Self-Efficacy, Health & One Easy Path Forward
Ever weaken to the allure of check-out counter Enquirer headlines? Perhaps you shake your head (in disgust or disbelieve) and then pick out a more reputable magazine on popular psychology, science or health. If so, you’ve certainly seen stories about “self-efficacy.”
In general terms, self-efficacy plays a role in how we think, act and feel about our place in community, and our ability to succeed in those roles. In less general terms, it’s all based on the work published in 1977 by Albert Bandura in his seminal paper “Self-Efficacy: Toward a Unifying Theory of Behavioral Change.” Addressing how we think, behave and feel in a particular situation, Bandura explains self-efficacy as:
“the belief in one’s capabilities to organize
and execute the courses of action
required to manage prospective situations.”
Self-efficacy has become a favored topic of research among educators, health care providers, psychologists and others. The range of disciplines involved reflect the fact that it impacts and influences so much of our lives.
As we age, our desires and goals certainly change. It’s likely that advancing our careers, starting a family or winning sports medals are goals that have faded from our view, or aren’t at the top of our to-do lists. We may not want to totally re-invent ourselves, but we still have goals (including those related to health and Aging with Pizzazz).
Virtually all of us can identify goals in our lives, things we want to achieve, experience or change. Putting our plans into action – OR NOT – is where self-efficacy shows up.
Evaluating Your Own Self-Efficacy
Before we consider the one easy path that the title hints at, we might want to consider our own situation. Granted, this is closer to ‘pop-psychology’ than a formal assessment, but it can be insightful if we evaluate our answers honestly. Give it a shot.
Do you keep trying even when things seem difficult?
Do you accept a task that is something you are unused to, rather than being threatened (and stilted or frozen) by it?
Do you feel confident in your ability to achieve a goal you set?
Do you take on goals for which you anticipate obvious difficulty, but know success is possible?
Do you prefer a Health Care (HC) provider who treats you like a partner, rather than a patient?
Do you tend to be positive about even baby-step progress, as opposed to being overwhelmed by everything left to do?
Do you tend to keep self-talk positive, rather than internally berating yourself?
It may be obvious, but the more questions above you are able to answer as “yes” or “most of the time,” then the better is your situation. If your answers are more like “I try” versus, “no,” then at least you aren’t on an entirely downward track.
Too Difficult to Improve Self-Efficacy?
One of the themes of this Aging_With_Pizzazz blog is capturing the low-hanging fruit. I point to it often, as the fruit there can be plenty sweet and nutritious. Possibilities for changing our behaviors can be taken from the same low, easy-to-reach area.
Luckily, the quality of our self-efficacy is more molded in wet clay than it is written in stone. There are ways to fortify ourselves and foster our strength, such as taking on ‘the hard stuff’ – and reinforce self-efficacy when the results are of interest to us.
A couple ways to improve that are taken from Bandura’s original work may be less adaptable for seniors. Not impossible, just perhaps ‘less our speed.’ These include “observing mentors and getting positive feedback.” The mentors seem harder to cultivate as we age, and for those living alone, feedback can be less accessible.
However, two other skills are easier to come by, and definitely worth our effort.
- Acknowledging success.
- Practicing positive self-talk.
Comparing the Two Skills
There is a similarity between these two skills of acknowledging success and positive self-talk. Still, the differences are important even if subtle.
Acknowledging your success is also known as “mastery experiences.” These aren’t necessarily about a lot of little successes (although that’s good too), but instead this is acknowledging small steps toward big efforts – big efforts that do not come easily to us. Bandura explained that performing a difficult task strengthens us, while giving up too quickly on such a challenge can undermine us.
Specifically, he states: “The most effective way of developing a strong sense of efficacy is through mastery experiences.” Like most things, we begin to develop both our sense of self and efficacy in early childhood. You may have gotten a head-start or learned bad lessons. However, our Growth doesn’t stop there. We can cultivate our self-efficacy through the elements mentioned above (mentors, feedback, acknowledging successes and self-talk) but especially as we age this acknowledgement of Mastery Experience may be our best leap forward. Said another popular way – go for it!
‘Practicing’ positive self-talk includes looking for ways to replace internal negativity with positive thoughts and unspoken words. Keep in mind a goal of promoting your belief in yourself. Even “acting as if” can help, meaning say nice things to yourself even if you know a cruel little voice inside wants to argue with you. I assume I’m not the only one with that little (s*#@y) voice grumbling away.
I Think I Can, I Think I Can
The Little Engine just needed to make it to the top of the bend. It didn’t work at first. It was steep and a hard climb, but not impossible. It was also a specific goal for that fairy-tale hill.
That’s a key difference between self-esteem, self-confidence and self-efficacy. Self-esteem basically describes the respect you hold for your own worth or value. Self-confidence refers to those with a general, all-around belief in themselves, in most contexts. Conversely, self-efficacy is more specific, content-dependent, and thus can change in different situations.
A mountain climber may have high self-efficacy on the upward route, and low self-efficacy playing softball. There could be a high-level teaching English literature, and low in the science lab. You can name any number of such differences. Self-esteem and confidence may be a bit more tricky, but most of us can see ourselves strong (or lacking) in specific situations.
