SELF-EFFICACY THAT AFFECTS THE PERFORMANCE OF NURSES

IN MITRA SEJATI GENERAL HOSPITAL

Elvipson Sinaga1*, Arlina Nurbaity Lubis2, Farida L. S. Siregar3

1*
Student of Master Program in Nursing, Faculty of Nursing, Universitas Sumatera Utara, Prof. Maas
Street Kampus USU, Medan, Indonesia, (061) 8211952
2
Faculty of Ekonomic, Universitas Sumatera Utara, Prof. Maas Street Kampus USU, Medan, Indonesia
3
Faculty of Nursing, Universitas Sumatera Utara, Prof. Maas Street Kampus USU, Medan, Indonesia
Corresponding Email: elvipsonssinaga1975@gmail.com

ABSTRACT
Nurse performance is very important for a hospital. Nurse performance at Medan Mitra Sejati
General Hospital is still low. The low performance of nurses in Medan Mitra Sejati General Hospital
is related to the self-efficacy experienced by nurses. This study aims to analyze the effect of self-
efficacy on the performance of nurses in Mitra Sejati General Hospital, Medan. This type of research
is analytic survey research with cross sectional research design that is to analyze the effect of self-
efficacy on the performance of nurses in Mitra Sejati Hospital Medan. The population in this study
were all nurses who served in Mitra Sejati General Hospital Medan with a total of 168 people and a
sample of 138 people. Data collection with primary and secondary data and analyzed by statistical
tests of Multiple Logistic Regression with a confidence level of 95%. The results showed that the
magnitude/level (p = 0.011), strength (p = 0.001) and generality/generalization (p = 0.017) affected
the performance of nurses at Mitra Sejati General Hospital in Medan and which most influenced the
performance of nurses in hospitals General Mitra Sejati Medan is a strength dimension (OR =
14,457). It is recommended for nursing services the need to provide an understanding to each nurse
about the importance of self-efficacy experienced so that nursing services can be carried out to the
maximum, superiors should provide an assessment of the performance of implementing nurses
continuously and continuously, for the nursing nurses to be able to practice nursing by managing
and coordinating Nursing care by integrating the needs of clients, families, staff and policy makers
and the participation of nurses in hospital committees can also be an effective solution in an
approach to improve self-efficacy, one of which measures the self-efficacy experienced and nurses
can reveal situations that can lead to self-efficacy The low one. .

Keywords: Self-Efficacy, Performance

ABSTRAK

Kinerja perawat merupakan hal yang sangat penting bagi suatu rumah sakit . Kinerja perawat di
Rumah Sakit Umum Mitra Sejati Medan masih rendah. Rendahnya kinerja perawat di Rumah
Sakit Umum Mitra Sejati Medan terkait dengan efikasi diri yang dialami oleh perawat . Penelitian ini
bertujuan untuk mengalisis pengaruh efikasi diri terhadap kinerja perawat di Rumah Sakit Umum
Mitra Sejati Medan.Jenis penelitian yang digunakan adalah penelitian survei analitik dengan desain
penelitian cross sectional yaitu untuk menganalisis pengaruh efikasi diri terhadap kinerja perawat di
RSU Mitra Sejati Medan. Populasi dalam penelitian ini adalah keseluruhan perawat pelaksana
yang bertugas di Rumah Sakit Umum Mitra Sejati Medan dengan jumlah 168 orang dan sampel
berjumlah 138 orang. Pengumpulan data dengan data primer dan sekunder dan dianalisis dengan
uji statistik Regresi Logistik Ganda dengan tingkat kepercayaan 95%. Hasil penelitian menunjukkan
bahwa variabelmagnitude/tingkat (p=0,011), strength/kekuatan (p=0,001) dan
generality/generalisasi (p=0,017) berpengaruh terhadap kinerja perawat di Rumah Sakit Umum
Mitra Sejati Medan dan yang paling mempengaruhi kinerja perawat di Rumah Sakit Umum Mitra
 Sejati Medan adalah variabelstrength/kekuatan (OR=14,457). Disarankan bagi pelayanan
keperawatan perlunya memberikan pemahaman kepada setiap perawat mengenai pentingnya
efikasi diri yang dialami agar pelayanan keperawatan dapat dilakukan dengan maksimal,
hendaknya atasan memberikan penilaian atas kinerja perawat pelaksana secara rutin dengan
frekuensi per triwulan, bagi perawat pelaksana agar dapat melakukan praktik keperawatan dengan
mengelola dan mengkoordinasi asuhan keperawatan dengan mengintegrasikan kebutuhan klien,
keluarga, staf dan pembuat kebijakan dan partisipasi perawat dalam komite rumah sakit juga dapat
menjadi solusi yang efektif dalam pendekatan untuk meningkatkan efikasi diri dengan salah
satunya mengukur efikasi diriperawat.

