Sunday, September 25, 2011

Self-efficacy: A concept analysis

Written by Nyi Nyi Htay
August, 2010


1.     Introduction                                    
Self-efficacy is one of the fundamental concepts of Albert Bandura’s social cognitive theory. It can be defined as the belief in one’s capabilities to organize and execute the courses of action required to attain targeted outcome or behavior (Bandura, 1986).
The belief and imagination of self-efficacy is a practical concept and applicable in various areas of research to strengthen one’s own will and capabilities to acquire a desired level of achievement in difficulty and challenging situation. It serves as a key strategy to prevent and promote health and wellbeing of the individuals, families and communities through empowering and ensuring fullest utilization of their cognitive capabilities and available resources in identifying and solving actual and potential health problems in most appropriate ways. The degree of achievement and its long-term sustainability vary according to the strength of self-efficacy belief and systematic delineation of self-exploration, self-reflection, self-determination, self-directed vicarious learning, self-responsibility, self-control, and self-motivation. Self-efficacy beliefs affect a person’s life choices, level of motivation, quality of functioning, resilience to adversity and vulnerability to stress and depression.  The ultimate goal of self-efficacy is helping oneself by using own capabilities for enhancing the quality of life and adopting healthy lifestyle and behavior.
Bandura described self-efficacy beliefs as determinants of how people feel, think, motivate themselves and behave in a social milieu. A strong sense of efficacy enhances human accomplishment and personal well-being in many ways. People with high assurance in their capabilities approach difficult tasks as challenges to be mastered rather than as threats to be avoided. Such an efficacious outlook fosters intrinsic interest and deep engrossment in activities as evidenced by setting challenging goals and having strong commitment to them, even in facing with failures and threatening condition (Cherry, 2010).
Nurses are the largest workforce of health care providers and dealing with various categories of patients in primary, secondary and tertiary level care settings. The roles of nurses are not limited to care of the sick people, but health promotion and illness prevention become a major goal of health in nursing today. On the other hand, caring tradition of nursing encompasses both art and science and nurses should give all the patients (either ill or well person) an utmost and wholehearted care for the purposes of health promotion, disease prevention, early diagnosis and treatment, and rehabilitation. Donaldson (1983) stated that “nursing without caring would not be nursing, and nurses have a legal, ethical and professional contract with society to care for all its members”. Nurses also have a major responsibility for helping the people to be equipped with knowledge and skill necessary to identify and eliminate certain health problem or risk behaviors. Helping the people for increasing their efficacious beliefs becomes one of the pivotal roles of nurses in the steps toward achievement of health in millennium development goals.
Each and every concept has specific underpinning attributes to offer clear understanding of its meaning behind the word. Therefore, this paper is aimed to increase awareness and understanding about the concept of self-efficacy through reviewing its meanings and usages from various perspectives, analyzing the supported attributes, and identifying the antecedents and consequences of the concept.  An operational definition of self-efficacy, and hypothetical model case and contrary case are also illustrated in this paper.
2.     Literature Review
2.1.  Concept and concept analysis
Concepts are the backbone of theory. Neither of theory can be built without having clear and validated concepts. Wuest’s diary (as cited in Ducan, Cloutier, & Bailey, 2007) mentioned that concepts have become the cornerstone of nursing curriculum at both undergraduate and graduate levels. They are the respiratory of nursing knowledge and hence the lenses through which students view praxis. According to Kaplan’s diary (as cited in Walker & Avant, 2005), a concept is a mental image of a phenomenon, an idea, or a construct in the mind about a thing or an action.
Concept analysis is a formal, linguistic exercise to determine defining attributes of a concept (Walker & Avant, 2005).  Ducan, Cloutier, and Bailey (2007) stated that concepts have changed over time and the process of concept analysis works towards ‘the truth’ about a concept, from a ‘probable truth’ (immature concepts) towards ‘fixed truth’ (more mature concepts) through research. The purpose of concept analysis is to examine the basic elements (structure and function) of a concept (Walker & Avant, 2005). Hupcey, Morse, Lenz, and Tason (1996) stated that the ultimate purpose of concept inquiry is to enable the researcher to delineate the phenomenon and transform it to an operationalization of the phenomenon.

