Two studies examining the negative effect of self-efficacy on performance

Nursing leadership style and error management culture: a scoping review

PURPOSE

This paper aims to assess the influence of nursing leadership style on error management culture (EMC).

DESIGN/METHODOLOGY/APPROACH

This scoping review was conducted following the integrative review methodology of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, CINAHL, Scopus, Web of Science, Embase and EBSCO databases were systematically searched to identify studies on nursing leadership, error management and measurement, and error management culture. The studies' methodological quality was then assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies.

FINDINGS

Thirteen manuscripts were included for review. The analysis confirmed that nursing leadership plays an important role in EMC and nurses' intention to report errors. Three emerging themes were identified: 1) leadership and EMC; 2) leadership and the intention to report errors; and 3) leadership and error rate.

RESEARCH LIMITATIONS/IMPLICATIONS

A major limitation of the studies is that errors are often analyzed in a transversal way and associated with patient safety, and not as a single concept.

PRACTICAL IMPLICATIONS

Healthcare managers should promote training dedicated to head nurses and their leadership style, for creating a good work environment in which nurses feel free and empowered to report errors, learn from them and prevent their reoccurrence in the future.

ORIGINALITY/VALUE

There is a positive relationship between nursing leadership and error management in terms of reduced errors and increased benefits. Positive nursing leadership leads to improvements in the caring quality.

Framework Development for Reducing Attrition in Digital Dietary Interventions: Systematic Review and Thematic Synthesis

BACKGROUND

Dietary behaviors significantly influence health outcomes across populations. Unhealthy diets are linked to serious diseases and substantial economic burdens, contributing to approximately 11 million deaths and significant disability-adjusted life years annually. Digital dietary interventions offer accessible solutions to improve dietary behaviors. However, attrition, defined as participant dropout before intervention completion, is a major challenge, with rates as high as 75%-99%. High attrition compromises intervention validity and reliability and exacerbates health disparities, highlighting the need to understand and address its causes.

OBJECTIVE

This study systematically reviews the literature on attrition in digital dietary interventions to identify the underlying causes, propose potential solutions, and integrate these findings with behavior theory concepts to develop a comprehensive theoretical framework. This framework aims to elucidate the behavioral mechanisms behind attrition and guide the design and implementation of more effective digital dietary interventions, ultimately reducing attrition rates and mitigating health inequalities.

METHODS

We conducted a systematic review, meta-analysis, and thematic synthesis. A comprehensive search across 7 electronic databases (PubMed, MEDLINE, Embase, CENTRAL, Web of Science, CINAHL Plus, and Academic Search Complete) was performed for studies published between 2013 and 2023. Eligibility criteria included original research exploring attrition in digital dietary interventions. Data extraction focused on study characteristics, sample demographics, attrition rates, reasons for attrition, and potential solutions. We followed ENTREQ (Enhancing the Transparency in Reporting the Synthesis of Qualitative Research) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used RStudio (Posit) for meta-analysis and NVivo for thematic synthesis.

RESULTS

Out of the 442 identified studies, 21 met the inclusion criteria. The meta-analysis showed mean attrition rates of 35% for control groups, 38% for intervention groups, and 40% for observational studies, with high heterogeneity (I²=94%-99%) indicating diverse influencing factors. Thematic synthesis identified 15 interconnected themes that align with behavior theory concepts. Based on these themes, the force-resource model was developed to explore the underlying causes of attrition and guide the design and implementation of future interventions from a behavior theory perspective.

CONCLUSIONS

High attrition rates are a significant issue in digital dietary interventions. The developed framework conceptualizes attrition through the interaction between the driving force system and the supporting resource system, providing a nuanced understanding of participant attrition, summarized as insufficient motivation and inadequate or poorly matched resources. It underscores the critical necessity for digital dietary interventions to balance motivational components with available resources dynamically. Key recommendations include user-friendly design, behavior-factor activation, literacy training, force-resource matching, social support, personalized adaptation, and dynamic follow-up. Expanding these strategies to a population level can enhance digital health equity. Further empirical validation of the framework is necessary, alongside the development of behavior theory-guided guidelines for digital dietary interventions.

TRIAL REGISTRATION

PROSPERO CRD42024512902; https://tinyurl.com/3rjt2df9.

Public Perception Towards Drug Abuse in South Korea: The Effects of Overconfidence and Affirmation

OBJECTIVE

The abuse of prescription drugs and over-the-counter medicines has been a major issue addressed as a serious public health problem worldwide. This study explored factors contributing to substance abuse in Korea by examining the status of substance abuse among Korean adults and evaluating their knowledge, attitudes, and intentions toward substance abuse.

METHODS

Data were collected online from a sample of participants 19 years old or older from May 20 to June 1, 2020 (n=1,020). The survey consisted of questions on demographics, perceptions of drug risk, motives for drug use, and attitudes toward drug addiction treatment. Principal component and multiple logistic regression analyses were used to explore the factors contributing to the perception of drug abuse.

RESULTS

In the multivariate regression analysis, overconfidence in handling drug usage, acceptance of addictive substances, and affirmation of public support for drug abuse were associated with opioid abuse (Nagelkerke R2=0.486), and additionally affirmation of legal cannabis usage and motivation to use diet pills were associated with diet pill abuse (Nagelkerke R2=0.569).

CONCLUSION

The findings of this study suggest that the actual situation of substance abuse among Korean adults increases awareness of and attitudes toward drug use related to substance abuse.

Health perceptions and attitudes on mobile health apps in China

Since the COVID-19 pandemic, the use of mobile health apps has been increasing significantly. Many have started using mobile health apps to manage their health and well-being. People need to develop healthy habits that will increase their job productivity, life expectancy and improve their social relationships. This study tests the Health Belief Model with adults in China in influencing health motivation and in turn improving their health behavior. A mobile and online survey was developed, and 120 usable responses were collected. A structural equation modeling was used to test the relationships between perceived benefits, perceived susceptibility, perceived barriers, health motivation, and health behavior. We found perceived self-efficacy, perceived benefits, and perceived susceptibility predicts health motivation, and health motivation predicts health behavior. We did not find that perceived barrier is a predictor for health motivation. We conclude that to encourage behavioral change, it is important to enhance self-efficacy and address the benefits; in the meantime, educating people on susceptibility is also important.

