Motivational Mechanisms Underlying Physicians’ Occupational Health: A Self-Determination Theory Perspective (original) (raw)
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US Physicians’ Work Motivation and Their Occupational Health
Medical Care, 2019
Background: Poor occupational health among physicians poses a serious risk both to physicians themselves and the patients under their care. Prior research has found that occupational health among nonphysicians is associated with both degree and type of work motivation. Objective: The main purpose of this article was to assess the association between physician work motivation and their occupational health. Research Design: This study was a national survey of practicing physicians. A split-sample method was used to validate a measure of work motivation adapted for physicians. Subjects: In total, 3589 physicians were selected from the American Medical Association Physician Masterfile among whom 2247 physicians completed a survey (response rate of 62.6%). Measures: Eight-item measure adapted from the Work Extrinsic and Intrinsic Motivation Scale. Grounded in self-determination theory, this measure includes 2 superordinate subscales of autonomous and controlled work motivation (characterized by feeling free and volitional versus pressured or compelled, respectively). Indicators of physicians' occupational health included single-item measures of general health, burnout, job satisfaction, intention to leave their practice, and intention to leave medicine, and a 2-item measure of depression risk. Results: Confirmatory factor analyses found that an 8-item, 2 superordinate (4 subordinate subscale) measure had good factor structure [χ 2 (14, n = 500) = 35.62, P < 0.001; χ 2 (14, n = 1747) = 108.85, P < 0.001]. Autonomous work motivation was found to be positively related to all 6 indicators of physicians' occupational health. Controlled work motivation was negatively related to 3 of 6 occupational health indicators. Conclusions: Physicians who are more autonomously motivated at work reported having better occupational health. Fostering a health care work environment that supports autonomous motivation may benefit the well-being of physicians and their patients.
Motivational determinants among physicians in Lahore, Pakistan
BMC Health Services Research, 2010
Introduction: Human resource crises in developing countries have been identified as a critical aspect of poor quality and low accessibility in health care. Worker motivation is an important facet of this issue. Specifically, motivation among physicians, who are an important bridge between health systems and patients, should be considered. This study aimed to identify the determinants of job motivation among physicians, a neglected perspective, especially in developing countries. Methods: A stratified random sample of 360 physicians was selected from public primary, public secondary and public and private tertiary health facilities in the Lahore district, Pakistan. Pretested, semi-structured, selfadministered questionnaires were used. For the descriptive part of this study, physicians were asked to report their 5 most important work motivators and demotivators within the context of their current jobs and in general. Responses were coded according to emergent themes and frequencies calculated. Of the 30 factors identified, 10 were classified as intrinsic, 16 as organizational and 4 as socio-cultural. Results: Intrinsic and socio-cultural factors like serving people, respect and career growth were important motivators. Conversely, demotivators across setups were mostly organizational, especially in current jobs. Among these, less pay was reported the most frequently. Fewer opportunities for higher qualifications was a demotivator among primary and secondary physicians. Less personal safety and poor working conditions were important in the public sector, particularly among female physicians. Among private tertiary physicians financial incentives other than pay and good working conditions were motivators in current jobs. Socio-cultural and intrinsic factors like less personal and social time and the inability to financially support oneself and family were more important among male physicians. Conclusion: Motivational determinants differed across different levels of care, sectors and genders. Nonetheless, the important motivators across setups in this study were mostly intrinsic and socio-cultural, which are difficult to affect while the demotivators were largely organizational. Many can be addressed even at the facility level such as less personal safety and poor working conditions. Thus, in resource limited settings a good strategic starting point could be small scale changes that may markedly improve physicians' motivation and subsequently the quality of health care.
BMC Medical Education, 2019
Background: Continuing professional development and lifelong learning are crucial to secure safe and good quality healthcare. Lack of motivation has been found to be among the most important barriers for participation in lifelong learning. This study was conducted to investigate the relationships between medical specialists' work motivation, lifelong learning motivation, autonomy, competence and relatedness satisfaction. Methods: Self-Determination Theory was used as a theoretical framework for this study. Data were collected through an online survey, that was sent to all (N = 1591) medical specialists in four Dutch hospitals. The survey measured background characteristics, autonomy, competence, and relatedness satisfaction, autonomous and controlled work motivation, and lifelong learning motivation. Two step factor path analysis with the method of Croon was used to analyze the data from 193 cases. Results: Autonomy need satisfaction was positively associated with autonomous work motivation which in turn was positively associated with lifelong learning motivation. Competence need satisfaction and age were negatively associated with controlled work motivation. Competence need satisfaction was also positively related with lifelong learning motivation. No significant nor any hypothesized associations were found for relatedness. Conclusions: Our findings, in line with Self-determination Theory literature, show that autonomy and competence need satisfaction are the important factors as they were positively associated with medical specialists' motivation for work and for lifelong learning.
