Critiquing a Middle Range TheoryResearch Paper

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[. . .] Fig 1: SDT Innovative Diagram

3c. Summarize of Two Research Articles

This study uses two research articles to test the efficacy of SDT and the first article is titled "Facilitating Health Behavior change and its Maintenance: Interventions based on Self-Determination Theory" and written by (Ryan, et al. 2008 p 2). The authors use the self-determination theory to reveal how people's health outcomes are being affected by their heath behaviors and lifestyle factors that include physical activity, diet, smoking and hygiene. By consequence, maintenance of people's behaviors requires experience in self-determination, internal values and skills for change.

Ryan, et al. (2008) argue that SDT focuses on concept autonomy where an individual acquires motivation for health related behaviors. In essence, developing a sense of competence and autonomy requires the integration and internalization through sustainable behavior to achieve a better health and well-being. The authors point out that people's health behaviors are inherently enjoyable activities and not intrinsic motivated. To enact behaviors such as taking medication, increase physical activity and quitting smoking, people should be able to endorse their importance and value for such behaviors. Unfortunately, many people indulge in behaviors labeled as controlled motivation because they will get external rewards from such behaviors or want to comply with social pressures.

The authors identify introjections as other form of controlled motivation where patients receive praise or approval. Ryan et al. (2008) use the field study as an instrument to test the theory, and from the results of the field study, adherence to a long-term medication is related to patients' substantial autonomy. Maintained weight loss is also linked to internalization treatments goals and treatment autonomy support. In essence, there has been a linkage between internal motivation, treatment outcomes and autonomy support.

Meanwhile, Ryan et al. (2008) distinguish between extrinsic and intrinsic life goals. The intrinsic life goals focus on inherently satisfying goal that includes physical health, personal goal, and generativity. On the other hand, extrinsic life goals focus on having fame, being physically attractive and acquiring wealth. However, extrinsic goals assist an individual to indulge in a lesser healthy and more risky behaviors.

"There have also been some randomized controlled clinical trials testing the efficacy of SDT-based interventions. These include interventions concerning tobacco dependence, physical activity (Fortier, Sweet, O'Sullivan, and dental hygiene" (Ryan et al. 2008 p 4).

The results reveal that the interventions facilitate and improve treatment outcomes.

The second research article is titled "Chapter 20: Self-Determination Theory" (Deci, at al 2013 p 4). The authors use the SDT to differentiate between controlled and autonomous motivation. The authors relate SDT to the concept social psychology that shows how social environments affect people's attitude. The authors relate the SDT with social psychology, which influences social environments based on values, attitudes, motivations, as well as behaviors. Typically, the SDT assumes that human are intrinsically motivated, inherently active, and oriented towards the development of integrative process. Although, men are not required to learn these qualities because they are naturally inherent in man, however, men are required to operate effectively towards healthy development and human nutriments, however, man will exhibit abnormal behaviors in the absence these nutriments.

The authors discuss the instruments to measure the SDT where "college students were paid for working on intrinsically interesting puzzles and the monetary rewards undermined their intrinsic motivation for the activity." (Deci, at al 2013 p 5). The experiment and other similar experiments carried out reveal that rewards might not motivate subsequent persistence; however, rewards can undermine the effectiveness of intrinsic motivation.

d. Strengths and Limitations of the SDT

The outcomes of the evaluation model reveal several strengths of the SDT. First, the theory is theoretical sound revealing the motive people indulge in physical exercise and other healthy behaviors. Silva et al. (2008) argue that the theory can assist in designing an appropriate motivation strategy to assist people in implementing appropriate healthy styles such as engaging in physical exercise to reduce weight or obese body. In the contemporary health environments, the number of people with obese bodies is increasing rapidly. Typically, obesity is the major health problems associated with the number of chronic diseases. Obesity is also associated with psychological problems especially for women. In essence, weight loss through physical exercise is an important clinical management strategy for obesity. However, it is difficult to maintain a weight loss for a long period if appropriate motivation is not implemented. Thus, the strength of the theory has assisted in enhancing a greater understanding of motivated behaviors to manage obesity. For example, healthy diet and regular physical exercise can play a greater role in health maintenance.