Kata Kunci:Efikasi Diri, Kinerja

BACKGROUND from all actions, then the performance is the

Nurse performance is one of the most achievement obtained by someone in his work
important elements to determine the quality of in accordance with applicable standards, so
service in a hospital, because nurse that performance does not only include the
performance is an embodiment of the character seen in a person, but the work that
behavior performed by nurses or that is has been done or will be done.
shown in performing nursing care or as a Sunyoto (2012) states that
result of work in accordance with the duties performance is an achievement achieved
and roles of nurses in a hospital within a when doing work that is given to individuals.
certain time. Nurse performance is a Rosidah (2014) a person's capability can be
determinant of the success of the quality of formed on a number of skills that exist in
nursing services in a hospital. In hospital employees. Competence or capability is the
organizations, nurses are one of the main ability of employees to perform all the tasks
components in building or improving hospital they carry. This capability contains various
progress. This situation should be encouraged aspects, namely abilities and intelligence,
by the good work of nurses, if there is no good which include: education, training and abilities
nurse performance, then a hospital cannot that are demanded based on work plans.
achieve its goals (Mangkunegara, 2013). Capability refers to a composition of a
The decreasing quality of nurse person's ability to carry out various jobs.
performance will affect the quality of nursing Gibson (2006) capability is a trait possessed
services. Research conducted by the or studied by individuals capable of
Directorate of Nursing and Medical performing tasks psychologically or physically
Engineering of the Republic of Indonesia Performance performed by nurses
Ministry of Health, 2000 in 4 (four) provinces arises from an efficient or psychological
in Indonesia, namely Jakarta, North Sumatra, response to the work done by nurses.
North Sulawesi and East Kalimantan, found Therefore performance has a major role to
that nurses who did not have clear job improve the quality of nursing services. This is
descriptions in writing were 47.4%, nurses in line with Dahlan's research (2010). There is
have never attended training for the past 3 a correlation between the quality and results
years at 70.9%, nurses still carry out non- of nursing services with the satisfaction of
nursing activities at 39.8% and have no patients who use health services. The better
progress in monitoring and evaluating the the quality of nursing services, the patient
nurse's performance system (Basri, 2007). satisfaction in using health services in
Performance is the effect of the hospitals will also be higher.
interaction between motivation and ability To achieve maximum nurse
(Munandar, 2012).Sudarmanto (2013) performance results, the hospital needs to
performance is the achievement obtained refresh the nurses through training, through
this training nurses can increase the arise can be even greater, explaining if self-
knowledge or ability of nurses so that the efficacy can cause a person to have a bad
quality of service will also increase (Widiastuti, judgment and a bad arrangement of oneself.
2013). To advance the optimal quality of As a result if someone has self-efficacy, as
hospital services, hospitals must instill mentioned Sulistiyani (2011) then someone
responsibilities that must be carried out by will be more optimistic.
nurses in order to achieve good performance According to Mohamadirizi's research
(Nursalam, 2015). This situation needs to (2015) about the relationship between clinical
motivate nurses and build awareness of competence and clinical self-efficacy between
nurses to better understand the importance of nursing and midwifery students at Isfahan
improving skills and continuing education, so University of Medical Sciences, Iran obtained
nurses can provide nursing services to that 50% (n = 75) and 37.4% (n= 56) of
patients with good quality. In addition to nursing students and obstetrics have good
improving the performance of nurses, hospital clinical competence and clinical self-efficacy
institutions need to provide all the appropriate respectively and based on Pearson's
equipment, provide rewards or rewards from correlation coefficient shows there is a
