Patient's Perceived Autonomy Support Affecting their Levels of Depression and Treatment Motivation

After many modem and dynamic discoveries in health care sector, human behavior along with his attitude is still the main influencer on the deviations that occurs in the health-related consequences (Schroeder, 2007). People when become aware of their diagnoses with cancer, their health and eudemonia gets highly affected. In order to fulfill the bio-psychosocial requirements of cancer patients, their therapeutic interventions should include the patient focused considerations like living standards, depressive symptoms along with physiologic measures (Glasgow, 2003). According to self-determination theory (SDT: Deci & Ryan, 2000) patient's experience and motivation should be monitored carefully as they are the behavioral mediators of health outcomes. SDT provides a theoretical account to highlight how professionals, investigators, and rules personage can work progressively for the biological and psychosocial consequences of the patient. SDT investigators presume that congenitally individuals are directed towards development and wellness; they feel self-reliant, capable and considered as important (Sheldon, Williams, & Joiner, 2003). SDT differentiates between autonomous and controlled supportive environment by defining autonomy as an experience of choice and will power when a person behaves congruously with his own deep rooted beliefs and values. Whereas controlled support involves behavior due to requirement or warnings from either extraneous factor (e.g., family member) or rigid belief to avoid guilt or disgrace one must behave accordingly. SDT depicts that psychological responses towards cancer depends upon counseling of health care professionals' experiencing both self-reliant and skilled (Williams, Deci, & Ryan, 1998). Multiple aspects of human autonomy have evaluated in clinical research, some care must be required to adopt and distinguish among these concepts. For example in many areas it has been mentioned that sometime patients with achievement/independent are more vulnerable for depression (Nietzel & Harris, 1990). In some other work it also focused on autonomous motivation for treatment (Zuroff, Koestner, Moskowitz, McBride, Marshall, & Bagby, 2007). However the both versions of autonomy can show the relatively stable characteristics of the individual that can be preventively measured before the treatment. In opposite to it interaction of individual within the group setting is defined as autonomy satisfaction and thus, can be validly measured by group treatment.As per SDT theory the patients requires maintenance in their behaviors to adopt values along with skills to change internally and then expose themselves to self-governance. In this theory it also comments that maximizing the patient's internalized experience of his independence, ability and likeliness can maintain the patient's behavioral change (Williams, Deci, & Ryan, 1998). SDT being the general motivation theory, engendered experimental and field studies on the influence of perceived autonomy support on patient's depression and thus on treatment motivation (Deci & Ryan, 2000). From the past one and a half decades growing studies on change in health related behavior include application of SDT (Patrick & Williams, 2011; Ryan & Deci, 2008; Williams et ah, 1998). These studies focused on the action of factors linked with the patient's autonomy ability and relatedness in the treatment environment and their effect on change initiation and its stability over time.SDT focused on the procedures adopted by a person to motivate the initiation of new health related behaviors and sustaining them consistently. Sense of autonomy and competence is vital component of internalization and integration which determines person's self- regulation and retain behaviors contributing to wellness and health. Thus, the climates where the intervention being done can bear autonomy and can provide assurance which in turn increases the adaptability and thus enhance health outcomes. …