Factors Influencing Farmers' Use of Adaptive and Maladaptive Coping Strategies

OBJECTIVES

Chronic stress is associated with a variety of negative outcomes for farmers in the United States (U.S) and worldwide, who face near-constant exposure to internal (e.g. family conflict) and external (e.g. weather) stressors. Research indicates that farmers' stress may be reduced by engaging in adaptive coping strategies and avoiding maladaptive coping strategies. However, little is known about what predicts their coping strategy use. Informed by the transactional theory of stress and coping, the present manuscript seeks to identify factors associated with U.S. farmers' use of adaptive and maladaptive coping strategies.

METHODS

U.S. farmers (N = 135) completed survey assessments of factors theorized to be associated with coping strategy choice (maladaptive beliefs about farm stress management, farm stress management self-efficacy, age, and sex) as well as measures of adaptive and maladaptive coping.

RESULTS

Farm stress management self-efficacy was a significant, positive predictor of adaptive coping, and maladaptive beliefs about farm stress management were a significant, positive predictor of maladaptive coping. Maladaptive beliefs about farm stress management and farm stress management self-efficacy interacted to predict maladaptive coping, such that the positive relationship between maladaptive beliefs about farm stress management and maladaptive coping was significant at higher levels of self-efficacy. Sex was unrelated to coping strategies, and age was negatively associated with maladaptive coping strategies but unassociated with adaptive coping strategies.

CONCLUSION

The findings point to the utility of increasing farm stress self-management self-efficacy to increase farmers' adaptive coping and reducing maladaptive beliefs about farm stress management to reduce maladaptive coping. Efforts to promote adaptive coping by increasing self-efficacy should also target maladaptive beliefs farmers hold toward stress management, because increasing self-efficacy may also increase the likelihood of maladaptive coping when maladaptive beliefs are present.

Within-person association of volitional factors and physical activity: Insights from an ecological momentary assessment study

OBJECTIVE

Current health behavior models of physical activity (PA) suggest that not all PA intentions are translated into actual PA behavior, resulting in a significant intention-behavior gap (IBG) of almost 50%. These models further suggest that higher self-efficacy and specific planning can aid in decreasing this gap. However, as most evidence stems from between-person (trait level), questionnaire-based research, it is unclear how large short-term IBGs are, how self-efficacy and planning covary within-persons across time and whether they similarly predict smaller IBGs. It is likely that day-to-day changes in circumstances and barriers affect these variables thus the applicability of theoretical models is uncertain. Here, within-person prospective analyses of ecological momentary assessment (EMA) data can provide insights.

METHODS

35 healthy participants (aged 23-67) completed four EMA-based questionnaires every day for three weeks. Each prompt assessed PA (retrospectively, "since the last EMA prompt"); PA intentions, planning specificity, self-efficacy, and intrinsic motivation (prospectively, "until the next EMA prompt") and momentary affect. Generalized logistic mixed-effect modeling was used to test predictors of PA.

RESULTS

Across the 2341 answered EMA prompts, PA intentions were not enacted in 25% of the episodes (IBG). In episodes with given intentions, PA likelihood increased with higher levels of self-efficacy, planning specificity, and intrinsic motivation. The latter two also positively predicted PA duration and intensity.

CONCLUSIONS

Short-term intention behavior gaps seem to be smaller than what is known from more long-term studies, most likely as individuals can anticipate the actual circumstances of PA. Further, current health behavior models show validity in explaining within-person dynamics in IBGs across time. Knowing the relevance of planning specificity, self-efficacy and intrinsic motivation for day-to-day variations in PA enactment can inform respective real-time mHealth interventions for facilitating PA.

Effects of False Feedback on Pain Tolerability Among Young Healthy Adults: Predictive Roles of Intentional Effort Investment and Perceived Pain Intensity

Purpose

Expectations and modification gained through critical learning influence pain perception. We tested how pain tolerability was influenced by the effects of orally delivered false feedback and participant status immediately prior to performing tasks.

Patients and Methods

A total of 125 healthy college students (69 females and 56 males) were randomly assigned to 3 groups (positive, negative, and control) to participate in two formal cold pressor tests (CPTs). Participants completed the same series of task-related questionnaires (perceived importance, intended effort, current affect, and self-efficacy) before each CPT. False performance feedback was delivered after completion of the baseline level CPT. After completion of each CPT, both pain intensity and pain tolerability (duration in ice water) were recorded.

Results

The results of linear mixed models revealed significant condition × time interactions on pain tolerability and task self-efficacy after controlling for individual variance as a random effect. Participants who received negative feedback exhibited increased pain tolerability without decreasing their self-efficacy, whereas participants who received positive feedback showed increased self-efficacy with no change in pain tolerability. A longer pain tolerance duration was also predicted by a more intentional investment of effort and a lower intensity of experienced pain as well as the effect of false feedback.

Conclusion

The research highlights the effect of powerful situational influences on laboratory-induced pain tolerance.

Understanding the role of social media usage and health self-efficacy in the processing of COVID-19 rumors: A SOR perspective

Apart from the direct health and behavioral influence of the COVID-19 pandemic itself, COVID-19 rumors as an infodemic enormously amplified public anxiety and cause serious outcomes. Although factors influencing such rumors propagation have been widely studied by previous studies, the role of spatial factors (e.g., proximity to the pandemic) on individuals' response regarding COVID-19 rumors remain largely unexplored. Accordingly, this study, drawing on the stimulus-organism-response (SOR) framework, examined how proximity to the pandemic (stimulus) influences anxiety (organism), which in turn determines rumor beliefs and rumor outcomes (response). Further, the contingent role of social media usage and health self-efficacy were tested. The research model was tested using 1246 samples via an online survey during the COVID-19 pandemic in China. The results indicate that: (1)The proximity closer the public is to the pandemic, the higher their perceived anxiety; (2) Anxiety increases rumor beliefs, which is further positively associated rumor outcomes; (3) When the level of social media usage is high, the relationship between proximity to the pandemic and anxiety is strengthened; (4) When the level of health self-efficacy is high, the effect of anxiety on rumor beliefs is strengthened and the effect of rumor beliefs on rumor outcomes is also strengthened. This study provides a better understanding of the underlying mechanism of the propagation of COVID-19 rumors from a SOR perspective. Additionally, this paper is one of the first that proposes and empirically verifies the contingent role of social media usage and health self-efficacy on the SOR framework. The findings of study can assist the pandemic prevention department in to efficiently manage rumors with the aim of alleviating public anxiety and avoiding negative outcomes cause by rumors.

