Findings of this review suggest that basic need satisfaction is a mechanism through which subjective vitality and subjective fatigue can be improved. Interventions that facilitate
30
autonomy, competence and relatedness satisfaction could help people who are suffering from increased fatigue or lack vitality. According to SDT, autonomy satisfaction can be supported by providing opportunities for choice, competence satisfaction can be supported by providing structure and informational feedback and relatedness satisfaction can be supported by interest and care for participants involved in the intervention (Deci & Ryan, 1991; Mageau & Vallerand, 2003; Ryan & Deci, 2002). In line with SDT, an autonomy-supportive exercise intervention for patients with RA led to a significant increase in subjective vitality and had a positive effect on the decrease of subjective fatigue (Rouse et al., 2015). Concluding, intervention developers should incorporate need-supportive techniques to improve subjective vitality and fatigue.
Future research should continue and expand the research of this systematic review to contribute to the empirical soundness of SDT. Causal evidence for the assumption that the basic psychological needs are determinants of subjective vitality and subjective fatigue is still insufficient since in some studies, the positive effects of autonomy, competence and relatedness satisfaction on subjective vitality did non-reach statistical significance. In addition, experimental studies should examine whether the basic psychological needs are related but yet distinct requirement for subjective vitality as this systematic review found only partial support for this assumption. Researchers should make sure that they use measurement devices for basic need satisfaction and subjective vitality that possess sufficient psychometric properties. Also, they should take into consideration the findings of this review in their choices concerning manipulation of basic need satisfaction and the control of potential confounding variables. In addition, researchers are encouraged to expand the findings of this review to other settings and populations.
Likewise, the relationship between the basic psychological needs and subjective fatigue was identified as a fruitful but yet uncharted future research topic. For example, it still needs to be explored whether autonomy, competence and relatedness satisfaction are determinants of subjective fatigue and its different components. Also, measurement tools such as the BRAF-MDQ could be adapted to other contexts and populations as they enable a multidimensional assessment of subjective fatigue. Since findings suggest that subjective fatigue is an outcome of basic need satisfaction that SDT is lacking, research on the negative causal relationship between basic need satisfaction and subjective fatigue might improve the
31
explanatory and predictive power of SDT. Indeed, exploring whether causal evidence supports the assumption that basic psychological needs are determinants of subjective fatigue might provide new insights for SDT research and research on subjective fatigue.
Finally, future researchers are encouraged to explore to what extent subjective vitality and subjective fatigue are related or distinct constructs. In view of Ryan and Frederick (1997) they are distinct constructs that must be distinguished as they represent qualitative different states of energy. However, they might just as well be related constructs in the sense that subjective fatigue is the state of lacking subjective vitality and vice versa. Exploring whether subjective vitality is more than the absence of subjective fatigue and subjective fatigue is more than the absence of subjective vitality also would open the possibility to question and refine the prevailing conceptualization of subjective vitality. For example, findings of this systematic review suggest that the experience of low emotional fatigue, which includes being motivated and interested, might be closely conceptually related to subjective vitality and that relatedness satisfaction might be a determinant of such an emotional dimension of subjective vitality. Indeed, if subjective fatigue is the state of lacking subjective vitality and vice versa, this would mean enrichment of insights, measurement tools, and treatments for SDT research and for research on subjective fatigue.
Conclusion
This systematic review contributes to the empirical soundness of SDT since best available research supports SDT's central assumption that the basic psychological needs are determinants of subjective vitality. In addition, the found evidence emphasizes that the explanatory and predictive power of SDT might be improved by incorporating subjective fatigue as an outcome of basic need satisfaction. Causal evidence also supports SDT's conceptualization of the basic psychological needs as theoretical related constructs and requirements for subjective vitality, whether they are three distinct constructs still needs to be explored. Causal evidence for the assumptions examined in this review is still insufficient but vital because evidence-based need-supportive interventions seem to provide a way to improve subjective vitality and subjective fatigue. Moreover, exploring to what extent subjective vitality and subjective fatigue are related or distinct constructs would open up the
32
possibility to question and refine the definition and unidimensional operationalization of subjective vitality.
Box 1. Take home message
"There is nothing more practical than a good theory" wrote Lewin (1952, p. 169). Causal evidence for the assumptions examined in this review is still insufficient but vital because evidence based need-supportive interventions might provide a way to improve subjective vitality and subjective fatigue. If you want to change this, feel encouraged to continue and expand the research of this systematic review!
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Appendix
Appendix ATable 6. Inclusion and exclusion criteria
Inclusion criteria Exclusion criteria
Type of studies
Systematic reviews Meta-analyses
Experimental/interventional studies RCTs
Completely randomized trials Field trials Community trials Quasi-experimental studies Type of studies Observational studies Descriptive studies Ecological studies Cross-sectional studies Case-control studies Cohort studies Qualitative studies Book extracts
Survey validating studies Constructs
Basic psychological needs for autonomy, competence and/or relatedness
Subjective vitality and/or subjective fatigue Relationships between constructs
Studies that did examine and analyze the relationship between basic psychological need(s) and subjective vitality or subjective fatigue
Studies that did report on the relative effect of each basic psychological need
Practical reasons
Written in English, German or Dutch
Constructs
Other constructs
Relationships between constructs
Studies that did not examine or analyze the relationship between basic psychological need(s) and subjective vitality or subjective fatigue
Studies that did not report on the relative effect of each basic psychological need Practical reasons
Other languages
Research from areas of biochemistry, genetics and molecular biology, agricultural and biological sciences as well as business, management and accounting
Appendix B
Box 2. Extraction form, Inga Thieler, March 2017
1. General information
Author
Year of publication Type of publication
44 Citation (APA)
2. Study characteristics
Aim/objective of the study Study design (e.g. RCT) 3. Sample characteristics and setting
Description of the sample (e.g. students) Mean age of the sample
Sample size Setting
4. Manipulation/Intervention characteristics Manipulation procedures/intervention