nurses' skills, work conditions, conducive correlation between clinical competence and
workplace conditions and physical work self-efficacy (P <0.05, r = 0.73) of senior
(Sulistiyani, 2011). nursing and midwifery students.
Dambisya (2007) states that if Cherian's (2013) research on the
someone who works in the health world in effect of self-efficacy on employee motivation
carrying out all their duties internally (in) is and performance shows that self-efficacy
influenced by self-confidence. Confidence is a (belief in one's capability in doing work) has
person's confidence in predicting the an impact on individuals determining their
capability of himself to do a job or that is work related to performance and motivation.
needed in achieving certain targets. In contrast to Indrawati's research (2014), the
Stages of self-efficacy reflect how results show that self-esteem, self-confidence
high a person's confidence in themselves that have an impact on job satisfaction, job
the individual is able to do the job well. If a satisfaction has an effect on nurses'
person assumes that he has no chance of performance, while self-efficacy and self-
success, he does not have great enthusiasm esteem have no impact on nurse
in completing work (Luoma, 2004) performance.
Handoko (2013) explains that often Then a study by Ajala (2013) on Self-
the strong ability to become lost arises due to Efficacy, Performance, Training and Well-
not having self-efficacy. Someone who has Being of Industrial Workers in Lagos, Nigeria
the same ability but a decision that can not be using t-test statistics found that workers who
defeated and has self-efficacy can be more have good self-confidence produce good
successful than someone who has strong performance and workers who have poor self-
capabilities but does not have self-efficacy. If confidence, less able to attend training when
someone knows their shortcomings, but does compared to workers who have good self-
not pay attention or ignore it means that the confidence. Significant differences can be
person feels there is something useful about further confirmed where workers with high
him. self-efficacy (X = 22.96) show good
Santrock (2013) explains the lack of performance compared to workers with poor
self-efficacy can cause sentimental uneasy self-confidence (X = 20.96).
feelings that are not continuous, but can Based on a preliminary survey
create many problems. When the level of self- conducted by researchers at the Medan Mitra
efficacy is not correlated with nursing services Sejati General Hospital it was found that
such as poor performance, problems that through the patient satisfaction questionnaire
collected from inpatients in January 2019 it carry out nursing actions in patients. Then
was found that patients were 63% satisfied based on interviews with 7 (seven) new
and 37% dissatisfied. Patient dissatisfaction is nurses who work at Mitra Sejati Hospital there
caused by nurses being slow and less are 3 (three) nurses lacking confidence in
responsive in serving patients and carrying performing nursing actions, for example,
out nursing actions, for example in the doubting the installation of an infusion is not
installation of infusion is still repeated immediately successful, not comfortable with
because nurses are not calm. the patient repeatedly doing so succeeded
In addition, based on the results of and 2 (two) nurses said they were afraid if the
direct observation to nurses in providing nursing action carried out later would have a
nursing actions, there are still nurses who are bad effect on the patient and 2 (two) nurses
not calm enough to perform nursing actions were sure and there were no doubts in
and such as hesitant to perform nursing carrying out the nursing action. Then based
service actions that are indicated by nurses on direct interviews with 5 (five) patients it
such as nurses putting up an IV must be was found that 3 patients said nurses were
repeated. still showing doubts in performing nursing
The results of interviews with the actions such as infusion must be repeated,
head of nursing at Mitra Sejati Medan General and 2 patients said nurses calmly and
Hospital obtained that the evaluation of the confidently every nursing action.
work of implementing nurses at Mitra Sejati Through the above phenomenon, so
Medan General Hospital conducted by the the researcher wants to carry out research
