Aims and Research Questions
Self-determination Theory (SDT; Deci & Ryan, 1985; Ryan & Deci, 2000) claims and research indicates that an autonomy-supportive clinic context facilitate patient autonomous motivation and competence, which both are critical prerequisites for increased responsibility for own health behaviour, long-term behaviour change and health functioning. Thus, the aims of this project are to answer the following research questions:
- What relations are there between autonomy-support provided by dental hygienists and dentists and (a) patients motivation for dental home care, their dental self-care behaviour and self-rated oral health? (b) patients motivation and anxiety for dental treatment, their dental self-care behaviour and dental clinic attendance? (c) patients motivation for dental treatment, their self-rated oral health and subjective dental well-being?
- Would an autonomy-supportive intervention (relative to standard treatment) lead to positive changes in patient needs satisfaction, autonomous motivation for dental care, improved dental health behaviour and reductions in dental plaque and gingivitis?
The Self-Determination Theory Process Model of Change Recent research supports that medical students who perceived their instructors as more autonomy-supportive became more autonomous in their learning and perceived themselves to be more competent, which in turn led them to be more effective when they interviewed a simulated patient six months later (Williams & Deci, 1996). Other research has highlighted the importance of autonomy-supportive patient care for
- increases in autonomous motivation and perceived competence for attendance at a weight-loss program and for long-term maintained weight loss (Williams et al., 1996);
- facilitating autonomous motivation for taking medications which in turn led to patients’ medication adherence (Williams, Rodin, et al., 1998);
- enhancement of autonomous motivation and perceived competence for diabetes self-management and improved glycemic control for patients with Type 2 diabetes (Williams et al., 2004); and
- increases in motivation for dental treatment, perceived dental competence, and dental behaviour, and reductions in dental plaque and gingivitis (Halvari & Halvari, 2006).
Thus, in the present studies, we hypothesized that patients’ perceptions of autonomy supportive dental professionals were expected to be positively associated with patients’ motivation for dental care, which in turn would be positively linked to: (study 1a) dental behaviours and self-rated oral health; (study 1b) dental behaviours and dental clinic attendance; and (study1c) self-rated oral health and subjective dental well-being. In study 2 we hypothesized that an autonomy-supportive clinic intervention, relative to standard care, would lead to positive changes in autonomous motivation for dental care and perceived dental competence, positive changes in dental health behaviours, and reductions in dental plaque and gingivitis over 6 months.