The evaluation results reveal that the SDT improve the outcome of the people with obesity, however, the SDT may face challenges in enhancing weight loss for a long period if people are extrinsic motivated. Moreover, the results derived from using the RCT for the SDT evaluation contributes to a better understanding on the strategy the motivations can be used for the treatment of obesity. Although, the cumulative evidence of using the SDT for the regular physical activities is recorded, however, only 20% are able to achieve a long lasting weight loss. Nevertheless, the SDT assists in enhancing a greater understanding of motivation for the obesity management.

Motivation is the psychological forces that impel an individual towards conducting in a specific goal. The SDT assists in enhancing a greater understanding about how an intrinsic motivation can assist people to conduct an appropriate health behavior because this kind of motivation makes people to demonstrate an enjoyable behavior. The theory also assists in making people to understand that extrinsic motivation such as external regulation is not appropriate to make people conduct a healthy behavior because external regulation will conduct people into a forced behavior, which may not produce a long-term health benefits. More importantly, the theory assists in enhancing a greater understanding of the concept amotivation, which involves lack of intention to engage in a specific behavior. Thus, the theory will assist a health promoter such as Jill Watson to understand there is a need to apply a specific motivation technique to make people indulging in a healthy behavior.

Other strength of the theory lies in its wide scope because its application cut across various cultures. It also encompasses a wide range of phenomena and cut across various life domains since the theory can be used to internalize the individual goals in order to increase performances. Moreover, the intrinsic motivation assists individuals desired to achieve personal growth as well as achieving self-defined goals. More importantly, the theory assists individuals to seek personal improvement.

Moreover, the SDT can be used for many applications that include medical health, workplace, education culture, family relationships, romantic relationships, mental health, sport and leisure. For example, Niemiec & Ryan (2009) applies the SDT in education and the outcomes show that the theory has supported the student's satisfaction to achieve autonomy, relatedness and competence. Deci & Ryan (2008) also reviews several studies that apply SDT in sport and exercises. The outcomes show that the theory assists in delivering positive autonomy, performances as well-being for individuals.

Despite the strengths recorded by the theory, however, the limitation of the SDT is that it fails to provide intrinsic impetus for individuals to become personal motivated.

Applicability and Usefulness of the SDT to the Advanced Nursing Practice

Several criteria can be identified in the theory, which can make the SDT applicable to the advanced nursing practice. First, the theory can assist the nursing professionals to understand the strategy to make patients to conduct in certain healthy behaviors. For example, nursing professionals can use the theory to make people desist from smoking tobacco, which is one of the major causes of cancer. Moreover, application of intrinsic motivation can assist nursing professionals to make patients indulging in behavioral outcome to manage the glucose control for diabetes patients. Moreover, the SDT intervention will make nursing professional to understand the strategy to promote health-related behaviors. Using the SDT, nurses will able to understand the strategy to manipulate patients to engage in weight control in order to achieve a long-term weight management.

Reference

Deci, E.L. & Ryan, R.M. (2013). Handbook of Theories of Social Psychology: Volume 1 Self-Determination Theory. SAGE Publications Ltd.

Ng, J.Y.Y., Ntoumanis, N., Thogersen-Ntoumani, C. (2012). Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science, 7, 325-340.

Niemiec, C.P., & Ryan, R.M. (2009). Autonomy, competence, and relatedness in the classroom: Applying self-determination theory to educational practice. Theory and Research in Education, 7, 133-144

Patrick, H. & Williams, G.C. (2012). Self-determination theory: its application to health behavior and complementarity with motivational interviewing. Int J. Behav Nutr Phys Act. 9: 18.

Ryan, R.M., Patrick, H., Deci, E.L., & Williams, G.C. (2008). Facilitating health behaviour change and its maintenance: Interventions based… [END OF PREVIEW]

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