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Journal of Aging and Physical Activity Sep 2019Identifying the difference in barriers and motivators between middle-age and older adults could contribute toward the development of age-specific health promotion... (Review)
Review
Identifying the difference in barriers and motivators between middle-age and older adults could contribute toward the development of age-specific health promotion interventions. The aim of this review was to synthesize the literature on barriers and motivators for physical activity in middle-aged (50-64 years) and older adults (65-70 years). The review examined qualitative and quantitative studies using the theoretical domain framework as the guiding theory. The search generated 9400 results from seven databases. A total of fifty-five articles meeting the inclusion criteria. Results indicate that barriers are comparable across the two age groups with environmental factors and resources being the most commonly identified barriers. In older adults, social influences, reinforcement and assistance in managing change were the most identified motivators. Middle-aged identified goals settings, believe that activity will be beneficial and social influences were most important. Findings can be used by professionals to encourage engagement with and adherence to physical activity.
Topics: Aging; Exercise; Female; Health Promotion; Humans; Male; Middle Aged; Motivation; Physical Fitness; Social Participation; Social Support
PubMed: 31141447
DOI: 10.1123/japa.2018-0343 -
Journal of Advanced Nursing Jul 2020To identify current best evidence on the types of interventions that have been developed to improve job satisfaction among nurses and on the effectiveness of these... (Meta-Analysis)
Meta-Analysis Review
AIMS
To identify current best evidence on the types of interventions that have been developed to improve job satisfaction among nurses and on the effectiveness of these interventions.
DESIGN
The systematic review is a quantitative systematic review and meta-analysis following a profile-likelihood random-effects model.
DATA SOURCES
CINAHL, Medic, and Pubmed (Medline).
REVIEW METHODS
PICOS eligibility criteria were used to select original studies published between 2003-2019. The articles were screened by title (N = 489), abstract (N = 61), and full-text (N = 47). A total of 20 articles remained after the full-text screening process and further assess on risk of bias. The screening process was conducted by two authors independently and finally agreed together. A meta-analysis was performed to determine how the identified interventions influence nurses' job satisfaction.
RESULTS
The interventions were primarily educational and consisted of workshops, educational sessions, lessons, and training sessions. The postintervention differences between intervention and control groups in meta-analysis revealed that two interventions significantly improved nurses' job satisfaction. Notably, the spiritual intelligence training protocol and Professional Identity Development Program were found to be effective in improving job satisfaction.
CONCLUSION
Healthcare organizations and managers should consider implementing effective interventions to improve nurses' job satisfaction and reduce turnover. The results reported in this study highlight that nurse managers should focus on organizational strategies that will foster the intrinsic motivation of employees.
IMPACT
The current nursing shortage and increased turnover intentions are proving to be a global problem. For this reason, it is imperative that nurse managers plan strategies to improve nurses´ job satisfaction. The effective interventions detected in this study are a first step for developing human resource strategies for healthcare organizations. These findings propose that extrinsic factors (e.g., salary and rewards) will never be as effective in maintaining job satisfaction as intrinsic factors (e.g., spiritual intelligence, professional identity, and awareness).
Topics: Humans; Job Satisfaction; Motivation; Nurses; Nursing Staff, Hospital; Personnel Turnover
PubMed: 32128864
DOI: 10.1111/jan.14342 -
The British Journal of General Practice... Apr 2005Motivational Interviewing is a well-known, scientifically tested method of counselling clients developed by Miller and Rollnick and viewed as a useful intervention... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Motivational Interviewing is a well-known, scientifically tested method of counselling clients developed by Miller and Rollnick and viewed as a useful intervention strategy in the treatment of lifestyle problems and disease.
AIM
To evaluate the effectiveness of motivational interviewing in different areas of disease and to identify factors shaping outcomes.
DESIGN OF STUDY
A systematic review and meta-analysis of randomised controlled trials using motivational interviewing as the intervention.
METHOD
After selection criteria a systematic literature search in 16 databases produced 72 randomised controlled trials the first of which was published in 1991. A quality assessment was made with a validated scale. A meta-analysis was performed as a generic inverse variance meta-analysis.
RESULTS
Meta-analysis showed a significant effect (95% confidence interval) for motivational interviewing for combined effect estimates for body mass index, total blood cholesterol, systolic blood pressure, blood alcohol concentration and standard ethanol content, while combined effect estimates for cigarettes per day and for HbA(1c) were not significant. Motivational interviewing had a significant and clinically relevant effect in approximately three out of four studies, with an equal effect on physiological (72%) and psychological (75%) diseases. Psychologists and physicians obtained an effect in approximately 80% of the studies, while other healthcare providers obtained an effect in 46% of the studies. When using motivational interviewing in brief encounters of 15 minutes, 64% of the studies showed an effect. More than one encounter with the patient ensures the effectiveness of motivational interviewing.
