Using self‐determination theory in research and evaluation in primary care

Abstract

Background Multimorbidity (the co‐existence of two or more long‐term conditions within an individual) is a complex management challenge, with a very limited evidence base. Theories can help in the design and operationalization of complex interventions. Objective This article proposes self‐determination theory (SDT) as a candidate theory for the development and evaluation of interventions in multimorbidity. Methods We provide an overview of SDT, its use in research to date, and its potential utility in complex interventions for patients with multimorbidity based on the new MRC framework. Results SDT‐based interventions have mainly focused on health behaviour change in the primary prevention of disease, with limited use in primary care and chronic conditions management. However, SDT may be a useful candidate theory in informing complex intervention development and evaluation, both in randomized controlled trials and in evaluations of ‘natural experiments’. We illustrate how it could be used multimorbidity interventions in primary care by drawing on the example of CARE Plus (a primary care‐based complex intervention for patients with multimorbidity in deprived areas of Scotland). Conclusions SDT may have utility in both the design and evaluation of complex interventions for multimorbidity. Further research is required to establish its usefulness, and limitations, compared with other candidate theories. Patient or Public Contribution Our funded research programme, of which this paper is an early output, has a newly embedded patient and public involvement group of four members with lived experience of long‐term conditions and/or of being informal carers. They read and commented on the draft manuscript and made useful suggestions on the text. They will be fully involved at all stages in the rest of the programme of research.

Effective analysis of job satisfaction among medical staff in Chinese public hospitals: a random forest model

“…Thirdly, democracy is the third key variable that affects medical staff job satisfaction. Self-determination theory believes that individuals pursue autonomy and control after meeting their basic needs ( 64 ). Equity and democracy can effectively promote the sustainable development of public health ( 65 ).…”

A Psychological Examination of the Status Syndrome and Its Application for Promoting Well-Being

“…This understanding establishes the possibility that behavioral drive can transition from non-autonomous to autonomous motivation through the process of internalization. This process refers to the adoption and assimilation of external practices and rules into individuals' value systems (Huang et al, 2022;Ryan et al, 2008Ryan et al, , 2022. The goal of SDT-based interventions is to facilitate this transition through an autonomy-supportive environment, enabling individuals to assume control over the steering wheel of their own behavior (Ahmadi et al, 2023;Huang et al, 2022;Ryan et al, 2022).…”

“…This process refers to the adoption and assimilation of external practices and rules into individuals' value systems (Huang et al, 2022;Ryan et al, 2008Ryan et al, , 2022. The goal of SDT-based interventions is to facilitate this transition through an autonomy-supportive environment, enabling individuals to assume control over the steering wheel of their own behavior (Ahmadi et al, 2023;Huang et al, 2022;Ryan et al, 2022). In addition, self-regulated behavior facilitates individuals to address and fulfill other basic psychological needs (i.e., competence, and relatedness) (Ryan & Deci, 2017).…”

“…This has played a crucial role in refining theory and enhancing real-world practices across a wide array of fields (Ryan et al, 2022). For instance, it has proven to be useful for designing interventions aimed at enhancing academic performance (Ahmadi et al, 2023) and improving health-related behaviors (Huang et al, 2022) among other behaviors.…”

Breast cancer screening motivation among women: an application of Self-determination theory

“…This theory focuses on understanding human motivation and the factors that in uence individuals' behaviors and decisions. There are three types of motivation: intrinsic motivation, external motivation, and amotivation (13). This theory has been widely applied and provides insights into how to create environments to support individuals' natural tendencies, ultimately enhancing overall motivation and well-being.…”