Structuring the situation: Organizational goals trigger and direct decision-making

Organizational goals are assigned to individuals, and thus differ from goals that individuals voluntarily adopt. The Carnegie School has a significant research stream on how organizations are affected by goals, with a focus on how disappointing performance disrupts regular organizational behavior and triggers a search for alternative actions. We have a good understanding of the organization-level process of setting aspiration levels, triggering search for alternatives, and making decisions, but the individual-level mechanisms contributing to it are less well known. An assessment of the progress of Carnegie School research so far reveals a list of research questions that should be resolved in order to understand how individual updating of aspiration levels, triggering of search, directing of search, and decision-making help explain organizational responses to goals. The role of construal, or interpretation, in guiding these processes is a central theoretical mechanism that needs further investigation.

Performance of village midwives in detecting neonatal emergency through self efficacy and work engagement as mediation: Cross-sectional study in Pamekasan Regency, Indonesia

Backgrounds

The government's strategy in reducing the high infant mortality rate (IMR) in Indonesia is to place midwives in the village and use the Integrated Management of Young Infants (MTBM) guidelines that integrate all steps through early detection and effective treatment. Midwives have not shown maximum performance in neonatal coverage and neonatal complications, each of which has not reached the target. This study aims to analyze the effect of self-efficacy and work engagement on task performance in the Pamekasan Public Health Center Work Area.

Designs and methods

This research was conducted as an analytic study with a cross-sectional study. A sample of 151 village midwives in each Puskesmas' working area, was then analyzed and interpreted to test the model with SEMPLS.

Results

Directly self-efficacy has no effect on performance (t statistic 0.315 < 1.96; p-value 0.753 > 0.05), self-efficacy affects work engagement (t statistic 13.98 > 1.96; p-value 0.000 < 0.05), while work engagement has an effect on performance (t statistic 11.426 > 1.96; p-value 0.000 > 0.05). Indirectly, self-efficacy will affect performance if it is through work engagement (t statistic 7.392 > 1.96; p-value 0.000 > 0.05).

Conclusion

The findings show that self-efficacy and work engagement can help improve the performance of village midwives in detecting neonatal emergencies.

Within- and between-patients associations between self-efficacy, outcome expectation, and symptom change in cognitive behavioral therapy for generalized anxiety disorder

OBJECTIVES

There is limited information on how a change in patients' expectations over time results in symptom change in psychotherapy. This study aimed to investigate the changes in patients' expectations and symptoms during treatment and across follow-up as well as to determine the within- and between-patient relationships between two types of patient expectations, that is, self-efficacy and outcome expectation, and symptom change.

METHODS

Participants (80 participants × 6 repeated measures; 480 observations) with generalized anxiety disorder were treated using cognitive behavioral therapy and the within- and between-patient scores of self-efficacy and outcome expectation were evaluated in multilevel models as predictors of symptom change.

RESULTS

Patients' self-efficacy and outcome expectation increased, whereas severity of their symptoms reduced during and after treatment. At the within-patient (WP) level, an increase in self-efficacy was associated with a decrease in worry and depressive symptoms, and an increase in outcome expectation was associated with a decrease in depressive symptoms. The between-patient (BP) effect, however, was contrary to the WP effect, that is, self-efficacy was positively correlated with worry and outcome expectation was positively correlated with depressive symptoms CONCLUSION: These results highlight the importance of disaggregating the WP variability from BP variability in psychotherapy process-outcome research as they exhibit different associations at the within- and between-patient levels. Clinical Trial Registration: ClinicalTrial.gov (NCT03079336).

When Does Group Efficacy Deteriorate Group Performance? Implications of Group Competency

While the social cognitive theory suggests that a group’s efficacy belief enhances its performance, emerging evidence indicates that this relationship is more complex than it appears to be. This study explores the boundary conditions of this relationship using the data of 389 employees from 41 work groups in a manufacturing company in South Korea. The results show that group efficacy is positively related to group performance and that this relationship is stronger when members are generally incompetent than competent. We also found that a bottleneck, which is operationalized as a group’s minimum competency, in an efficacious group is at least one condition that forms a negative relationship between group efficacy and its performance.

Exploration of the mediating role of physicians' managerial attitude in the relationship between their self-efficacy and workplace performance

PURPOSE

Self-efficacy, or a person's belief in his/her ability to perform specific tasks, has been correlated with workplace performance and role adjustments. Despite its relevance, and numerous studies of it in the management literature, evidence regarding its function in professionals employed in hybrid roles, such as doctor-managers, is lacking. The aim of this study was to fill this gap by exploring the mediating effect of physicians' managerial attitude on the relationship between their self-efficacy and workplace performance.

DESIGN/METHODOLOGY/APPROACH

Primary and secondary data from 126 doctor-managers were obtained from the Italian National Health Service. A structural equation modeling approach was used for analysis.

FINDINGS

This study's results provide for the first time empirical evidence about a surprisingly little-analyzed topic: how physicians' managerial attitude mediates the relationship between their self-efficacy and workplace performance. The study offers important evidence both for scholars and organizations.

PRACTICAL IMPLICATIONS

This study's results provide valuable input for the human resources management of hybrid roles in professional-based organizations, suggesting a systematic provision of feedback about doctor-managers' performance, the adoption of a competence approach for their recruitment, and a new design of doctor-managers' career paths.

ORIGINALITY/VALUE

The authors provide new evidence about the importance of managerial traits for accountable healthcare organizations, documenting that behavioral traits of physicians enrolled into managerial roles matter for healthcare organizations success.

