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PubMed1999

Motivation for medical school: the relationship to gender and specialty preferences in a nationwide sample.

OBJECTIVES: Motivation for going to medical school and career plans of a 1 year cohort of students entering medical school in Norway (n = 420 response rate: 90%, 54% women, mean age: 22 years) were surveyed by a postal questionnaire the first month after they had started. DESIGN: Motives for choosing medicine were categorized into three indexes: 'people orientated', 'status/security orientated' and 'natural science orientated' motives. SETTING: University of Oslo. SUBJECTS: Medical students. RESULTS: Students picked out which they preferred among 53 specialties. The highest motivational scores were on the 'person orientated' index, female students scoring higher than men. Female students were, however, nearly as highly motivated by status/security and interests in natural science as were men. 'Person orientated' and 'natural science orientated' motives exerted the strongest influence on specialty preferences. Those who preferred family medicine were more person orientated and less natural science orientated, while those who preferred internal medicine were more natural science orientated. Father being a physician did not influence the motivational pattern, but increased the preference for laboratory and internal medicine. Frequently repeated upper secondary school exams for acceptance into medical school were negatively related to natural science motivation, and to increased preference for becoming a surgeon. CONCLUSIONS: In this first month of the curriculum students regarded person oriented motives as the most important for becoming a doctor.

Adult↗
PubMed1998

Muscular development motives for exercise participation: the missing variable in current questionnaire analysis?

Motivation questionnaires that are currently validated do not account for muscular development motives in exercise populations, and have rarely been used to examine resistance training populations. Resistance training is a popular and widely available exercise, so the lack of such motivational information is a cause for concern. The aim of this study was to assess the need for considering motives for muscular development. This was achieved by the development of a simple scale that matched the format and style of the Exercise Motivations Inventory. The muscular development scale was combined with the 'weight management' and 'appearance' items of the Exercise Motivations Inventory to form a 13-item test questionnaire. This was administered to four groups of experienced exercisers: resistance training males (n = 40), resistance training females (n = 36), males training in a variety of sports (n = 27) and aerobic training females (n = 40). Factor analysis with varimax rotation revealed a relatively distinct muscular development factor, but with cross-loading on weight management. Muscular development was shown to be the most effective discriminator for the four groups. A multivariate analysis of variance and additional discriminant analysis revealed a series of significant differences between groups, which suggests that motive-based differences are more powerful than sex factors in determining choice of exercise modality. Although the interrelated nature of muscular development and weight management needs to be recognized and accounted for, there is a clear need for considering muscular development motives in future investigations, especially those that intend to examine motives for 'ideal' physical appearance.

Adolescent↗
PubMed1999

A review of motivational climate in physical activity.

Here we provide, within a social-cognitive framework, a critical review of research on the motivational impact of different psychological climates in physical activity. Motivational, cognitive, affective and behavioural outcomes are considered in sport, school physical education and exercise. We first review laboratory and field studies that tried to manipulate the perceived structures of motivational environments and to examine the subsequent outcomes on participants' cognitive and affective responses. Then we discuss studies influenced by the work of Ames in classroom settings and involving questionnaires to measure individuals' perceptions of 'motivational climates'. The impact of mastery and performance climates on various indices of motivation is narratively reviewed, and statistically estimated effect sizes from 14 studies (n = 4484) are presented as supporting evidence. We conclude that a mastery motivational climate is associated with more adaptive motivational patterns, while a performance climate is linked with less adaptive or maladaptive motivational and affective responses. Future research should determine the personal and situational variables that can moderate the impact of such relationships. Furthermore, a broader perspective is proposed, to understand the creation of perceived motivational climates, which is based on the integration of political, cultural, coaching and parental influences.

Adaptation, Psychological↗
PubMed2002

A cross-national study of motives for drinking alcohol.

The role of individualism-collectivism in influencing the motives for alcohol use was examined by comparing motives for drinking among 72 U.S. (individualist) and 83 Nigerian (collectivist) respondents in 1998. The study also examined the role of gender. The Drinking Motives Questionnaire (Cooper, M.L.; Russell. M.; Skinner. J.B.; Windle, M. Development and Validation of a Three-Dimensional Measure of Drinking Motives. Psychol. Assess. 1992, 4, 123-132.) that classifies drinking motives into coping. enhancement, and social motives was used. The U.S. respondents were hypothesized to score higher on coping motives and lower on social motives than Nigerian participants. This hypothesis was supported. Male respondents also scored higher than females on all the three motives. These results have implications for intervention approaches regarding alcohol use for people with differing cultural orientations.

