Journal of Nursing Education

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BRIEFS 

Attribution Theory and Behavior Change: Ideas for Nursing Settings

Rebecca Bardwell, PhD

Abstract

Imagine, for a moment, that you are trying to put an IV into a patient, but you can't find a vein. You find yourself getting warm and beginning to get shaky. The nurse assisting you in the procedure asks if you are feeling okay, you brush it off by saying, "Everything is fine, I've just been up since five with a sick child." Later in the day a friend stops and asks what's up, that you don't look good, is something wrong at home. Again you brush it off, this time explaining that all the patients in your unit need special care, and you haven't been able to catch your breath all day.

The following day your supervisor calls you aside and says she has noticed that your work has been suffering lately and asks if you are sure you can handle the work. What is noticed is that we seek explanations for our behavior and the behavior of others. Rarely do we say, "I just did it." Usually we say, "I did it because . . ." The because will be some explanation of why it happened. In most situations a plausible explanation for behavior exists, and the effect of that explanation can influence feelings toward ourselves and the people around us. If performance is related to overwork or fatigue, we might feel if we can just hang on until the workload diminishes we can then catch up and get back on an even keel. Whereas if one thinks one can no longer handle the stress of the job, it may result in even more distress and may make matters worse. Likewise, if peers or supervising personnel feel a performance decrement is due to one's inability to handle stress, the person may be treated differently and given less important tasks to do. If they felt it was due to an influx of patients with complex care needs they may feel that everyone is stressed and just ride out the storm. Similarly, if they thought the performance decrement was due to a particular stress such as having a sick child, they may rally around and give extra support.

It can be seen then that the rationale people have for their own behavior and the behavior of others has a powerful effect on their feelings, plans, hopes, and well-being. These explanations and the ensuing consequences are the basis for one important motivation theory: Attribution theory. Attribution theory is concerned with the perceptions people have about the causes of their own and others' behavior and the effect that these perceptions have on their subsequent behavior.

Antecedents of Attributions

Attribution theorists have isolated four major causes of behavior - ability, effort, the task, and luck (Weiner, 1972; 1974; 1979). These four cases can be conceptualized in a two-dimensional framework.

The first dimension is the locus or source of the cause. This locus can be internal - caused by something inside oneself, or external - caused by something outside oneself. The second dimension is the stability of the cause. The cause may be stable - and likeiy to occur again; or unstable - unpredictable in its recurrence pattern. The four causes - ability, effort, task, and luck - fit into the framework. Ability is an internal and stable cause, while effort is an internal and unstable cause. The task difficulty is an external, stable cause while luck is an external, unstable cause. Research has shown that different causes or attributions are used depending upon the patterns of previous behaviors and the outcome of these behaviors. That is why we use past information to formulate…

Imagine, for a moment, that you are trying to put an IV into a patient, but you can't find a vein. You find yourself getting warm and beginning to get shaky. The nurse assisting you in the procedure asks if you are feeling okay, you brush it off by saying, "Everything is fine, I've just been up since five with a sick child." Later in the day a friend stops and asks what's up, that you don't look good, is something wrong at home. Again you brush it off, this time explaining that all the patients in your unit need special care, and you haven't been able to catch your breath all day.

The following day your supervisor calls you aside and says she has noticed that your work has been suffering lately and asks if you are sure you can handle the work. What is noticed is that we seek explanations for our behavior and the behavior of others. Rarely do we say, "I just did it." Usually we say, "I did it because . . ." The because will be some explanation of why it happened. In most situations a plausible explanation for behavior exists, and the effect of that explanation can influence feelings toward ourselves and the people around us. If performance is related to overwork or fatigue, we might feel if we can just hang on until the workload diminishes we can then catch up and get back on an even keel. Whereas if one thinks one can no longer handle the stress of the job, it may result in even more distress and may make matters worse. Likewise, if peers or supervising personnel feel a performance decrement is due to one's inability to handle stress, the person may be treated differently and given less important tasks to do. If they felt it was due to an influx of patients with complex care needs they may feel that everyone is stressed and just ride out the storm. Similarly, if they thought the performance decrement was due to a particular stress such as having a sick child, they may rally around and give extra support.

It can be seen then that the rationale people have for their own behavior and the behavior of others has a powerful effect on their feelings, plans, hopes, and well-being. These explanations and the ensuing consequences are the basis for one important motivation theory: Attribution theory. Attribution theory is concerned with the perceptions people have about the causes of their own and others' behavior and the effect that these perceptions have on their subsequent behavior.

