Middle-Range Theory for the Nursing Diagnosis of Low Self-Efficacy in Health

Abstract

Objectives: theoretical validation of the concept of low self-efficacy in health as a nursing diagnosis construct. Methods: construction of a middle-range theory for validating diagnoses, comprised of five stages: definition of the approach for building the theory; definition of the main concepts; creation of a pictorial diagram; formulation of proposals; establishment of causal relationships and evidence for clinical practice. The main concepts were identified through a literature review and the studies were taken from the LILACS, SCOPUS, CINAHL and PubMed/MEDLINE databases. The final sample was comprised of 92 articles. Results: eighteen etiological factors and 16 clinical indicators were identified; characterized as antecedents and manifestations for inferring a diagnosis of low self-efficacy in health. Conclusions: the related concepts of the new nursing diagnosis of low self-efficacy in health, to be applied in clinical nursing practice, were identified and defined.

Content validity of the nursing diagnosis low self‐efficacy in health

“…In the same way, its relationship with other nursing diagnoses was directly exposed. Therefore, the judges ratify the results of the middle‐range theory developed for the validation of this diagnosis, described as changes in the perception of self‐efficacy precede this type of phenomenon related to health behaviors (Barreiro et al., 2020). Furthermore, a low level of self‐efficacy in health is a related factor to some nursing diagnoses in the NANDA I taxonomy such as risk‐prone health behavior, ineffective health maintenance behaviors, ineffective health self‐management, and sedentary lifestyle (Herdman et al., 2021).…”

“…The elements mentioned above explain how a poor sense of self‐efficacy is one of the main predictors of a lack of interest in adopting healthy behaviors and of adopting risk‐prone health behaviors (Bandura, 1997; Resnick, 2003). Likewise, an alteration in self‐efficacy can be manifested by personal incompetence to comply with the therapeutic regimen and follow the recommendations of health professionals (Andrade & Céspedes, 2017; Barreiro et al., 2020), which is covered by the clinical indicator of low adherence to treatment. A person with low self‐efficacy in health distrusts his/her abilities and perceives that he/she cannot exercise self‐care actions (Bailey et al., 2016; Gutiérrez & Gómez, 2018), which is covered by the clinical indicator self‐care deficit.…”

“…Low self‐efficacy in health causes doubts and generates the perception of needing help to carry out the necessary actions to face any alteration in well‐being and/or solve a problematic health situation (Clum et al., 2014), which is covered by the indicator of decreased problem‐solving ability in health. Similarly, failure to act to prevent health problems reflects that the person is perceived as incapable of efficiently undertaking and carrying out actions to prevent or face a pathological process (Bandura, 1997; Barreiro et al., 2020; Clum et al., 2014).…”

“…However, even though it has been empirically proven that the perception of self‐efficacy is an important predictor in the adoption and maintenance of healthy behaviors, for this reason, it corresponds to a related factor of several diagnoses such as risk‐prone health behavior, ineffective health maintenance behaviors, ineffective health self‐management, sedentary lifestyle (Herdman et al., 2021); in the literature, there is no evidence that this phenomenon has been analyzed as a diagnostic construct for nursing (Barreiro et al., 2020). For this reason, we propose an analysis of the self‐efficacy concept according to the structure for diagnoses of NANDA‐I.…”

Evaluation on the efficacy of nursing intervention based on the self-efficacy theory model in elderly patients undergoing total laparoscopic hysterectomy

“…Specifically, it refers to an individual's subjective evaluation of whether his or her capacity to behave in a way that achieves the desired outcome [1]. The development on nursing intervention strategies based on the self-efficacy model has been proven to enhance selfefficacy and self-management, minimize the occurrence of post-operative complications, and dramatically expedite the recovery of perioperative patients [2,3]. However, there is insufficient data to demonstrate the feasibility and effectiveness of improving the recovery of elderly patients undergoing total hysterectomy.…”