head of the room through the performance with the title "Effect of self-efficacy on the
evaluation form of implementing nurses to 5 performance of nurses in Mitra Sejati Hospital
nurses showed good performance with 3 Medan.
nurses and poor performance 2 nurse.
  Then the phenomenon that occurs in METHODS
implementing nurses at Mitra Sejati Medan The type of this research is
General Hospital is that it is considered quantitative research with analytic survey
unable to address all patient needs, nurses research design with cross sectional research
carry out more nursing actions according to design. The population in this study were all
doctor's instructions, lack discipline in work as nurses who served in Mitra Sejati Medan
evidenced by late coming to work and even General Hospital, totaling 168 nurses. The
absent from work when working hours, sample was 138 nurses selected by
besides that there are still many nurses who consecutive sampling. Data were collected
are not so dexterous in carrying out nursing using a questionnaire consisting of four parts:
actions. magnitude, strength, generalityand
Some other phenomena found in performance. The analysis used in this study
Mitra Sejati General Hospital Medan that is the Multiple Logistic Regression Test.
nurses who have poor performance
evaluation are especially nurses who have RESULTS
just worked or nurses who have just Characteristics of nurses
graduated and directly work at Mitra Sejati The results of this study showed that a
General Hospital without experience from majority of respondents were aged 26-30
other hospitals, lacking confidence where the (n=60, 43.5%), females (n=111, 80.4%), and
nurses are less brave to perform nursing hold Diploma III of nursing education (n=92,
actions independently, nurses more silent and 66.7%) and had worked as nurses for > 5
only see artists to perform nursing actions. years (n=72, 52.2%). The characteristics of
The above situation proves that respondents in details are presented in Table
nurses estimate less trust in her ability to 1.
 Table 1. Characteristics of staff nurses(n =
138) Performance Pvalue
No Variabel Good Poor
Characteristics Frequency Precentage f % f %
Age Magnitude
≤ 25years 3 2.4 1 High 61 85.9 10 14.1 0.0001
26-30 years 39 31.0 2 Low 4 6.0 63 94.0
31-35 years 56 44.4 Strength
> 35years 27 21.4 1 High 58 87.9 8 12.1 0.0001
Gender 2 Low 7 9.7 63 94.0
Male 27 19.6 Generality
Female 111 80.4 1 High 57 85.1 10 14.9 0.0001
Education 2 Low 8 63 88.7
Diploma III of 92 66,7
Nursing 46 80.4 Tabel 3 shows that chi square test results
Ners obtained variable magnitude p-value = 0.0001
Work experience <0.05 means that there is a relationship of
≤ 1 years 32 23.2 magnitude with the performance of nurses at
2-5 years 34 24.6 Mitra Sejati General Hospital Medan, strength
>5 years 72 52.2 variable with a value of p-value = 0.0001
<0.05 means that there is a relationship of
Table 2.Frequency distribution by research strength with nurse performance at Mitra
variable category (n=138) Sejati Medan General Hospital and generality
Category Frequency Percentage variable with a value of p-value = 0.0001
Magnitude/level <0.05 meaning there is a relationship of
High 71 51.4 generality with the performance of nurses at
Low 67 48.6 Mitra Sejati Medan General Hospital.
Strength
High 66 47.8 Table 4. Effect of Self-Efficacy on Nurse
Low 72 52.2 Performance at Mitra Sejati Hospital
Generality in Medan
High 67 48.6
Low 71 51.4 Variabel B value P value Exp (B)
Performance Magnitude 2.252 0.005 9.502
Good 65 47.1 Strength 2.612 0.000 13.627
Generality 1.831 0.014 6.237
Poor 73 52.9
Constant -9.702 0.000 0.000
Table 2 shows that the magnitude/level
Table 4 shows that the results of the
of nurses at Mitra Sejati Medan General
Multiple Logistic Regression test analysis
Hospital is mostly 71 people (51.4%) high,
show that the independent variable is the
nurses strength with a low category of 72
magnitude variable with a p-value = of 0.005
people (52.2%), generality nurseswas mostly
(p <0.05), strength with a p-value = of 0,000
low with 71 people (51.4%) and the
(p <0.05) and generality with a p-value = of
performance of nurses was mostly not good
0.014 (p <0.05), then the variable magnitude,
as many as 73 people (52.9%).
strength and generality affect the performance
of nurses at Mitra Sejati General Hospital,