2.2.   History of self-efficacy
The history of self-efficacy began with the popularity of psychologist Albert Bandura’s (1977) social learning theory that was renamed social cognitive theory in 1986. Bandura’s theory initiates new dimension of learning theory to explain a wide variety of behaviors as he emphasizes the role of observational learning, social experience, and reciprocal determinism in the development of human behavior and personality.
Self-efficacy is one of the central concepts of Bandura’s theory. He believed that self-efficacy is a fundamental requirement to organize and execute a series of action required to attain expected outcomes by exploring and utilization of one’s own capabilities. Bandura also mentioned that efficacy involves a generative capability in which cognitive, social, and behavioral sub-skills must be organized into integrated courses of action to serve innumerable purposes. Both skills and self-beliefs are required to be used effectively for competent functioning. Self-efficacy theory asserts that the quality of an actual performance depends highly on the individual's belief in his or her own competence.
Bandura argued that perceived self-efficacy influences all aspects of behaviors, including acquisition of new behavior, inhibition of existing behaviors and disinhibition of behaviors. Self-efficacy also affects people’s choices of behavioral settings, the amount of effort they will expend in a task, and the length of time they will persist in the face of obstacles. In addition, self-efficacy affects people’s psychological status and emotional reaction in handling a difficult and complex task or situation (Clark & Becker, 1998).
2.3   Dimensions of self-efficacy
There are three major dimensions of efficacy expectations: - level, generality and strength. “Level” refers to the magnitude of self-judgment efficacy ordering from simple to complex nature of tasks. The persons having low level efficacy expectation feel capable of performing only the simples of a graded series of tasks, while those with high level expectation have increased confidence in performing higher order tasks. “Generality” concerns the transferability of self-efficacy beliefs across activities. In other word, it is the extent of expectations about a particular situation or experience generalizes to other situations. For example, beliefs of people with HIV/AIDS about their capabilities of self-care supervised by family caregiver may or may not generalize to those living alone. “Strength” deals with how fix is the belief held in the person. The degree of correspondence between self-efficacy judgment and performance will vary depending on the strength of the belief in one’s capabilities. The persons with stronger perceived self-efficacy are more likely to select and handle the difficulties and challenging tasks successfully (Bandura, 1986).
2.4   Sources of self-efficacy information
            Self-efficacy expectations are learned from four major sources (Bandura, 1977, 1986). The first source, “performance accomplishments” is one’s personal mastery experiences by learning through past successes or failures. These experiences form expectations that are generalized to other situations that may be similar or substantially different from the original experience. For example, strong efficacy expectations are developed through repeated successes of a behavior, and reduced efficacy expectations can result from failures. Successful accomplishment of performance attained by personal experience is the most potent source of efficacy expectation. Personal mastery for a behavior can be developed through participant modeling, performance exposure, self-instructed performances, and performance desensitization (Bandura, 1977, 1986).
            The second source is “vicarious experience”, which includes observing certain events or others’ behaviors and performances in dealing with complex and challenging tasks. This experience can promote personal self-efficacy by perceiving the activity as “do-able” with fewer complications. Vicarious experience can be enhanced through live modeling or symbolic modeling (Bandura, 1977, 1986). Pender, Murdaugh and Parsons (2006) suggested some important issues in using modeling approach to facilitate self-efficacy and resultant behavior change which include (1) the model must be available and relevant to specific characteristics of the learner, (2) the learner must have an actual opportunity and attend to observe the desired behavior, (3) the learner must have the requisite knowledge and skills to reproduce the behavior, and (4) the learners must have the opportunity to rehearse the target behavior.
            “Verbal persuasion” represents the third source of efficacy expectation. People are led to believe they can successfully accomplish a task or behavior through the use of suggestion, exhortation, or self-instruction. Because of verbal persuasion is not grounded in personal experience, it is a weaker inducer of efficacy and may be extinguished by histories of past failures (Bandura, 1977, 1986).
            One’s “physiological state” or “emotional arousal” constitutes the final source of information that can influence efficacy expectations. Bandura believed that high physiological arousals are associated with decreased performance, reduced success and other avoidance behaviors, and therefore perceived self-efficacy can be enhanced by diminishing and controlling such physiological arousals as fear, stress and physical agitation. Emotional arousal can be mitigated with repeated symbolic exposure that allows people to practice dealing with stress, relaxation techniques and symbolic desensitization (Bandura, 1977, 1984).
