Autonomous motivation was introduced from the Self-determination theory (Deci & Ryan, 2000); a theory focusing on the intrinsic motivation of a person. In contrast to extrinsic motivation, autonomous motivation is more significant in goal progression (Koestner et al, 2008). Literature found the need satisfaction will predict autonomous motivation, which in turn predicts exercise adherence (Weman-Josefesson et al, 2015). Therefore, in order to improve the compliance to exercise, patients need to build up autonomous motivation. Competence and relatedness were found to have positive relationships with motivation. Consequently, clinicians have to consider the competence of clients and the relatedness of the exercise when prescribing exercise program.
A client has to be able to complete the exercise in order to successfully follow an exercise program. The intensity, dosage, and form of exercise can all affect the competence of a client to complete the exercise. Moreover, clients with particular conditions need extra consideration when prescribing physical activity. For example, a population with chronic pain were found to experience more obstacles to complete the exercise program (Joelsson et al, 2017). Therefore, perceived efforts should be measured when completing an exercise program. The Borg RPE scale, the OMNI scale, the Talk Test and the Feeling Scale are examples of tools that can be used to assess difficulty levels and will aid in modulating cardiorespiratory and resistance exercises (Garber et al, 2011).
In clinics, the measures mentioned above should be promoted to monitor the competence of clients to complete an exercise program, with the aim to improve the motivation to adhere to the program. Practitioners can hand out these measures to clients and encourage clients to use them together with an exercise diary. Practitioners need to explain the significance of those measures to clients, and ensure that they understand these outcome measures. This is crucial as engaging others is necessary to implement a strategy successfully and it is also an inevitable part of the Health LEADS Australia model. In order to successfully engage with clients, practitioners need to communicate with clients with honesty and respect. In practice, we need to understand the difficulties for the client to implement these outcome measures such as a challenging home environment, understanding of the outcome measures or lack of family support. This highlights the importance for practitioners to discuss some strategies to address these difficulties.
Practitioners’ then need to monitor patient outcomes. As stated in the Health LEADS model, achieving outcomes is a key component for successful leadership. Practitioners can assess clients’ measures when there is a need to progress the exercise program. Moreover, questionnaires designed to assess motivation can be used. Continually monitoring the results is good to assess the success of the exercise program as well as motivate clients to adhere with the exercises.
Finally, practitioners can involve the family to monitor the outcome measures. For example, clinician can explain the BORG scale to the family and ask them to monitor the client while the client is exercising. The Health LEADS model promotes a systems based thinking approach, and so in practice, practitioners can think about the involvement of other individuals important to the client, in order to improve motivation.
Hence, outcome measures can be utilized to ensure client competence in order to improve motivation. Engaging others, Achieving Outcomes and Shaping Systems in the leadership model are useful in implementing the change.
Deci, E. L., & Ryan, R. M. (2000). The” what” and” why” of goal pursuits: Human needs and the self-determination of behavior. Psychological inquiry, 11(4), 227-268.
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., … & Swain, D. P. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine & Science in Sports & Exercise, 43(7), 1334-1359.
Joelsson, M., Bernhardsson, S., & Larsson, M. E. (2017). Patients with chronic pain may need extra support when prescribed physical activity in primary care: a qualitative study. Scandinavian journal of primary health care, 35(1), 64-74.
Koestner, R., Otis, N., Powers, T. A., Pelletier, L., & Gagnon, H. (2008). Autonomous motivation, controlled motivation, and goal progress. Journal of personality, 76(5), 1201-1230.
Weman-Josefsson, K., Lindwall, M., & Ivarsson, A. (2015). Need satisfaction, motivational regulations and exercise: moderation and mediation effects. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 67.