CONCLUSION
Motivational interviewing in a scientific setting outperforms traditional advice giving in the treatment of a broad range of behavioural problems and diseases. Large-scale studies are now needed to prove that motivational interviewing can be implemented into daily clinical work in primary and secondary health care.
Topics: Data Collection; Humans; Interviews as Topic; Motivation; Randomized Controlled Trials as Topic; Reproducibility of Results
PubMed: 15826439
DOI: No ID Found -
BMC Health Services Research Dec 2017Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing.
METHODS
Reviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised.
RESULTS
Nine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant.
CONCLUSIONS
In making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave.
TRIAL REGISTRATION
PROSPERO Registration 17 March 2015: CRD42015017613 .
Topics: Adult; Female; Humans; Intention; Interpersonal Relations; Job Satisfaction; Leadership; Male; Motivation; Nursing Staff; Organizational Culture; Personnel Turnover; Power, Psychological; Review Literature as Topic; Salaries and Fringe Benefits; Workload
PubMed: 29246221
DOI: 10.1186/s12913-017-2707-0 -
Health Technology Assessment... Jun 2020For people with diabetes mellitus to achieve optimal glycaemic control, motivation to perform self-management is important. The research team wanted to determine whether...
BACKGROUND
For people with diabetes mellitus to achieve optimal glycaemic control, motivation to perform self-management is important. The research team wanted to determine whether or not psychological interventions are clinically effective and cost-effective in increasing self-management and improving glycaemic control.
OBJECTIVES
The first objective was to determine the clinical effectiveness of psychological interventions for people with type 1 diabetes mellitus and people with type 2 diabetes mellitus so that they have improved (1) glycated haemoglobin levels, (2) diabetes self-management and (3) quality of life, and fewer depressive symptoms. The second objective was to determine the cost-effectiveness of psychological interventions.
DATA SOURCES
The following databases were accessed (searches took place between 2003 and 2016): MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PsycINFO, EMBASE, Cochrane Controlled Trials Register, Web of Science, and Dissertation Abstracts International. Diabetes conference abstracts, reference lists of included studies and Clinicaltrials.gov trial registry were also searched.
REVIEW METHODS
Systematic review, aggregate meta-analysis, network meta-analysis, individual patient data meta-analysis and cost-effectiveness modelling were all used. Risk of bias of randomised and non-randomised controlled trials was assessed using the Cochrane Handbook (Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. 2011;:d5928).
DESIGN
Systematic review, meta-analysis, cost-effectiveness analysis and patient and public consultation were all used.
SETTING
Settings in primary or secondary care were included.
PARTICIPANTS
Adolescents and children with type 1 diabetes mellitus and adults with types 1 and 2 diabetes mellitus were included.
INTERVENTIONS
The interventions used were psychological treatments, including and not restricted to cognitive-behavioural therapy, counselling, family therapy and psychotherapy.
MAIN OUTCOME MEASURES
Glycated haemoglobin levels, self-management behaviours, body mass index, blood pressure levels, depressive symptoms and quality of life were all used as outcome measures.
RESULTS
A total of 96 studies were included in the systematic review ( = 18,659 participants). In random-effects meta-analysis, data on glycated haemoglobin levels were available for seven studies conducted in adults with type 1 diabetes mellitus ( = 851 participants) that demonstrated a pooled mean difference of -0.13 (95% confidence interval -0.33 to 0.07), a non-significant decrease in favour of psychological treatment; 18 studies conducted in adolescents/children with type 1 diabetes mellitus ( = 2583 participants) that demonstrated a pooled mean difference of 0.00 (95% confidence interval -0.18 to 0.18), indicating no change; and 49 studies conducted in adults with type 2 diabetes mellitus ( = 12,009 participants) that demonstrated a pooled mean difference of -0.21 (95% confidence interval -0.31 to -0.10), equivalent to reduction in glycated haemoglobin levels of -0.33% or ≈3.5 mmol/mol. For type 2 diabetes mellitus, there was evidence that psychological interventions improved dietary behaviour and quality of life but not blood pressure, body mass index or depressive symptoms. The results of the network meta-analysis, which considers direct and indirect effects of multiple treatment comparisons, suggest that, for adults with type 1 diabetes mellitus (7 studies; 968 participants), attention control and cognitive-behavioural therapy are clinically effective and cognitive-behavioural therapy is cost-effective. For adults with type 2 diabetes mellitus (49 studies; 12,409 participants), cognitive-behavioural therapy and counselling are effective and cognitive-behavioural therapy is potentially cost-effective. The results of the individual patient data meta-analysis for adolescents/children with type 1 diabetes mellitus (9 studies; 1392 participants) suggest that there were main effects for age and diabetes duration. For adults with type 2 diabetes mellitus (19 studies; 3639 participants), baseline glycated haemoglobin levels moderated treatment outcome.
