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Intrinsic motivation: how can it play a pivotal role in changing clinician behaviour?

Nantha YS

J Health Organ Manag, 2013;27(2):266-72.
PMID: 23802402

In the light of an increasing healthcare burden, this paper seeks to offer insight about how intrinsic motivation could play a pivotal role in improving the pre-existing healthcare service delivery systems by altering clinician behaviour. The paper argues the case for four salient dimensions worth exploring through the lens of intrinsic motivation--non-financial incentives, positive affective states, organizational culture and prescribing quality.

Matched MeSH terms: Professional Autonomy*
Fulltext Intention to adopt clinical decision support systems in a developing country: effect of physician's perceived professional autonomy, involvement and belief: a cross-sectional study

Sambasivan M, Esmaeilzadeh P, Kumar N, Nezakati H

BMC Med Inform Decis Mak, 2012;12:142.
PMID: 23216866 DOI: 10.1186/1472-6947-12-142

Computer-based clinical decision support systems (CDSS) are regarded as a key element to enhance decision-making in a healthcare environment to improve the quality of medical care delivery. The concern of having new CDSS unused is still one of the biggest issues in developing countries for the developers and implementers of clinical IT systems. The main objectives of this study are to determine whether (1) the physician's perceived professional autonomy, (2) involvement in the decision to implement CDSS and (3) the belief that CDSS will improve job performance increase the intention to adopt CDSS. Four hypotheses were formulated and tested.

Matched MeSH terms: Professional Autonomy*
Influence of job demands and job control on work-life balance among Taiwanese nurses

Ng LP, Chen IC, Ng HF, Lin BY, Kuar LS

J Nurs Manag, 2017 Sep;25(6):438-448.
PMID: 28419626 DOI: 10.1111/jonm.12482

AIM: This study investigated the extent to which the job demands and job control of nurses were related to their work-life balance.
BACKGROUND: The inability to achieve work-life balance is one of the major reasons for the declining retention rate among nurses. Job demands and job control are two major work domain factors that can have a significant influence on the work-life balance of nurses.
METHOD: The study measured the job demands, job control and work-life balance of 2040 nurses in eight private hospitals in Taiwan in 2013.
RESULTS: Job demands and job control significantly predicted all the dimensions of work-life balance. Job demands increased the level of work-life imbalance among nurses. While job control showed positive effects on work/personal life enhancement, it was found to increase both work interference with personal life and personal life interference with work.
CONCLUSION: Reducing the level of job demands (particularly for psychological demands) between family and career development and maintaining a proper level of job control are essential to the work-life balance of nurses.
IMPLICATIONS FOR NURSING MANAGEMENT: Flexible work practices and team-based management could be considered by nursing management to lessen job demand pressure and to facilitate job engagement and participation among nurses, thus promoting a better balance between work and personal life.

Matched MeSH terms: Professional Autonomy*
Work-related stress and its associated factors among primary care doctors in Malaysia during the COVID-19 pandemic

Shahrudin MS, Nik-Nasir NM, Mohamed-Yassin MS

BMC Prim Care, 2025 Jan 07;26(1):4.
PMID: 39773193 DOI: 10.1186/s12875-024-02697-7

BACKGROUND: In Malaysia, the recent COVID-19 pandemic had increased the workload of all health professionals, especially primary care doctors (PCDs). Hence, this study aimed to determine the level of work-related stress and factors associated with higher levels of work-related stress among PCDs in Malaysia during this pandemic.
METHODS: A cross-sectional study was conducted online using Google Forms™. Sociodemographic as well as work and workplace data were collected. The Job Demand Inventory, Physicians' Lack of Professional Autonomy, and Health Professions Stress Inventory questionnaires were used to assess the job demand score, job autonomy score, and the level of work-related stress, respectively. Multiple linear regression was performed to determine the significant factors associated with higher work-related stress.
RESULTS: A total of 301 PCDs participated in this study with the majority being female (76.1%), Malay (67.8%), married (73.1%), medical officers (68.8%), and worked in urban (70.4%) and public primary care clinics (83%). The mean (SD) score for work-related stress was 62.8 (18.4), (score range 0-120). PCDs who had any degree of worry about being alienated by friends and relatives because of close contact with COVID-19 patients had higher work-related stress levels compared to PCDs who did not have any worry [rarely (b = 10.23, 95% CI:5.57, 14.89), sometimes (b = 10.41, 95% CI:5.68, 15.13), often (b = 10.12, 95% CI:4.16, 16.08), and always (b = 14.65, 95% CI:7.43, 21.89)]. The other significant factor was higher job demand scores (b = 1.13, 95% CI:0.91, 1.35). In contrast, PCDs who always received support from supervisors at their workplace were found to have lower work-related stress levels compared to those who did not receive any support (b=-5.65, 95% CI:-10.38, -0.93).
CONCLUSIONS: The level of work-related stress among Malaysian PCDs during the COVID-19 pandemic was higher compared to American PCDs and Malaysian physicians before the pandemic but lower compared to Australian emergency physicians during the pandemic. Urgent measures to address the above-mentioned associated factors should be implemented as another pandemic may be just around the corner.