The roles of self efficacy and sharia financial literacy to SMES performance: business model as intermediate variable

Background: SMEs have made a major contribution to the national economy, but Pandemic covid-19 made the decline of SMEs which directly affected the economy in Indonesia. The purpose of this research focus to explore the innovation of business models the novelty of the research model in the business model of innovation research models is to include the variable self-efficacy. This research emphasizes self-efficacy and Islamic financial literacy as independent variables, business model innovation as an intermediate model and business performance variables as dependent variables, with the focus of research on SMEs. Methods: This quantitative study uses partial least square structural equation modeling (PLS-SEM) and a questionnaire survey to analyze the 40 Street Vendors which is categorized as SMEs around Unisba. In the initial stages, the Questionnaire was tested with the Validity and Reliability test. In the PLS-SEM analysis, the validity of the indicators / items forming latent variables is based on the significance value of t arithmetic obtained from the loading factor value divided by the standard error. After being collected, the data is then processed and analyzed. The analytical method used in this study is the simultaneous equation model, namely Partial Least Square (PLS). The statistical tool used to test the hypothesis is Smart PLS. Results: The results showed that self-efficacy and Islamic financial literacy through business model innovation, had a positive effect on SMEs business performance simultaneously or partially.   Conclusion: So that by having good self-efficacy and good Islamic financial literacy plus an appropriate business innovation model, it will improve the business performance of SMEs.

Linking Female College Students’ Causal Attribution Habits, Cultural Orientation, and Self-Efficacy: A Study on Cross-National Differences

The present research concerns the extent to which explanations for desirable or undesirable academic outcomes (grades) as well as cultural orientation could account for self-efficacy beliefs of female undergraduate students from two societies with dissimilar cultural traditions. The United States of America (U.S.) was selected for its individualistic culture, whereas the Kingdom of Saudi Arabia (KSA) was chosen for its mix of traditional collectivist and individualistic values. A matched-pairs design ensured that students’ self-efficacy levels were equated between cultural groups (n = 560; 280 matched pairs). The research uncovered cultural differences in the choice of explanations and in the extent to which explanations might contribute to self-efficacy beliefs. These findings represent a blueprint for informing instructional interventions intended to effectively prepare students from different cultures for academic success.

Creative Self and Fear of Rejection

Abstract. Realization of creative potential in everyday life, sharing an original product or idea with others involves the risk of being rejected. In the current study, we explored the factors affecting the process of realization of creative potential in creative activities and creative achievements. We examined whether creative self-efficacy and creative personal identity, on the one hand, and fear of negative evaluation and rejection sensitivity, on the other hand, moderate the relationship between creative potential and real-life creativity (i.e., creative activities and achievements). According to the results, the relationship between creative potential and real-life creativity is stronger when people with creative potential have high creative personal identity and fear of negative evaluation scores. However, the relationship between creative potential and real-life creativity is not significant when people with creative potential have high scores on the creative self-efficacy and rejection expectancy scales (a cognitive aspect of rejection sensitivity). Possible explanations of the different results related to the different indicators of creativity and implications for future research are discussed.

The Assessment Rationale of Postgraduate Medical Trainees With Incongruent Self and Faculty Assigned Entrustment Scores

Background

Self-assessment is a central skill in competency-based medical education (CBME) and should be fostered in order to promote life-long learning. One measure that will guide the development of self-assessment is the alignment between it and external expert assessment. In this study, we explored the qualitative themes in the self-assessment rationale among trainees with incongruent self and faculty-assigned entrustment scores.

Methods

A total of 40 postgraduate medical trainees completed a four-scenario summative objective structured clinical examination (OSCE) as part of a simulation-based resuscitation curriculum in December 2017. After each scenario, an assessment involving an entrustment score and narrative rationale was completed by both trainee (self) and faculty. The differences between the trainee and faculty scores were calculated for each scenario and summed to give a single “incongruence score”. Trainees who consistently scored themselves higher than the faculty were said to have a “positive-incongruence score” and those scoring below the faculty were said to have a “negative-incongruence” score. Through this method, 10 trainees with the highest and lowest scores were assigned to each group and their narrative rationales were coded and thematically analyzed.

Results

The content of the self-assessment narrative rationale differed between the two groups. Trainees in the positive-incongruence group focused on the concepts of speed and situational management, while trainees in the negative-incongruence group commented on lack of support, and a need to improve communication, diagnosis, and code blue management. The quality of the self-assessment rationale also differed between groups. Trainees in the negative-incongruence group provided higher-quality comments that were more detailed and granular.

Conclusion

We found differences in the content and quality of the self-assessment rationale between trainees whose self and faculty-assigned assessment is incongruent. This provides insight into how these groups differ and has valuable implications for the development of curricula targeting self-assessment skills.

Discrepancies Between Clinician and Participant Intervention Adherence Ratings Predict Percent Weight Change During a Six-Month Behavioral Weight Loss Intervention

BACKGROUND

Individuals receiving behavioral weight loss treatment frequently fail to adhere to prescribed dietary and self-monitoring instructions, resulting in weight loss clinicians often needing to assess and intervene in these important weight control behaviors. A significant obstacle to improving adherence is that clinicians and clients sometimes disagree on the degree to which clients are actually adherent. However, prior research has not examined how clinicians and clients differ in their perceptions of client adherence to weight control behaviors, nor the implications for treatment outcomes.

PURPOSE

In the context of a 6-month weight-loss treatment, we examined differences between participants and clinicians when rating adherence to weight control behaviors (dietary self-monitoring; limiting calorie intake) and evaluated the hypothesis that rating one's own adherence more highly than one's clinician would predict less weight loss during treatment.

METHODS

Using clinician and participant-reported measures of self-monitoring and calorie intake adherence, each assessed using a single item with a 7- or 8-point scale, we characterized discrepancies between participant and clinician adherence and examined associations with percent weight change over 6 months using linear mixed-effects models.

RESULTS

Results indicated that ratings of adherence were higher when reported by participants and supported the hypothesis that participants who provided higher adherence ratings relative to their clinicians lost less weight during treatment (p < 0.001).

CONCLUSIONS

These findings suggest that participants in weight loss treatment frequently appraise their own adherence more highly than their clinicians and that participants who do so to a greater degree tend to lose less weight.

A psychometric evaluation of the Family Decision-Making Self-Efficacy Scale among surrogate decision-makers of the critically ill

OBJECTIVES

The purpose of this study was to report the psychometric properties, in terms of validity and reliability, of the Unconscious Version of the Family Decision-Making Self-Efficacy Scale (FDMSE).