2.5   Related beliefs of self-efficacy
Self-efficacy beliefs differ conceptually and psychometrically from closely related constructs, such as self-concept, effectance motivation and outcome expectations.
The self-concept is a composite view of oneself that is formed through direct experience and evaluations adopted from significant others (Bandura, 1986). It is a more general self-descriptive construct that incorporates many forms of self-knowledge and self-evaluative feelings (Marsh & Shavelson’s diary, cited in Zimmerman, 2000). Bandura argued that a global perception of oneself does not do justice to the complexity of self-efficacy beliefs, which vary across different activities and circumstances. Also, perceived self-efficacy is distinguishable from the belief of self-esteem. Self-esteem pertains to the evaluation of self-worth, where self-efficacy concerns with the judgment of personal capabilities. Although both self-esteem and self-efficacy contribute in their own way to the quality of human life, judgment of self-worth and self-capability have no uniform relation (Bandura, 1986).
            Effectance motivation is an intrinsic drive to acquire new experience and behavior change. It is presumably develops through cumulative acquisition of knowledge and skills in dealing with the environment. However, in the social cognitive view, choice behavior, effort expenditure and affective arousal are governed in part by percepts of self-efficacy rather than by a drive. In addition, the effectance develops gradually through prolonged transitions with one’s surrounding, where perceived self-efficacy results from diverse sources of information and direct personal experiences (Bandura, 1986).
            The third similar belief of self-efficacy is outcome expectations. Perceived self-efficacy is a judgment of one’s capability to accomplish a certain level of performance, whereas outcome expectations depend heavily on the judgments of the types of performances and the likely consequences of such behavior. Outcome expectations are also misconstrued as the effectiveness of a technique. An efficacious technique is a means for producing outcomes, but it is not itself an outcome expectation (Bandura, 1986).
2.6   Self-efficacy in people with HIV/AIDS
The problem of HIV/AIDS has been growing in all countries and challenging to the quality of life of the world population. UNAIDS (2009) declared that 33.4 million people were living with HIV globally and an estimated 2.7 million people became newly infected with HIV, which killed 2.0 million in 2008. All governments of the world recognize the problem of HIV/AIDS as a huge social, economic, political and national concern, and have been taking commitment to fight against the burden of HIV/AIDS to achieve one of the millennium development goals – to combat HIV/AIDS, malaria and other diseases.
The people living with HIV/AIDS (PLWA) usually face with complex physical problems and various psychosocial problems. Being stigmatized and discriminated, the PLWA tends to be highly anxious, ashamed, fearful, and easily shocked, and has a sense of denial and guilt. They may be facing multiple losses such as rejection by family and friends, loss of financial security, normal roles, self-esteem and privacy, and inability to control bodily functions including procreation and interact meaningfully with the environment (Department of Health, 1992; Rubinow, 1984).   
Living with HIV/AIDS harmoniously in society is a challenging concern. Many PLWA cannot cope with this dreadful nature of disease and perceive self as useless and burden for the other people. Based on research findings, self-efficacy belief is very helpful for not only perception and avoidance of risk for HIV/AIDS, but also coping with the disease and empowering health and socioeconomic conditions.
2.7   Previous research findings
Kristen (2009) conducted a concept analysis study on self-efficacy. The author defined self-efficacy as a person’s own judgment of capabilities to perform a certain activity in order to attain an outcome. Cognitive processes, affective processes and locus of control are the key defining attributes of self-efficacy. A model case is illustrated and antecedents and consequences of self-efficacy are discussed.
Bandura and Adams (1977) conducted two experimental tests on analysis of self-efficacy theory of behavior change. The first study investigated the hypothesis that systematic desensitization effects changes in avoidance behavior by creating and strengthening expectations of personal efficacy. Thorough extinction of anxiety arousal to visualized threats by desensitization treatment produced differential increases in self-efficacy. In accord with prediction, microanalysis of congruence between self-efficacy and performance showed self-efficacy to be a highly accurate predictor of degree of behavioral change following complete desensitization. The findings also lend support to the view that perceived self-efficacy mediates anxiety arousal. The second experiment investigated the process of efficacy and behavioral change during the course of treatment by participant modeling. Self-efficacy proved to be a superior predictor of amount of behavioral improvement phobic’s gained from partial mastery of threats at different phases of treatment.
