Critical Assessment Literature Review

Critical Assessment Literature Review
Critical Assessment Literature Review

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Critical Assessment Literature Review

Write 6-7 pages of a Critical Assessment Literature Review related to your research question. Your textbook (McMillan, 2012) includes an excellent definition of, and step-by-step instructions for, writing a literature review in chapter 3.

Research Question: How can I use group forums to motivate students in an eighth-grade algebra class? 
Use the literature review template (see attachments). 
Use the following instructions to complete your literature review:

1. In addition to the peer-reviewed primary research articles, you found earlier this week, locate and use 2-5 additional sources related to your research question.

Critical Assessment Literature Review

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2. Analyze the literature and write a scholarly review of the 5-8 sources as they pertain to your question/statement.

3. Use the Sample Literature Review 1, and Sample Literature Review 2 as guidelines for your writing.

The Sample Literature Review is a full review from a thesis paper. For this assignment, your literature review needs to be only 6 pages (double-spaced, 12 point, APA format). 4. Use the Literature Review Template to write your literature review.5. Include a reference page with proper APA style and formatting.

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Mining Existing Literature Reviews on Mental Health Services

Mining Existing Literature Reviews
Mining Existing Literature Reviews

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Mining Existing Literature Reviews

This paper entails mining existing literature reviews of three dissertations concerning transition of veterans from armed forces to civilian-force. The mining and evaluation process will involve pointing out the common themes, quoted authors, outline organization and its rationale.  Finally, the findings are summarized and provided along with each dissertation’s literature review outline and a highlight of how it is connected to the proposed dissertation topic. 

Serving those who served: Retention of newly returning veterans from Iraq and Afghanistan in mental health treatment

Table 1 and Table 2 below provide outline of the literature review and summary of quoted authors respectively. Furthermore, the analysis of this literature will follow.      

Table 1

Outline for Literature Review
Definition of Mental Health     Veterans with mental disorders   Combat stressors Effects of OEF/OIF on mental health   Evidence-Based Interventions   Relevance to Veteran Affairs (VA) services to veterans with PTSDPTSD Diagnosis Mental Health/PTSD Interventions   Retention and number of visits mental health services   Favorable environmental intervention and support   Teaching social emotional education to the veterans   VA Chart and Psychotherapy protocols for monitoring   Summary
Table 2
AuthorsBroad Topics
Hoge Milliken   Schell Marshall Ramchand Schnurr     Frayne Cohen     Seal Sayer   Rosenheck  Rate of PTSD and related veteran mental health services   The risk of PTSD in discharged and retired OEF/OIF  Veterans The rate of PTSD soldiers as in active-duty soldiers     Diagnosis of PTSD and utilization of both mental and non-mental services by veterans     PTSD mental and non-mental health services interventions and monitoring   Implementing sustainable interventions for the purpose of dealing with PTSD stressors.    

Time to Treatment among Veterans of Conflicts in Iraq and Afghanistan with Psychiatric Diagnoses

Table 3 and Table 4 below provide outline of the literature review and summary of quoted authors respectively. Furthermore, the analysis of this literature will follow.  

Table 3  

Outline for Literature Review
Definition of Psychiatric Diagnoses      Veterans of Conflicts in Afghanistan and Iraq   Main cause of psychiatric diagnoses Effects of mental health treatment timing on OEF/OIF veterans after deployment     Evidence-Based Interventions   Chronic mental health problems Psychiatric  DiagnosesPsychiatric  Diagnoses Interventions    Veteran Affairs (VA) health servicesEarly mental health treatment initiation Determinants of time to initial mental health visit (age, race or ethnic)   VA services and timing of care for monitoring     Summary
Table 4
AuthorsBroad Topics
Seal Schell     Wang Lane Olfson   Litz Maguen   O’Donnell Bryant  Creamer  Rates of utilization of mental health and primary care services among OEF/ OIF/OND veterans   The risk factors to psychiatric diagnoses among OEF/OIF  Veterans   Diagnosis of chronic mental conditions among OEF/OIF veterans     Early mental health timing Prevention of psychiatric symptoms chronicity

A Hero’s Welcome? Exploring the Prevalence and Problems of Military Veterans in the Arrestee Population

Table 5 and Table 6 below provide outline of the literature review and summary of quoted authors respectively. Furthermore, the analysis of this literature will follow.  

Mining Existing Literature Reviews

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Table 5

Outline for Literature Review
History on Returning Military Veterans   Definition of mental disorders that affected veterans   Combat veterans from Vietnam and 9/11 wars  The Link between Military Service, Combat-related Problems and CriminalityVeteran in Criminal Justice System     Relevance to Criminal Justice System  Veteran Affairs (VA) services to veterans with anti-social behaviors Retention and number of visits mental health services   Favorable environmental intervention and support   Teaching social emotional education to the veterans   Creating awareness among veterans on the criminal justice systemAlternative approaches to veterans who have been arrested and incarcerated    Summary     
Table 6
AuthorsBroad Topics
Mumola   Noonan Mumola   Fontana Rosenheck   Seal, Bertenthal, Miner, Sen, & Marmar   Greenburg RoyRate of incarcerated veterans with mental health conditions Historical comparison of the populations of incarcerated veterans and those who have transitioned   The Link between Military Service, Combat-related Problems and Criminality   Diagnosis  and Treatment of Combat-related Problems among veterans   Awareness and alternative approaches to incarcerated veterans  

Summary of the mined literature reviews   

The purpose of these dissertations literature reviews was to evaluate the growing concerns on the status of the mental health services offered to veterans returning home from Afghanistan (Operation Enduring Freedom [OEF] and Iraq (Operation Iraq Freedom [OIF]) mainly with regards to retention in mental health treatment of veterans with PTSD.

