Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Department of Experimental Clinical and Health Psychology, UGent, Ghent, Belgium.
Disabil Rehabil. 2022 May;44(10):2053-2062. doi: 10.1080/09638288.2020.1826584. Epub 2020 Oct 5.
Motivation may predict return to work (RTW), yet the measurement of motivation needs more scientific evidence. We adopt a dimensional approach, based on the self-determination theory (SDT), distinguishing between amotivation, controlled and autonomous motivation. We seek to explore the presence of these dimensions in sick-disabled patients, and are interested in associations with quality of life, depression, patient's predictions of RTW, and health care provider estimations of patient's motivation.
A cross-sectional study in 336 patients was conducted. Motivation was assessed using the Motivation at Work Scale (MAWS) and examined in relation to patient outcomes, patient's prediction of RTW, and health care provider estimations of patients' motivation. A cluster analysis was performed, and differential associations between motivational profiles were explored.
Cluster analysis revealed four profiles. Highly controlled profiles were most prevalent, reported poorer mental quality of life, and expected a longer time before RTW, regardless of the level of autonomous motivation. Interestingly, the health care provider's estimation was not related to controlled motivation.
Our results show that SDT may help to differentiate people with a work disability regarding their motivation to RTW. Most notably, the devastating consequences of controlled motivation are discussed, and clinical implications are provided.Implications for RehabilitationAssessing the different dimensions of motivation in the context of RTW will be a significant advance as the self-report measures appear to be viable tools.Controlled motivation, which indicates that people are motivated to RTW but only because they "have to", has negative consequences yet a high prevalence and should therefore be addressed by the practitioner.Practitioners should keep in mind that employees are motivated by several motives at the same time, with some being more beneficial than others.Controlled motivation can be converted into autonomous (i.e., good quality) motivation by supporting autonomy of the patient, by supporting their relationships with colleagues, managers, and health care providers and by supporting their feeling of competence in the RTW process.
动机可能会预测重返工作岗位（RTW），但动机的测量需要更多的科学证据。我们采用基于自我决定理论（SDT）的维度方法，区分动机缺乏、受控动机和自主动机。我们试图探索这些维度在患病残疾患者中的存在，并关注它们与生活质量、抑郁、患者对 RTW 的预测以及医疗保健提供者对患者动机的估计的关联。
对 336 名患者进行了横断面研究。使用工作动机量表（MAWS）评估动机，并检查其与患者结局、患者对 RTW 的预测以及医疗保健提供者对患者动机的估计之间的关系。进行了聚类分析，并探讨了不同动机特征之间的差异关联。
聚类分析揭示了四个特征。高度受控的特征最为普遍，报告的心理健康质量较差，并且预计 RTW 前的时间较长，无论自主动机水平如何。有趣的是，医疗保健提供者的估计与受控动机无关。
我们的研究结果表明，SDT 可能有助于区分有工作障碍的人对 RTW 的动机。值得注意的是，讨论了受控动机的破坏性后果，并提供了临床意义。
在 RTW 背景下评估动机的不同维度将是一个重大进展，因为自我报告的测量似乎是可行的工具。受控动机表明人们有动力重返工作岗位，但只是因为他们“必须”这样做，这会带来负面影响，但患病率很高，因此从业者应该解决这个问题。从业者应该记住，员工同时受到多种动机的激励，其中一些比其他动机更有益。通过支持患者的自主性、支持他们与同事、经理和医疗保健提供者的关系以及支持他们在 RTW 过程中的能力感，受控动机可以转化为自主（即高质量）动机。