Antecedents of Attributions

Attribution theorists have isolated four major causes of behavior - ability, effort, the task, and luck (Weiner, 1972; 1974; 1979). These four cases can be conceptualized in a two-dimensional framework.

The first dimension is the locus or source of the cause. This locus can be internal - caused by something inside oneself, or external - caused by something outside oneself. The second dimension is the stability of the cause. The cause may be stable - and likeiy to occur again; or unstable - unpredictable in its recurrence pattern. The four causes - ability, effort, task, and luck - fit into the framework. Ability is an internal and stable cause, while effort is an internal and unstable cause. The task difficulty is an external, stable cause while luck is an external, unstable cause. Research has shown that different causes or attributions are used depending upon the patterns of previous behaviors and the outcome of these behaviors. That is why we use past information to formulate attributions.

Attributions to ability are based primarily on information from the past. Repeated successes or failures suggest high or low ability (Frieze, 1976). Consistency is important for attributions to ability. For example: Consistently high grades leads one to think "I'm smart," whereas winning many games suggests a good team. When looking for the causes of others' behavior two other cues often influence ability attributions. The pattern of the behavior and the maximum level of the behavior Persons whose performance begins high and descends are seen as having higher ability than persons whose performance starts low and ascends even though their overall average performance is the same (Jones, Rock, Shaver, Goethals, & Ward, 1968). Likewise, a person whose performance peaked at a single high point is seen as more able than a person with constant scores even though the average scores were the same for both persons (Rosenbaum, 1972).

One might think a person knows how hard he or she tries and this internal subjective information is enough to decide whether or not effort was expended. This is not necessarily so. Persons use outcome information to decide how hard they tried. Successful persons report they tried harder than unsuccessful persons (Kukla, 1972; Weiner & Kukla, 1970). Patterns of behavior are also a cue to effort attributions. Persons whose scores increase or get better over time report they tried harder than persons whose scores decrease or get worse over time and than persons with random scores or scores with no apparent pattern (Jones, Rock, Shaver, Goethals & Ward, 1968).

Attributions to the task are inferred from social norms. If many people succeed, the task is considered easy; if many failed, the task is considered difficult (Frieze & Weiner, 1971). Task attributions often depend on the reference group we are using to develop the social norms. If a nurse is not successful inserting an IV needle, a client might attribute the failure to the knowledge that many other health care personnel have the same difficulty because of the patient's particular vein configuration. Whereas the nurse involved might compare herself or himself to others in his or her group who have not had difficulties with this patient and attribute the failure to ability.

The most salient feature of luck attributions is the type of task. Tasks such as flipping a coin or throwing a die are clearly games of chance and performance on them is attributed to luck (Phares, 1957). Also, if there is no apparent pattern to success and failure, performance is often considered a matter of luck (Feather, 1969; Feather & Simon, 1971). Persons also tend to attribute the success of their enemies to luck (Mann, 1974).

In general, persons give internal attributions of ability and effort for successes and external attributions of task difficulty and luck for failures (Frieze & Weiner, 1971). In other words, we are inclined to take credit for success and find external excuses for failure. For example, a nurse may be obtaining more pertinent information on an intake history with a client and conclude that he or she is getting quite expert at interviewing. On the other hand, the nurse criticized for sketchy nursing histories may counter that the patients were too stressed to answer questions or were uncommunicative, and it was not the nurse's fault that the data procured were incomplete.

Persons tend to attribute their own behaviors to external causes and the behavior of others to internal causes (Jones & Nisbett, 1972). For example, Nurse Brown using an external cause to explain her lateness in starting the shift report might begin report by stating, "Sorry I'm late, Ms. Grover's NG tube came out." While Nurse Brown's colleagues waiting for report might be muttering, "We always get started late when Brown is in charge, she is so totally disorganized."

Consequences of Attributions

As well as following, and being due to, certain patterns of previous performance, attributions have important consequences for subsequent behavior. These consequences can be related to affective reactions, such as changes in self-esteem. One thinks more highly about ones' success if it can be attributed to ability rather than to the ease of the task. On the other hand, one may think more poorly about oneself if a failure ensues and is attributed to lack of ability rather than to a difficult task (McMillan & Sprat, 1983; Weiner, Russell & Lerman, 1978).

Attributions may aiso affect one's cognitive reactions such as one's expectations regarding future outcomes. If a person attributes success to a stable cause like ability, an expectation for success in the future will prevail. If success is assigned an unstable cause like effort, a person won't have as much confidence in future success and may change their level of expectation (McMahan, 1973; Valle & Frieze, 1976).