Pajares and Miller (1994) conducted a path analysis study to test the predictive and mediational role of self-efficacy beliefs in mathematical problem solving. Results revealed that math self-efficacy was more predictive of problem solving than was math self-concept, perceived usefulness of mathematics, prior experience with mathematics, or gender (N = 350). Self-efficacy also mediated the effect of gender and prior experience on self-concept, perceived usefulness, and problem solving. Gender and prior experience influenced self-concept, perceived usefulness, and problem solving largely through the mediation role of self-efficacy. Men had higher performance, self-efficacy, and self-concept and lower anxiety, but these differences were due largely to the influence of self-efficacy, for gender had a direct effect only on self-efficacy and a prior experience variable. Results support the hypothesized role of self-efficacy in Bandura's (1986) social cognitive theory.
Zimmerman (2000) conducted a literature analysis of self-efficacy as an essential motive to learn. The results of the study indicated that self-efficacy differs conceptually and psychometrically from related motivational constructs, such as outcome expectations, self-concept, or locus of control. Researchers have succeeded in verifying its discriminant validity as well as convergent validity in predicting common motivational outcomes, such as students’ activity choices, effort, persistence, and emotional reactions. Self-efficacy beliefs have been found to be sensitive to subtle changes in students’ performance context, to interact with self-regulated learning processes, and to mediate students’ academic achievement.
Basen-Engquist and Parcel (1992) conducted a cross-sectional, statewide survey of 1,720 Texas ninth graders in 13 school districts, to test the model of psychosocial predictors of human immunodeficiency virus (HIV)-related sexual risk behavior. Predictor variables in the model, based on variables from the Theory of Reasoned Action and Social Learning Theory, were attitudes, norms, self-efficacy, and behavioral intentions. Attitudes, norms and self-efficacy predicted 36% of the variance in the intention to limit the number of sexual partners and the same variables plus intention predicted 24.6% of the variance in number of sexual partners in the past year. Attitudes, norms and self-efficacy regarding condom use predicted 17.0% of the variance in condom use intentions; these variables plus intentions predicted 19.0% of the variance in condom use frequency. Attitudes, norms, and intentions were directly related to the number of sexual partners, while self-efficacy and condom use intentions were directly related to frequency of condom use.
3.     Procedures for Concept Analysis
In this study, eight steps of concept analysis method, developed by Walker and Avant (2005) were applied to analyze the concept of self-efficacy.
Step-1  Selecting a concept
The concept of self-efficacy is chosen to be analyzed in this study.
Rational for selecting the term self-efficacy for concept analysis
Self-efficacy is a central construct in health promotion model to build a healthy society. It is very difficult to achieve “health for all” goal without having self-efficacy beliefs. All categories of health care provider have a due responsibility for helping the people to enhance awareness of and utilization of their capabilities and judgmental skills in interaction with their adjacent environments.
Pender, Murdaugh and Parsons (2006) described that feeling efficacious and skills in one’s performance is likely to encourage one to engage in the target behavior more frequently than is feeling inept and unskilled. Of the health promotion model studies reviewed, 86% provided support for the importance of self-efficacy as determinant of health promoting behavior. Self-efficacy motivates health promoting behavior directly by efficacy expectations and indirectly by affecting perceived barriers and level of commitment or persistence in pursuing a plan of action.
There are limited numbers of concept analysis studies relating to uncovering the in-depth characteristics of the meaning of self-efficacy. Most of the studies focused to investigate applicability and generalizability of self-efficacy construct in changing or developing a new behavior. Indeed the meaning of self-efficacy is very subjective, thoughtful and imaginable. Sometimes, it is seemed to be complex and difficult to implement in practical situation. However, many studies suggested that it is very beneficial and applicable in the real world. Therefore, understanding the underpinning attributes of its meaning is primarily important to apply the self-efficacy construct effectively in empowering the people to adopt beneficial behavior and deliver positive outcomes. 
In addition, the concept of self-efficacy is manageable to be analyzed and applicable in my academic research which focuses to develop strategies for promoting health status of people with HIV/AIDS in community.     
Step-2  Aim and objectives
Aim
The aim of this concept analysis study is to increase understanding about the concept of self-efficacy.
Objectives
1.      To examine the defining attributes of self-efficacy.
2.      To identify model case and contrary case of self-efficacy.
3.      To determine the antecedents and consequences of the concept of self-efficacy.
4.      To determine empirical referents of self-efficacy.
5.      To develop operational definition of self-efficacy.
Step-3  Identification of all uses of the concept of self-efficacy
3.1   Uses of efficacy
Firstly, the meaning of efficacy was searched in literatures. Generally, efficacy is used as “the power or capacity to produce an effect”. It has different specific meanings in different fields.

