This paper targets the critical analysis of the self-efficacy theory elaborated by Barbara Resnick. Based on the theoretical underpinnings of Bandura’s self-efficacy and social cognitive theories, Resnick adopted them and transformed, focusing on gerontology patients’ needs. The theory involves four meta paradigms that determine its essence: a person, health, nursing, and environment. In the model of this theory, there are three key elements such as verbal encouragement, physiological sensations, and role-modeling that are also known as self-modeling. The majority of studies reflect the effectiveness of the self-efficacy model applied in various clinical settings. The heuristic value of this theory is the opportunity to assist patients in a greater understanding of their needs and their corresponding fulfillment. Furthermore, the theory implies some cooperation with the function-focused care that only increases its theoretical and practical value.
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A nursing theorist and the author of the self-efficacy theory, Barbara Resnick, was born in 1957. She is an Associate Professor working for the University of Maryland School of Nursing and coordinating the Adult / Gerontological Nurse Practitioner Program (“Dr. Barbara Resnick—Eminent nurse,” 2017). Currently, her clinical practice is performed at Roland Park Place. Resnick published more than 200 scholarly articles and researched such nursing areas as gerontology, therapeutics, advanced practice nursing, et cetera. There are various honors given to this theorist, including Honorary Doctor of Science from State University of New York and an inductee into the Sigma Theta Tau International Nurse Researcher Hall of Fame (“Dr. Barbara Resnick,” 2017). The theoretical discoveries of Resnick were largely affected by Bandura’s assumptions and social cognitive theory.
Two important underpinnings compose the basis for the theory of self-efficacy elaborated by Resnick. According to the definition of Bandura, self-efficacy determines the present behavior in combination with the environment, previous behavior, and other personality characteristics (Akhu-Zaheya, Gharaibeh, & Alostaz, 2013). In his concept of expectations, Bandura distinguishes between the expectation of effectiveness (efficacy expectation) and the expectation of results (outcome expectation) (Chao, Scherer, Wu, Lucke, & Montgomery, 2013). However, self-efficacy is not the same as expectations about the results or consequences of one’s actions. Instead, it may be understood as a person’s confidence that he or she can carry out specific actions, while the assumptions about the result refer to what he or she thinks about the possible consequences of his activities (Hoffman, 2013). In other words, self-efficacy is an assessment of one’s own ability to cope with certain specific tasks in a particular situation.
The second philosophical consideration is associated with the socio-cognitive theory of personality and regulation developed by Bandura. According to the mentioned theorist, there is no more essential mechanism of subjectivity than beliefs in one’s effectiveness. The socio-cognitive theory refers to personality, as stated by Stacey, James, Chapman, Courneya, and Lubans (2015). Even though it is often attributed to behaviorist theories of personality, it offers a fundamentally different idea. It emphasizes the collaborative interaction of the environment, behavior, and personal factors, in which a special place is given to cognitive processes that provide mental self-control and self-efficacy of an individual (Young, Plotnikoff, Collins, Callister, & Morgan, 2014). They influence the personality in the same way as a person influences the environment, and they shape each other (Young et al., 2014). This continuous interaction of forces creates a certain balance between freedom and determinism. Based on the adaptation of the presented theoretical considerations, Resnick developed her theory.
Main Concepts of the Theory
The key concepts of Resnick’s theory correspond to those of the traditional nursing care metaparigms that consist of the following elements: a person, nursing, health, and environment. In the identified theory, a person is determined as an individual with peculiar needs and expectations, which are largely related to his or her behavioral patterns (Sitzmann & Yeo, 2013). The concept of health is understood as the state of a person that can be described as overall well-being, both physical and psychological (Smith & Liehr, 2018). It is important to point out the fact that the role of nursing in this theory is to help patients in improving self-efficacy through education and increased awareness of their own health needs (Christian & Krumwiede, 2013). Last but not least, the environment plays a vital role in one’s self-efficacy. Speaking more precisely, one may state that the environment forms a person, while the latter also affects the former.