Table 3. The Relationship of Self-Efficacy
Medan.
Magnitude with Nurse Performance
at Mitra Sejati Hospital in Medan
 The results of the Multiple Logistic The nurse will choose the easiest level,
Regression test analysis showed that the because it is to measure her ability to
most dominant variable affecting the complete the task. Another important point is
performance of nurses at Mitra Sejati Medan a positive view of the work being done.
General Hospital was the strength variable, Through positive thinking will have a positive
which was the regression coefficient of OR impact on the realization of a task, in addition
13,627 (95% CI = 3,529-52,615) and the to the effectiveness and efficiency of the
strength variable was positive indicating that completion of the task.
This variable has a direct (positive) influence In this study nurses who have a high
on nurse performance at Mitra Sejati General magnitude/level at Mitra Sejati Medan
Hospital, Medan. So it can be interpreted General Hospital in conducting nursing care
theoretically that the strengthincreases can overcome the obstacles faced by nurses.
considerably if the nurse's performance is This can be proven by nurses who are very
further enhanced. confident in being able to handle tasks in
Then based on the model summary accordance with the competency level with a
table, the nagelkerke coefficient R Square = percentage of 23.9%, can remain calm when
0.802, meaning that the magnitude, strength facing difficulties in work because they can
and generality variables used in the study rely on their abilities of 45.7%. The ability of
were able to explain the diversity of data on nurses like this needs to be trained because
the nurse performance variable at Mitra Sejati in providing nursing actions will be very
General Hospital in Medan by 80.2%, while closely related to various problems or
the remaining 19,8% is explained by other obstacles in its resolution.
variables outside the research model In this study, although nurses at the
Mitra Sejati General Hospital in Medan with a
DISCUSSION low magnitude, but good performance nurses
The results showed that nurses with a reached 6.0%. This means that not all nurses
low magnitude / level of category there was a with low magnitude will automatically not
poor performance of nurses at Mitra Sejati perform well. This situation could have
General Hospital, Medan, at 94.0%. Then happened because nurses try hard must be
based on the multiple logistic regression test, able to complete their duties well even though
it was found that there was a significant the strength of confidence in their abilities is
influence between the magnitude / level of the lacking, but with a hard effort by nurses to
performance of nurses at Mitra Sejati Medan cover the weak magnitude/level, nurses can
General Hospital with a value of p-value = carry out the level of difficulty of the task.
0.005 <α = 0.05. This is in accordance with Ismail's
This is according to Badura (2008) (2016) research on the role of self efficacy in
that the important level or magnitude aspect is improving cooperative performance in
the effort to try to behave that is capable or Indonesia, it was found that self efficacy,
can be done. In this context, nurses will not namely magnitude, has a positive and
carry out tasks beyond their means. Nurses significant effect on performance.
will choose to do tasks according to what can The results obtained that nurses who
be done and completed and avoid behavior have low strength category there is a poor
that is difficult or difficult to complete. performance of nurses at Mitra Sejati General
The high magnitude/level of nurses at Hospital, Medan at 90.3%. Then based on the
Mitra Sejati Medan General Hospital is useful Multiple Logistic Regression test it was found
to overcome obstacles in the level of difficulty that there was a significant effect between
of the task at hand. For nurses who have strengthon the performance of nurses at Mitra
never done a task before, it will start the task Sejati Medan General Hospital with a value of
with the easiest level to the most difficult level. p-value = 0,000 <α = 0.05.
 Strengths referred to in this study are The results obtained that nurses who
the abilities possessed in dealing with various have a low generality/generalization there is a
tasks, feel able to do all the tasks when poor performance of nurses in Mitra Sejati