METHODS

A convenience sample of 215 surrogate decision-makers for critically ill patients undergoing mechanical ventilation was recruited from four intensive care units at a tertiary hospital. Cross-sectional data were collected from participants between days 3 and 7 of a decisionally impaired patient's exposure to acute mechanical ventilation. Participants completed a self-report demographic form and subjective measures of family decision-making self-efficacy, preparation for decision-making, and decisional fatigue. Exploratory factor analyses, correlation coefficients, and internal consistency reliability estimates were computed to evaluate the FDMSE's validity and reliability in surrogate decision-makers of critically ill patients.

RESULTS

The exploratory factor analyses revealed a two-factor, 11-item version of the FDMSE was the most parsimonious in this sample. Furthermore, modified 11-item FDMSE demonstrated discriminant validity with the measures of fatigue and preparation for decision-making and demonstrated acceptable internal consistency reliability estimates.

SIGNIFICANCE OF RESULTS

This is the first known study to provide evidence for a two-factor structure for a modified, 11-item FDMSE. These dimensions represent treatment and palliation-related domains of family decision-making self-efficacy. The modified FDMSE is a valid and reliable instrument that can be used to measure family decision-making self-efficacy among surrogate decision-makers of the critically ill.

A mediating and moderating role on employee performance appraisal

Purpose

This study aims to determine the relationship between transformational leadership, self-efficacy, gender, intrinsic motivation and employee performance in mediating and moderating roles.

Design/methodology/approach

Respondents in this study were 531 hotel employees (human resources development staff, financial, relationship) in Yogyakarta who were led by women. Structural equation modeling was used to test the hypotheses using AMOS 22.0.

Findings

The results show that transformational leadership has a positive and significant effect on employee performance, self-efficacy acts as a mediating variable on the relationship between transformational leadership and employee performance. The results also indicate that gender acts as a moderating variable by strengthening the relationship between transformational leadership and employee performance and intrinsic motivation acts as a moderating variable by strengthening the relationship between self-efficacy and employee performance.

Research limitations/implications

This study has two limitations. First, the research results cannot conclude the company in general because the sampling of this study is limited to the hotel business which is led by women only. Future research is needed to explore more deeply to compare the performance of employees in companies led by women and those led by men. Second, this study uses only one independent variable. Future research needs to be done to explore the effect of other variables on company performance, such as work culture, work environment and job satisfaction.

Practical implications

The main managerial contribution of this study is directed to companies that are interested in developing employee performance. First, self-efficacy is able to mediate transformational leadership in achieving employee performance. Besides this research offers a clear strategy for companies to stimulate their employees to strengthen leadership individually so as to improve the quality of their work. Thus, companies can carry out leadership training that is focused on being able to recognize employees who have low self-efficacy. If this is done, the company can reduce expenses that are not small but can make a significant contribution.

Originality/value

To the best of the authors’ knowledge, this study is the first to examine the mediating and moderating role of transformational leadership, employee performance, self-efficacy, gender and intrinsic motivation, especially in a hotel business led by women in Yogyakarta, Indonesia.

The boomerang effect of tuberculosis knowledge and self-efficacy on Chinese parents' intention to seek timely treatment and adhere to doctors' regimens

OBJECTIVE

The present study tested the level of tuberculosis (TB) knowledge of Chinese parents whose children attended kindergarten, primary school, and middle school, and examined whether their TB knowledge and self-efficacy in TB management exhibited a curvilinear relationship with their intention to seek timely TB treatment and adhere to doctors' regimens if their children are infected with TB.

METHODS

An online cross-sectional survey (N = 1129) was conducted. TB knowledge was assessed based on the manual provided by the Chinese Center for Disease Control and Prevention (CDC). Hierarchical polynomial regression was conducted to test the proposed curvilinear relationships.

RESULTS

Chinese parents lacked knowledge about risks of TB and how to prevent TB. TB knowledge and self-efficacy in TB management motivated Chinese parents to seek timely TB treatment and adhere to doctors' regimens, but too much knowledge and self-efficacy predicted both intentions negatively.

CONCLUSION

Excessive levels of self-efficacy in self-management and health knowledge could backfire.

PRACTICE IMPLICATION

Practitioners should elevate Chinese parents' perceptions of severity of TB and susceptibility to TB. Additionally, health education should not be limited to providing medical facts but offer guidance on how to access professional medical resources. Self-efficacy in self-management should not be elevated.

What Impacts Socially Responsible Consumption?

This study examines factors related to socially responsible consumption based on a sample of 636 Spanish consumers. The results indicate that socio-demographic factors such as sex, age, education level, and economic activity affect responsible consumption. In addition, it was found that in order to assess the antecedents of socially responsible consumption it is necessary to specify the type of consumer behavior (for example, purchasing specific products or initiatives against the purchase of certain products). It is found that perceived efficacy, affective commitment, and materialism explain different levels of variance in socially responsible consumption. Purchasing cause-related products is most influenced by affective commitment and perceived efficacy. Materialism affects purchasing motivated by firm behavior and the volume of consumption. The study finds that the referents to the responsibility that consumers adopt can be explained independently. In conclusion, with the aim of supporting a more sustainable society, the need for studies on anti-consumption behaviors as an instrument for sustainability is stressed.

Vain or able? Strong inference and the efficacy debate

Purpose

This study aims to address the efficacy debate by exploring the nature of how prior team level performance affects future performance. That is, the purpose of this study is to understand whether or not the boost of efficacy associated with success leads to overconfidence that harms performance or to motivation that enhances performance.

Design/methodology/approach

This study used a quantitative approach to test competing hypotheses derived from both social cognitive theory and control theory. Specifically, the study made use of archival National Football League data, containing 5,120 longitudinal team level observations. This paper uses multi-level modeling to analyze how prior team level performance affected future performance episodes.

Findings

The findings of this study suggest that prior success leads to overconfidence which ultimately harms future team performance. Therefore, the findings support control theory in favor of the social cognitive theory. However, this study finds that the detrimental effects of overconfidence could be offset by monitoring and work breaks.

Research limitations/implications

Due to the nature of the archival data source, it was not possible to directly measure efficacy. Thus, efficacy is inferred based on past performance outcomes.