Adult↗
PubMedDate not supplied

An exploration of the usefulness of motivational interviewing in facilitating secondary prevention gains in cardiac rehabilitation.

Motivational interviewing is a client-centered, directive counseling approach aimed at promoting motivation in clients to change certain behaviors. Its effect is to reduce defensiveness and promote disclosure, engagement, and participation, thereby motivating the client to make behavioral changes. Motivational interviewing marries well with the principles of cardiac rehabilitation (CR) in terms of increasing motivation among CR clients, promoting a client-centered approach and in the cost- and time-effective practices of CR. Very little research has been conducted examining the effectiveness of motivational interviewing in enhancing CR outcomes. This article discusses research that has been conducted in motivational interviewing that relates to the components of CR, provides examples of how motivational interviewing can be applied to CR, and recommends further exploration, development, and investigation of the usefulness of motivational interviewing in the field of CR.

Counseling↗
PubMed2004

The profit motive and spine surgery.

STUDY DESIGN: The profit motive and market medicine have had a significant impact on clinical practice and research in the field of spine surgery. An overview of current concerns is presented. OBJECTIVE: The objective of this study was to provide those involved in the study and treatment of spinal disorders with a critical overview of the effects of the profit motive on our practices. SUMMARY OF BACKGROUND DATA: Historically, the profit motive has been viewed as eroding the standards of spine surgery, encouraging surgeons to operate aggressively and researchers to bias their results. Although there are legitimate concerns regarding the role played by such market forces, the profit motive exerts several quite positive effects on spine surgery as well. METHODS: Negative and positive aspects of the profit motive in spine surgery are explored along with alternative approaches. RESULTS: The profit motive in spine surgery can result in unnecessary surgery, as well as the push to market of unproven technologies. Yet, without a robust profit motive, it is unclear where sufficient funding could be found to support research and education, and to underwrite the advancement of new technologies. CONCLUSIONS: The profit motive significantly influences the way we practice and conduct research in spine surgery. To minimize the negative aspects of the profit motive, spine surgeons and researchers must refrain from being used by companies to rush products to market and/or compromising patient care out of self-interest.

Biomedical Research↗
PubMed2003

On the hierarchical structure of self-determined motivation: a test of top-down, bottom-up, reciprocal, and horizontal effects.

This article aimed to test some hypotheses about the hierarchical structure of self-determined motivation in two longitudinal studies. First, the authors verified the stability of global self-determined motivation and school self-determined motivation over time. Second, they tested top-down, bottom-up, reciprocal, and horizontal effects between global self-determined motivation and school self-determined motivation. In Study 1, 122 college students were evaluated on two occasions with a 5-year interval on their global and school self-determined motivation. In Study 2, 294 college students were evaluated on the same variables with a 1-year interval. Results from both studies revealed that (a) global self-determined motivation was not more stable than self-determined school motivation over time and (b) a cross-lag model including reciprocal effects between self-determined global and self-determined school motivation offered the best fit indices comparatively to a model involving only horizontal (or stability) effects. Discussion emphasizes the theoretical implications of the results.

Adult↗
PubMed2003

Implicit and explicit motives influence accessibility to different autobiographical knowledge.

In two studies, participants completed implicit and explicit measures of achievement and intimacy/affiliation motivation. In Study 1, they recalled an emotional and a self-descriptive memory. In both domains, implicit motive scores were higher when motivational content was present in the emotional memory. When motivational content was present in the self-descriptive memory, explicit motive scores were higher in both domains. In Study 2, participants recalled four autobiographical memories (two agentic, two communal) that were then categorized as specific or general events. Implicit motive scores were higher for participants who recalled specific agentic and communal events. Explicit motive scores were higher for participants who recalled general achievement events but not general communal events. Findings suggest that implicit motives are linked to accessibility of specific and emotional experiences, whereas explicit motives are linked more strongly to accessibility of specific and general memories that relate to the self-concept.

Adult↗
PubMed2006

Weight concerns affect motivation to remain abstinent from smoking postpartum.