performing nursing actions, have confidence General Hospital Medan at 88.7%. Then
that the amount of effort undertaken can based on the Multiple Logistic Regression
achieve goals, have a test, it was found that there was a significant
persistence/perseverance in fulfilling or effect between generality/ generalization on
completing tasks, able to handle unexpected the performance of nurses at Mitra Sejati
nursing problems well, never give up on a General Hospital, Medan, with a value of p-
problem of nursing actions before trying hard value = 0.014 <α = 0.05.
to solve the problem. Generality/generalization referred to
In addition Strength has the in this study is the belief in the ability to carry
confidence in the ability to carry out nursing out various or all tasks of nursing actions, the
actions, has a strong stability in the ability to ability to perform different nursing actions,
do the task, feels ready for most of the responding properly to all nursing actions to
demands in the job, has a strong self- be performed, displaying attitudes that show
confidence in the potential for completing the self-confidence in every nursing action, put
task, has a fighting spirit that is not easily give confidence in fulfilling all guidelines as an
up when experiencing obstacles in completing executive nurse, have perseverance in
a task. In this case the strength of nurses at achieving goals, take responsibility when
Mitra Sejati Medan General Hospital performing nursing actions and display
prioritizes the level of strength of belief or attitudes that show confidence in the entire
hope nurses will survive in their efforts despite work process as professional care.
many difficulties and obstacles. This is according to Badura (2008)
This is according to Badura (2008) aspects of generality or breadth, an individual
aspects of strength consists of three elements is able to respond to various situations and
namely, (1) have a strong self-confidence in conditions through a positive attitude.
completing the task. Employees who have Individuals strived to be unhurried or
high self-confidence will certainly have high emotional in determining attitudes. No doubt,
trust and efficacy. (2) Having a fighting spirit certain situations and conditions can easily
and not giving up easily when experiencing burn an emotional individual. Individuals
obstacles or failures in tasks. should be able to respond to any situation and
In this study it was found that condition either that leads to constructive
although the nurses were implementing at wisely. Correspondingly, there is a suggestion
Mitra Sejati Medan General Hospital with low that the best teacher is experience. It is
strength but there was still a good nurse important to position life experiences as a
performance even though it only reached learning step or stepping stone to achieving
9.7%. This can happen because some the desired success as a wise step.
implementing nurses try to have a strong In the aspect of generality there are
belief, they will survive with their efforts even three important elements namely (1)
though there are many difficulties and employees are expected to be able to
obstacles. respond to various situations and conditions
This is consistent with Ismail's (2016) with a positive attitude. In contrast to the
research on the role of self-efficacy in positive attitude on the magnitude element
improving the performance of Indonesian which is more likely to respond positively to
cooperatives. It is found that self-efficacy certain situations in the task, while for this
namely strength has a positive and significant element, it is more to respond positively to
effect on performance. diverse situations and conditions. It is
expected that the better attitude of employees
in addressing the situation will have a positive affected the performance of nurses in Mitra
impact on the work results of these Sejati General Hospital Medan by 80.2%.
employees in various situations. There is no
reason not to be able to complete the task REFERENCES
because of a situation that is less supportive Ajala, E. M. (2013). Self-Efficacy,
or otherwise.(2) Using life experiences as a Performance, Training and Well-
step in achieving success.This element has Being of Industrial Workers in
something to do with employee recruitment Lagos, Nigeria. International Journal
patterns, namely companies are more likely to of Psychological Studies, 5 (2), 66-
