Understanding informal caregivers' motivation from the perspective of self‐determination theory: an integrative review

Abstract

Scand J Caring Sci; 2020; 34: 267-279. Dombestein H, Norheim A, Lunde Husebø AM.Understanding informal caregivers' motivation from the perspective of self-determination theory: an integrative review.Background: A long-term illness is stressful both for the person with the diagnosis and for his or her informal caregivers. Many people willingly assume the caregiving role, so it is important to understand why they stay in this role and how their motivation affects their health. Self-determination theory (SDT) is a theory of human motivation that has been successfully applied in human research domains. To our knowledge, there is no literature review on the application of SDT in a caregiver context. A systematic review of the literature could improve the understanding of motivation in caregiver work and contribute to the utility of SDT. Aim: To describe and explore empirical studies of caregivers' motivation from the perspective of self-determination theory. Methods: An integrative literature review according to Whittemore and Knafl was conducted with systematic repetitive searches in the MEDLINE, Scopus, PsychInfo, PsycNET, Chinal, Cochrane Library and EMBASE databases. The searches were performed from May through December 2018. The PRISMA diagram was used for study selection, and papers were assessed for quality based on the Mixed Methods Appraisal Tool. Data analysis consisted of a four-stage narrative analysis method. Result: Of 159 articles, 10 were eligible for inclusion. All studies considered satisfaction of the three basic psychological needs for competence, autonomy and relatedness as essential in predicting the quality of caregivers' motivation and thereby their well-being. In this review, autonomous motivation was the most important determinant of caregivers' well-being. Conclusions: Findings showed that SDT can be applied to identify, categorise, explain, predict, promote and support motivation among caregivers. This lends interesting support for SDT and promotes further study and application of the theory as a psychological approach to caregivers' health and health promotion.

Blessings or burdens: an Interpretative Phenomenological Analysis (IPA) study on the motivations and their impact on end-of-life caregiving among Asian family caregivers

“…Findings from a number of studies show that fulfilling one's sense of self-determination appears central to sustaining one's motivation and innate satisfaction in caregiving [34][35][36]. The findings from this paper indicate that caregivers are driven by motivations that could equally contribute to wellbeing nurturance or diminishment.…”

“…Family caregivers contributing to this theme displayed confidence in carrying out previously unfamiliar caregiving tasks (competence), affirmed a stronger sense of kinship (relatedness) with the patient and their families, and took ownership of their caregiving responsibilities and challenges (autonomy). Encouragingly, numerous studies have proposed that high quality motivations stemming from self-determination can elicit outcomes of greater fortitude, higher commitment, and more positive emotions and self-concepts [34][35][36].…”

Caring for home‐dwelling parents with dementia: A qualitative study of adult‐child caregivers' motivation

“…These findings differ from a main assumption of the SDT framework, where being autonomous and self‐determined are premises for high‐quality motivation (Ng et al., 2012; Ryan & Deci, 2017; Weinstein & Ryan, 2010). In work‐related contexts, satisfying the needs for autonomy, competence and relatedness is valued as equally important (Williams et al., 2014), as is the case for the long‐term caregiver context (Dombestein et al., 2019). In this study, dementia caregivers' needs for competence and autonomy were important, but not as important as relatedness.…”

“…Self‐determination theory has been applied to several healthcare contexts (Ng et al., 2012; Ntoumanis et al., 2020) such as caregivers' motivation for persons with cancer (Kim, Carver, & Cannady, 2015; Ng, Griva, Lim, Tan, & Mahendran, 2016) and chronic pain (Kindt, Vansteenkiste, Cano, & Goubert, 2017) as well as to caregivers caring for relatives with different long‐term illnesses (Dombestein, Norheim, & Lunde Husebø, 2019). To our knowledge, SDT has not yet been applied to adult children caring for home‐dwelling parents with dementia.…”

Dependent person in self‐care: analysis of care needs

“…Dependency in self-care is not exclusive to the elderly (8) and could be related to anyone with a chronic disease, at any age of the lifespan. A dependent person is someone with limited capacity or inability to initiate and carry out a set of activities necessary for the maintenance of life, health and well-being, without the help of another person (9). It concerns basic actions in daily living activities such as eating, bathing, care of personal hygiene, the ability to position oneself, walking, transfer or even use of the toilet (10).…”