Healthcare

In a healthcare context, efficacy indicates the capacity for beneficial change (or therapeutic effect) of a given intervention, e.g., a medicine, medical device, surgical procedure, or a public health intervention (Wikipedia).

Insolvency

In an insolvency context, the efficacy of an arrangement is judged by the extent to which it is achieving its aims of getting money in to pay to the creditors of the debtor (Wikipedia).

Pharmacology

In pharmacology, efficacy refers to the maximum response achievable from a drug. It is often described by the parameter Emax (Wikipedia).

Lighting

In lighting design, efficacy refers to the amount of light (luminous flux) produced by a lamp (a light bulb or other light source), usually measured in lumens, as a ratio of the amount of power consumed to produce it, and specified in watts (Wikipedia).

Lutheranism

In Lutheranism, efficacy is used to describe the characteristics of Scripture. The efficacy of Scripture means that it is united with the power of the Holy Spirit and with it, not only demands, but also creates the acceptance of its teaching and that this teaching produces faith and obedience. Efficacy further means that Holy Scripture is not a dead letter, but rather, the power of the Holy Spirit is inherent in it and that Scripture does not compel a mere intellectual assent to its doctrine, resting on logical argumentation, but rather it creates the living agreement of faith (Wikipedia).

Difference amplifiers

The efficacy of a differential amplifier is measured by the degree of its rejection of common-mode signals in preference to differential signals. Referred to as common-mode rejection ratio (CMRR); typically specified in decibels (Wkipedia).
3.2   Uses of self-efficacy
Uses of the concept of self-efficacy are identified through online dictionaries, texts, journals and articles. According to Bandura (1977), “self-efficacy is defined as a person’s belief about their ability to organize and execute courses of action necessary to achieve a goal”. Self-efficacy can be achieved by learning through personal experience, observing other’s behavior and performance, following verbal persuasion and controlling physiological arousals (Bandura, 1986).
Kristen (2009) defined self-efficacy as “a person’s own judgment of capabilities to perform a certain activity in order to attain a certain outcome”.  Glanz, Rimer and Viswanath (2008) defined that “self-efficacy is a person’s beliefs about his or her capacity to influence the quality of functioning and the events that affect their life”. Edberg (2007) defined self-efficacy as “a person’s confidence that he or she can perform a behavior”. Lowenstein, Foord-May and Romano (2009) defined that “self-efficacy is the degree of confidence a person has that he or she can perform a certain behavior and overcome any barriers that may impede progress”.
In the essaypride.com, self-efficacy is defined as “Efficacy is the behavior or being effective, efficacious and in control. The self can be defined as ones identity. This means that self-efficacy can be defined as the ability to effectively control their own outcomes by changing their actions.”
From online dictionaries, common uses of the term “self-efficacy” are “ A person's belief about his or her ability and capacity to accomplish a task or to deal with the challenges of life” (Business dictionary.com); “A person’s belief in his or her ability to succeed in a particular situation” (Psychology.about.com); “An individual's estimate or personal judgment of his or her own ability to succeed in reaching a specific goal” (Mondofacto.com); “Capacity for producing a desired result or effect; effectiveness: a remedy of great efficacy” (Dictionary.reference.com); “Power or capacity to produce a desired effect” (Answers.com); “Positive subjective assessment of one's ability to cope with a given situation; sense of personal power” (Thefreedictionary.com); “Self-efficacy` is an impression that one is capable of performing in a certain manner or attaining certain goals. It is a belief that one has the capabilities to execute the courses of actions required to manage prospective situations.” (Wikipedia); “The ability to produce a beneficial or desired effect that may detect, relieve, or eliminate symptoms or a disease” (Encyclopedia.com); and “A performer's belief that he or she can execute a behaviour required to produce a certain outcome successfully; the ability to successfully achieve an intended result” (Sports Science and Medicine).
3.3   Synonyms and Antonyms
The synonyms of the term efficacy include ability, adequacy, capability, capableness, capacity, competence, effect, effectiveness, efficaciousness, energy, force, influence, performance, potency, power, strength, success, sufficiency, use, vigor, virtue and weight. The antonyms are failure, inefficacy, inefficiency, unproductiveness, uselessness and weakness (Thesaurus.com).
According to Bandura’s (1986), the similar beliefs of self-efficacy are self-concept, effectance motivation and outcome expectations.
Step-4  Determination of defining attributes
Determining the defining attributes is the heart of concept analysis. Based on the review and analysis of all collected definitions and uses of efficacy and self-efficacy, four defining attributes of self-efficacy were identified.
1.      Utilization of cognitive capability to obtain a beneficial outcome;
2.      A belief of self-confidence, self-determinism and self-responsibility;
3.      Ability to control emotional arousals; and
4.      Learning through personal experiences and observations.
Step-5  Identification of a model case
A model case is an example of the use of the concept that demonstrates all the defining attributes of the concept. That is, the model case should be a pure case of the concept, a paradigmatic example, or a pure exemplar (Walker & Avant, 2005). To clear the concept, the model case of self-efficacy is illustrated as follows:-
“An 18-year old girl knows that she has HIV infection at the time of attempting to participate in the school’s blood donation activity. She feels shock, shy, despair and fear. However, she has a strong sense of expectations for her health and wellbeing, education, socialization and future life, after meeting with nurse counselor. By the helps of school nurse, she gets a chance to observe and participate in peer group. She observes and learns the behaviors of others.  She searches and applies the literatures about her problem. She accepts her HIV positive status and follows the instructions of health care providers including adhering ART to control the progress of disease. She always tries to promote her health condition by taking nutritious foods, moderate exercises, rests and meditation. She is able to take care of herself and actively involves in the activities of peer group in her school and community.”