BACKGROUND: Although many women quit smoking during pregnancy, most resume smoking postpartum. One factor that may be important in postpartum relapse is a pregnant woman's motivation to remain abstinent after delivery. PURPOSE: We assessed motivation for postpartum abstinence among pregnant women who had quit smoking and examined the relationship of weight concerns and mood to abstinence motivation. METHODS: Pregnant former smokers, recruited between February 2000 and November 2004, completed assessments of smoking, weight concerns, depressive symptoms, and perceived stress. RESULTS: Sixty-five percent were highly motivated to remain abstinent postpartum. Women who were and were not motivated were similar in age, race, and nicotine dependence. However, motivated women reported more stress, greater self-efficacy for weight management, less hunger, and less smoking for weight control than did less motivated women. After controlling for intention to breast-feed, nicotine dependence, years of smoking, partner smoking, and race, self-efficacy for weight control was related to motivation to maintain postpartum abstinence. CONCLUSIONS: These data suggest that weight concerns are associated with motivation for postpartum smoking abstinence, and interventions designed to prevent postpartum smoking relapse may need to target eating, weight, and shape concerns.

Adult↗
PubMedDate not supplied

Motivation in nurse education practice: a case study approach.

"There are three things to remember about education. The first is motivation. The second one is motivation. The third one is motivation" (Maehr and Meyer, 1997 p372). It is important to understand motivation and the reasons why nurses, including educators and clinicians, need to continually motivate their students both in the classroom and within clinical practice. Using relevant literature, the following case study explores the significant issues pertinent in motivating a student undertaking a Postgraduate Diploma in Specialist Nursing. A combination of motivational and learning theories are used in the process of assisting this student to learn from her recent assessment failure and to become re-motivated. There is a discussion of the significance of this case and the key issues drawn from it, which may assist nursing staff in supporting student nurses to remain motivated within the clinical area.

Drive↗
PubMed2004

Patient motivation for bariatric surgery: characteristics and impact on outcomes.

BACKGROUND: Motivation for seeking obesity surgery has not been studied. The authors explored the patient's motivation for selecting surgery and examined for a relationship between primary motivating factors and weight outcomes. METHODS: 208 (177F: 31M) unselected participants followed at least 1 year after Lap-Band placement completed a short questionnaire. 6 statements were scored 1-6 from the most important through to the least important. Statements included appearance, embarrassment, medical conditions, health concerns, physical fitness and physical limitation. Any additional factors were also sought. RESULTS: Mean age, weight and BMI before surgery were 41+/-10 years, 129+/-16 kg and 46+/-8 kg/m(2) respectively. Responses to appearance and embarrassment correlated strongly and were grouped together. Medical conditions and health concerns account for 52%, appearance and embarrassment for 32%, and poor physical fitness and physical limitation for 16% of first choices. Those who scored 1 for appearance or embarrassment (n=67) had a lower presenting BMI (44 kg/m(2), P=0.03) and all but 1 were female (P<0.001). This group reported more depressive symptoms, poorer mental quality of life and poorer body image preoperatively. Men were more likely than women to be motivated by medical problems (P=0.007). Subjects motivated by a medical condition were more likely to have hypertension or diabetes and less likely to smoke. This group tended to be older. Weight history did not influence motivation. The first choice of motivating factor was not associated with weight outcomes at 1-3 years following surgery. CONCLUSION: Health issues dominate the motivation for seeking surgery. Weight outcomes do not appear to be affected by the patient's primary motivating factor.

Adult↗
PubMed2002

Personal goals as predictors of college student drinking motives, alcohol use and related problems.

OBJECTIVE: Although there has been extensive research examining drinking motives, relatively little of that research has focused on those factors that might underlie drinking motives. The present study examines whether nonalcohol-related motives (personal goals) can predict drinking motives, self-reported drinking and alcohol-related problems in a college student sample. METHOD: For an experiment on "attitudes and drinking," 290 volunteer undergraduate students (169 women and 121 men) completed measures of daily goal functioning (Personal Projects Analysis), drinking motives (Drinking Motives Questionnaire), frequency and quantity of alcohol consumed and alcohol-related problems (Drinkers Inventory of Consequences). RESULTS: Using path analysis, it was found that nonalcohol-related goals serve as significant distal predictors of alcohol-related problems, with their effects almost entirely mediated by drinking motives and/or drinking level. Perceptions of life goals involving goal self-efficacy, meaningfulness and social support appear to be significant protective factors, and goal-related distress is a significant risk factor. CONCLUSIONS: The present study extends previous research by focusing on a more idiographic, personally meaningful manifestation of motivation through the evaluation of nonalcohol-related personal goals. The daily pursuits of college students were shown to be predictive of drinking and drinking-related problems, especially as mediated through drinking motives. The findings suggest that several goal mechanisms could be considered for their potential role in improving interventions.

Adolescent↗
PubMed1997

Effects of reading motivation on the belief in and consumption of newspapers among youth.

