As mentioned above, in the hierarchy of the levels of nursing theory, middle-range theories are between grand and practice-level theories. Wayne (2021) notes that, in comparison to grand ones, middle-ranged theories are more limited in scope and their concepts and proposals are at lower levels of abstraction. Levels of abstraction are what the grouping of theories into grand, middle-range, and practice-level is based on: it is only one of three possible ways of classification. According to Wayne (2021), two other ways to grade theories are founded on their function and goal orientation. Nursing scholars proposed a middle-range theory level due to how difficult the testing of grand theories was. Most mid-level theories are founded on the works of grand theorists, but they can also use nursing practice, research, or other disciplines’ theories as their basis.
When it comes to the self-efficacy theory in nursing, it is reported to have received a lot of attention as a precursor of behavioral change and self-care governance in healthcare-related research. According to Shorey and Lopez (2021), this can be partly explained by the shift in the healthcare paradigm from it being disease-oriented (pathogenic) to becoming health-oriented (salutogenic). The salutogenic approach emphasizes a person’s well-being and their perfect state of health as the main goals and works to achieve them, whereas the pathogenic perspective is essentially based on the identification of problems and attempts to solve them. The salutogenic theory’s one major concept is the sense of coherence: it refers to the ability of an individual to use present and potential resources to combat stress and advance health. It is estimated on the basis of a person’s perceived value of behavior outcomes (meaningfulness), their belief in the behavior actually leading to these outcomes (comprehensibility), and their capability to successfully perform this behavior (manageability). The similarity of these factors to the three factors of self-efficacious behavior is evident: these are self-efficacy beliefs, behavior-efficacy beliefs, and the value of expected results.
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Shorey, S., & Lopez, V. (2021). Self-efficacy in a nursing context. In G. Haugan & M. Eriksson (Eds.), Health promotion in health care – vital theories and research (pp. 145-158). Springer.
Wayne, G. (2021). Nursing theories and theorists. Nurseslabs.