This model case illustrates that the girl has a strong self-efficacy expectations and utilizes her ability the best for her health and the health of other. Although the girl faces with unexpected and dreadful situation, she can make appropriate and correct decision to counteract her physical and emotional problem. Also, she can apply effectively the principles of learning through personal experience and observation, including following the verbal persuasions by nurse counselor and controlling emotional arousals. As increasing self-confidence, she is able to take responsibility and commitment for her own health and beneficial outcomes for her society.   

Step-6  Identification of a contrary case
Walker and Avant (2005) stated that contrary cases are clear examples of “not the concept”, but they are very helpful to understand the concept easily by excluding all its defining attributes. The following case is undoubtedly an example of a person with very poor self-efficacy expectations, devoid of all critical attributes of self-efficacy.
“A boy was born HIV positive. His parent died of this deadly disease since he was the age of kindergarten. He was growing in the family of his eldest uncle. He did not know his real story until 14-year old. On a holiday, his brother in law disclosed his confidential situation. He felt shock and unexplainable sadness. He could not cope with this dreadful news. Frequently he went to a bar, instead of going to the school. He felt that he is useless and everything is unfair and bias. He blamed to his fortune. Sometimes, he searched pleasures by unprotected sex with commercial sex workers (CSWs). He had no ambition and his life was meaningless for him.”