Practical implications

This study suggests that it is important for managers and team leaders to pay careful attention to their team after successful performances. Specifically, team leaders may want to monitor their members or give them a break after successful performance episodes to avoid the negative effects of overconfidence.

Originality/value

This paper provides a direct test of the efficacy debate at the team level.

What affected Chinese parents' decisions about tuberculosis (TB) treatment: Implications based on a cross-sectional survey

OBJECTIVE

Although progress has been made in tuberculosis (TB) treatment, China still remains one of the high-burden TB countries. One important reason that has not received sufficient scholarly attention is that Chinese individuals tend to underestimate the threat of TB. This contributed to the high rate of delay in seeking TB treatment and noncompliance with doctors' regimen. Hence, this research examined how TB knowledge affected Chinese parents' risk perceptions and their efficacy appraisal in TB treatment, and how their risk perception and efficacy appraisal affected their intentions to seek timely TB treatment for their children and adhere to doctors' regimen.

METHODS

We conducted an online cross-sectional survey with 1129 parents of children attending kindergarten, primary school, and middle school in Shajing, a region with high TB incidence in China. Perceived severity of TB threat to self and to others, perceived susceptibility, response efficacy, and self-efficacy were measured, in addition to TB knowledge and intentions to seek timely TB treatment and adhere to doctors' regimens.

RESULTS

Ordinal least squares regression demonstrated that TB knowledge was positively associated with perceived severity of TB threat to self, perceived severity of TB threat to others, perceived susceptibility, response efficacy, and self-efficacy, but it did not affect their medical decisions. In addition, binary logistic regression revealed that response efficacy and self-efficacy predicted both intentions positively, and perceived severity of TB threat to self only enhanced Chinese individuals' intention to follow doctors' regimens.

CONCLUSION

Health education aimed at knowledge improvement may be effective in changing one's perceptions of the given health threat but may not be effective to change their behavior. Thus, practitioners need to focus on changing Chinese parents' perceptions of TB rather than simply improving their knowledge. Specifically, it is necessary to lower their efficacy in self-management and enhance their perceived infectiousness of TB.

Disentangling Trait-Like Between-Individual vs. State-Like Within-Individual Effects in Studying the Mechanisms of Change in CBT

Hofmann et al. argued that "[w]hile the clinical field has produced a dizzying number of treatment models and treatment protocols for virtually every psychiatric and psychological problem imaginable, increases in understanding of the processes of change in psychotherapy has been slow to arrive." We propose that one of the reasons for the slow progress is that prior psychotherapy research conflates trait-like and state-like components of mechanisms of change. Trait-like components can serve as prescriptive or prognostic variables, whereas state-like components reflect within-client processes of change, and may highlight active ingredients of successful treatment. Distinguishing between the two is essential for clarifying the underlying processes of change in psychotherapy, and ultimately identifying empirically-derived individualized treatment targets. We review studies that implement methodological and statistical approaches for disentangling the two. These studies clarified particular mechanisms of change that may operate in a given treatment, highlighted differences in the processes of change between different treatments, and explored the within-individual interplay between different mechanisms of change during treatment. Examples include studies investigating the therapeutic role of behavioral, cognitive, and interpersonal skills, as well as emotional processing. We conclude with suggestions for future research, including attention to diversity, improved measurement to facilitate a reliable and valid estimation of trait-like and state-like components, the use of appropriate statistical approaches to adequately disentangle the two components, integration of theory-driven and data-driven methods of analysis, and the need to experimentally manipulate the state-like changes in a given mechanism of change to strengthen causal inferences.

Core Self-Evaluations, Self-Leadership, and the Self-Serving Bias in Managerial Decision Making: A Laboratory Experiment

The self-leadership construct has received great attention from scholars over the last 40 years due to its capacity to influence personal effectiveness. However, despite strongly influencing individuals’ self-efficacy, performed studies did not determine whether self-leadership is connected, and how, with the Core-Self Evaluation (CSE) trait—a complex personality disposition based on self-efficacy, self-esteem, locus of control, and emotional stability—that has been found impacting decision-making processes within organizations. Moreover, it has not been identified whether individuals with a high level of self-leadership are more prone to be victims of some cognitive biases in decision-making processes, such as the internal attribution of successes and external attribution of failures (i.e., Self-Serving Bias, SSB) that are usually led by the strong belief of individuals in their own capacities. The outlined gaps can be substantiated by the following two research questions: “How is self-leadership related with CSE?” and “How does self-leadership influence the attribution of successes/failures?”. To answer these questions, the following were identified and analyzed for 93 executives: (i) the tendency in the attribution of successes and failures, (ii) the CSE, and (iii) their self-leadership level. Results show that: (i) a high level of CSE is connected with high levels of self-leadership; (ii) high levels of self-leadership bring individuals to the internal attribution of successes and external attribution of failures. This work reinforces the stream of (the few) studies that considers a high level of CSE and self-leadership as not always being desirable for managerial decision-making processes and consequent performance. This paper aims to enrich the debate concerning the relations between, on the one hand, self-leadership and, on the other hand, personality traits between self-leadership and decision making.

Why Do We Need Computational Models of Psychological Change and Recovery, and How Should They Be Designed and Tested?

Traditional research methodologies typically assume that humans operate on the basis of an "open loop" stimulus-process-response rather than the "closed loop" control of internal state. They also average behavioral data across repeated measures rather than assess it continuously, and they draw inferences about the working of an individual from statistical group effects. As such, we propose that they are limited in their capacity to accurately identify and test for the mechanisms of change within psychological therapies. As a solution, we explain the advantages of using a closed loop functional architecture, based on an extended homeostatic model of the brain, to construct working computational models of individual clients that can be tested against real-world data. Specifically, we describe tests of a perceptual control theory (PCT) account of psychological change that combines the components of negative feedback control, hierarchies, conflict, reorganization, and awareness into a working model of psychological function, and dysfunction. In brief, psychopathology is proposed to be the loss of control experienced due to chronic, unresolved conflict between important personal goals. The mechanism of change across disorders and different psychological therapies is proposed to be the capacity for the therapist to help the client shift and sustain their awareness on the higher level goals that are driving goal conflict, for sufficiently long enough to permit a trial-and-error learning process, known as reorganization, to "stumble" upon a solution that regains control. We report on data from studies that have modeled these components both separately and in combination, and we describe the parallels with human data, such as the pattern of early gains and sudden gains within psychological therapy. We conclude with a description of our current research program that involves the following stages: (1) construct a model of the conflicting goals that are held by people with specific phobias; (2) optimize a model for each individual using their dynamic movement data from a virtual reality exposure task (VRET); (3) construct and optimize a learning parameter (reorganization) within each model using a subsequent VRET; (3) validate the model of each individual against a third VRET. The application of this methodology to robotics, attachment dynamics in childhood, and neuroimaging is discussed.

