to Sakakibara, Miller, Janice, Backman, and Routhier (2014), the essence of such a model is to help other patients to easily identify with them step by step.
The third element of this theory is social persuasion. Peterson and Bredow (2012) affirm that social persuasion is the individual’s efforts to influence behavior. In this technique, nurses encourage patients to go an extra mile by accomplishing more than what they have been achieving (Taliaferro, Hammond, & Wyant, 2015). Persuasion is also made realistic and short-termed to encourage patients to see the results of their efforts. Understanding the ability of the patients and what they believe in is possible. Self-efficacy is also increased through effective teaching methods. The method of teaching that nurses adopt will determine the level of patients’ self-denial. Walker and Avant (2010) recommend health professionals to deliver content that patients can easily understand and appreciate. The content of teaching should also be easy to read and remember. It is important for the health professional to understand the patient’s level of education or literacy before embarking on the teaching exercise. Training materials should be adapted to the patient’s knowledge level. The complex scientific language that is used in the field of health should be simplified for patients to understand the content. Sakakibara et al., (2014) say that health officers should also encourage patients to read, watch, or listen to health contents that are aimed at improving their health. The use of teaching aids, diagrams, images, and pictures that simplify the health content into small and easy-to-understand contents also enhances self-efficacy. Nurses should also adopt benevolent and encouraging words that can motivate patients to go an extra mile in improving their health. According to Mahat, Scoloveno, and Ayres (2014), factors such as good communication skills and choice of words are excellent approaches to enhancing self-efficacy. Efforts to engage in beneficial health activities such as body exercises, dieting, washing and disinfecting, the brushing of teeth, and eating balanced diet should be simplified in a way that can make patients identify with them.
Self-efficacy can be analyzed using elements such as experience/enactive attainment, vicarious attainment, social persuasion, and psychological factors. According to Walker and Avant (2010), experience is the greatest determinant of an individual’s self-efficacy. Mastery of content and activities that are deemed necessary for goal attainment determines an individual’s self-efficacy level. Besides, success in a particular task raises the level of self-efficacy in an individual. In the same way, Jongen et al. (2014) affirm that failure to succeed in a given mission that is considered important to individual health workers or patients lowers their self-efficacy. According to Shoji et al. (2014), it is possible to determine patients’ self-efficacy levels by analyzing their history. In such analysis, health workers determine whether an individual has had any related experience in their history. Any previous success story in similar conditions acts as a motivation to the patient in fighting the current state of affairs. In a similar way, previous failures in fighting similar issues may result in low motivation in fighting the new condition and hence low self-efficacy. Nurses who have facilitated the healing process in previous patients are also likely to have a high self-efficacy when they face with similar conditions (Oetker-Black, Kreye, Underwood, Price, & DeMetro, 2014; Katz, Eilot, & Nevo, 2014). Therefore, it is important to evaluate the level of experience of a particular nurse before carrying out job assignment. In fact, Chan (2014) affirms that health professionals who have high levels of experience are likely to have high levels of self-efficacy.
Vicarious experience is another powerful factor that drives self-efficacy. Chao-Wen et al. (2014) affirm that vicarious experience dwells on the premise, ‘if someone else can do it, then I can also do it’. When individuals observe others succeed in a particular task, their self-efficacy level is raised. They start believing that they can also manage similar success. Health officers use models to influence patients to behave in a similar way and to believe that everything is possible. In the process of analyzing the level of self-efficacy in a particular individual, it is important to evaluate the models in their lives. As Peterson and Bredow (2012) recommend, exposing patients to models that they can relate with raises their self-efficacy. However, such models should be evaluated based on the patients’ gender, race, socioeconomic levels, education, and the environment. Higher levels of similarity between the patient and either of the elements predict higher efficacy. Katz et al. (2014) assert that people learn easily from other with whom they can identify themselves. Vicarious experience is important in influencing people who do not believe in themselves. When such people observe others in similar conditions bodily fight over and succeed, they also develop the determination to overcome any obstacle.