Attributions may also affect one's behavioral reactions, such as one's persistence. A person will work harder on a task in the future if he or she feels that performance is due to effort, rather than the result of an easy task or luck ( Arkin & Maruyama, 1979; Fyans & Maehr, 1979; Kukla, 1972).

Thus we see that attribution theory can have an important impact upon how we approach a task, the confidence we feel, and our expectations for the future. It will help clarify the practical application of attribution theory if one looks at the theory as it applies to the roles of a nurse. Specifically, the theory can be used to facilitate personnel relationships, to improve leadership, and, most importantly, to improve nursing care.

Attribution Theory for Nurses

Though nurses don't often think of themselves as teachers, they do teach people. Nurses teach people new ways to care for themselves or those around them, they teach people about the illness they have, what the medication might be and what to expect from the course of the illness. Nurse managers teach nurses to use new techniques, to question present behaviors and to try something new. They encourage nurses to be consumers of research and to become aware of and interested in the research process. For example, a nurse may express a reluctance to write a nursing diagnosis. When asked to do so, the nurse might respond with a statement like, "I don't think I've stated this correctly." - ability attribution.

Here the nurse is expressing an anxiety about not doing well and an expected failure - attributing expected failure to a stable cause. Thus, the expectation for the future is continued failure. One of the tasks of the nurse manager in this teaching situation is to redirect the nurse's attribution to an effort attribution, which is an internal, unstable attribution and thus a controllable and changeable cause. The role of praise and criticism is also important since it will be interpreted differently depending upon whether it follows an easy or a difficult task. Praise following a difficult task is interpreted as high ability while, interestingly, praise following an easy task is interpreted as low ability Reassure the nurse that, yes, this is a difficult task so that subsequent praise will not be attributed to low ability; but also assure the nurse that you are certain that he or she has the skills to complete the task and all that is lacking is effort. Effort is an unstable, internal cause and is, after all, the cause which someone has the most control over. It is through that control that one can exhibit an immediate change in behavior. In most settings, attributions to effort or lack of effort are the most positive and beneficial.

In general, attribution theory suggests that persons who attribute failure to an internal, unstable cause such as effort and success to an internal, stable cause such as ability tend to exhibit more adaptive behavior. That is, they are likely to approach rather than to avoid tasks, persist in the face of failure, and perform tasks with greater intensity. On the other hand, persons who attribute success to an external cause like the nature of the task or luck and failure to an internal and stable cause such as ability show a very different pattern. These persons may exhibit maladaptive, helpless behavior. In view of these consequences, it is important to encourage a person to use the more adaptive pattern of causal attributions for their success and failure, that is to attribute success to an internal, stable cause (e.g., ability) and failure to an internal, unstable cause (e.g., effort). A nurse-teacher can do this as simply as directing learners toward the adaptive attributions through their instructions, feedback and behavior. In general, it is important to encourage people learning something new that effort - an internal, unstable attribution - is an important cause of achievement. If you try hard, you might succeed; if you don't try, you might fail. Effort is something a person has immediate control over. It can take the form of studying a new procedure ahead of time at home, listening in lectures, following instructions, or trying hard on the job. Most importantly it can be changed by a person's own will.

Persons should also be encouraged to attribute their successes to internal causes. An internal attribution allows people to take credit for their success and increases one's satisfaction and feelings of competence. It also increases the tendency to approach tasks in the future. Persons should be discouraged from attributing failure to internal, stable causes like lack of ability because this pattern facilitates the development of a helpless feeling. This is not to say that persons should be encouraged to form an unrealistic perception that achievement depends only on effort. Persons should be encouraged to establish realistic self-expectations of their ability, but within this realistic self-assessment, the importance of effort should be emphasized. Following are some things one can do to encourage an adaptive attributional style:

1. Directly refer to effort attributions for both a person's successes and failures. The effort attribution is the attribution over which a person has immediate control.

2. Praise someone after success on a difficult task which implies trying hard and high ability. Be careful of using praise on easy tasks since that will imply low ability.

3. Don't use too diffuse positive and negative statements, but focus on a specific, task related behavior. Keep judgments to the task at hand. If one uses too frequent positive and negative appeals for other than job- related behaviors, others interpret these statements as reflecting a general attitude toward them and not as reflecting an assessment of their achievement. If a supervisor comments on a person's manner or attire, unless directly related to the job, the person may interpret the comments as a reflection of the supervisor's feeling toward the person rather than toward the job. It is important as a supervisor to judge a person's behaviors, and not to pass judgment on them as persons.

References

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10.3928/0148-4834-19860301-10

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