In her theory, Resnick adapted Bandura’s ideas and implemented them in adult care. There are three major concepts that she introduced in nursing practice: verbal encouragement, role-modeling also known as self-modeling, and physiological sensations. This theory is also supported by the so-called function-focused care that implies greater engagement of patients using adequate physical exercising (Galik, Resnick, Hammersla, & Brightwater, 2013; Resnick, Galik, & Boltz, 2013). For example, one of the recent studies illustrates the improvement in adults with trauma after the mentioned approach was implemented (Resnick, Galik, Wells, Boltz, & Holtzman, 2015). One more research proves the effectiveness of the theory applied in the community-dwelling patients prone to falls and osteoporosis (Resnick et al., 2014; Boltz, Resnick, Capezuti, & Shuluk, 2014). The use of this theory in the mentioned study also supports the positive role of function-focused care.
In combination with the socio-ecological model, the theory of self-efficacy was also successful for patients with cardiovascular health concerns, as noted by Doran, Resnick, Kim, Lynn, and McCormick (2017). It is assumed that the development of self-efficacy is provided through the formation of cognitive skills to build behavior, acquire indirect experience, exercise verbal self-suggestion, and enter a state of physical or emotional recovery that ensures success (Koo, Idzik, S. R., Hammersla, & Windemuth, 2013). Thus, the evidence shows that not only behavior but also communication, physiological contact, and self-modeling are significant.
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Heuristic Value of the Theory
The theory of self-efficacy of Resnick is utilized in various clinical settings, namely, for managing adults with cardiovascular, oncologic, and other health problems. According to Liu, Galik, and Resnick (2015), the paramount heuristic value of this model lies in the assumption that patients with higher self-efficacy are less likely to develop depression and have greater chances for recovery. In this regard, it should be emphasized that perceived self-efficacy is a belief in one’s abilities to organize and implement the actions required to improve health outcomes (Resnick, 2013). If people are not convinced that by their actions they can produce the desired effects, they have little determination to act. This theory is used to not only assist patients with their health needs but also guide them with their self-care, thus achieving better self-awareness and health outcomes.
Analysis and Critique of the Theory
There is little evidence that provides a critique of the theory under discussion. One may note that the majority of studies Resnick conducted in cooperation with colleagues who support her ideas. Nevertheless, it is clearly stated that further research is required to test the theory’s assumptions and apply them in different contexts (Galik, Resnick, Lerner, Hammersla, & Gruber-Baldini, 2015). One of the key areas that need such a theory is gerontology (Resnick, 2014). In their article, Metzelthin et al. (2017) focus on the “Stay Active at Home” program elaborated especially for self-care of adults and older adults. According to the above program results, it is found that the use of self-efficacy theory proved to be beneficial and promoting a better connection between nurses and patients due to verbal encouragement. As an example, one may also note the study by Purath, Keller, McPherson, and Ainsworth (2013) who revealed the increased potential of older adults to take physical activity in terms of office-based settings. In general, the utilization of self-efficacy theory seems to be thought-provoking and important to older adults who need appropriate self-care and better self-reliance.
To conclude, it should be emphasized that this paper discussed the theoretical and practical perspectives offered by Resnick’s theory of self-efficacy. It is discovered that this theory focuses on integrating self-modeling, verbal encouragement, and physical connection, which compose the basis for better self-care in adults and older adults. A range of recent studies demonstrates that the theory is capable of improving patients’ self-reliance and, subsequently, their health outcomes. Further research is still necessary to reveal all strengths and weaknesses of the theory, ensure the best care quality possible, and equip patients with relevant tools of self-care.
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Boltz, M., Resnick, B., Capezuti, E., & Shuluk, J. (2014). Activity restriction vs. self‐direction: Hospitalised older adults’ response to fear of falling. International Journal of Older People Nursing, 9(1), 44-53.
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Metzelthin, S. F., Zijlstra, G. A., van Rossum, E., de Man-van Ginkel, J. M., Resnick, B., Lewin, G.,… Kempen, G. I. (2017). ‘Doing with…’rather than ‘doing for…’older adults: Rationale and content of the ‘Stay Active at Home’ programme. Clinical Rehabilitation, 31(11), 1419-1430.
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Resnick, B., Galik, E., Wells, C. L., Boltz, M., & Holtzman, L. (2015). Optimizing physical activity among older adults post trauma: Overcoming system and patient challenges. International Journal of Orthopaedic and Trauma Nursing, 19(4), 194-206.
Resnick, B., Nahm, E. S., Zhu, S., Brown, C., An, M., Park, B., & Brown, J. (2014). The impact of osteoporosis, falls, fear of falling and efficacy expectations on exercise among community dwelling older adults. Orthopaedic Nursing/National Association of Orthopaedic Nurses, 33(5), 277-286.
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