Testing the theory of self-determination as a predictor of quality of life in neurological conditions in long-term care

McCourt, Katie

Abstract

Self-determination theory (SDT; Deci & Ryan, 2008; Ryan & Deci, 2017) provides a framework for intervention development by setting out a comprehensive approach to motivation and health behaviour through its theory and measurement of autonomy, perceived competence and relatedness to others (Deci and Ryan, 1985), whilst also considering the influential role of social context and how this supports or debilitates motivation. SDT has been applied across a number of different health care settings.
However, to date there is little existing research that investigates the application of SDT to those with neurological conditions. There is also limited research that looks at the application of SDT within long- term health care settings, but rather the current literature focuses on acute or outpatient settings.

The key aim of this research is to therefore test the applicableness of the SDT to those with neurological conditions, residing in long-term care settings. To address this gap in literature, a mixed-methods design has been implemented to first quantitatively test the theory of self-determination and then to qualitatively explore the lived experiences of such individuals, in order to gain an understanding of how to support the basic psychological needs of such individuals. For the first phase of data collection (quantitative), fifty-four participants (25 female, 29 male) with neurological conditions, living in long-term care completed SDT and QoL questionnaires. A multiple regression analysis was then ran to establish whether SDT predicts QoL in neurological conditions. Whilst overall, the three key constructs (autonomy, relatedness and competence) did not significantly predict QoL, autonomy was found to be the biggest predictor of QoL.

To explore these results further, in-depth semi-structured interviews were carried out with five participants (1 female, 4 male). Using Interpretative Phenomenological Analysis (IPA), three themes were generated, 1) Living with a neurological condition; 2) What autonomy means to me; 3) Life as a permanent resident. The qualitative results support SDT research and highlight an importance of autonomy-supportive contexts and health care approaches. The results also indicate a need for competence and relatedness to maintain wellbeing and caregivers require training to support these needs adequately. What also became apparent within this research is that an environment can be more disabling than a physical condition and that autonomy becomes more important, as one’s sense of autonomy reduces. As such, research in the future should consider ways to support feelings of autonomy, competence and relatedness of those with neurological conditions residing in long-term care.

• Thesis Type: Thesis
• Deposit Date: Sep 7, 2021
• Publicly Available Date: Apr 25, 2022
• Keywords: Self-Determination Theory
• Public URL: https://uwe-repository.worktribe.com/output/7743362
• Award Date: Apr 25, 2022