| 1. |
- Duprez, Veerle, et al.
(författare)
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Capturing motivating versus demotivating self-management support : Development and validation of a vignette-based tool grounded in Self-determination Theory
- 2021
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The trend towards more active involvement of patients in the management of their chronic condition requires professionals to interact in a way that facilitates patients' autonomy and motivation. A self-assessment tool that measures simultaneously motivating and demotivating interaction styles in counselling chronic ill patients is currently not available.OBJECTIVES: Grounded in Self-Determination Theory, this study aimed to develop and validate a self-report tool that captures healthcare professionals' motivating (i.e., autonomy-support and structure) and demotivating (i.e., control and chaos) interaction styles while supporting patients towards self-management.METHODS: The Situations In Self-management support - HealthCare Professionals (SIS-HCP) was developed throughout a five-phased psychometric validation study with (1) construct definition, (2) development of the vignette-based questionnaire, (3) ecological validation and piloting, (4) psychometric evaluation (round 1) by multidimensional scaling analysis, and (5) psychometric evaluation (round 2) by internal and construct validity, and reliability testing procedures in 5 independent samples (total N = 1133), between August 2015 and March 2018.RESULTS: Multidimensional scaling analysis provided evidence for a two-dimensional structure, with motivating, relative to demotivating counselling and high, relative to low, directive counselling representing the two axes. Four styles could be distinguished: autonomy-support (rather motivating and non-directive), structure (rather motivating & directive), control (rather demotivating & directive) and chaos (rather demotivating & non-directive) within self-management support. The SIS-HCP demonstrated good construct validity, and high internal consistency and test-retest reliability.CONCLUSION: The SIS-HCP is a vignette-based tool, which allows to explore, in an integrative way, which motivating (i.e., autonomy-support and structure) and demotivating (i.e., control and chaos) styles healthcare professionals use when counselling patients living with a chronic illness. The SIS-HCP might enhance professionals' awareness of their (de)motivating counselling styles and the extent to which they promote ownership among patients. The SIS-HCP represents an interesting addition to existing instruments which measure what professionals do in the field of self-management support, and how confident they feel doing so. The thorough process of development and validation led to a theoretical underpinned tool, with the identified (de)motivating dimensions yielding strong psychometric properties. The SIS-HCP can be used as a reflective tool for professionals and for tailored training.
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| 2. |
- Duprez, Veerle, et al.
(författare)
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Is nurses' self-esteem interwoven with patients' achievements? The concept of patient-invested contingent self-esteem
- 2019
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Ingår i: Journal of Clinical Nursing. - : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 28:21-22, s. 3858-3865
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore the notion of Patient-invested Contingent Self-Esteem (Pa-CSE) and investigate its association to nurses' self-reported engagement in controlling or autonomy-supportive interactions with chronic care patients.BACKGROUND: Considering the high number of patients sub-optimally managing their chronic condition, nurses might experience a drop and rise in self-worth when patients fail and succeed, respectively, in managing their chronic condition. This dynamic has not received prior research attention.DESIGN: Multivariate analysis employing cross-sectional data according to STROBE guidelines.METHODS: Self-reports among nurses employed in chronic care (N=394) from eight randomly selected hospitals in Belgium. Exploratory factor analysis and stepwise linear regression analyses were conducted.RESULTS: Success-based and failure-based orientations could be distinguished and refer to nurses' tendency to associate, respectively, patients' successes with feelings of professional success and self-worth and patients' failures with feelings of professional failure, shame, and inadequacy. Nurses' self-esteem is fairly interwoven with patients' achievements in the management of their chronic condition. A success-based orientation was positively related to autonomy-supportive care in case a failure-based orientation was low. Nurses with a simultaneous success-based and failure-based orientation interacted in a more controlling way.CONCLUSIONS: The findings of this study suggest that basing one's self-worth on patients' accomplishments may be a double-edged sword. Although tying one's personal glory to the successes of one's patient is related to greater patient participation and support of autonomy, these effects only emerge if nurses' self-worth is not interwoven with patients' failures. In fact, having both success- and failure-oriented contingent self-worth is related to a more pressuring approach.RELEVANCE TO CLINICAL PRACTICE: To prevent nurses from developing inferior professional feelings when their patients fail to manage their condition, a reflective stance towards the impact of patients' behaviour on the nurses' professional feeling of (in)adequacy is an important step to deal with such situations.
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| 3. |
- Duprez, Veerle, et al.
