Application of Motivational Theory in Healthcare

Employee Motivation

Maslow's Hierarchy of Needs is perhaps the most commonly known theory of motivation, which is likely due to the broad applicability of the theory. Maslow developed his hierarchy of needs as part of his research on human potential and a component of positive psychology he termed self-actualization (Maslow, 1943; 1954). Maslow believed that human motivation is heightened when people seek fulfillment through personal growth and discovery. Self-actualized people are fully engaged with their potential, in an ongoing, lifelong effort to create meaning in their lives through highly personalized, positive endeavor (Maslow, 1962).

Doubtless, employers would enjoy not having to be concerned with motivating their employees if, in fact, their employees would "self-actualize" through their work. Indeed, some people do experience self-actualization when they are engaged in their paid employment. But, perhaps more often than not, people who become self-actualized are able to spend time either playing or laboring in a field for which they have a special talent or an intense and all-consuming interest. Maslow (1962) believed that self-actualization was manifested -- and could be measured -- by peak experiences in which a person experiences euphoria, joy, or wonder. Maslow described self-actualization as a "person's desire for self-fulfillment, namely, to the tendency for him to become actualized in what he is potentially." (Maslow, 1943, p. 382). Sadly, experts estimate that less than two percent of the population are self-actualized (Maslow, 1962). Modern social scientists Tay and Diener (2011) argue that human needs are not hierarchical since all of them are important, but their extensive analysis seems to split hairs. While it is true that many now famous artists lived in poverty, they still were able to meet their basic needs on some level and had relationships with other people to varying degrees of success.

Herzberg's (1959) Two Factor Theory took a reductionist approach to motivational theory and asserted that there are two types of factors that affect motivation through different paths. In an odd choice of terminology, Herzberg claimed that hygiene factors can be a source of dissatisfaction -- hence, motivational -- if people consider them to be inequitable or inadequate. If hygiene factors -- such as salary, working conditions, or job security -- are perceived as good or adequate, they do not have motivating power. Herzberg was apparently less inspired when he labeled the second set of factors, calling them simply motivators. These factors were considered by Herzberg to be intrinsic and include achievement, personal growth, recognition, and responsibility.

Motivational theories are broadly categorized according to three different perspectives: Content theories, process theories, and reinforcement theories. The focus of content theories is the relation between the needs and goals of individuals and what they find motivating in that psychological or physical space. Major motivational content theorists include Alderfer, Herzberg, Maslow, and McCelland. Process theories of motivation address the mechanisms of motivation that enable motivation to occur. Major motivational process theorists include, for instance, Adams, Locke, Porter and Lawler, and Vroom.

Reinforcement theory stems from a corpus of evidence-based work that encompasses several lines of research, including classic behaviorism and cognitive behavior theory. Reinforcement motivational theorists include Skinner, Thorndike, and Watson. A significantly softened form of behavior reinforcement is applied in most forms of labor, as a fairly straightforward relationship exists between the elements of employment: A job or position (stimulus), labor or work effort (response) and compensation or wages (reinforcement). Certainly positions can be designed to be optimally reinforcing to workers, and perks can be piled on to act as incentives to other observant workers and to the employees who receive the benefits directly. For example, nurses can be given their choice of shifts according to seniority. Training for advancement can be offered to nurses who show promise as candidates for positions as nursing leaders or nurse educators.