Bandura’s Self-Efficacy Theory
Bandura’s Self-Efficacy Theory is a social cognitive
theory which is essentially, “the self-perceptions that individuals hold about
their capabilities” (Pajares, 2009).
There are 4 sources that affect self-efficacy, including (Kitchie,
2014):
1.) Mastery Experience—Previous achievement
of a similar task
2.) Vicarious Experience – Observing the
success or failure of others attributes to the belief of ones’ own capabilities
(Peer Modeling)
3.) Social or Verbal Persuasions –
Positive verbal encouragement from others
4.) Physiologic Reactions – Including somatic
and emotional states (anxiety, stress and mood)
Self-efficacy is a vital piece of teaching because it stands
as a strong indicator for whether a particular health behavior will be carried
out or not. We, as health educators, need
to be aware of what level a patient’s self-efficacy level is at. We can play on the 4 sources of efficacy to
increase the likelihood of our patients following their intended health
plan.
Since mastery experience is proven to be one of the biggest
motivating factors for optimal self-efficacy, we need to investigate what other
medical triumphs they have had in the past (Kitchie, 2014). If we can relate the two behaviors with both
positive outcomes, the chances of the patient coming through with the care plan
will be much higher.
Our greatest strength as a provider is to provide the
necessary support and genuine encouragement and positive reinforcement to
empower the patient to make a change. I often
use the analogy of “mind over matter”, keeping an open and positive mind set to
overcome physical restraints brought on by medical illness.
SELF-BELIEF (increased self-confidence) = SELF-EFFICACY
Self-Efficacy in the ICU
I recently had a patient in the ICU with newly (within 2
months) diagnosed of pancreatic cancer with metastasis. She was a 30 day readmit for recurrent bowel
obstructions with severe deconditioning secondary to weakness and
immobility. On the second day of her
hospital stay, her acute medical issues were resolving and we were progressing
diet and implementing early mobility in hopes of overall improvement in her
condition. She was quite hesitant about
getting out of bed because she was feeling so weak for so many days.
To think of it, I couldn’t apply the mastery experience with
her in regards to research on the pros of initiating early mobility in
hospitalized patients on the first day but once we got out of bed with
sufficient assistance to make her feel comfortable about not falling she felt
much more motivated to get up the next day.
From her mastery experience on getting up on day one, even though it was
just to the edge of the bed, it highly motivated her to get up to the chair the
next day. I also used verbal persuasion
with reasonable outcomes for her.
Physiologically, we managed her pain and kept her stress at a minimal,
which also empowered her to increase her activity even more the next day.
References
Kitchie, S. (2014). Determinants of
Learning, in S. Bastable (Ed.), Nurse as Educator: Principles of Teaching and
Learning for Nursing Practice (pp. 113-158) Boston, Jones and Bartlett
Publishers.
Pajares, F. (2009). Self-Efficacy
Theory. Retrieved October 3, 2015, from
http://www.education.com/reference/article/self-efficacy-theory/
Great job with helping your patient find the motivation she needed to have a success in her recovery. It must be difficult for this patient to find the strength to have a positive outlook and the desire to allow encouragement from you and others with the metastasis.
ReplyDeleteShoua, very good description of the theoretical components of Bandura's theory and how these can be applied in your clinical setting. The idea of mastering small steps toward a larger goal is a major component of self-efficacy. Nancy.
ReplyDeleteHi Shoua,
ReplyDeleteOnce again, a beautiful presentation. It is amazing to think that today in 2015 that so much culture which has been learned and shared from the past can influence how someone thinks, acts and makes decisions today with healthcare.
Culture and language have a huge impact on health literacy as you pointed out. A patient’s belief in how much they can control what is going on around them based on health beliefs and behaviors, while trying to understand the physical and mental roles of the family members.
The nurse plays an important role in both the patient’s health while appreciating the cultural impact on what the patient or family will allow based on their understanding.
Some of the items to consider are the consent forms, discharge planning, along with specialized nutritional recommendations. Food can by a large part of culture. Asking someone to change what they eat or need to give up can be met with apprehension.
Recognizing that culture, health literacy, communication, language all present when someone admits is one of the smartest things that we as nurses have learned. Knowing how to handle this in a diplomatic, respectful way is one of the best things we as nurses have learned.
Good job on taking care of your patient. Your whole patient, which includes the family.
Singleton, K., Krause, E., (Sept. 30, 2009) "Understanding Cultural and Linguistic Barriers to Health Literacy" OJIN: The Online Journal of Issues in Nursing. Vol. 14, No. 3, Manuscript 4.