In this case study, the boy demonstrates very poor self-efficacy expectations. He cannot use his ability to adopt healthy behavior or obtain a beneficial outcome. He cannot cope with his own life and makes inappropriate decision to solve the problem. He has no self-confidence and self-responsibility for his behavior. In addition, there is no evidence of learning through personal experiences and observations.
 Step-7  Identification of antecedents and consequences
Antecedents
Walker and Avant (2005) suggested that antecedents are those events that must occur prior to the occurrence of the concept. The antecedents of self-efficacy that arise from the literatures are:-
1.      Presence of strong self-efficacy expectations (performance accomplishments, vicarious experience, verbal persuasion and physiological cues);
2.      Performing self-efficacy appraisal through self-reflections on personal performance;
3.      Having reinforcement to adopt, change, or eliminate the behavior;
4.      A desire to acquire a new challenging task or behavior;
5.      Proactive thinking;
6.      Ability to make judgment and decision;
7.      Ability and readiness to learn a difficult task or behavior; and
8.      Having a supportive environment;
Consequences
Walker and Avant (2005) stated that consequences are those events or incidents that occur as a result of the occurrence of the concept. According to the result of literature analysis, the consequences of robust self-efficacy encompass the followings.
1.      Increase confident in one’s capacity to execute a task or behavior;
2.      View challenging problems as tasks to be mastered;
3.      Increase reasoning ability;
4.      Increased self-determinism and self-responsibility;
5.      Stronger sense of commitment to one’s interests and activities;
6.      Develop deeper interest and involvement in the targeted activities;
7.      Recover quickly from setbacks and disappointments;
8.      Increase satisfaction and motivation;
9.      Increase ability to control emotional arousals;
10.  Increase tolerance of difficulties and struggles; and
11.  Harmonious in social milieu;
Step-8  Determining empirical referents
Determining the empirical referents is extremely useful in instrument development because these are categories of phenomena whose presence demonstrate the occurrence of the concept (Walker & Avant, 2005).  In this study, the empirical referents of self-efficacy include:-
1.      The level, generality and strength of self-efficacy expectations
2.      Ability to organize and execute a task or behavior to produce a desired outcome
3.      Self-confidence, self-determinism and self-responsibility
4.      Ability to adapt physiological arousals
5.      Utilizing the principle of learning through personal experiences and observations
Various quantitative and qualitative studies are needed to clarify and validate the empirical referents of self-efficacy. Use of structured questionnaires, observation, interviewing, focus group discussion and record reviewing methods are suitable to determine the concept of self-efficacy. Evidence based studies and literary analysis method are essential to confirm the reliability and validity of these referents.

4.     The Author’s Operational Definition of Self-efficacy   
Operational definition is the first most essential tool to test the validity of a concept. Walker and Avant (2005) stated that without operational definition, there is no way to test and validate the theory and its concepts in the ‘real world’.   Based on the identified defining attributes, the operational definition of self-efficacy was synthesized as follows.
“Self-efficacy is a strongly subjective concept, but observational and measurable. It focuses on a person’s fullest utilization of his or her cognitive capability to produce a beneficial outcome through learning by personal experience and observation. It is mediated by one’s level of self-confidence, self-determinism, self-responsibility and self-control.”
5.     Limitations
1.    The defining attributes are constructed highly based on dictionary meanings and literatures from some articles. Critically analysis of literatures concerning uses of self-efficacy with large scale is needed.
2.      Both model case and contrary case are constructed hypothetically since the concept of self-efficacy meeting or not all the defining attributes in real situation is difficult to be identified.
3.      It is difficult to prove the measurability of all empirical referents of the concept of self-efficacy in real situation.
6.     Conclusion
Self-efficacy is a fundamental concept to develop a healthy and productive society. It is one of the best strategies to acquire a challenging task or behavior by using one’s cognitive capability and learning through observation. People must, therefore, have a strong sense of efficacy to sustain the perseverant effort needed to succeed. This paper is an attempt to explain the concept of self-efficacy by examining its meanings, usages, attributes, antecedents, consequences and empirical referents, including illustration of hypothetical model case and contrary case. Based on the results of analysis, an operational definition of self-efficacy was developed. However, it is important to note that this work is only a prerequisite for the term. Further exploration of this concept is certainly needed.

