Self-Determination Theory and Outpatient Follow-Up After Psychiatric Hospitalization

Abstract

The objective of this study was to assess whether the constructs of self-determination theory-autonomy, competence, and relatedness-are associated with adherence to outpatient follow-up appointments after psychiatric hospitalization. 242 individuals discharged from inpatient psychiatric treatment within the Veterans Health Administration completed surveys assessing self-determination theory constructs as well as measures of depression and barriers to treatment. Medical records were used to count the number of mental health visits and no-shows in the 14 weeks following discharge. Logistic regression models assessed the association between survey items assessing theory constructs and attendance at mental healthcare visits. In multivariate models, none of the self-determination theory factors predicted outpatient follow-up attendance. The constructs of self-determination theory as measured by a single self-report survey may not reliably predict adherence to post-hospital care. Need factors such as depression may be more strongly predictive of treatment adherence.

From the challenge of assessing autonomy to the instruments used in practice: A scoping review

“…55 The present study concludes that, between the 34 articles, thirteen uses this instrument to evaluate the autonomous behaviors. 19,22–25,27,28,34,38,40,43,45,53…”

“…Thus, we found 16 quantitative, correlational and cross-sectorial study, 18–33 9 quantitative, randomized control trial study, 34–42 1 quantitative, correlational and longitudinal study, 43 1 quantitative, scale translation and validation, 44 1 mixed study, quasi-experimental design protocol study, 45 1 qualitative with focus group (1 st phase) and interviews (2 nd phase), 46 1 qualitative, multi-site cross-sectional study, 47 1 quantitative, scale validation, 48 1 quantitative, randomized crossover design 49 and 1 quantitative case-control study. 50 Eight of these studies were carried out in the United States of America (USA), 19,26,31,40,47,50–52 7 in Norway, 20,21,27,34,43,45,48 5 in Finland, 22–25,28 3 in Holland, 32,35,44 2 in England, 30,39 1 in Australia, 38 1 in Thailand, 18 1 in Denmark, 36 1 in Belgium, 37 1 in Ireland, 29,46 1 in Canada, 53 1 in France 54 and 1 in Iran. 33…”

“…Several versions were used by the studies found in the present research, namely the version of the autonomous motivation for the control of diabetes, 22,24,25,34,45 for adherence to a rehabilitation program, 43 for adherence to the practice of physical exercise and rehabilitation plan, 23,28,38 for adherence to consultations after psychiatric hospitalisation, 19 for adherence to oral health programs, 27 for adherence to drug treatment 40 and, finally, for adherence to cognitive-behavioural therapy, interpersonal therapy and pharmacotherapy. 53 This instrument allows, in this way, to evaluate the reasons why the person took a particular behavior and to verify if that decision making was autonomous and without the influence of third parties and was used in quantitative, correlacional, crosssectorial or longitudinal studies, 19,[22][23][24][25]27,28,43 in mixed, quasi-experimental design 45 and quantitative randomized control trial. 34,38,40,53 According to the theory of self-determination, the BNSG scale was designed to assess autonomy, competence, and relationship.…”

“…The scale can be used to assess this motivation for various behaviors, such as the version referring to patients’ behaviors with diabetes and the version referring to participation in a weight loss program. Several versions were used by the studies found in the present research, namely the version of the autonomous motivation for the control of diabetes, 22,24,25,34,45 for adherence to a rehabilitation program, 43 for adherence to the practice of physical exercise and rehabilitation plan, 23,28,38 for adherence to consultations after psychiatric hospitalisation, 19 for adherence to oral health programs, 27 for adherence to drug treatment 40 and, finally, for adherence to cognitive-behavioural therapy, interpersonal therapy and pharmacotherapy. 53…”

“…This instrument allows, in this way, to evaluate the reasons why the person took a particular behavior and to verify if that decision making was autonomous and without the influence of third parties and was used in quantitative, correlacional, cross-sectorial or longitudinal studies, 19,22–25,27,28,43 in mixed, quasi-experimental design 45 and quantitative randomized control trial. 34,38,40,53…”