A motivational model of newspaper consumption was elaborated. In this model, reading motives are supposed to generate certain beliefs in newspapers. The belief in the satisfying properties of a newspaper is based on an evaluation of how well the attributes of a newspaper are expected to match the motives of individuals. Once a match between the motives and the belief is established, then motivation is triggered, and newspaper consumption should occur. We tested the model with the hypotheses that reading motives explain belief in newspapers to a greater extent than the consumption of them and that beliefs explain consumption to a greater extent than reading motives. Reading motives, beliefs and consumption of general broadsheet, business and tabloid newspapers were measured in 1343 young people between the ages of 15 and 25. The results supported the hypotheses. The results indicate that the profiling and development of the newspapers toward more loyal and new readers should be based on the readers' beliefs in newspapers and the motives explaining them.

Adolescent↗
PubMed2001

A model for achievement motives, goal orientations, intrinsic interest, and academic achievement.

This study investigated the effects of approach and avoidance achievement motives (the motive to achieve success and the motive to avoid failure) on three goal orientations (mastery, performance-approach, performance-avoidance goals) and the effects of goal orientations on intrinsic interest in learning and academic achievement for 157 tenth and 135 eleventh grade students of a Japanese girls' high school. Structural equation modeling indicated that mastery goals arose mainly from the motive to achieve success; however, the positive relation between the motive to avoid failure and mastery goals was also found. Performance-approach goals were related both the motive to achieve success and the motive to avoid failure. Performance-avoidance goals arouse mainly from the motive to avoid failure; however, the positive relation between the motive to achieve success and these goals was found. Mastery goals positively correlated with intrinsic interest and academic achievement, and scores on both performance-approach goals and performance-avoidance goals had no significant effects on either intrinsic or academic achievement.

Achievement↗
PubMedDate not supplied

Evaluation of motivationally tailored vs. standard self-help physical activity interventions at the workplace.

PURPOSE: This study compares the efficacy of a self-help intervention tailored to the individual's stage of motivational readiness for exercise adoption with a standard self-help exercise promotion intervention. DESIGN: Interventions were delivered at baseline and 1 month; assessments were collected at baseline and 3 months. SETTING: Eleven worksites participating in the Working Healthy Research Trial. SUBJECTS: Participants (n = 1559) were a subsample of employees at participating worksites, individually randomized to one of two treatment conditions. INTERVENTION: Printed self-help exercise promotion materials either (1) matched to the individual's stage of motivational readiness for exercise adoption (motivationally tailored), or (2) standard materials (standard). MEASURES: Measures of stage of motivational readiness for exercise and items from the 7-Day Physical Activity Recall. RESULTS: Among intervention completers (n = 903), chi-square analyses showed that, compared to the standard intervention, those receiving the motivationally tailored intervention were significantly more likely to show increases (37% vs. 27%) and less likely to show either no change (52% vs. 58%) or regression (11% vs. 15%) in stage of motivational readiness. Multivariate analyses of variance showed that changes in stage of motivational readiness were significantly associated with changes in self-reported time spent in exercise. CONCLUSIONS: This is the first prospective, randomized, controlled trial demonstrating the efficacy of a brief motivationally tailored intervention compared to a standard self-help intervention for exercise adoption. These findings appear to support treatment approaches that tailor interventions to the individual's stage of motivational readiness for exercise adoption.

Adult↗
PubMedDate not supplied

[Development of a scale for assessing lack of motivation in elderly persons].

