Bandura's Concept Of Self-efficacy Research Articles

Development of Self-Efficacy Tools for Parents and Professionals Caring for Children and Young People with Lymphedema (ILF Parent SE and ILF Professional SE).

Background: Self-management is a key aspect of lymphedema treatment and self-efficacy is a key factor linked to long-term adherence to treatment. The study aimed to generate self-efficacy scales to support the care of children and adolescents with lymphedema to support self-management. Methods and Results: Parents of children with lymphedema and the professionals caring for them were recruited during a lymphedema educational camp. Six individual semistructured focus groups were undertaken in Italian, French, and English (three for parents and three for professionals) with simultaneous translation. Scale item generation was developed using interpretative phenomenological analysis and adopted Bandura's self-efficacy concept. Two self-efficacy tools were developed from research with 26 parents and 14 professionals. The parental tool (ILF parent SE) has 6 domains and 44 items: school; home and leisure; understanding the condition and treatment, and managing child and parent emotions. The professional tool (ILF Professional SE) has 4 domains and 21 items. This scale has two parts; the first indicates the level of professional autonomy in decision making, and the second covers assessment and treatment, patient understanding, and managing emotional reactions. Both tools adopt a 0- to 100-point scale using a 10-unit interval with 0 (cannot do) through to 100 (high certainty of being able to do). Initial face validity has been undertaken. Conclusion: Self-efficacy has emerged as a complex issue faced by parents and professionals involved with children and young people with lymphedema. By being able to assess the challenges parents face in self-efficacy individualized programs can be developed that will assist families in managing this complex disease and lead to greater well-being. Increased professional self-awareness will help the development of mentorship programs to support professionals dealing daily with the stress of managing a rare disease in which the outcome may be uncertain.

Child health-centre-based promotion of a tobacco-free environment--a Swedish case study.

Environmental tobacco smoke exposure is an important health risk for small children. The development, spread and evaluation of a national child health-centre-based counselling method targeting environmental tobacco smoke is described. The work progressed in six steps. In a first step, accomplished in 1994, it was found that child health nurses used a limited repertoire of techniques and were dissatisfied with their discussion on tobacco smoke. In a second step, routine recording of parental smoking status was introduced at all child health centres. In a third step, a counselling method based on Bandura's self-efficacy concept was developed, 'smoke-free children'. In a fourth step, smoke-free children was tested by 28 nurses in 128 families. At follow-up discussions, all parents said that they now smoked outdoors and that they had cut down on their smoking. In a fifth step, the national dissemination of smoke-free children was studied. A manual and a videotape were launched in 1995, supported by a newsletter and 10 regional conferences in the following years. In January 1997, 36% of the child health nurses in Sweden (three counties excluded) stated that they used the method. Training of county instructors did not seem to have improved dissemination. In a sixth step, routinely collected information on parental smoking in Stockholm county on infants born 1995-1997 was used to study the effect. Little change in smoking rates between two consecutive years was found before the introduction of smoke-free children. Yet, after training of the child health nurses, the annual decrease was 1.7% in a pilot area and later, in remaining parts of the county, 2.7%. Thus, answers to two crucial questions were given: first, that the method seemed to affect parental behaviour; and secondly, that the training of county instructors might not have affected the dissemination of smoke-free children.

Theoretical weaknesses lead to practical problems: The example of self-efficacy theory

Bandura's self-efficacy concept has received widespread acceptance from psychologists dealing with a varied range of behaviors. This paper argues that, like many related models, its ability to explain human behavior is largely illusory. It has its basis in the argument that behavior arises from complex interactions between unobservable variables which are vaguely defined and cannot be assessed. For example, the process by which efficacy expectations arise from various sources of information, and the interaction of self-efficacy with levels of skill and motivation, are argued to be important, but there is no model to explain how these processes occur. Since unambiguous predictions cannot be made, it is impossible to test the model in a spientific sense. This weakness seriously compromises the practical usefulness of the theory.