Contrary to self-esteem and confidence, self-efficacy is easier to develop. Further, research suggests that there is a positive connection between efficacy and esteem. Taking steps related to our self-efficacy in health, plays dual reciprocal roles – healthier psychology and healthier body. No surprise, they feed each other as well.
Darker Side of the Hill
If you don’t picture yourself – ever – as the Little Engine that “could,” then you tend to set yourself up for failure. This includes health issues, like nutrition, Exercise and illness.
People with poor self-efficacy can be described with these tendencies.
- Avoid challenging tasks. (Self-talk like “I never seem to stick to an improved Diet, so why try.”)
- Believe certain tasks are beyond their capability. (Self-talk like “There’s no way I can get into shape; I can’t even do a squat.”)
- Focus on negative outcomes and personal failings. (Self-talk like “It’s unbelievable that I could have gained so much weight, and so quickly.”)
- Lose confidence quickly when any stumbling block arises. (Self-talk like “Now that I have Diabetes, I may as well throw in the towel to strive for longevity.”)
- Don’t try any longer.
We’re not going to achieve every goal we can think of. Well, I know I won’t (but believe me I can think of LOTS of goals). Still, I hope you, like me, don’t want to stay on the dark side. Better yet, the more we “think we can” the more likely it’s true.
Leaving the Dark Side of the Hill
Even as we age, we can accomplish so much, including many health-care goals.
As an example, someone who is demonstrating good self-efficacy might include the following attributes.
An older person struggling with a chronic illness
works in partnership with her health care provider
to evaluate her situation and determine treatment and home care.
She reminds herself of the progress she makes most days and
feels confident she can make more by setting up
small goals leading to a bigger improvement.
Hopefully that doesn’t sound like pie-in-the-sky to you. It’s doable. It also leads me to the coordination of self-efficacy and health care.
We need to shift our perspective in health care (if you haven’t already) away from passive care to more responsibility. This personal active behavior includes plans in which we develop and master more Lifestyle changes.
Actively participating in positive health behaviors, which we help design, leads to better outcomes. Especially so in managing long-term solutions. It promotes higher self-efficacy and that too leads to better outcomes. (Ask any good HC provider.)
1 Easy Path: Self-Efficacy Managing HC
I am going to suggest one small plan toward better health. It’s an easy first step. However, remember that helping design goals yourself can also be important to believing you will succeed. So, adapt, expand or improve upon this plan for yourself.
Here’s my sample plan that I suggest you immediately augment if it’s too easy for you, or attempt even if it is sounds too difficult.
- 2 days a week, take a long walk.
- 2 days a week, do fun activities that include movement.
- 1 day a week, do a session of PizzazzEE-25, to ensure you are working all your muscles and all your joints at a level right for you.
- 1 day a week, do a fun activity that need not be movement, but which you enjoy.
- 2 days a week, eat full-on-healthy, avoiding meat and empty sweets.
- 1 day a week (or more), contemplate how truly miraculous you are.
FINAL THOUGHT
Our self-efficacy affects many parts of our lives, as well as those with whom we share our life. Believing in ourselves to improve our own health and our own quality aging is vital to achieving both. I do my best in this department, although none of us are perfect. Trying is a key.
I share my own goal with you. I hope for you all to be that ‘Little Engine that Could’ and ultimately learn that you know you can, you know you can. 
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REFERNCES
Cameron JE, Voth J, Jaglal SB, et al. “In this together: social identification predicts health outcomes (via self-efficacy) in a chronic disease self-management program.” Social Sci & Med, 2018;208:172–179.
Cherry, Kendra. “Albert Bandura’s Biography (1925-2021).” VeryWellMind, March 20, 2023 Albert Bandura: Biography, Theories, and Contributions to Psychology (verywellmind.com)
Cherry, Kendra. “Self Efficacy and Why Believing in Yourself Matters.” VeryWellMind, Updated on February 27, 2023 (Medically reviewed by Amy Morin, LCSW, Editor-in-Chief. Self-Efficacy: Why Believing in Yourself Matters (verywellmind.com)
Elbers S, Wittink H, Pool JJM, Smeets RJEM. The effectiveness of generic self-management interventions for patients with chronic musculoskeletal pain on physical function, self-efficacy, pain intensity and physical activity: A systematic review and meta-analysis. Euro J Pain, 2018;22(9):1577-1596.
Hoffman AJ. Enhancing self-efficacy for optimized patient outcomes through the theory of symptom self-management. Cancer Nursing, 2013;36(1).
Hutting N, Johnston V, Staal JB, Heerkens YF. Promoting the use of self-management strategies for people with persistent musculoskeletal disorders: the role of physical Therapists. J Ortho & Sports Phys Ther, 2019;49(4):212-215.
Rice-Christopher, Elizabeth, DC, MSc, CSCS, RYT, ACSM-CPT. “Improving Patient Self -Efficacy. What you need to know.” Dynamic Chiropractic May 2023 Improving Patient Self-Efficacy | Dynamic Chiropractic
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Picture credit: Train; tevyaw 673642_1280 courtesy of Pixabay
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