OBJECTIVE: Apathy is made of depression and of loss of motivation. For patients with senile dementia of Alzheimer-type, the MMS score is inversely correlated with apathy and depression. The aim of this study is to build a scale aimed at loss of motivation and validated for elderly people. METHODS: The study was performed on 44 non-demented elderly people, 54 outpatients with dementia, mainly Alzheimer's type. After agreement of the patients and the family, patients were assessed using different scales: Cornell's for depression, Marin's for apathy, MMS for cognitive disorders. At the same time, we tested with caregivers a 21 items indirect scale listing various disorders related to loss of motivation, scored from 1 to 4: very often, often, sometimes, never. Patients were retested by 7 different caregivers, and different investigators, immediately and a month later to evaluate reproducibility, temporal stability using Cohen's Kappa and Spearman coefficients. The demotivation scale was then correlated with the other scales and Cronbach's alpha coefficient was studied. RESULTS: The 44 non-demented people were 80.25 years old +/- 7.75. 54 demented patients were included: 15 men and 39 women. The mean age was 81.47 years +/- 8.03. As Cohen's Kappa and Spearman coefficients were not sufficient for 6 items, the scale was reduced to 15 items (Presented). The depression scale is strongly and significantly correlated with the Marin's apathy scale. Internal coherence is particularly significant: Cronbach's alpha coefficient = 0.91. For the 54 patients with dementia, the depression score worsens significantly as cognitive disorders worsen. In these patients Marin's scale shows a progression of apathy with the impairment observed in MMS, but the MMS is not correlated with the score at the demotivation scale. So this latter scale seems to measure something close but independent from apathy. DISCUSSION: The loss of motivation is a frequent behavioral disorder in old patients. Loss of motivation can be present in any chronic disease with asthenia. This disorder is frequent in depression, in dementia and even in endocrine disease, for instance hyperthyroidism. It triggers a loss of commitment of old people and paves the way for the loss of autonomy. Apathy is a loss of motivation associated with an affective blunting. Demotivation is congruent with the actual presence of apathy in patients as measured using Marin's scale that has been used as a standard in this study. This paper presents a methodology for an evaluation scale aimed at the loss of motivation in old people. A psychologist and seven different caregivers working in a day care hospital on 98 patients performed an indirect assessment. An estimation of specificity, sensibility, reproducibility and homogeneity was tested with appropriate techniques. The results obtained with this scale answer the preliminary methodological queries, allowing us to trigger further researches for a final validation. According to our results, demotivation does not increase with age neither in demented nor in non-demented patients. Conversely, the aggravation of cognitive disorders in dementia is associated with increasing demotivation and depression. The loss of motivation participates to the learnt and acquired helplessness. Its care is necessarily global, using pharmacological, psychological and sociotherapeutic treatment. CONCLUSION: EAD scale appears a reliable tool to assess loss of motivation in old and very old patients.

Aged↗
PubMed2002

Gender differences in first-year dental students' motivation to attend dental school.

Women's role in the field of dentistry has historically been limited to the dental auxiliary fields, rather than that of D.D.S. or D.M.D. Today, women are nearly 38 percent of U.S. dental school students and 14 percent of active practitioners. The slow(er) influx of women into dentistry has been little studied by dental educators. During the 2000-01 academic year, we conducted a survey of first-year dental students at a sample of publicly funded U.S. dental schools. The purpose of the survey was to assess gender differences in motives for pursuing a dental career. The data show that male dental students rate self-employment and business-related motives as more important, while female dental students rate people-oriented motives more highly. Factor analysis revealed four distinct clusters of motives for pursuing a dental career: a financial motive, a business-oriented motive, a people-oriented or caring motive, and a flexibility motive. Women scored significantly higher than men on the caring factor, whereas the reverse was true on the business factor. Male and female students rated financial and flexibility motives equally. The implications of the results for attracting students to the profession of dentistry are discussed.

Adult↗
PubMed2005

Motivational interviewing: a systematic review and meta-analysis.

BACKGROUND: Motivational Interviewing is a well-known, scientifically tested method of counselling clients developed by Miller and Rollnick and viewed as a useful intervention strategy in the treatment of lifestyle problems and disease. AIM: To evaluate the effectiveness of motivational interviewing in different areas of disease and to identify factors shaping outcomes. DESIGN OF STUDY: A systematic review and meta-analysis of randomised controlled trials using motivational interviewing as the intervention. METHOD: After selection criteria a systematic literature search in 16 databases produced 72 randomised controlled trials the first of which was published in 1991. A quality assessment was made with a validated scale. A meta-analysis was performed as a generic inverse variance meta-analysis. RESULTS: Meta-analysis showed a significant effect (95% confidence interval) for motivational interviewing for combined effect estimates for body mass index, total blood cholesterol, systolic blood pressure, blood alcohol concentration and standard ethanol content, while combined effect estimates for cigarettes per day and for HbA(1c) were not significant. Motivational interviewing had a significant and clinically relevant effect in approximately three out of four studies, with an equal effect on physiological (72%) and psychological (75%) diseases. Psychologists and physicians obtained an effect in approximately 80% of the studies, while other healthcare providers obtained an effect in 46% of the studies. When using motivational interviewing in brief encounters of 15 minutes, 64% of the studies showed an effect. More than one encounter with the patient ensures the effectiveness of motivational interviewing. CONCLUSION: Motivational interviewing in a scientific setting outperforms traditional advice giving in the treatment of a broad range of behavioural problems and diseases. Large-scale studies are now needed to prove that motivational interviewing can be implemented into daily clinical work in primary and secondary health care.

Data Collection↗