take employees who have experience in the 73.
same field. When employees have experience
in a field, then in any case it will be easier for Bandura, A. (2008). Perceived Self-Efficacy in
employees to complete tasks. Included also Cognitive Theory. American
will have implications for employee confidence Psychologist, (44), 1175-1184
in completing work tasks. (3) employees are
able to behave that shows self-confidence Basri, H. (2007). Development of Nurses'
which is the result of the learning process of Performance Management and
the past. This shows that there is a better Midwives Evaluation Training in
behavior improvement process in completing Kulon Progo. Taken on May 9, 2017
the task, because experience can be used as from http://www.kinerjaklinik-
the best lesson for success in carrying out the perawatbidan.or.id/home/index.php
task.
In this study it was found that Cherian, J., & Jacob, J. (2013). Impact of Self
although the nurses in the Mitra Sejati Efficacy on Motivation and
General Hospital in Medan had a low Performance of Employees,
generality/self-efficacy, there was still a good International Journal of Business
nurse performance even though it only and Management, 8 (14), 80-88.
reached 11.3%. This can happen because
some implementing nurses try to respond to Dahlan, A. (2010). The Relationship between
various situations and conditions with a Service Quality and Non Askes
positive attitude. Patient Satisfaction Level in
This is in accordance with Ismail's Outpatient Installation of Achmad
(2016) research on the role of self-efficacy in Mochtar Bukittingi Hospital.
improving the performance of Indonesian Yogyakarta: Gajah Mada University.
cooperatives obtained that self-efficacy Thesis. UGM Post-graduate
namely generality/generalization has a Program.
positive and significant effect on performance.
Dambisya, Y. M. (2007). A review of non-
financial incentives for health worker
retention in east and southern
Africa. Equinet Discussion Paper
CONCLUSION Number 44 With Esc A-Hc.
Self-efficacy namely the variable magnitude Produced with support from the
/level, strengthand generality effect on the University of Namibia, Training and
performance of nurses in Mitra Sejati Medan Research Support Center (TARSC)
General Hospital, the most dominant variable and SIDA (Sweden).
affecting the performance of nurses in Mitra
Sejati Medan General Hospital is the variable Gibson. (2006). Organization (Translation).
strengthand self-efficacy used in this study Jakarta: Erlangga.
Handoko, T. H. (2013). Personnel Santrock, J. W. (2013). Life-Span
Management and Human Development: Life-Time
Resources. Yogyakarta: BPFE. Development. (Volume 2) (Issue
13). Jakarta: Erlangga.
Indrawati, Y. (2014). Effect of Self Esteem,
Self Efficacy and Job Satisfaction on Sudarmanto. (2013). HR Competency
Employee Performance (Case Performance and Development.
Study of Nurses at Siloam Hospital Yogyakarta: Student Library.
Manado). Journal of Business and
Management Research. (2), 12-14. Sulistiyani, A.T, (2011). Understanding Good
Governance. In the Perspective of
Ismail, I. (2016). The Role of Self Efficacy in Human Resources. Yogyakarta:
Improving the Performance of Gava Media.
Indonesian Cooperatives.
Indonesian Business Management Sunyoto, A. (2012). Human Resource
Journal. (4), 35-50. Management. Jakarta: IPWI.

Luoma, S. (2004). Assessing Speking. Widyastuti, U.S. (2013). The Relationship

Cambridge: Cambridge University Between Nurse Service Quality with
Press. 212 pp. ISBN: 0-521-80487-6 Patient Satisfaction Level in
(paperback). Inpatient Room at Wonosegoro I
Boyolali Health Center. Thesis.
Mangkunegara, A. P. (2013). Corporate Surakarta: Muhammadiyah
Human Resource Management. University
Bandung: PT. Teen Rosdakarya. .

Mohamadirizi, S. (2015). The Relationship

between Clinical Competence and
Clinical Self-efficacy among Nursing
and Midwifery Students. Int J
Pediatr, Vol. 3, N.6-2, Serial No. 24

Munandar, M. (2012). Budgeting: Work

Planning, Work Coordination and
Work Supervision. Second edition.
Yogyakarta. Bpfe.

Nursalam. (2015). Nursing Management,

Application in Professional Nursing
Practices. Jakarta: Salemba
Medika.

Rosidah. (2014). Effect of Work Competence

and Organizational Commitment on
Employee Performance of PT.
Indachi Prima Purwakarta. Thesis.
Bandung: Indonesian Education
University.