Abstract
ObjectivesFrom a self-determination theory perspective, the purpose of this cross sectional study was to better understand how to motivate hospitalized older adults’ behaviors and test an integrative model of the role of causality orientations and a supportive/controlled environment on basic need satisfaction, motivation for health oriented physical activity, positive and negative affective states, depressive symptoms, apathy, and boredom.MethodsOlder adults (N = 146; Mage = 81.27 years, SD = 7.75, 74.7% female) in French hospital units completed self-report questionnaires and socio-demographic data were also collected.ResultsPartial least squares path modeling results showed that participants’ autonomy orientation positively associated with the perception of a supportive environment was related to need satisfaction, autonomous motivation for health-oriented physical activity, and high scores on positive affective states. Conversely, participants’ impersonal orientation positively associated with the perception of a controlled environment was related to undermining need satisfaction, controlled motivation for health-oriented physical activity, and amotivation, and high scores on both negative affective states, and boredom.ConclusionThe present results indicate that taking into account personality factors in hospital units can be useful and health professionals should take an interest both in the patients’ causality orientations and the supportive nature of the environment in order to understand better how to motivate patients’ behaviors. The present study points to the need to focus on all motivational dynamics which allow patients’ need satisfaction.
Highlights
IntroductionIn France, certain structures exist such as aftercare and rehabilitation services (A-CRS) which have the dual aim of ensuring older people’s access to appropriate care and optimizing management of hospital stays
Older people are a frail population often in high proportion in hospital units
We found that this result was important because if Ntoumanis et al (2020, p. 3) in their meta-analysis of 73 SDT intervention studies in health context found that “SDT interventions have focused on enhancing perceptions of need support, often by training significant others to utilize behaviors that facilitate experiences of psychological need satisfaction and foster autonomous motivation for behavioral engagement,” the present study shows that creating a supportive environment is a key point, but that it is necessary to consider the autonomous orientation that allows individuals to be motivated by engagement and inherent interest in activities, focusing on how they could act as their own agent, or on how activities could deepen their experiences
Summary
In France, certain structures exist such as aftercare and rehabilitation services (A-CRS) which have the dual aim of ensuring older people’s access to appropriate care and optimizing management of hospital stays. Within these units, the average length of stay is 34.8 days (Coquelet and Valdelièvre, 2011), with a return home for 82% of patients, placement in medical-surgery health units for 13%, and admission into a nursing home for 5% (Coquelet, 2015). Adherence to rehabilitation programs is a key aspect in the success of these units and motivation for health oriented physical activity greatly influences behavior outcomes (Boiché et al, 2016). Need-supportive programs to physical activity have been shown to improve patients’ quality of motivation and to influence long-term physical activity adherence (e.g., Rodrigues et al, 2018), and a collaborative and empathetic approach from health professionals to foster patients’ psychological need satisfaction (e.g., Lock et al, 2018)
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