It is noted that retention as well as numbers of visits declined among OIF-OEF veterans primarily mainly due comorbid conditions and age; hence, the design of interventions should be aimed at specific health care barriers.  In addition, it has also be noted that failure to effectively offer appropriate mental health services to veterans with PTSD prior to their transition from armed force to civilian-force results to increased criminal records.  

Mining Existing Literature Reviews

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Thematic organizations in the three dissertations is done chronologically with authors adopting a pyramid-like approach, which starts with basic/background concepts, then diagnosis issues, and finally mental and non-mental interventions. An observation of the themes covered in the three dissertations, the common ones included growing rates of PTSD, Combat PTSD stressors or risk factors, the need for proper diagnosis of PTSD, available mental and non-mental health services for veterans facilitated by Veteran Affairs (VA).

The themes are strongly related to my dissertation topic because they are primarily covering on health services required for veterans, especially those with mental conditions or PTSD mostly arising from their role in combat particularly in Iraq and Afghanistan.  Hence, these themes are mainly concerned with health services crucial for the transition of veterans from armed force (combat) to civilian force (non-combat) which is my dissertation topic.

Mining Existing Literature Reviews


Harpaz-Rotem, I., & Rosenheck, R. A.  (2011). Serving those who served: Retention of newly returning veterans from Iraq and Afghanistan in mental health treatment. Psychiatric Services, 62, 22-27. (Dissertation)

Magen, S., Madden, E., Cohen, B. E., Bertenthal, D., & Seal, K. H. (2012). Time to Treatment among Veterans of Conflicts in Iraq and Afghanistan with Psychiatric Diagnoses. Psychiatric Services, 63(12) 1206-12. (Dissertation)    

White, M. D., Mulvey, P., Fox, A. M., & Choate, D. (2011). A Hero’s Welcome? Exploring the Prevalence and Problems of Military Veterans in the Arrestee Population. Justice Quarterly, First published on: 28 March 2011 (iFirst): 1-29. (Dissertation)

Mining Existing Literature Reviews

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Transition Experience of New Graduate Nurses Literature Review

Transition Experience of New Graduate Nurses
Transition Experience of New Graduate Nurses

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Transition Experience of New Graduate Nurses

Transitioning from a student into a professional practitioner is a difficult experience for most people. However, the transition experience is especially difficult for graduate nurses who are ushered into a demanding work environment. Most new nurses are shocked at the sheer contrast between student life and work. Just a few weeks after employment, Graduate nurses are expected to take up serious responsibilities including patient care and supervisory duties.

This review explores literature on the New Graduate Nurse (NG) transition experience with the aim of discovering shortcomings in this knowledge area. This research hopes to bridge the gap in knowledge about self-care strategies that NGNs can use as the transition to Registered Nurses.


Waves of research have studied the experiences of nurses as they transit from student to practicing Registered nurses. The first research wave focused on the experiences of individual nurses during the transition phase. The second wave, investigated the effectiveness of interventions meant to support nurses during the transition. Most studies into the experience of New Graduate Nurses (NGNs) used survey and interviews to arrive at their conclusions. The studies reported that NGNs initially found the role of practicing nurse extremely stressing and they reported many challenges.

However, role stress decreased as NGNs gained confidence, obtained clinical support and developed competence (Casey, Fink, Krugman, &Propst 2004; Halfer& Graf, 2006). NGNs described the transition as a difficult time filled with feeling or incompetence, fear of physicians, an overwhelming sense of responsibility, and difficulties in prioritizing, organizing or delegating tasks. Bowles and Candela (2005) carried a study in Nevada that sought to find the attrition rates of new nurse.

It was reported that approximately 30% of NGNs quit their first nursing jobs within the first year of employment. In just two years, 57% had moved from their first jobs. According to Bowles and Candela (2005), the high nurse turnover hinders work productivity, quality patient outcomes and the morale of the staff. Moreover, high turnover means healthcare organization have to incur the cost of rehiring and retraining new nurses to take the roles of those who leave. 

While training more nurses may solve the nurse shortage problem, the problem of deficient patient care and supportive work environment needs to be handled to smooth the nurse transition. Casey et al (2004) found that NGNs are not satisfied with their working environment as they lamented the lack of a consistent preceptor, struggles with authority, a feeling of being undervalued, and workload issues. Chi, Laschinger and Wong (2006) carried out a study on transition among 226 nurses with less than 2 years practice experience.

The study reported similar results to Casey et al (2005); they indicated that there were high burnout rates among new nurses. The nurse complained about the lack of support, limitation of access to resources and opportunities as their main barrier to productivity at the transition phase. However, the job satisfaction outcomes of NGNs improved significantly after the first 18 months of practice. Halfer and Graf (2006) reported high job satisfaction rates among 84 subject of their research.

The two authors argued that nurse started to enjoy their work once they were able to organize their time, prioritize tasks, access resource, understand job expectation, and were made aware of the availability of professional development opportunities.  Studies of nursing thought processes also indicate support the conclusion that the transition is a stressing time for graduate nurses.

According to Pellico, Brewer and Kovner (2009), NGNs’ confidence was initially low as they were unsure about the experience and knowledge , they also feared the interaction with patients as they felt they would not be able to understand their issues. NGNs were also worried about acting autonomously and deciding when it was necessary to call physicians.  By the 9 month, NGNs had significantly boosted their confidence and were able to make competent patient care decisions.

The research wave on NGNs’ transition experience was followed by studies that investigated institutional initiatives to smooth the transition. The second wave was concerned with the preceptor and recognized him/her as a crucial component of the NGN transition process (Bowles and Candela, 2005). This phase of research proposed formal classes; evidence based practice, and guidance and mentoring as crucial precepts of nursing practice. 