Predictors of job motivation among doctors and nurses in a tertiary hospital in Sokoto, Nigeria
Background: Doctors and nurses are the largest and very important human resources for health within health service organizations; therefore their performance will impact the overall organizational performance. The study was aimed to assess the predictors of job motivation among Doctors and nurses of a tertiary hospital. Methods: A descriptive cross sectional study was conducted among 334 doctors and nurses. Multi-stage sampling method was used to select study respondents and self-administered questionnaires developed based on Maslow and Herzberg theories of motivation. Linear regression analysis was performed to determine the predictors of job motivation. The level of statistical significance was set at p<0.05. Results: The motivators were ranked in order of importance from achievement factors, remuneration, job attributes and co-workers. Linear regression revealed only respondents' designation significantly predicted job attributes as a motivating factor. Doctors were less likely to be motivated by their job attributes compared with nurses (p=0.03). Sex (p=0.01) and holding managerial position (p=0.001) predicted remuneration as a motivating factor for doctors and nurses. Disaggregation by profession showed, only holding managerial position (p=0.02) predicted remuneration as a motivating factor for doctors while for nurses, predictors were sex (p=0.001) and holding managerial position (p=0.02). Co-workers as a motivating factor for all groups were predicted by holding managerial position (p=0.01) and designation (p=0.03). Conclusions: Motivation was influenced by both financial (remuneration) and non-financial incentives (achievements). Healthcare professionals tend to be motivated more by non-financial factors, implying that this should be a cogent strategy for effective employee management.
Decent Work, Work Motivation, Work Engagement and Burnout in Physicians
International Journal of Applied Positive Psychology
This article presents the relationships among decent work (DW; Decent Work Questionnaire), work motivation (Multidimensional Work Motivation Scale), work engagement (Utrecht Work Engagement Scale) and personal-burnout (subscale of Copenhagen Burnout Inventory) in Portuguese and Brazilian physicians (N = 605). Canonical correlation analyses were performed. The results in the Portuguese sample: the seven DW factors were related to identified and intrinsic-work-motivation, work-engagement and less personal-burnout. Adequate-working-time-and-workload is associated with decreases of identified-work-motivation and personal-burnout. Less meaningful-remuneration-forthe-exercise-of-citizenship is related to less extrinsic-material-work-motivation and extrinsic-social-work-motivation; in the Brazilian sample: fundamental-principles-and-valuesat-work, adequate-working-time-and-workload, fulfilling-and-productive-work, and opportunities relate to identified and intrinsic-work-motivation, work-engagement, less amotivation and less personal-burnout. Less adequate-working-time-and-workload and less social-protection are associated with more personal-burnout. In both samples, the DW global score were related significantly and positively with the more self-determined types of work-motivation (intrinsic and identified); and significantly and negatively with the amotivation. These results help human resources management to enhance physicians' performance and well-being, and therefore the quality of care provided.
BH ekonomski forum, 2021
Health organizations are increasingly trying to guide and motivate physicians in many ways. The current era is competitive and healthcare organizations, regardless of size, technology and market focus, are also facing retention of physicians. To achieve prosperity, healthcare organizations use different strategies to compete with competitors. Successful healthcare organizations view their physicians as a key development resource. Physicians are an essential part that contributes to the growth and development of the healthcare organization. The main theoretical goal of this paper is to find out how extent motivation affects the improvement of job satisfaction among physicians, especially in terms of non-financial motivation. Within this paper, empirical research will be conducted, with a total of 8 questions, in order to get an idea of how much and to what extent non-financial motivation affects the job satisfaction of physicians. The choice will be the Likert scale with which the respondents will express their agreement or disagreement through a five-point scale (1 = I do not agree at all, 2 = Partially disagree, 3 = Neutral (neither agree nor disagree, 4 = Partially I agree, 5 = I completely agree). The results of this research can be used for further research on a similar topic, but also as a useful recommendation for managers or the human resources department who would like to explore the degree of motivation and job satisfaction within their organization.
Developing and assessing a tool to measure motivation among physicians in Lahore, Pakistan
PLOS ONE
Physicians' motivation plays avital role in health systems particularly in dense and urban cities, which deal with high volumes of patients in a variety of settings. The loss of physicians due to low motivation to developed countries is also a critical aspect affecting the quality of care in many regions. Fewer studies have explored health provider and particularly physicians' motivation in developing countries, which is critical to health service delivery. In addition, limited relevant tools have been developed and tested in low and middle-income settings like Pakistan. The purpose of this study was to create and test a tool for measuring physician motivation. A tool was developed to explore physicians' motivation in the Lahore district, Pakistan. Three sections of the questionnaire, which included intrinsic, socio-cultural and organizational factors, were tested with a stratified, random sample of 360 physicians from the public and private health facilities. Factor analysis produced six factors for 'intrinsic motivation,' seven for 'organizational motivation' and three for 'socio-cultural motivation' that explained 47.7%, 52.6% and 40.6% of the total variance, respectively. Bartlett's test of sphericity and the KMO were significant. Cronbach's α and confirmatory factor analysis were found satisfactory for all three sections of questionnaires. In addition to identifying important intrinsic, socio-cultural and organizational factors study found the questionnaires reliable and valid and recommend further testing the applicability of the instrument in similar and diverse settings.