LIMITATIONS
Aggregate meta-analysis was limited to glycaemic control for type 1 diabetes mellitus. It was not possible to model cost-effectiveness for adolescents/children with type 1 diabetes mellitus and modelling for type 2 diabetes mellitus involved substantial uncertainty. The individual patient data meta-analysis included only 40-50% of studies.
CONCLUSIONS
This review suggests that psychological treatments offer minimal clinical benefit in improving glycated haemoglobin levels for adults with type 2 diabetes mellitus. However, there was no evidence of benefit compared with control interventions in improving glycated haemoglobin levels for people with type 1 diabetes mellitus.
FUTURE WORK
Future work should consider the competency of the interventionists delivering a therapy and psychological approaches that are matched to a person and their life course.
STUDY REGISTRATION
This study is registered as PROSPERO CRD42016033619.
FUNDING
This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in ; Vol. 24, No. 28. See the NIHR Journals Library website for further project information.
Topics: Cognitive Behavioral Therapy; Cost-Benefit Analysis; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Humans; Motivation; Psychosocial Intervention; Psychotherapy; Quality of Life; Self-Management
PubMed: 32568666
DOI: 10.3310/hta24280 -
Psychological Medicine Oct 2016Exercise can improve clinical outcomes in people with severe mental illness (SMI). However, this population typically engages in low levels of physical activity with... (Meta-Analysis)
Meta-Analysis Review
Exercise can improve clinical outcomes in people with severe mental illness (SMI). However, this population typically engages in low levels of physical activity with poor adherence to exercise interventions. Understanding the motivating factors and barriers towards exercise for people with SMI would help to maximize exercise participation. A search of major electronic databases was conducted from inception until May 2016. Quantitative studies providing proportional data on the motivating factors and/or barriers towards exercise among patients with SMI were eligible. Random-effects meta-analyses were undertaken to calculate proportional data and 95% confidence intervals (CI) for motivating factors and barriers toward exercise. From 1468 studies, 12 independent studies of 6431 psychiatric patients were eligible for inclusion. Meta-analyses showed that 91% of people with SMI endorsed 'improving health' as a reason for exercise (N = 6, n = 790, 95% CI 80-94). Among specific aspects of health and well-being, the most common motivations were 'losing weight' (83% of patients), 'improving mood' (81%) and 'reducing stress' (78%). However, low mood and stress were also identified as the most prevalent barriers towards exercise (61% of patients), followed by 'lack of support' (50%). Many of the desirable outcomes of exercise for people with SMI, such as mood improvement, stress reduction and increased energy, are inversely related to the barriers of depression, stress and fatigue which frequently restrict their participation in exercise. Providing patients with professional support to identify and achieve their exercise goals may enable them to overcome psychological barriers, and maintain motivation towards regular physical activity.
Topics: Exercise; Humans; Mental Disorders; Motivation
PubMed: 27502153
DOI: 10.1017/S0033291716001732 -
Psychological Bulletin Mar 2012A review of 13 years of research into antecedents of university students' grade point average (GPA) scores generated the following: a comprehensive, conceptual map of... (Meta-Analysis)
Meta-Analysis Review
A review of 13 years of research into antecedents of university students' grade point average (GPA) scores generated the following: a comprehensive, conceptual map of known correlates of tertiary GPA; assessment of the magnitude of average, weighted correlations with GPA; and tests of multivariate models of GPA correlates within and across research domains. A systematic search of PsycINFO and Web of Knowledge databases between 1997 and 2010 identified 7,167 English-language articles yielding 241 data sets, which reported on 50 conceptually distinct correlates of GPA, including 3 demographic factors and 5 traditional measures of cognitive capacity or prior academic performance. In addition, 42 non-intellective constructs were identified from 5 conceptually overlapping but distinct research domains: (a) personality traits, (b) motivational factors, (c) self-regulatory learning strategies, (d) students' approaches to learning, and (e) psychosocial contextual influences. We retrieved 1,105 independent correlations and analyzed data using hypothesis-driven, random-effects meta-analyses. Significant average, weighted correlations were found for 41 of 50 measures. Univariate analyses revealed that demographic and psychosocial contextual factors generated, at best, small correlations with GPA. Medium-sized correlations were observed for high school GPA, SAT, ACT, and A level scores. Three non-intellective constructs also showed medium-sized correlations with GPA: academic self-efficacy, grade goal, and effort regulation. A large correlation was observed for performance self-efficacy, which was the strongest correlate (of 50 measures) followed by high school GPA, ACT, and grade goal. Implications for future research, student assessment, and intervention design are discussed.