The studies proposed that all medical care should be involved in precepting, the presence of a designated preceptor and rewards for those who successfully carry out the preceptor’s role (Bowles and Candela, 2005). Some studies indicated that extended residencies and structured orientation to support the NGN transition improved job satisfaction and reduced the high nurse turnover. NGNs have complained about limited orientation, disorientation, feelings of confusion and loss, overwhelming responsibility as the main barriers to successful transitions.

The difficulties of the NGNs transition to practice are further complicated by other changes in their life (Scott, Engelke and Swanson, 2008). NGNs may have moved to a new town, become married or changed schools. Obviously, the new nurse transition face is fraught with difficult and there is need for support and self-management strategies to handle the stresses of this phase of a nurse’s career.

Experiences of New Nurses

 NGNs transitioning issues can be classified into four broad themes; demands on nurses, support at the workplace, the control of their role as employees, and perceptions of self efficacy (Bowles and Candela, 2005). 

Workplace Demands

Demand in the workplace on new nurses is a theme that has been explored by many studies. NGNs identified workplace demands such as staff shortages, workload, decision making responsibilities and administrative duties as overwhelming issues (Casey et al, 2004). A survey of newly licensed nurses around the US found that demands relating to time were among the most stressing issues for NGNs. Nurses complained that they were often required to work hard or fast by their supervisors.

Casey et al (2004) also noted that nurses found it stressing to take responsibility for patient care provided by unregulated staff. Unfortunately, nursing has the dubious distinction of being the only profession which requires new practitioners to assume supervisory duties.  Studies exploring the expectations of the multidisciplinary team working with new nurses reveal too high expectations of the (NGNs Waite, 2004). At eight weeks, the multidisciplinary team studied in the research expected new nurses to be able to make specific clinical assessments, be able to use laboratory data, and be able to react to emergencies (Dyess and Sherman, 2009).

In addition, the team expected the NGNs to be knowledgeable about the whole health systems.  Many employers have complained about the deficit of key skills and the readiness of NGNs to deal with the demanding clinical environment.  NGNs critical thinking skills and approaches to medication administration have also been called into question by some scholars.  Romyn et al (2009) argued that NGNs are often responsible for near misses and medication errors as they are not proficient enough handle the medication demands of the job. 

According to Edwards et al (2015), the concerns about the competence of NGNs are not unwarranted as competent performance is not guaranteed while working with graduate nurses.  The lack of a consistent system to measure the performance of NGNs also further complicates the expectation of competence placed upon them. One of the common criteria for measuring competence in nursing is speed and ability to complete specific tasks (Romyn et al, 2009).

Unfortunately, the speed of New Graduate nurses may be quite low and they may not have the same capability to handle patient issues as experienced nurses (Delaney, 2003).  This method of evaluating the performance of NGNs sees their work condemned as unsatisfactory and is often associated with stress among the new graduates joining the workforce.

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Many NGNs report concerns about the control or autonomy of their new roles as practicing nurses. Many new nurses complained that being responsible and accountable to patients was stressing (Delaney, 2003). Duchscher and Cowin (2004) pointed out student nurse roles did little to equip NGNs for the responsibilities awaiting them in practice. Duchscher and Cowin (2004) support the view that patient care decision and outcome responsibilities often overwhelm new nurses. 

However, the reactions of the NGNs varied as some embraced the new responsibilities, but most reported a feeling of being overwhelmed (Delaney, 2003). Researchers have argued that control is a double edged sword in the transition period. For nurses who embrace responsibility and accountability easily, it is exhilarating and exciting. In contrast, control brings about a feeling of anxiety for nurses who are unprepared for the new responsibilities.

NGNs may also suffer disorientation and poor sense of control as a result of unfamiliarity with the practice environment.  NGNs are surprised when they realize that the practice environment is significantly different from the school context (Duchscher, 2001). Chang and Hancock (2003) argue that NGNs can experience as a result of uncertain expectation of the new role which gives rise to role ambiguity.


Support by supervisors or coworkers plays a significant role in easing the NGN transition process. Often NGNs expend much effort in trying to familiarize themselves with existing workers in their healthcare setting (Casey et al, 2004). Duchscher and Cowin (2004) note that NGNs are in need the support of other members of the multidisciplinary team. Majority of NGNs report that there are adequately supported by preceptors and colleagues (Delaney, 2003).

They also reported that they felt part of the team. However, new nurse could not challenge established ways of doing things as they lacked support in doing this. Nurses also need support from family and friends outside the workplace. In fact, nurse reported that they performed better when they received support from outside the workplace.


Casey et al (2004) reported that NGNs feel incompetent and inadequate as they begin practicing as nurses. Many new nurses report feeling as if they did not posses the necessary skills or knowledge to work as Registered Nurses (Delaney, 2003; Duchscher and Cowin, 2004). NGNs also greatly doubted their clinical competence as they lacked a frame of reference unlike experienced healthcare workers (Duchscher and Cowin, 2004). Duchscher and Cowin (2004) points out those NGNs felt their inadequate knowledge was a serious limitation.  However, NGNs reported higher self-efficacy and confidence scores as they continued to gain clinical experience. 

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Transition Impacts

Job stress

Job stress is one of the most widely reported results of the NGN transition (Delaney, 2003; Duchscher and Cowin, 2004; Twibell et al 2012; Pellico, Brewer and Kovner, 2009). Despite the emphasis on job stress in many studies, few have investigated the intensity of stress affecting NGNs. Chang and Hancock (2003) reported that the transition experience resulted in moderate amounts of stress among NGNs. According to Casey et al (2004), NGNs comfort and confidence is initially very high as the new graduates join the profession, however, it decreases with time in the job.

