2. Definition of Motivation
Motivation defined as
1. a psychological force that moves a person toward some
kind of action,
OR
2. a willingness of the learner to embrace learning, with
readiness to learn as evidence of motivation
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3. Definition of Motivation
• according to Kort, it is the result of both internal and
external factors and not the result of external motivation
alone.
• Motivation is Movement in the direction of meeting a need
or reaching a goal
• Ideally, the nurse’s role is to help the learner to reach a
desired goal and to prevent untimely delays
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4. Motivation
• Maslow (1943): The major premises of Maslow's
motivation theory are integrated wholeness of the
individual and a hierarchy of needs.
• These needs are organized by level of potency—
physiological, safety, love/belonging, Self-esteem, and self-
actualization.
e.g. the basic need to satisfy hunger
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5. Motivational Factors
• Factors that influence motivation can serve as incentives or
obstacles to achieve desired behaviors.
• Both creating incentives and decreasing obstacles to
motivation pose a challenge for the nurse as a teacher of
patients
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6. Motivational Factors
Facilitating or blocking factors that shape motivation can be
classified Into three categories
1- Personal attributes
consist of physical, developmental, and psychological
components of the individual learner
2- Environmental influences which include the surroundings,
and the attitudes of others
3- Relationship systems: such as significant other, family,
community, and teacher learner interaction
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7. Motivational Factors
1- Personal attributes
Developmental stage
Age
Gender
Emotional readiness
Value and beliefs
Sensory functioning
Cognitive ability
Educational level
Actual or perceived state of health
Severity and/or chronicity of illness
Level of natural curiosity
Capacity for short-term & long-term memory
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8. Motivational Factors
2- Environmental influences
Factors that influence motivation includes:
• Physical characteristics of the learner environment
• Accessibility and availability of human and material
resources
• Different types of behavioral rewards
3- Relationship systems
such as significant other, family, community, and teacher
learner interaction all influence an individual’s
motivation
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9. Motivational Axioms
Motivational axioms are rules that set the stages for
motivation.
They include:
The state of optimum anxiety
Learner readiness
realistic goals setting
Learner satisfaction/success
Dialogue about uncertainty
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10. Parameters of Assessment of Motivation
• When collecting assessment data the nurse can ask
several questions of the learner, such as those focusing on
1. previous attempts,
2. curiosity,
3. goal setting,
4. self-care,
5. stress factors,
6. survival issues, and
7. life situation
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11. Parameters of Assessment of
Motivation…cont.
Motivational assessment needs to be comprehensive,
systematic, and based on concepts:
A. Cognitive variables
B. Affective variables
C. Physiological variables
D. Experiential variables
E. Environmental variables
F. Educator-learner relationship system
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12. A. Cognitive Variables
Capacity to learn
Readiness to learn
Expressed self determination
Constructive (positive )attitude
Expressed desire and interest
Willingness to contract for behavioral outcomes
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13. B. Affective Variables
Expressions of constructive emotional state
Moderate level of anxiety (optimum state)
C. Physiological Variables
• Capacity to perform required behavior
D. Experiential Variables
• Previous successful experiences
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14. E. Environmental Variables
Appropriateness of physical environment
Social support systems
Family
Group
Work
Community resources
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16. Motivational Strategies
• Incentives, can be either intrinsically or extrinsically
generated, incentives and motivation are both stimuli to
act.
• When applicable incentive are absent or reduced, then the
individual is likely to move away from the desired outcome.
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17. Motivational Strategies (cont’d
When Teaching others, the nurse shall clarify
communication directions and expectations are critical.
The nurse shall organize material in a way that makes
information meaningful to learner,
The nurse shall give positive verbal and non-verbal feedback
The nurse shall provide opportunities for success.
In the educational situation, reducing or eliminating barriers
to achieve goals helps to instill or maintain motivation
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18. Motivational/Models
ARCS Model:
According to John Keller’s ARCS Model of Motivational
Design Theories, there are four steps for promoting and
sustaining motivation in the learning process: Attention,
Relevance, Confidence, Satisfaction (ARCS)
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19. ARCS Model of Motivational Design (Keller)
1. Attention
Keller attention can be gained in two ways: (1) Perceptual
arousal – uses surprise or uncertainly to gain interest. Uses
novel, surprising, incongruous, and uncertain events; or (2)
Inquiry arousal – stimulates curiosity by posing challenging
questions or problems to be solved.
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20. • Methods for grabbing the learners’ attention include the
use of:
Active participation -Adopt strategies such as games,
roleplay or other hands-on methods to get learners
involved with the material or subject matter.
Variability – To better reinforce materials and account for
individual differences in learning styles, use a variety of
methods in presenting material (e.g. use of videos, short
lectures, mini-discussion groups).
Humor -Maintain interest by use a small amount of humor
(but not too much to be distracting)
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21. Incongruity and Conflict – A devil’s advocate approach in
which statements are posed that go against a learner’s past
experiences.
Specific examples – Use a visual stimuli, story, or biography.
Inquiry – Pose questions or problems for the learners to
solve, e.g. brainstorming activities.
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22. 2. Relevance
• Establish relevance in order to increase a learner’s
motivation. To do this, use concrete language and examples
with which the learners are familiar. Six major strategies
described by Keller include:
Experience – Tell the learners how the new learning will use their
existing skills. We best learn by building upon our preset
knowledge or skills.
