Intrinsic motivator occurs when an individual engage in an activity for its own interest, without the presence of any external reward, just for the fun of it. (Lecture notes. 16th October 2006) For instance, a hobby is a good example as well as curiosity and interest. On the other hand, extrinsic motivator is when the individual is motivated by external factors and involve the use of incentives either positive or negative. (Lecture notes. 16th October 2006) For example: airlines use air miles, supermarkets use loyalty cards and discounts, companies use bonuses and commissions. Extrinsic motivation is everywhere.
Some behaviours or beliefs may put individuals in conflict, for instance, smoking. This is part of one of the cognitive theories, cognitive dissonance; which can be considerer a stage of denial or dissonance. (Oliver, R. 1995) At this stage, individual’s cognition concerning behaviour or situation are mutually exclusive. Knowing that something a person likes or enjoys is wrong or is bad on any sort of way for the individual’s life, makes it confront with conflicts by differing cognition. (Oliver, R. 1995) Therefore, for the individual will be facing the difficult decision of giving up an activity or denying any affect to that behaviour towards it. Consequently, there must be some keen on solving the dissonance by bringing cognition into a more consonant bond. (Lecture notes. 16th October 2006) The situation leads to Goal setting, a powerful motivator in which the individual is committed to that goal with perception of its own ability to handle the situation. However, people may believe to have control over their lives and that is known to be Locus of Control. (Oliver, R. 1995) Locus of Control can be External; when the control is over events recognised to outside world or external factor, typically has a more fatalistic view on events and internal; when the events are attributed to self, normally has a stronger sense of control over events and what happened to them. A smoker may think or say that cancer will not ever touch it or just compare itself to people that had have long life being a smoker and that can happen when there is a lack of belief of oneself to give up smoking. It has been proposed that a high perceived value allows people to perform better than those with equal ability but less belief in that ability. (Lecture notes. 16th October 2006)
However, Abraham Maslow proposed a theory in which he it is said that as humans meet basic needs they are seeking to satisfy one after another higher needs in a hierarchy order. (Oliver, R. 1995) Maslow's hierarchy of needs is often shown as a pyramid consisting of five levels: the four lower levels are grouped together as deficiency needs or D-motives. (Gross, R. 2005) Those deficiency needs are associated with physiological needs such as, hunger, thirst. Mostly depends on external objects or individuals, where the preservation of the individual is one of the principal objectives and as a result, key point in the preservation of its health. (Oliver, R. 1995) Whereas, the top level is called growth needs or B-motives associated with psychological needs such as, curiosity. Those needs are met by individual’s own seek and there are often, independent or external factors. (Lecture notes. 16th October 2006) While deficiency needs must be met, growth needs are frequently shaping behaviour. Basically, the higher needs in this hierarchy only come into focus once all the needs that are lower down in the pyramid have been mainly or entirely satisfied. (Oliver, R. 1995) For Maslow these basic needs are ordered from bottom to top as follow: Physiological needs are biological needs for instance, oxygen, food, water and a relatively constant body temperature. Once all this needs are satisfied and are no more controlling behaviours or thoughts, is when the safe needs are activated. People have the need to feel secure and safe or out of danger. (Fredrickson, B. et al 2003) In third position or in the middle are the need of love, affection and belongingness; Maslow states that people are seeking to overcome loneliness and alienation, involving giving and receiving love, be accepted and belong. (Fredrickson, B. et al 2003) When those three needs are met, the needs for esteem can become quite dominant. This involves to self esteem, to achieve, be competent and gain approval and recognition. (Practical Assessment, Research & Evaluation, 13th November 2006). Last but not least is self-actualisation, which is activated once all the foregoing needs satisfied. It is the person’s need to find self-fulfilment and realised one’s own potential. Not everybody agrees with Maslow’s theory, some people have claimed that his self-actualisation is poorly defined and that de-emphasised the role of society to play in influencing the self concept and the testing of ideas not to be well presented. (Lecture notes. 