Fortunately, nurse comfort and confidence starts to increase as they gain experience and peaks one year after commencing practice. Chang and Hancock (2003) reported that nurses experience many stressors during the transition process.  According to the two, the initial stressors include role ambiguity and responsibilities.  After one year of employment, the main stressor is role overload.

Job Satisfaction

One of the most ignored outcomes of NGN transition is the job satisfaction impact. Common studies have emphasized on the challenges experienced during the transition phase but rarely have the satisfying job aspects being explored.  Delaney (2003) reported that some new nurses reported that they found their new roles as practicing nurses satisfying. Nurse’s satisfaction with their work increased when they started to recognize available opportunities for personal growth and development.

Some NGNs reported that it felt exciting to finally take up the role of a practicing nurse.  However, NGNs also reported many dissatisfying elements in their work, these included dizzying pace of work, inadequate staffing and too much autonomy and responsibility (Pellico, Brewer and Kovner, 2009; Casey et al, 2004; Chang and Hancock, 2003). Nurse who were satisfied with their work also were also more intent on staying with their employer.

Further research explored job satisfaction as an independent variable and presented interesting research findings.  Delaney (2003) reported that nurses who were satisfied with their jobs felt a strong sense of belonging to the organization. Satisfaction in jobs was also negatively associated with role stress, role ambiguity and conflict during the transition process (Chang & Hancock, 2003).

Research has also explored outcomes such as turnover intent and nurse turnover. Many of these outcomes increase when there is shortage of nursing manpower.  A high patient:nurse turnover is likely to precede and increase in patient mortality and has been indicated as an accelerator of nurse burnout (Bowles and Candela, 2005). Nurses report that the main causes of high turnover among NGNs are poor work design and emotional exhaustion.

These result support the need to research into self-management strategies that nurses can use to cope to the stressing experiences of the transition process. Twibell et al (2012) have hypothesized that self-care strategies may help nurse achieve higher levels of satisfaction with their jobs.

Interventions to support NGNs

Decades of research have popularized the notion that NGN transition is a process that needs to be addressed (Bowles and Candela, 2005).  Many interventions have been applied to assist is making the transitioning process easy. However, there are few reports of intervention that aim to teach nurses how to self-manage the transition by performing recommended self-care practices. 

Early studies recommended the use of internship programs and preceptor pairing to expose the nurse to the “real world” prior to commencing practice (Bowles and Candela, 2005).  However, the value of preceptor and internship programs have come into questions recently and new research is needed to clarify the value they add to the NGN transition process.

One of the gaps in NGN transition research is the lack of measurement of the effectiveness of interventions to support NGN transition (Bowles and Candela, 2005). Many of the early studies, presented subjective results of the effectiveness of the interventions they were studying.  Later studies in the late 1980s started to include quantitative measures of the effectiveness of the interventions (Casey et al 2004). However, most of the studies failed to measure the impact of the studies on patient outcome. Some of these studies are included in this review.


The NGN transition process is a well researched area within the nursing profession. Most stakeholders seem to be aware of the problems that face NGNs as they transition into their practice.  Decades of research present findings detailing mostly ineffective interventions to deal with the NGN transition process. One of the most common intervention experimented in research was the use of internship, residencies and preceptors. However, many researchers call into question the usefulness of these interventions in addressing the problems of new nurse’s commencing practice.

This research reveals two reasons why intervention to smooth the NGN transition failed to work despite decades of research.  First, the early interventions were never objectively evaluated and thus the opportunity to gauge their effectiveness and increase their impact was missed. Furthermore, most of the intervention were designed to address problems identified in specific health care settings and were not backed by an understanding of the issues facing NGNs. 

Few of the interventions sought to get to the bottom of the stress experienced by NGNs. Secondly, the interventions failed to take into consideration the many elements of the practice environment. This review presents some of the environmental factors that lead to a difficult experience for NGNs transitioning to practice. NGNs perception of their own abilities and knowledge is among the most stressing factors.

Many NGNs feel incompetent and inadequate when there are starting out. This attitude contrast sharply to the work demand, high expectation, and responsibility that characterize their work environment. Other healthcare workers expect nurses to exhibit the same level of competence and skills as experienced practitioners less than two months after being employed. 

Few nurses are prepared for the sudden responsibility and autonomy they have over patient care decision.  Many find the new responsibility overwhelming and are stressed. However, a substantial number of new nurses are excited and exhilarated to work autonomously. This review also indicates that support from colleagues, supervisors, family and friends are important for a successful transition. Nurses who receive support express confidence in their ability, Skills and knowledge. 

This review has revealed that the NGN transition process can be an extremely stressing period. Many studies point to the stress and emotional distraught that is experienced by NGNs during the transition. Most studies report that new nurse feel overwhelmed by the demands of the new environment, feelings of inadequacy and fear of failure. Very few studies have investigated the possible positive impact of self-care mechanism that may assist nurse’s cope with the difficult transition period. This research will seek to address this gap in research and provide valuable evidence that may be used to improve the NGN transition experience significantly.


Bowles, C., & Candela, L. (2005). The first job experiences of recent RN graduates. Journal of Nursing Administration, 32(3), 130Y136.

Casey, K., Fink, R. R., Krugman, A. M., & Propst, F. J. (2004). The graduate nurse experience. Journal of Nursing Administration34(6), 303-311.

Chang, E., & Hancock, K. (2003). Role stress and role ambiguity in new nursing graduates in Australia. Nursing & health sciences5(2), 155-163.

Cho, J., Laschinger, H., & Wong, C. (2006). Workplace empowerment, work engagement and organizational commitment of the new graduate nurses. Nursing Leadership, 19(3), 43Y60.

