Motivation in the return to work process: a self-determination cluster approach

Abstract

Purpose

Motivation may predict return to work (RTW), yet the measurement of motivation needs more scientific evidence. We adopt a dimensional approach, based on the self-determination theory (SDT), distinguishing between amotivation, controlled and autonomous motivation. We seek to explore the presence of these dimensions in sick-disabled patients, and are interested in associations with quality of life, depression, patient’s predictions of RTW, and health care provider estimations of patient’s motivation.

Materials and methods

A cross-sectional study in 336 patients was conducted. Motivation was assessed using the Motivation at Work Scale (MAWS) and examined in relation to patient outcomes, patient’s prediction of RTW, and health care provider estimations of patients’ motivation. A cluster analysis was performed, and differential associations between motivational profiles were explored.

Results

Cluster analysis revealed four profiles. Highly controlled profiles were most prevalent, reported poorer mental quality of life, and expected a longer time before RTW, regardless of the level of autonomous motivation. Interestingly, the health care provider’s estimation was not related to controlled motivation.

Conclusions

Our results show that SDT may help to differentiate people with a work disability regarding their motivation to RTW. Most notably, the devastating consequences of controlled motivation are discussed, and clinical implications are provided.

Implications for Rehabilitation

• Assessing the different dimensions of motivation in the context of RTW will be a significant advance as the self-report measures appear to be viable tools.

• Controlled motivation, which indicates that people are motivated to RTW but only because they “have to”, has negative consequences yet a high prevalence and should therefore be addressed by the practitioner.

• Practitioners should keep in mind that employees are motivated by several motives at the same time, with some being more beneficial than others.

• Controlled motivation can be converted into autonomous (i.e., good quality) motivation by supporting autonomy of the patient, by supporting their relationships with colleagues, managers, and health care providers and by supporting their feeling of competence in the RTW process.

Keywords:

• Self-determination theory
• motivation
• return to work
• work disability
• vocational rehabilitation
• quality

Acknowledgements

The authors thank the Alliance of Christian Sickness funds for their support on recruitment and data collection and prof. Maarten Vansteenkiste for the explanatory notes and availability of the BPNSFS questionnaire.

Disclosure statement

Partial funding for the study was provided by the Alliance of Christian Sickness funds. The authors report no conflict of interest.

Notes

1 Only 230 of the 366 participants filled in this item.

2 Only 130 participants filled in this question.