16th October 2006) For example, Frederick Herzberg has a different theory, which is about job factors that motivate employees. Factors such as company policy, supervision, interpersonal relations, working conditions, and salary are hygiene factors rather than motivators. (Gross, R. 2005) With this theory he seems to mean that, the absence of those hygiene factors can create job dissatisfaction, but their presence does not motivate or create satisfaction. On the other hand, he resolute that the motivators are elements that enriched a person's job; he found five factors that were strong determiners of job satisfaction; achievement, advancement, the work itself, responsibility, and recognition. These motivators satisfy, were associated with long-term positive effects in job performance while the hygiene factors, dissatisfies consistently producing only short-term changes in job attitudes and performance, which quickly fell back to its previous level. (Gross, R. 2005) Motivation leads to work effort which, once is combined with appropriate individual abilities and organisational support, leads to performance achievement. The motivational impact of any rewards received for this performance achievement depends on equity and reinforcement considerations. Another theory is the Self-determination theory, which is a general theory of human motivation concerned about the development and functioning of personality within social context. (Fredrickson, B. et al 2003) This theory focuses on the degree to which human behaviours are volitional or in some cases self-determined. That is, the degree to which people endorse their actions at the highest level of reflection and engage in the actions with full sense of their choice. Over the past three decades self-development theory has evolved into a set of four mini-theories that share the organismic-dialectical meta-theory and the concept of basic needs. Self-determination theory has been brought to many applied settings such as health care, education, parenting, work organizations, sports, and mental health. The theory developed from psychological research done by , . (Self-Determination theory, 5th December 2006)
As a health professional the understanding of the theories of motivation is important from the point of view that health professionals have the tools to motive patients/people. For instance, a smoker who seeks for information to stop smoking is because it has made the decision to do it for itself without the risk of any illness, just coming to the conclusion to stop before any illness is presented. That patient is already motivated yes, but it needs the support and in some stages the courage to continue and why not the praise of carry on with its goal. Whereas for a patient that has not come to the idea by itself will need the help of the health professionals to motivate that person by making it think about its own health, explaining the benefits of no smoking. Health professionals can teach people to hear their inner-feeling voices and to be aware of their inner selves; to transcend their cultural conditioning and become world citizens; discover their vocation in life, their calling, fate or destiny. Patients’ motives and values may be very different to that of health professional. In the case of the elderly, this can be more difficult, because the person can be giving up on life due to an illness. In many occasion the illness is not so life threatening but it important to look at the bigger picture. It can be very easy to motivate an elderly person although it can be very difficult too. Because the elderly person may think that it has reached its self actualisation therefore, being ill and in pain will make difficult task to motivate that person to do something with its life. In any occasion what happens with elderly people is that they loose the thought of being useful. Examples include ideas about the quality of life - a patient with a terminal prognosis might value a life free from medical intervention more, than a chance for living longer. Motivation requires a goal and when the person itself can not find the goal, health professionals can suggest a goal. Patients with chronic disease may want to die or even kill themselves by refusing any type of treatment. A patient suffering from depression may see this as away out of its suffering. Depression could be defined as a lack of motivation and some patients may find ideas about causes and treatment. Health professionals are to show people that controls are good, and complete abandon is bad. It takes control to improve the quality of life in all areas.
Once motivation is established does not last if it is not repeated, it requires recognition. In health care people must be accepted as the person that it is and help the person learn their inner nature, seeing that the person's basic needs for life are satisfied.
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REFERENCES
Fredrickson, B. et al (2003), Atkinson & Hilgard’s Introduction to Psychology. 14th Ed, Wadsworth.
Gross, R. (2005), Psychology. The Science of Mind and Behaviour. 5th Ed, Hodder Arnold.
Lecture notes. 16th October 2006. Motivation.
Oliver, R. (1995) Psychology of Health Care. Bailliere Tindall.
Practical Assessment, Research & Evaluation, 1997, Maslow’s Hierarchy of Needs [online] 13th November 2006,
Rotter, D. (1966) General Expectancies for Internal vs. External Reinforcement. Psychological Monographs
Self-determination, 5th December 2006, [online] 20th December 2006
Wikipedia, 19th October 2006, Motivation [online] 19th November 2006,
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