Delaney, C. (2003). Walking a fine line: Graduate nurses’ transition experiences during orientationJournal of Nursing Education42(10), 437-443.

Duchscher, J. E. B., & Cowin, L. S. (2004). The experience of marginalization in new nursing graduates. Nursing Outlook52(6), 289-296.

Dyess, S. M., & Sherman, R. O. (2009). The first year of practice: New graduate nurses’ transition and learning needs. The Journal of Continuing Education in Nursing40(9), 403-410.

Edwards, D., Hawker, C., Carrier, J., & Rees, C. (2015). A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse.International journal of nursing studies52(7), 1254-1268.

Halfer, D., & Graf, E. (2006). Graduate nurse perceptions of the work experience. Nursing Economics24(3), 150.

Pellico, L. H., Brewer, C. S., & Kovner, C. T. (2009). What newly licensed registered nurses have to say about their first experiences.Nursing outlook57(4), 194-203.

Romyn, D. M., Linton, N., Giblin, C., Hendrickson, B., Houger Limacher, L., Murray, C., … & Weidner, A. (2009). Successful transition of the new graduate nurse. International Journal of Nursing Education Scholarship6(1).

Scott, E. S., Engelke, M. K., & Swanson, M. (2008). New graduate nurse transitioning: necessary or nice?. Applied Nursing Research,21(2), 75-83.

Twibell, R., St Pierre, J., Johnson, D., Barton, D., Davis, C., Kidd, M., & Rook, G. (2012). Tripping over the welcome mat: Why new nurses don’t stay and what the evidence says we can do about it. American Nurse Today7(6), 357-365.

Waite, R. (2004). Psychiatric nurses: Transitioning from student to advance beginner RN. Journal of the American Psychiatric Nurses Association10(4), 173-180.

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Theories of Motivation: Literature review

Theories of Motivation: Literature review
Theories of Motivation: Literature review

Theories of Motivation: Literature review

Literature Review


            This chapter shall present a review of the literature on the problems presented in this research. The theory builds a platform of understanding the implication of non-financial rewards within the framework of the total rewards structure. Specifically, the areas that shall be covered in this chapter are theories of motivation, financial rewards, non-financial rewards, and the work environment. This chapter shall begin with theoretical review followed by a conceptual framework, empirical review and research gap.

Theoretical Review

            Following Anfara & Mertz (2006), a theoretical framework determines the problem that should be investigated, what specific question should be asking, and data that should be collected to address all questions. Therefore, in this study, it is empirical to include theories Herzberg’s Two-Factor Theory, Maslow’s theory of needs, social exchange and expectancy theory.

Herzberg’s Two-Factor Theory

            Dr. Fredrick Herzberg, a psychologist, determined to understand the effects of attitude towards motivation, he had set a research by asking questions to selected people about their behavior towards their jobs. On the basis of research’s result, he had developed Herzberg’s Motivation-Hygiene Theory, also known as Herzberg’s Two-Factor Theory. This theory suggests that motivation is two-dimensional and each dimension has unique factors. Herzberg revealed that each factor is associated with job satisfaction and job dissatisfaction.

He suggested that when an intrinsic factor or motivator is present, it promotes motivation. In contrast, the latter, if none of the factors are present, hence, employees become frustrated, unsatisfied and reduces motivation, which he referred the act as hygiene. In the simpler note, motivators are identified as achievement, recognition, advancement, personal and professional growth.

Hygiene on the other hand, Herzberg classified the factors salary, benefits, interpersonal relationship with supervisors and colleagues, administrative policies and attitude, working conditions and environment, and security (IFPO, 2007; Stello, 2011; Thompson, 2013). In this research, it is conventional to use the theory as a basis for understanding the factors that considerably affects the employee’s behavior towards their tasks.

Incorporating Herzberg’s theory into this research, it suggests that intrinsic and extrinsic motivators can crucially influence the workforce. Moreover, Herzberg had pointed that the ability of the workforce to achieve the goals are mainly related to job satisfaction (Stello, 2011).

However, in the expansion of the theory, the initial hypothesis concludes that job satisfaction and dissatisfaction cannot be dependably measured in the same range. It profoundly explains in Herzberg’s main hypothesis, that factors that lead to positive attitude will differ to those factors that lead to negative attitudes. In the second hypothesis, it is mentioned that factors and effects will differ from long-range sequences of events to a short-range sequence (Stello, 2011; Thompson, 2013).

In this case, Herzberg found that a relatively high sequence from a small number of factors can promote positive behavior towards the job. Predominantly, most of the factors where intrinsic motivators and that it steamed longer than extrinsic. Extrinsic motivators showed low sequence events; it is rare when these factors are found in high-frequency events (Bassett‐Jones & Lloyd, 2005; Stello, 2011).

Satisfaction (positive)

            Consequently, the given figure shows that salary as a part of the extrinsic factor may show similar frequency in both low and high sequence events. However, salary may be viewed as satisfier if related to a job appreciation and not a factor itself. Therefore, when salary is addressed individually, the context can lead to dissatisfier factor (Bassett‐Jones & Lloyd, 2005; Stello, 2011).

Maslow’s hierarchy of needs

            In-depth understanding what motivates people, Maslow’s Hierarchy of Needs will support the efficacy of human needs. In this theory, Maslow stated that to achieve certain needs; people are motivated. Thus, when a need is fulfilled, the person’s next step is to achieve another need and so on. It is why, self-actualization priced on the top of his theory (McLeod, 2007; Montana & Charnov, 2008).

The pyramid illustrates how Maslow ranked human needs. This suggests that Self-actualization is believed to impose the higher level of human need. Although Maslow does not intend to imply that human receives complete satisfaction, he believed that when an experiencing human achievement and personal growth, a new set of attitude will be designed to placate its new needs (Montana & Charnov, 2008).

