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The self-efficacy idea has drawn a lot of interest as a behavioral change and self-care management predictor in educational and medical research. This might in part be attributable to the paradigm change in health care from a disease-centered (pathogenic) to a health-centered (salutogenic) approach. Instead of focusing on detecting issues or diseases and solely trying to treat them, the salutogenic orientation emphasizes personal well-being and an ideal state of health as the ultimate goals and seeks to achieve these [31, 32]. The feeling of coherence, one of the key ideas in the salutogenic theory, refers to a person’s capacity to use both current and future resources to reduce stress and advance health.  

The three criteria Antonovsky [32] compared to the three conditions for self-efficacious behavior—self-efficacy beliefs, behavioral efficacy beliefs, and the value of anticipated outcomes [33]—are how one’s perception of the behavior’s outcome (meaningfulness), their belief that the behavior will actually result in that outcome (comprehensibility), and their ability to carry it out successfully. The salutogenic method shares many characteristics with Bandura’s self-efficacy theory [1], which emphasized the critical role that perceived self-efficacy plays in the decision of behavioral settings [34,35,36,37]. 

In a recent study, it was discovered that self-efficacy was positively correlated with feeling of coherence; this correlation was largest in those with poor sense of coherence [38]. Additionally, it has been discovered that self-efficacy either acts as a mediator between other psychological characteristics and health behavior [42, 43] or has a strong direct effect on behaviors [39,40,41]. 

Use of Self-Efficacy in Health Promotion Among Patients with Chronic Illness. 

Higher levels of self-efficacy to manage one’s own chronic conditions are linked to higher health-related quality of life (QoL) for patients with chronic medical conditions (such as sickle cell disease, asthma, cardiovascular disease (CVD), inflammatory bowel disease, and cancer), reduced perceived stress [49,50,51], fewer anxiety and depressive symptoms [47, 48, 52], lower symptom severity [48, 53], and also predict symptom resolution [49]. Higher self-efficacy was positively correlated with mental and physical health related in mental illness research looking at unipolar and bipolar disorders [54, 55]. Similar findings were made in investigations of bipolar and unipolar illnesses. In contrast, a study on multi-morbid primary care patients found that lower self-efficacy and a greater disease load are associated with lower quality of life (QoL) [56]. The complicated nature of addressing patient self-efficacy is highlighted by the notable bidirectional association between a few variables and outcomes. 

Role of Self-Efficacy in Nursing Education. 

Regarding nursing education and training, self-efficacy is also applied in the healthcare sector. Nursing students who get effective clinical training should develop a sense of self-efficacy, which is essential for operating autonomously and competently in the nursing profession [123,124,125]. Individual perceived self-efficacy affects students’ clinical performance, course completion, and achievement incentives [125,126,127]. Strong feeling of self-efficacy and job satisfaction are essential in avoiding attrition in the nursing profession [126, 129] since Bandura [128] asserts that students with low self-efficacy will seek to avoid situations that led to earlier failures. Lastly, in order to deliver high-quality healthcare and guarantee patient safety, future healthcare practitioners must have clinical self-efficacy and competency [125]. 


The self-efficacy theory interacts with other psychological theories to impact behavioral changes that promote health in a variety of contexts. The use of self-efficacy in a variety of nursing contexts ultimately comes down to improving patient safety, health promotion, and healthcare quality. The idea of self-efficacy has been crucial in predicting people’s physical and psychological welfare, abilities, and self-care management. It has also frequently served as a theoretical underpinning for clinical and educational interventions that are already in use. Despite the well-established literature base, new research on the connection between sense of coherence and self-efficacy as well as the gradual transition of the health care paradigm to a salutogenic orientation show that future nursing research must continue to tailor and improve methods to improve self-efficacy. 

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