Present Worth – What will the subject matter do for me today?
Future Usefulness – What will the subject matter do for me
tomorrow?
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23. Needs Matching – Take advantage of the dynamics of
achievement, risk taking, power, and affiliation.
Modeling – First of all, “be what you want them to do!”
Other strategies include guest speakers, videos, and having
the learners who finish their work first to serve as tutors.
Choice – Allow the learners to use different methods to
pursue their work or allowing s choice in how they
organize it.
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24. • 3. Confidence
• Help students understand their likelihood for success. If they feel they
cannot meet the objectives or that the cost (time or effort) is too high,
their motivation will decrease.
• Provide objectives and prerequisites – Help students estimate the
probability of success by presenting performance requirements and
evaluation criteria. Ensure the learners are aware of performance
requirements and evaluative criteria.
• Allow for success that is meaningful.
• Grow the Learners – Allow for small steps of growth during the
learning process.
• Feedback – Provide feedback and support internal attributions for
success.
• Learner Control – Learners should feel some degree of control over
their learning and assessment. They should believe that their success is
a direct result of the amount of effort they have put forth.
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25. 4. Satisfaction
• Learning must be rewarding or satisfying in some way,
whether it is from a sense of achievement, praise from a
higher-up, or mere entertainment.
• Make the learner feel as though the skill is useful or
beneficial by providing opportunities to use newly
acquired knowledge in a real setting.
• Provide feedback and reinforcement. When learners
appreciate the results, they will be motivated to learn.
Satisfaction is based upon motivation, which can be
intrinsic or extrinsic.
• Do not patronize the learner by over-rewarding easy tasks.
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26. Definition of Compliance Terminology
Compliance:
Is term used to describe submission or yielding to
predetermined goals.
Healthcare literature suggests that:
Compliance is the equivalent of achieving a goal based on a
preset regimen.
Compliance to health regimen is an observable behavior and
as such can be directly measured
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27. Definition of Compliance Terminology
(cont’d)
Adherence is a commitment or attachment to a prescribed,
predetermined regimen.
Both compliance and adherence are term used in the
measurement of health outcome; interchangeably.
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28. Definition of Compliance Terminology
(cont’d)
Noncompliance: non submission or resistance of an individual
to follow a prescribed, predetermined regimen.
This term carries a negative implication of the learner, but may
in fact be a rigid response or defensive coping mechanism to
a stressful situation.
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29. Compliance/Adherence
• Compliance:
is observable
Can be measured
Health care provider viewed as authority
Learner viewed as submissive
Refers to the ability to maintain health -promoting regimens
Outcomes determined largely by health-care provider
Compliance can be directly measured through the health behavior
while motivation measured by behavioral consequences or results
Adherence: commitment to a regimen, can be used interchangeably
with compliance
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30. Compliance and control
Concepts Impacting on Compliance
Health locus of control
• Internals: self directed
• Externals: Others powerful in influencing health
outcomes Functional literacy & locus of control
influence compliance
• Non compliance: resistance of the individual to follow
predetermined regimen
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32. 1. Health Belief Model
• HBM was developed in 1950 to examine why people did not
participate in health-screening programs.
• This model was modified by Becker (1974) to address
compliance to therapeutic regimens.
• Becker 1990 notified two major premises of the model that
need to be present:
• 1- the client’s willingness to participate in disease prevention
and curing regimen
• 2- the belief that health is highly valued
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34. Health Belief Model
• HBM used as a predictor of preventive health behavior.
• HBM shows the direction and the flow of three components:
1- the individual perception component compromises
perceived susceptibility or perceived severity of a specific
disease.
2-The modifying factors component consists of (demographic,
socio-psychological, and structural variables).
3-The likelihood of action component consists of perceived
benefits minus perceived barriers.
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35. 2. Health Promotion Model
HPM developed 1987 and revised 1996
The emphasis on actualizing health potential and increasing the
level of well-being Using approach behaviors rather than
avoidance of disease behaviors
Distinguishes this model as a health promotion rather than
health a disease prevention model
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36. … Health Promotion Model
The three major components are as follow:
1- Individual characteristics and experiences, which consist of
two variables—prior related behavior and personal factors.
2- Behavior-specific cognitions and affect, which consist of
perceived benefit, perceived barriers, perceived self-efficacy,
activity-related affect, interpersonal influence,& situational
influence.
3- Behavioral outcome which consist of health-promoting
behavior.
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38. 3. Stages of Change model
SC Model (1982) was developed around addictive and problem
behavior.
The six stages as follow:
1- Pre contemplation stage—the individual makes no plans to
change. teaching strategy—discussion
2- Contemplation stage—identify the problem & contemplate
change. teaching Strategy—clarify issues
3- Preparation stage—plans to make change soon
teaching Strategy—develop plan for action
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39. … Stages of Change model
4- Action stage—actively changes behavior
teaching Strategy—create environment conductive to
change
5- Maintenance stage—maintains new behavior over time
teaching Strategy—maintain environment to conductive
change.
6-Termination stage—no further risk of relapse to old behavior
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43. 43
IN CONCLUSION:
When information Is imparted, accepted, and applied, the
foundation is set for change in health behaviors.
When people are motivated and know that they can make a
difference in their own lives, then a barrier to health has
been lifted.