If taking Herzberg’s Two-Factor Theory of Motivation into consideration, the theory somehow parallels to Maslow’s hierarchy of needs. Understanding the higher level of Maslow’s theory, Herzberg refers them as motivators. Maslow’s esteem and self-actualization needs also correspond to Herzberg’s motivators idea. Therefore, to meet a specific set of needs, both theories has a profound goal to propitiate human behavior and maintain it.          

Social Exchange Theory

            Social exchange theory explains a social change and a process of negotiation exchange between parties. George Simmel, a German sociologist, pointed that the significance of “reciprocity” in human being’s everyday life and how human interacts involving forms of exchange (Baker, 2001). In Cropanzano & Mitchell (2005) research, both mentioned that Social Exchange is considered as one of the most influential conceptual patterns in understanding the behavior of a specific workplace.

Thus, an exchange rule must be followed to build a constant relationship and exchanges. In a simpler thought, the assumption of the theory implies that when parties enter and maintain their relationship, a trace of tangible and intangible rewards can be expected (Chew & Gottschalk, 2009).

            If highlighted in a workplace environment, a recognition of employee from a positive contributing work attitude simplifies Simmel’s theory. It may include economic exchange relationship (Aryee, Budhwar, & Chen, 2002), wherein, an economic benefit shall be provided to the employee in exchange for his or her efforts towards achieving work-related goals. In response to the theory, research had been formed to validate its efficiency towards understanding human motivation towards work.

With the available literature resources, results show that a continuity of social exchange theory as a part of the work-based evidence, employ a positive employee commitment and involvement, empowerment and motivation (Aryee, Budhwar, & Chen, 2002; Gould-Williams & Davies, 2005).

            As highlighted in Haar’s (2006) research, the perception of advantageous rewards or exchange from the workforce results to an increased engagement towards its organization. On the other hand, if the organization failed to provide rewards to the employees, would likely result in a reduction of organizational engagement. In this case, when there are favorable stances within working environment both employees and organization will equally benefit.

However, keeping in mind that employees tend to react in a dissatisfying working condition by negating rightful working attitude such as, being late, absenteeism and planning to quit organization; an antecedent-consequence relationship as mentioned by Crede et al. (2007).

Expectancy Theory

            This theory recommends that every individual’s expectations be dependent on its motivation and the ability to perform the given task and receive the desired rewards (Daft, 2005). In simpler form, if a person understood the worth of a certain task, he or she will be motivated to reach the goal, given with skills and knowledge to achieve it (Koontz, O’Donnell, & Weihrich, 2008).

Victor H. Vroom, a psychologist, suggests that motivation is highly predisposed by a continuous interrelated sequence of people’s effort will lead to performance, performance to specific outcomes and these outcomes are to be valued by the individual (Wlodarczyk, 2011). Moreover, in Vroom’s definition of the theory (Mancheno-Smoak, 2008), he mentioned that motivation depends on three system; expectancy, instrumentality, and valence.

            E -P expectancy this explains when putting effort into a job may result in a high performance or may lead to the desired outcome (Daft, 2005). In this case, when a person works hard, a better result can be expected, and when a person is unresponsive to a particular job or task will lead to a valence of zero (Koontz, O’Donnell, & Weihrich, 2008). P -O expectancy explains if a successful performance can lead to the desired outcome. As an example, when a person is motivated to achieve a job-related award it is believed that the room of expectancy towards high performance can lead to award (Daft, 2005).

            On another context, when an individual places importance upon an expected outcome, based on needs, values and goals Vroom identified the strength as valence (Daft, 2005). In this case, if the availability of an outcome extracted from high efforts and good performance; however, are not valued by the employees, the result motivation will end up low. On the other hand, if employees will highly value the outcome, motivation will be higher.

            The implications are crucial when influencing employee’s motivation. According to Sims (2002), managers should understand the importance of the theory. It is recognized that expectancy theory, provides powerful explanation towards employee’s motivation. Another example as cited by Koontz, O’Donnell, & Weihrich (2008), when a person is motivated to accomplish some tasks, can be determined by person’s wish to accomplish the task.

Conceptual Framework

            This section attempts to determine the implication of non-financial rewards on driving organizational strategy at Communications Authority of Kenya. The non-financial rewards include motivation, financial rewards, non-financial rewards, and the work environment. This study shall determine the effects of the independent variable on the dependent variables.


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Spurgeon, C. H. Lectures to My Students: Book Critique

Spurgeon, C. H. Lectures to My Students
Spurgeon, C. H. Lectures to My Students

Spurgeon, C. H. Lectures to My Students

Book Critique

Bibliographical Entry:

The Holy Bible, English Standard Version. Copyright ©2001 by Crossway Bibles, a publishing ministry of Good News Publishers.

Spurgeon, C. H. Lectures to My Students. Peabody, MA: Hendrickson Pub, 2010.


Spurgeon’s book “Lectures to my Students” is a journal that pastors, ministers, and those pursuing training for ministerial positions use as a reference. Charles Spurgeon has authored several books on the principles that people in ministry should adhere into a bid to be better ministers of the gospel. This book was written to establish the principles that spiritual leaders need to avoid that include unhallowed and the use of endearing words in ministry, thus showing the elements that pastors need to incorporate into their lives to remain consistent in their prayer lives.

Additionally, Spurgeon reiterates on the essence of developing a relationship with Christ, the necessity of prayer, the genuineness of having a call to serve, and a thirst to reach the lost. Speaking to his students on the element of Christian life Spurgeon ululates that, “For a herald of the Gospel of Christ to be spiritually out of context in an individual’s proper person is, both to himself and to the work he is called to do, a most serious catastrophe[1].

