Self-Efficacy Theory vs. Roy's Adaptation Model in Breast Cancer Care
This paper evaluates two nursing theories — Albert Bandura's self-efficacy theory and Sister Callista Roy's adaptation model — in the context of breast cancer care. After describing breast cancer as a chronic, life-threatening condition with significant psychological and economic burden, the paper summarizes each theory and applies a structured framework of internal and external criticism to assess clarity, logical development, adequacy, consistency, complexity, discrimination, reality convergence, utility, significance, and scope. The analysis concludes that the self-efficacy theory is the more appropriate framework for breast cancer management, given its emphasis on building patient confidence, facilitating behavioural change, and improving coping outcomes in women living with the disease.
- Introduction: Overview of two theories and paper structure
- Description of the Practice Problem: Breast cancer epidemiology, burden, and prevalence
- Summary of the Two Theories: Bandura's self-efficacy and Roy's adaptation model explained
- Theory Evaluation: Internal and external criticism applied to both theories
- Selection of the Appropriate Theory: Self-efficacy theory chosen for breast cancer practice
- Conclusion: Self-efficacy recommended with refined research question
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What makes this paper effective
- Uses a clearly defined two-part evaluative framework (internal and external criticism) to assess both theories systematically, giving the comparison a rigorous, parallel structure.
- Grounds the theoretical discussion in a specific clinical context — breast cancer — making abstract concepts concrete and clinically relevant throughout.
- Supports every evaluative claim with multiple citations, demonstrating strong use of the nursing literature to justify the final theory selection.
- Closes with a refined practice research question that demonstrates how theory evaluation translates directly into evidence-based inquiry.
Key academic technique demonstrated
The paper demonstrates structured comparative theory evaluation using established nursing science criteria. Rather than simply summarizing two theories, the author applies the same ten-point evaluative rubric to both, enabling a fair, side-by-side assessment. This technique — common in graduate nursing coursework — shows how theoretical frameworks should be interrogated before they are applied to a clinical population.
Structure breakdown
The paper follows a logical five-part progression: (1) a brief introduction naming the two theories and the clinical context; (2) a description of the practice problem (breast cancer epidemiology and burden); (3) summaries of both theories; (4) parallel evaluations of each theory using internal and external criticism criteria; and (5) a justified selection of the self-efficacy theory, supported by clinical evidence, ending with a refined practice research question.
Introduction
Middle range and interdisciplinary theories can significantly inform clinical practice. This is particularly true of Albert Bandura's self-efficacy theory and Sister Callista Roy's adaptation model. This paper evaluates the applicability of both models in breast cancer care. First, a description of breast cancer is provided. Next, the two theories are summarized. Attention is then paid to a critical evaluation of the two theories. Finally, the most appropriate theory for breast cancer care is identified.
Description of the Practice Problem
Breast cancer is the most common type of cancer and the leading cause of cancer death in women across the globe (Jemal, 2011). Statistics indicate that breast cancer accounts for approximately a quarter of all cancers in women, with the majority of victims falling in the 40–49 years age group (Mousavi et al., 2007). Lifestyle factors such as smoking, physical inactivity, and unhealthy eating have been identified as major causes of breast cancer (Jemal, 2011). Compared to most other types of cancer, breast cancer has one of the highest survival rates (Valdivieso et al., 2012). Even so, the condition has increasingly become chronic, with numerous persistent medical and non-medical complications occurring alongside it (Loh & Quek, 2011). Breast cancer can increase the risk of other morbidities, reduce quality of life, and impose a significant economic and psychological burden on victims and their families. This reality necessitates more effective interventions.
Summary of the Two Theories
Self-Efficacy Theory
With its roots in social cognitive theory, the theory of self-efficacy asserts that individual behaviour is influenced by what people think, believe, and feel (Bandura, 1977). In other words, psychological processes can lead to behaviour change by altering a person's level of self-efficacy. Self-efficacy — also referred to as personal efficacy — essentially denotes an individual's beliefs about their ability to reach a certain level of performance that influences events in their life (Loh & Quek, 2011). Those beliefs influence one's thoughts, feelings, motivation, and behaviour, consequently affecting one's perception of challenges as well as one's ability to deal with situations and accomplish a given task or goal (Porter et al., 2008).
An individual's beliefs influence their behaviour through cognitive, affective, motivational, and selection processes (Bandura, 1977). From a cognitive perspective, for instance, low self-efficacy can cause an individual to view challenges or tasks as harder than they really are. With respect to motivation, individuals with higher confidence in their abilities tend to perceive difficulties as challenges to be endured and overcome, rather than as threats to be avoided; they are therefore more motivated to accomplish tasks or face challenges. Conversely, individuals with lower confidence in their abilities tend to view difficulties as threats and shy away from them, exhibiting little motivation to face adversity (Bandura, 1977).
Roy's Adaptation Model
Grounded in the assertion that health and illness are inevitable aspects of life, Roy's adaptation model explains how individuals adapt to a changing environment. The model views the individual as a system with interrelated components — physiological, psychological, and social (Roy, 2015). The individual strives to achieve a balance between these components and the external environment. The environment may encompass aspects such as family, social support, and clinical experiences. As the individual constantly interacts with a changing environment, they innately adapt using biological, psychological, and social mechanisms. The individual's level of adaptation has a limit that indicates the extent of stimulation sufficient to trigger a positive response (Peterson & Bredow, 2009).
According to the model, adaptation occurs in four modes: the physiologic mode, the self-concept mode, the role function mode, and the interdependence mode (Naga, Al-atiyyat & Kassab, 2013). Adaptation in the physiologic mode entails maintaining physical wellbeing; nutrition and other basic needs fall within this mode. The nurse therefore seeks to determine the extent to which the individual's survival needs are fulfilled. The self-concept mode relates to psychic wellbeing, encompassing aspects such as self-perceptions and personal values. The role function mode emphasises social wellbeing — becoming accustomed to various role adjustments over the course of one's life results in social adaptation. For instance, retirement from work may lead to changes in lifestyle. The interdependence mode further stresses the need for social adaptation, recognising that individuals depend on others for help, affection, attention, and other purposes. Overall, based on these four modes, the goal of nursing practice is to promote adaptation, health, and quality of life (Peterson & Bredow, 2009). Prior to the commencement of care delivery, the nurse must assess the patient's wellbeing across the four modes, as that assessment informs subsequent care decisions.
Conclusion
Overall, compared to Roy's adaptation model, the self-efficacy theory is a more suitable framework for addressing breast cancer in women. It is imperative for breast cancer patients to have self-confidence — confidence that they can overcome the condition. More fundamentally, care providers ought to assess patient self-efficacy at the outset of the care delivery process, as this assessment is crucial for informed decision-making. To this end, the practice research question is refined as follows: In women with breast cancer, what is the impact of a self-efficacy-based intervention on coping behaviour?
References
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