Topics: Aptitude Tests; Data Collection; Educational Measurement; Educational Status; Forecasting; Goals; Humans; Learning; Models, Statistical; Motivation; Personality; Regression Analysis; Research Design; Self Efficacy; Students; Universities
PubMed: 22352812
DOI: 10.1037/a0026838 -
Journal of Sport & Exercise Psychology Oct 2011This article presents a systematic review of the literature examining the relationship between self-talk and performance. "Second-generation questions" regarding... (Review)
Review
This article presents a systematic review of the literature examining the relationship between self-talk and performance. "Second-generation questions" regarding potential mediators and moderators of the self-talk-performance relationship were also examined. A total of 47 studies were analyzed. Results indicated beneficial effects of positive, instructional, and motivational self-talk for performance. Somewhat surprisingly, two evidence-based challenges to popular current viewpoints on self-talk emerged. First, negative self-talk did not impede performance. Second, there was inconsistent evidence for the differential effects of instructional and motivational self-talk based on task characteristics. Results from the mediation-based analysis indicate that cognitive and behavioral factors had the most consistent relationships with self-talk. The findings are discussed in the context of recent theoretical advances, and the article includes recommendations for future research (e.g., the use of designs allowing the testing of meditational hypotheses) and for current applied practice (e.g., avoiding the use of thought-stopping techniques).
Topics: Adolescent; Adult; Athletes; Female; Humans; Male; Motivation; Self Stimulation; Task Performance and Analysis; Young Adult
PubMed: 21984641
DOI: 10.1123/jsep.33.5.666 -
Journal of Biomedical Informatics Jul 2017Gamification is a relatively new trend that focuses on applying game mechanics to non-game contexts in order to engage audiences and to inject a little fun into mundane... (Review)
Review
Gamification is a relatively new trend that focuses on applying game mechanics to non-game contexts in order to engage audiences and to inject a little fun into mundane activities besides generating motivational and cognitive benefits. While many fields such as Business, Marketing and e-Learning have taken advantage of the potential of gamification, the digital healthcare domain has also started to exploit this emerging trend. This paper aims to summarize the current knowledge regarding gamified e-Health applications. A systematic literature review was therefore conducted to explore the various gamification strategies employed in e-Health and to address the benefits and the pitfalls of this emerging discipline. A total of 46 studies from multiple sources were then considered and thoroughly investigated. The results show that the majority of the papers selected reported gamification and serious gaming in health and wellness contexts related specifically to chronic disease rehabilitation, physical activity and mental health. Although gamification in e-Health has attracted a great deal of attention during the last few years, there is still a dearth of valid empirical evidence in this field. Moreover, most of the e-Health applications and serious games investigated have been proven to yield solely short-term engagement through extrinsic rewards. For gamification to reach its full potential, it is therefore necessary to build e-Health solutions on well-founded theories that exploit the core experience and psychological effects of game mechanics.
Topics: Delivery of Health Care; Disease Management; Game Theory; Humans; Learning; Mental Health; Mobile Applications; Motivation; Motor Activity; Surveys and Questionnaires; Video Games
PubMed: 28536062
DOI: 10.1016/j.jbi.2017.05.011 -
Health Psychology Review Sep 2016Behaviour change interventions are effective in supporting individuals in achieving temporary behaviour change. Behaviour change maintenance, however, is rarely... (Review)
Review
BACKGROUND
Behaviour change interventions are effective in supporting individuals in achieving temporary behaviour change. Behaviour change maintenance, however, is rarely attained. The aim of this review was to identify and synthesise current theoretical explanations for behaviour change maintenance to inform future research and practice.
METHODS
Potentially relevant theories were identified through systematic searches of electronic databases (Ovid MEDLINE, Embase, PsycINFO). In addition, an existing database of 80 theories was searched, and 25 theory experts were consulted. Theories were included if they formulated hypotheses about behaviour change maintenance. Included theories were synthesised thematically to ascertain overarching explanations for behaviour change maintenance. Initial theoretical themes were cross-validated.
FINDINGS
One hundred and seventeen behaviour theories were identified, of which 100 met the inclusion criteria. Five overarching, interconnected themes representing theoretical explanations for behaviour change maintenance emerged. Theoretical explanations of behaviour change maintenance focus on the differential nature and role of motives, self-regulation, resources (psychological and physical), habits, and environmental and social influences from initiation to maintenance.
DISCUSSION
There are distinct patterns of theoretical explanations for behaviour change and for behaviour change maintenance. The findings from this review can guide the development and evaluation of interventions promoting maintenance of health behaviours and help in the development of an integrated theory of behaviour change maintenance.
Topics: Behavior Therapy; Habits; Health Behavior; Humans; Individuality; Learning; Models, Psychological; Motivation; Personal Satisfaction; Self-Control; Social Support
PubMed: 26854092
DOI: 10.1080/17437199.2016.1151372