Ministers in this care are required to be vigilant in prayer, faithful in their private devotions, and understanding the fact that their souls must be taken care of before they consider taking pastoral ministries on others.

Spurgeon delves into greater detail on the reasons why the call for ministry needs to be authentic, with origins from God. Ministers are therefore advised to have the desire to serve, an aspect that details the need for gentleness even under difficult circumstances, and the inclusion of good judgments in ministry. In his book, Spurgeon provides examples of unfortunate cases of individuals who go into ministry without authentic calls from God. 

In regards to the calamity, Spurgeon alleges that hundreds of ministers have lost their course and stumbled against the pulpit, sorrowful evidence that depicts the fruitlessness of their ministries and decaying churches which currently surround the world[2]. It is prudent to consider that Spurgeon points to the need to understand that God only opens doors for ministers who are faithful[3].

The call to ministry as evidenced by Spurgeon is a call to holiness and godly characters. Individuals striving to minister must be people who are looked up to by the society. They must be examples of what it means to be true followers of Christ. The ministers therefore need to pious and develop high moral standards that are consistent with the principles of the bible.

Spurgeon shows his eloquence in regard to a godly living by alleging that the world finds it challenging to trust people who are two faced, nor will the world believe in those whose practical and verbal testimonies are contradictory[4]. The inclusion of these godly characters resonates from an individual’s faith in the person of Christ. In his teachings about sermons, Spurgeon advices his student’s to preach Christ always[5].


Surgeon on his book Lectures to my Students is an important edition that offers ministers practical lessons and guidelines that prepare them for ministry especially on what they may encounter and approaches of staying on the right course. One of the greatest strengths of Surgeons works remains in the practical application presented to the ministers in the book. The practical application documented in the book is seen in the author’s presentation of what ministers need to do within their ministerial lives both in public and privately.

On the other hand, Spurgeon speaks more on sermons, hence insisting that sermons need to give teachings that can be applied in everyday life. Additionally, he insists that the truth should never be held back no matter how complex or unpopular it may sound[6]. The author also reminds ministers on the importance of humility, hence denoting the need for ministers to understand that they are called by their creator to serve the Universe. This intrigues the practicality and application of our place within God’s scheme, an approach that gives reverence to God’s priorities.

However, it is imperative to note that there are weaknesses to Spurgeon’s book to the 21st century readers. Spurgeon is considered to have served in England in the 1800’s and ministry has revolutioned since then. One aspect relates to language that has immensely changed over the last 200 years. Additionally, changes are notable in doctrinal beliefs among different Baptist groups in England compared to those that existed during Surgeons time.


Within the larger academic context, Spurgeon’s book Lectures to My Students is viewed as remarkable in standing the test of time by establishing approaches that ministers can enhance their relationship with Christ. Through this, the ministers of the Gospel are in a position to establishing the authenticity of their calling, and the need to fulfill the Great Commission.

The book therefore reminds spiritual leaders that things such as quit time, solitude, prayers and fasting are essential tools required in prospering the ministry of the Lord. In as much as these elements are viewed as popular, they remain essential in supporting the course of ministry. Spurgeon through his work exemplifies the ingredients required by pastors and servants of God in serving the world.

[1] . Spurgeon, C. H. Lectures to My Students. Peabody, MA: Hendrickson Pub, 2010.

[2] . Ibid. 1pp. 13

[3]. The Holy Bible, English Standard Version. Copyright ©2001 by Crossway Bibles, a publishing ministry of Good News Publishers.

[4]. Ibid. 2, pp. 17

[5]. Ibid. 3, pp.79

[6]. Ibid. 4, pp.75

Diabetes Self care: PICOT and Literature Review

Diabetes Self care
Diabetes Self care

Diabetes Self care: PICOT and Literature Review

  Diabetes self care us an integral part of diabetes therapy and entails active involvement of family members.  Effective self management is associated with positive clinical outcomes in diabetic patients. However, effective self management can be challenging because of the naturally evolving and age appropriate attitudes as well as biological factors in young adults. Several studies have shown low self discipline and management which results into higher hemoglobin A1C (HbA1c) (Jackson, Adibe, Okonta, & Ukwe, 2014).

In addition, standard self care of diabetes management involves prescribing constant drug dosages, which are often titrated based to patients condition during their clinic visits. The clinical visits for most patients are usually 2-3 times every month. Consequently, the patient drug dosage is determined by only these visits, which is not the true representation of daily patient health needs. This is associated with significantly elevated levels of blood glucose and frequent recurrent admission episodes attributed to treatment failure (Hinshaw & Basu, 2015).

 In this context, the study aims at investigating whether the use of social network ( can reduce the incidences of hypoglycaemia in adolescents patients diagnosed with diabetes type 1. The PICOT statement is as follows:  In adolescent patients diagnosed with diabetes type 1 (P), is integration of social network ( App) (I),  in comparison with standard care  (C),  reduce  hypoglycaemia  incidences (O), in  a period of eight months?

 Literature review

De Jongh, T., Gurol-Urganci, I., Vodopivec- Jamsek, V., Car, J., Atun, R. (2012). Mobile phone messaging for facilitating self management of long term illnesses. Cochrane Database System Rev 12 (12) : CD007459. doi: 10.1002/14651858.CD007459.pub2.

 This paper assesses the impact of mobile phone messaging applications in self management of chronic illnesses. The study evaluates the health outcomes and patients capacity to manage their health complication.  This systematic review examined randomized controlled trials, quasi controlled studies, interrupted time series (ITS) and controlled before- after (CBA) studies to ass the effects of mobile phone messaging.