Well Done! Effects of Positive Feedback on Perceived Self-Efficacy, Flow and Performance in a Mental Arithmetic Task

Self-efficacy is a well-known psychological resource, being positively associated with increased performance. Furthermore, results from field studies suggest a positive impact of self-efficacy on flow experience, which has not yet been tested experimentally. In this study, we manipulated self-efficacy by means of positive feedback and investigated whether self-efficacy serves as a mediator in the relationship between positive feedback and flow and in the relationship between positive feedback and performance. Our sample consisted of 102 participants (63 female, 39 male). The experimental group received positive feedback after completing 5 min of mental arithmetic tasks on a computer, whereas the control group received no feedback. A second session of a mental arithmetic task was then completed for 5 min. Mediation analyses confirmed that specific self-efficacy mediated a positive effect of positive feedback on flow as well as on both performance measures (quality and quantity) in a subsequent task. However, direct effects of feedback on flow and on performance were not significant, which suggests the presence of other mechanisms that remain to be investigated.

Brain condition may mediate the association between training and work engagement

Over the past two decades, the number of studies on work engagement has increased rapidly. Work engagement refers to a positive, affective-motivational state of high energy combined with high levels of dedication and a strong focus on work, leading to various work-related outcomes, including higher work performance. Several studies have indicated that training or coaching may increase work engagement, but other studies have shown contradicting results. These inconsistencies may be due to the indirectness between training/coaching and work engagement. Therefore, we investigated the relationship between training and brain structure as well as between brain structure and work engagement in cognitively normal participants. Brain structure was assessed using neuroimaging-derived measures, including the gray-matter brain healthcare quotient (GM-BHQ) and the fractional-anisotropy brain healthcare quotient (FA-BHQ), which are approved as the international standard (H.861.1) by ITU-T. Work engagement was assessed using the Utrecht Work Engagement Scale. To validate and enrich the analysis, we employed another two representative questionnaires, which are known to be close to but different from work engagement: The Social interaction Anxiety Scale and the Maslach Burnout Inventory-General Survey to gauge the levels of human relation ineffectiveness and burnout. The latter scale is subdivided into three variables including "Exhaustion," "Cynicism," and "Professional Efficacy." The results of the present study indicate that training is associated with an increase of FA-BHQ scores, and that an increase of the FA-BHQ scores is associated with an increase in Work Engagement and a decrease in Cynicism. On the other hand, the training with coaching was associated with a decrease in Interaction Anxiety. However, no correlation was observed for training with Work Engagement or the subscales of Burnout. Likewise, no correlation was observed for FA-BHQ with Exhaustion, Professional Efficacy, and Interaction Anxiety. The results of the current research provide the possibility to use brain information to evaluate training effectiveness from the viewpoint of neuroscience.

Motor Performance, Mental Workload and Self-Efficacy Dynamics during Learning of Reaching Movements throughout Multiple Practice Sessions

The human capability to learn new motor skills depends on the efficient engagement of cognitive-motor resources, as reflected by mental workload, and psychological mechanisms (e.g., self-efficacy). While numerous investigations have examined the relationship between motor behavior and mental workload or self-efficacy in a performance context, a fairly limited effort focused on the combined examination of these notions during learning. Thus, this study aimed to examine their concomitant dynamics during the learning of a novel reaching skill practiced throughout multiple sessions. Individuals had to learn to control a virtual robotic arm via a human-machine interface by using limited head motion throughout eight practice sessions while motor performance, mental workload, and self-efficacy were assessed. The results revealed that as individuals learned to control the robotic arm, performance improved at the fastest rate, followed by a more gradual reduction of mental workload and finally an increase in self-efficacy. These results suggest that once the performance improved, less cognitive-motor resources were recruited, leading to an attenuated mental workload. Considering that attention is a primary cognitive resource driving mental workload, it is suggested that during early learning, attentional resources are primarily allocated to address task demands and not enough are available to assess self-efficacy. However, as the performance becomes more automatic, a lower level of mental workload is attained driven by decreased recruitment of attentional resources. These available resources allow for a reliable assessment of self-efficacy resulting in a subsequent observable change. These results are also discussed in terms of the application to the training and design of assistive technologies.

Training methods that improve MD-PhD student self-efficacy for clinical research skills

Introduction:

MD-PhD training programs train physician-scientists to pursue careers involving both clinical care and research, but decreasing numbers of physician-scientists stay engaged in clinical research. We sought to identify current clinical research training methods utilized by MD–PhD programs and to assess how effective they are in promoting self-efficacy for clinical research.

Methods:

The US MD–PhD students were surveyed in April–May 2018. Students identified the clinical research training methods they participated in, and self-efficacy in clinical research was determined using a modified 12-item Clinical Research Appraisal Inventory.

Results:

Responses were received from 61 of 108 MD–PhD institutions. Responses were obtained from 647 MD–PhD students in all years of training. The primary methods of clinical research training included no clinical research training, and various combinations of didactics, mentored clinical research, and a clinical research practicum. Students with didactics plus mentored clinical research had similar self-efficacy as those with didactics plus clinical research practicum. Training activities that differentiated students who did and did not have the clinical research practicum experience and were associated with higher self-efficacy included exposure to Institutional Review Boards and participation in human subject recruitment.

Conclusions:

A clinical research practicum was found to be an effective option for MD–PhD students conducting basic science research to gain experience in clinical research skills. Clinical research self-efficacy was correlated with the amount of clinical research training and specific clinical research tasks, which may inform curriculum development for a variety of clinical and translational research training programs, for example, MD–PhD, TL1, and KL2.