Matched MeSH terms: Professional Autonomy
Adoption of clinical decision support systems in a developing country: Antecedents and outcomes of physician's threat to perceived professional autonomy

Esmaeilzadeh P, Sambasivan M, Kumar N, Nezakati H

Int J Med Inform, 2015 Aug;84(8):548-60.
PMID: 25920928 DOI: 10.1016/j.ijmedinf.2015.03.007

The basic objective of this research is to study the antecedents and outcomes of professional autonomy which is a central construct that affects physicians' intention to adopt clinical decision support systems (CDSS). The antecedents are physicians' attitude toward knowledge sharing and interactivity perception (about CDSS) and the outcomes are performance expectancy and intention to adopt CDSS. Besides, we include (1) the antecedents of attitude toward knowledge sharing-subjective norms, social factors and OCB (helping behavior) and (2) roles of physicians' involvement in decision making, computer self-efficacy and effort expectancy in our framework.

Matched MeSH terms: Professional Autonomy*
Orthopaedic surgeons and the device industry: skeletons in the closet

Poduval M

Indian J Med Ethics, 2011 Apr-Jun;8(2):97-102.
PMID: 22106619

The relationship between orthopaedic surgeons and the device industry is one that is mutually beneficial and productive. However there are skeletons in the closet. The financial implications of this relationship have come under intense scrutiny. The sponsorships and the financial benefits of this symbiotic relationship have been found to cross the boundaries considered acceptable to ethical practice of the profession. In India, the ethical transgressions resulting from unhealthy associations between the orthopaedic surgeon and the industry have yet to be given due importance. Adequate rules and regulations are yet to be enforced and self-regulation is practically non-existent. It is essential to deal with the problem and potential implications that can arise from this kind of misconduct at the organisational level and enforce them for compliance.

Matched MeSH terms: Professional Autonomy
Private medical practitioners and managed care in Malaysia: a survey of knowledge and attitudes held by Federal Territory based doctors

Marnoch G, Lian PC

Soc Sci Med, 2002 Mar;54(6):869-77.
PMID: 11996021

This paper considers the subject of managed care in Malaysia, providing a questionnaire-based analysis of the position adopted by private medical practitioners. Managed care is now seen as the dominant health care system in the United States, with many other countries around the world including Malaysia beginning to selectively use component parts to tackle particular health care problems. In this survey it was found that three out of four respondents have concerns regarding the implementation of managed care. The survey was used to identify and categorise these concerns. At the same time, three out of four respondents held the opinion that principles of managed care were already a reality or would be in the next 5 years. This group expressed an eagerness to be trained in managed care principles and be given the opportunity to be part of managed care organisations. It is argued that clinicians' knowledge and interest perceptions are an important influence on the implementation of managed care based systems. The survey-based evidence presented in this article is intended as a measure of current understandings and beliefs, in relation to clinical micro-management process associated with managed care.

Matched MeSH terms: Professional Autonomy
A nationwide study on generic medicines substitution practices of Australian community pharmacists and patient acceptance

Chong CP, March G, Clark A, Gilbert A, Hassali MA, Bahari MB

Health Policy, 2011 Feb;99(2):139-48.
PMID: 20732723 DOI: 10.1016/j.healthpol.2010.08.002

This study evaluated Australian community pharmacists' rate of generic medicine substitution, patient acceptance of generic substitution and cost-savings achieved for patients from substitution.

Matched MeSH terms: Professional Autonomy
Risk factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) hospitals in Kelantan

Aziah BD, Rusli BN, Winn T, Naing L, Tengku MA

Southeast Asian J Trop Med Public Health, 2004 Jun;35(2):468-75.
PMID: 15691158

A cross-sectional study was conducted to determine the risk factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) Hospitals in Kelantan, between September 2001 and February 2002. One hundred and two laboratory technicians from HUSM and 79 from KKM Hospitals were selected and 84 (82.4%) from HUSM and 71 (89.9%) from KKM Hospitals were recruited as study subjects. Data were collected by self-administered questionnaire using the validated Malay version of the Job Content Questionnaire (JCQ), originally developed by Robert Karasek. The results indicated significant associations between the risk factors of job-related depression, and low social support, and high psychological demands (OR 3.0, 95% CI 1.1-8.8) in laboratory technicians in HUSM. However, for laboratory technicians in KKM Hospitals, the significant association was between job-related depression, and low social support and low decision authority (OR 9.7, 95% CI 1.1-91.1). Low social support was highly associated with job-related depression in laboratory technicians in HUSM and KKM Hospitals. We, therefore, conclude that low social support positively predicted depression in laboratory technicians in HUSM and KKM Hospitals. In addition, high psychological demands also significantly predicted depression in laboratory technicians in HUSM; however, for laboratory technicians in KKM Hospitals, low decision authority was the significant predictor of depression.

Matched MeSH terms: Professional Autonomy
Evaluating community pharmacists' perceptions of future generic substitution policy implementation: a national survey from Malaysia

Chong CP, Hassali MA, Bahari MB, Shafie AA

Health Policy, 2010 Jan;94(1):68-75.
PMID: 19762106 DOI: 10.1016/j.healthpol.2009.08.011

This study aims to provide baseline data to support the implementation of generic substitution policy in Malaysia by evaluating the community pharmacists' perceptions and opinions on generic substitution and current substitution practices.

Matched MeSH terms: Professional Autonomy