References
Answers.com (n.d.). Self-efficacy. Retrieved 22nd July, 2010 from http://www.answers.com/topic/efficacy
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84 (2): 191-215.
Bandura, A., & Adams, N.E. (1977). Analysis of self-efficacy theory of behavioral change. Cognitive Therapy and Research, 1 (4): 287-310.
Bandura, A. (1986). Social Foundations of Thought and Action: A social cognitive theory. Eaglewood Cliffs, NJ: Prentice-Hall.
Bandura, A. (1995). Self-Efficacy in Changing Societies. Cambridge University Press.
Basen-Engquist, K., & Parcel, G.S. (1992). Attitudes, norms, and elf-efficacy: A model of adolescents’ HIV-related sexual risk behavior. Health Education Behavior, 19 (2): 263-277.
Business Dictionary.com (n.d.). Self-efficacy. Retrieved 22nd July, 2010 from http://www.businessdictionary.com/definition/self-efficacy.html
Cherry, K. (2010) What is self-efficacy? Retrieved 22nd July, 2010 from http://psychology.about.com/od/theoriesofpersonality/a/self_efficacy.htm
Clark, N.M., & Becker, M.H. (1998). Theoretical models and strategies for improving adherence and disease management, in Shumaker, S.A., Schron, E.B., Ockena, J.K., & McBee, W.L. (Eds). The Handbook of Health Behavior Change (2nd ed.). Springer Publishing Company, pp. 5-32.
Department of Health. (1992). Information about AIDS for Medical Officers and General Practitioners, AIDS Prevention and Control Project, Yangon.
Dictionary.reference.com (n.d.). Self-efficacy. Retrieved 22nd July, 2010 from http://dictionary.reference.com/browse/efficacy Dictionary.com
Donaldson, S.K. (1983). Let us not abandon the humanities. Nursing Outlook, 31: 113-120.
Ducan, C., Cloutier, J.D., & Bailey, P.H. (2007). Concept analysis: the importance of differentiating the ontological focus. Journal of Advanced Nursing, 58(3): 293-300.
Edberg, M. (2007). Essentials of Health Behavior: Social and Behavioral Theory in Public Health, Jones and Bartlett Publishers, Boston, pp. 52-55.
Encyclopedia.com (2008). Self-efficacy, in A Dictionary of Nursing. Retrieved 22nd July, 2010 from http://www.encyclopedia.com/doc/1O62-efficacy.html
Essaypride.com (n.d.). Self-efficay. Retrieved 22nd July, 2010 from http://www.essaypride.com/essays.php?free_essay=6144957&title=Self-efficacy
Glanz, K., Rimer, B.K., & Viswanath, K. (2008). Health Behavior and Health Education: Theory, Research, and Practice (4th ed.). John Wiley & Sons, Inc., San Francisco, pp. 97-121.
Hupcey, J.E., Morse, J.M., Lenz, E.R., & Tason, M.C. (1996). Wilsonian methods of concept analysis: A critique. Scholarly Inquiry for Nursing Practice: An International Journal,  10 (3): 185-210.
Kristen, Z. (2009). Self-efficacy: A concept analysis. Nursing Forum, 44 (2): 93-102.
Lowenstein, A.J., Foord-May, L., & Romano, J.C. (2009). Teaching Strategies for Health Education and Health Promotion: Working with Patients, Families, and Communities. Jones and Bartlett Publishers, Boston, pp. 310-313.
Mondofacto.com (2000). Self-efficacy. Retrieved 22nd July, 2010 from http://www.mondofacto.com/facts/dictionary?self-efficacy
Pajares, F., & Miller, M.D. (1994). Role of self-efficacy and self-concept beliefs in mathematical problem solving: A path analysis. Journal of Educational Psychology, 86 (2): 193-203.
Pender, N.J., Murdaugh, C.L., & Parsons, M.A. (2006). Health Promotion in Nursing Practice (5th ed.). Pearson Prentice Hall, Canada, pp. 41-42, 58-59.
Psychology.about.com (n.d.). Self-efficacy. Retrieved 22nd July, 2010 from http://psychology.about.com/b/2008/04/14/self-efficacy-psychology-definition-of-the-week.htm
Rubinow, D.R. (1984). The psychosocial impacts of AIDS. Topics in Clinical Nursing: Acquired Immune Deficiency Syndrome (AIDS), 6 (2): 26-32.
Socio.com (n.d.). Self-efficacy. Retrieved 22nd July, 2010 from www.socio.com/hivrapdemo/htm/glossary.htm
Sport Science and Medicine (n.d.). Self-efficacy. Retrieved 22nd July, 2010 from http://www.answers.com/topic/self-efficacy
Thefreedictionary.com (n.d.). Self-efficacy. Retrieved 22nd July, 2010 from http://medical-dictionary.thefreedictionary.com/self-efficacy
Thesaurus.com (n.d.). Efficacy. Retrieved 22nd July, 2010 from http://thesaurus.com/browse/efficacy
UNAIDS (2009) AIDS Epidemic Update 2009. World Health Organization.
Walker, L.O., & Avant, K.C. (2005). Strategies for Theory Construction in Nursing (4th ed.). Pearson Education, Inc., Upper Saddle River, New Jersey.
Wikipedia (n.d.). Self-efficacy. Retrieved 22nd July, 2010 from http://en.wikipedia.org/wiki/Self-efficacy
Zimmerman, B.J. (2000). Self-efficacy: An essential motive to learn. Contemporary Educational Psychology, 25: 82-91.


No comments:

Post a Comment