Dark sides of self-efficacy and task interdependence: victimization

Purpose

The purpose of this paper is to develop and test theoretical propositions explaining why and under what circumstances highly self-efficacious employees experience victimization at work and how task interdependence leads to the situation that employee victimization emerges.

Design/methodology/approach

To test hypotheses, the authors collected the data from four organizations, which are private company, public enterprise, medical institution and government office in Gyungbuk province, South Korea. The final sample for analyses was 209 employees.

Findings

Contrary to the prediction, high self-efficacy did not show a statistically significant relationship with victimization. However, task interdependence is related to victimization and functions as an important situational contributor to exacerbate highly self-efficacious employees’ victimization.

Research limitations/implications

The findings have research implications by exploring victimization of the employees with high self-efficacy, which is an underdeveloped area in the victimization literature and showing that task interdependence is the critical factor to trigger and aggravate employee victimization. Despite these implications, this study should be evaluated in light of several limitations such as the data from single source for all variables and the use of cross-sectional data.

Practical implications

Managers need to be aware that highly self-efficacious employees can be vulnerable to victimization at work, where there is high task interdependence. The evidence suggests that managers may take safeguards to deter employee victimization, when tasks are closely related among members.

Originality/value

This paper contributes to expand the understanding of employee victimization by examining the roles of self-efficacy and task interdependence to crystalize antecedents and boundary conditions of victimization at workplace.

Beyond Separate Emergence: A Systems View of Team Learning Climate

In this paper, we consider how the four key team emergent states for team learning identified by Bell et al. (2012), namely psychological safety, goal orientation, cohesion, and efficacy, operate as a system that produces the team's learning climate (TLC). Using the language of systems dynamics, we conceptualize TLC as a stock that rises and falls as a joint function of the psychological safety, goal orientation, cohesion, and efficacy that exists in the team. The systems approach highlights aspects of TLC management that are traditionally overlooked, such as the simultaneous influence of and feedback between the four team emergent states and the inertia that TLC can have as a result. The management of TLC becomes an issue of controlling the system rather than each state as an independent force, especially because changing one part of the system will also affect other parts in sometimes unintended and undesirable ways. Thus the value is to offer a systems view on the leadership function of team monitoring with regards to team emergent states, which we term team state monitoring. This view offers promising avenues for future research as well as practical wisdom. It can help leaders remember that TLC represents an equilibrium that needs balance, in addition to pointing to the various ways in which they can influence such equilibrium.

Mutual Support, Role Breadth Self-Efficacy, and Sustainable Job Performance of Workers in Young Firms

Coworking space has flourished in the past decade. Unlike traditional shared services organizations, coworking spaces put a much greater emphasis on ‘sharing’. Members not only can share the physical office space, but also the virtual social spaces created by the coworking space operators managing the office. As coworking spaces provide a community to foster the culture of sharing, which gives rise to social interactions and thus knowledge and idea exchange, entrepreneurs favor such coworking spaces to achieve a higher level of job performance among their workers. Although it is generally accepted that a worker’s job performance varies over time within a job, there have been limited studies on within-person performance sustainability and its comparison with between-person sustainability. We sampled 101 workers of young firms operating in six coworking spaces in Singapore who completed daily surveys twice a day across ten consecutive workdays. By treating participants as the first level and daily observations as the second level, our study develops a dual-path model to explain how daily mutual support influences daily job performance. Our results indicated that daily mutual support is positively related to sustainable job performance after controlling for sleep quality, job requirements and workload stress. Within-person sustainability in mutual support was found to account for part of within-person variance in job performance. We established that mutual support not only predicts job performance, but also varies across workdays. As the collaboration of team members depends on cooperation rather than competition, mutual support is considered essential for team work and thus employees’ job performance. Our study also demonstrated the importance of role breadth self-efficacy as a moderator in the link between mutual support and sustainable job performance. Role breadth self-efficacy refers to the extent to which people feel confident that they are able to carry out a broader and more proactive role, beyond traditional prescribed technical requirements. The results revealed an enhancing moderation effect, where increasing the role breath self-efficacy would enhance the effect of the mutual support predictor on sustainable job performance of workers in young firms operating in the coworking space.

From Data to Causes II: Comparing Approaches to Panel Data Analysis

This article compares a general cross-lagged model (GCLM) to other panel data methods based on their coherence with a causal logic and pragmatic concerns regarding modeled dynamics and hypothesis testing. We examine three “static” models that do not incorporate temporal dynamics: random- and fixed-effects models that estimate contemporaneous relationships; and latent curve models. We then describe “dynamic” models that incorporate temporal dynamics in the form of lagged effects: cross-lagged models estimated in a structural equation model (SEM) or multilevel model (MLM) framework; Arellano-Bond dynamic panel data methods; and autoregressive latent trajectory models. We describe the implications of overlooking temporal dynamics in static models and show how even popular cross-lagged models fail to control for stable factors over time. We also show that Arellano-Bond and autoregressive latent trajectory models have various shortcomings. By contrasting these approaches, we clarify the benefits and drawbacks of common methods for modeling panel data, including the GCLM approach we propose. We conclude with a discussion of issues regarding causal inference, including difficulties in separating different types of time-invariant and time-varying effects over time.

SELECTING CORPORATE FIRMS FOR COLLABORATIVE INNOVATION: ENTREPRENEURIAL DECISION MAKING IN ASYMMETRIC PARTNERSHIPS

Large companies increasingly look for collaborations with new ventures to accelerate their innovation process, and researchers stress the potential of such partnerships to develop innovations. But when are entrepreneurs willing to engage in a partnership with a larger player? We seek to understand when founders of new ventures are willing to engage in such asymmetric partnerships through consideration of the characteristics of the entrepreneurial decision maker and the perceived attributes of the larger counterpart. The results of a conjoint experiment with 115 startup entrepreneurs suggest that among the partner selection criteria a high level of openness on the part of the large corporate company and concise contractual design signal trustworthiness to entrepreneurs, which has a positive impact on their willingness to engage in collaborative innovation. Our study also suggests that entrepreneurs’ self-efficacy reduces the willingness to partner and the positive impact of concise contractual designs. The results have implications for the self-concept and design of innovation and partner management of large firms, and for entrepreneurs who consider asymmetric partnerships a growth opportunity.