(författare)
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Nurses' interaction styles when supporting patients in self-management : A profile approach
- 2020
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 110
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Tidskriftsartikel (refereegranskat)abstract
- Background: The rising attention to participation and self-regulation in chronic care requires nurses to move towards an approach in which patients' perspectives and choices are central, and in which patients' competency is fostered. According to Self-Determination Theory, nurses can differ in the way they interact with patients living with a chronic illness. That is, they can interact in an autonomy-supportive, controlling, structuring or chaotic way. However, in practice, nurses often use these styles side by side depending on personal and situational demands.Objective: Rooted in Self-Determination Theory, this study sought to identify distinct profiles among nurses involving the co-occurrence of autonomy support, structure, control and chaos (aim 1), and to examine whether such profiles are meaningfully driven by nurse-related indicators (aim 2).Design: A cross-sectional design with latent profile analysis.Methods: Data were collected using validated self-report questionnaires among nurses counselling chronically ill patients (N = 389). Latent profile analysis was performed to shed light on how nurses use different styles side by side; and subsequent MANCOVA testing was used to examine differences between the profiles in terms of nurse-related indicators.Results: Four profiles could be identified, each characterised by a unique combination of differing degrees of autonomy support, structure, control and chaos. The profiles included a motivating profile (20.31%) characterised by the dominant presence of autonomy support and structure; a demotivating chaotic profile (17.74%) characterised by the dominant presence of chaos; an active profile (24.17%) where all styles were highly present; and an undifferentiated profile (37.79%) characterised by an average presence of all styles. These four profiles were meaningfully related to a set of nurse-related indicators. Multivariate analysis (Pillai's Trace test =.38, F(15, 756) = 7.28; p <.001; eta(2) =.13) indicated that job competency, job autonomy and high-quality motivation were most elevated in the motivating profile.Conclusion: Profiling has supported our understanding of the natural co-occurrence of more motivating and demotivating styles among nurses when counselling patients in self-managing their life with chronic illness. The pattern of retained profiles indicates that, for some nurses, it will be important to move away from controlling or chaotic interactions. Future intervention development should augment nurses' competence levels and high-quality motivation, with attention to reduce the pressure in nurses to act in a result-based manner. Profiling can also be valuable to better assign nurses to an employment in chronic care, and to support their personal professional growth.
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| 4. |
- Teixeira, Pedro J., et al.
(författare)
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Classification of Techniques Used in Self-Determinationheory-Based Interventions in Health Contexts : An Expert Consensus Study
- 2020
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Ingår i: Motivation Science. - Washington, DC : American Psychological Association (APA). - 2333-8113 .- 2333-8121. ; 6:4, s. 438-445
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Tidskriftsartikel (refereegranskat)abstract
- While evidence suggests that interventions based on self-determination theory can be effective in motivating adoption and maintenance of health-related behaviors, and in promoting adaptive psychological outcomes, the motivational techniques that comprise the content of these interventions have not been comprehensively identified or described. The aim of the present study was to develop a classification system of the techniques that comprise self-determination theory interventions, with satisfaction of psychological needs as an organizing principle. Candidate techniques were identified through a comprehensive review of self-determination theory interventions and nomination by experts. The study team developed a preliminary list of candidate techniques accompanied by labels, definitions, and function descriptions of each. Each technique was aligned with the most closely-related psychological need satisfaction construct (autonomy, competence, or relatedness). Using an iterative expert consensus procedure, participating experts (N = 18) judged each technique on the preliminary list for redundancy, essentiality, uniqueness, and the proposed link between the technique and basic psychological need. The procedure produced a final classification of 21 motivation and behavior change techniques (MBCTs). Redundancies between final MBCTs against techniques from existing behavior change technique taxonomies were also checked. The classification system is the first formal attempt to systematize self-determination theory intervention techniques. The classification is expected to enhance consistency in descriptions of self-determination theory-based interventions in health contexts, and assist in facilitating synthesis of evidence on interventions based on the theory. The classification is also expected to guide future efforts to identify, describe, and classify the techniques that comprise self-determination theory-based interventions in multiple domains. © 2020, American Psychological Association.
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| 5. |
- Verschueren, Margaux, et al.
(författare)
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Identity Processes and Statuses in Patients with and without Eating Disorders.
- 2017
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Ingår i: European eating disorders review : the journal of the Eating Disorders Association. - : Wiley. - 1099-0968. ; 25:1, s. 26-35
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Tidskriftsartikel (refereegranskat)abstract
- Problems with identity formation are associated with a range of psychiatric disorders. Yet, the mechanisms underlying such problems and how they are refined into specific diagnostic presentations require further investigation. The present study investigated identity processes among 123 women with eating disorders (ED) and age-matched community controls via a newly developed identity model. Several clinical outcome variables were assessed. Patients with ED scored lower on committing to and identifying with identity-related choices and scored higher on maladaptive or ruminative exploration, identity diffusion and identity disorder. They also experienced less identity achievement as compared with controls. The identity disorder status was associated with the highest scores on anxiety, depression, borderline personality disorder symptoms, and non-suicidal self-injury and the lowest scores on need satisfaction. Results indicate that patients with ED experience more identity problems than community controls and those captured by an identity disorder status experience the most problematic psychosocial functioning. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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