The paper found some limited information regarding the implication of integrating technology in improving self management for chronic diseases. However, the study found some significant knowledge gaps regarding long term effects, costs, acceptability and risks associated with these interventions.

Dobson, R., Whittaker, R., Jiang, Y., Shepherd, M., Maddison, R., Carter, K., Cutfield, R., McNamara, C., Khanolkar, M., and Murphy, R. (2016). Text message-based diabetes self management support  (SMS4BG): Study protocol for a randomized controlled trial. Trials 17: 179. doi: 10.1186/s13063-016-1305-5.

 According to this article, utilization of technology to deliver self management is an effective support strategy that allows people to have patient centered care. The Self- Management Support for Blood Glucose (SMS4BG) is a novel technology that is text message based, and is used to support people diagnosed with diabetes to support self management strategy and to achieve better glycaemic control as well as patient education that is tailored to individual patient needs and preferences.

This randomized controlled study was conducted in New Zealand Health districts, where one thousand participants were randomized into 1:1 ratio to receive SMS4BG and usual standard care. The study findings indicated that this technology is associated with better glycaemic control (HbA1c), enhanced self efficacy, diabetes distress, and perceived social support and improved health related quality of life.

Hinshaw, L., & Basu, A. (2015). Technology Use for Problem Solving in Adolescent Type 1 Diabetes. Diabetes Technology & Therapeutics, 17(7), 443–444.

 According to this article, technology and use of social media in adolescent care has been associated with improved glucose control among the adolescents because it provides them with practical platform to solve their therapeutic issues, thereby improving their quality of life.  The qualitative study evaluated the relationship between use of modern technology and glycemic control. 

The study findings indicated that the modern technologies have significant impact in enhancing self care management because it provides an opportunity for individualized care for a given patient, making it need based and focuses. However, the paper warns that one size fits all approach in this approach may not effective due to unique health demands and preferences.

  Jackson, I. L., Adibe, M. O., Okonta, M. J., & Ukwe, C. V. (2014). Knowledge of self-care among type 2 diabetes patients in two states of Nigeria. Pharmacy Practice, 12(3), 404.

 This study aims at exploring knowledge of self care practices and factors responsible patients knowledge deficiency in patients diagnosed with diabetes type 2. The cross sectional survey was conducted on patients attending the University of Uyo teaching Hospital, where Diabetes Self Care Knowledge  (DSCK-30) was used to assess the self care knowledge.

The study found that nearly 70% of the population had basic knowledge about self care, but it was associated with the level of education, household income and the length the patient has suffered from the disease. The study recommended for further investigations that will help enhance self care and individualize care based on patient’s health needs or demands.

Ng, S. M. (2015). Improving patient outcomes with technology and social media in paediatric diabetes. BMJ Quality Improvement Reports, 4(1), u209396.w3846.

According to this article, there has been significant increase in the number of people diagnosed with diabetes Type 1 in Europe, but only small percentage of people attain better diabetes control. Recent studies have established novel digital strategies with the aim of improving overall patient health care.

The quantitative study evaluated 3 digital initiatives with the aim of implementing electronic diabetes information system that would help to undertake routine blood glucose values and calculate drug dosages with the aim of improving clinical outcomes.  The study concluded that use of digital initiatives is effective in empowering patients, improving efficiencies, satisfaction, communication, reduction on emergency admissions, and to reduce diabetes related complications.

Marques, M.B.,   da Silva, M.,  Coutinho,  J.V., & Lopes, M.V. (2013). Assessment of self-care competence of elderly people with diabetes. Revista da Escola de Enfermagem da USP, 47(2), 415-420.

The prevalence rated of diabetes is highest among the USA population.  Diabetes self care management is complex as it contains important recommendation for physical activity, nutrition, glucose levels and medications. Young adults and the elderly have issues that uniquely impact self care.

This is because as people age, their health status, mental abilities, nutritionl requirements and physical abilities change. Depression is also common among the diabetic patient is associated with the deterioration of self care behaviors. This descriptive cross-sectional and correlation study assess self care competencies among the population through Scale to Identify Diabetes Mellitus Patient’s Competence for Self Care as well as other factors associated with it. 

The study findings indicated that only 6% of the participants had self competence, highlighting the need to integrate other health promotion activities that target this population, assess their skills and to encourage effective self care practices that enhance planning of health interventions.


De Jongh, T., Gurol-Urganci, I., Vodopivec- Jamsek, V., Car, J., Atun, R. (2012). Mobile phone messaging for facilitating self management of long term illnesses. Cochrane Database System Rev 12 (12) : CD007459. doi: 10.1002/14651858.CD007459.pub2.

Dobson, R., Whittaker, R., Jiang, Y., Shepherd, M., Maddison, R., Carter, K., Cutfield, R., McNamara, C., Khanolkar, M., and Murphy, R. (2016). Text message-based diabetes self management support  (SMS4BG): Study protocol for a randomized controlled trial. Trials 17: 179. doi: 10.1186/s13063-016-1305-5.

Hinshaw, L., & Basu, A. (2015). Technology Use for Problem Solving in Adolescent Type 1 Diabetes. Diabetes Technology & Therapeutics, 17(7), 443–444.

  Jackson, I. L., Adibe, M. O., Okonta, M. J., & Ukwe, C. V. (2014). Knowledge of self-care among type 2 diabetes patients in two states of Nigeria. Pharmacy Practice, 12(3), 404.

Ng, S. M. (2015). Improving patient outcomes with technology and social media in paediatric diabetes. BMJ Quality Improvement Reports, 4(1), u209396.w3846.

Weinger, K., Beverly, E. A., & Smaldone, A. (2014). Diabetes Self-Care and the Older Adult. Western Journal of Nursing Research, 36(9), 1272–1298.

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