According to Shim et al. (2012), social persuasion can be evaluated based on instances of direct encouragement and discouragement from others. Social persuasion results from any encouraging word that an individual receives from others. Nurses encourage patients to engage in activities that make their health better. Nahm et al. (2012) assert that evaluating the content of words that nurses use when addressing patients can predict their (patients) self-efficacy levels. One can check the presence of such words like, ‘you are trying’ and/or ‘you have made a nice progress’. Such words encourage patients to be bolder in believing that they can face their conditions and win. This concept is built on the foundation of social influence. Listening to heartening words enhances motivation. Therefore, patients are persuaded by the words and actions of the nurses. According to Oetker-Black et al. (2014), when nurses use unkind words that discourage patients, there is a likelihood that the patients will believe that they cannot make it out of their conditions. Therefore, the level of self-efficacy that the patients demonstrate can be used in predicting the social relationship between them and nurses.
Peterson and Bredow (2012) confirm how self-efficacy can also be evaluated using people’s psychological behaviors. When individuals face stressful stimuli, they depict symptoms such as nausea, fear, fatigue, hallucination, and body aches. These conditions may result from psychological conditioning. As a response, the body depicts all or some of the aforementioned symptoms. These responses can change the level of self-efficacy that an individual depicts. For example, a person who believes that sweating before taking the stage to address people results from the lack of or inadequate preparations will believe that what the person goes ahead to present is mediocre. To them, sweating reflects inadequate preparations. Such a low self-assurance in the process of accomplishing goals only results in low self-efficacy and hence poor attainment of goals. When patients depict some of these symptoms, the indication is that they have low self-efficacy. Such a state threatens the attainment of their major goal of regaining their health. On the other hand, an individual who does not associate sweating just before delivering a public speech with inadequate preparation is likely to believe that he will make a good presentation. To such people, sweating is a normal biological condition that prepares them for an energy consuming activity. Park and John (2014) assert that people who demonstrate high levels of self-efficacy believe in their ability to accomplish tasks, regardless of their conditions. With reference to patients, sweating, headaches, nausea, and general body weaknesses result from medication reactions. They only happen to pave a way for better health. Therefore, health practitioners can assess patients’ psychological responses to determine their levels of self-efficacy (Tsai, Tsai, Chen, & Lee, 2014). The presence of signs such as nausea, fear, and general body pains indicates low self-efficacy. Such patients might require uplifting through modeling, social reinforcement, or observation.
Application of the Theory in Practice
Self-efficacy is applicable in various disciplines such as education, career guidance, and health. However, the paper has focused on the application of the theory in the nursing sector. In the field of health, Peterson and Bredow (2012) confirm how self-efficacy is perceived as a predictor, moderator, and mediator of behavior. In terms of prediction, self-efficacy is believed to be in charge of behavior formation, crafting of an action plan, and the actual initiation of activities. Self-efficacy begins with self-belief. Individuals are likely to model their lives according to what they believe they can do comfortably. Park and John (2014) concur with this assertion by claiming that it is only when individual patients are sure that they can manage a particular health undertaking that they can go ahead to plan and be involved in it. Crafting of an action plan is also dependent on self-efficacy. Individual patients will normally plan to do any activity, which they believe they have the ability to accomplish. Low self-efficacy levels result in the development of mediocre plans. On the other hand, high levels of self-efficacy result in the development of high-level action plans since the patients’ concerns are highly motivated. As a mediator, Mahat et al. (2014) claim that self-efficacy prevents the relapse of unwanted or unhealthy behavior. It has a high motivation effect on individuals. Patients who have a high self-efficacy believe that they can always achieve any mission, which they set out to do. For example, once they start the process of rehabilitation for drug use, they believe they are going to win and stop drug abuse. This determination prevents the recurrence of any unwanted behavior. Moreover, as a representative, selflessness enables the transformation of objectives into real proceedings. The implementation stage is the most difficult for many patients. One may decide to quit smoking. However, when he or she is exposed to cigarettes, he or she finds himself or herself smoking. With high self-efficacy, patients believe in achieving the ultimate goal, regardless of the circumstance. Once they make decisions to follow a certain direction, they never look back.
In conclusion, Resnick’s theory of self-efficacy can be termed as an excellent tool that addresses individuals’ belief in their ability to attain their goals. This theory is founded on skills that range from mastery, social persuasion, and modeling. Following Resnick’s plan as adopted in this paper, self-efficacy can be analyzed through psychological factors, experience, social persuasion, and modeling. The theory has been applied in the field of health as a predictor, moderator, and mediator of behavior.
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