In the context of behavior and attitudes, identify an example of the overjustification effect.

Motivational Interviewing

Motivational interviewing is an empirically supported interviewing approach gaining considerable attention in medical and mental health settings. More than an assessment strategy, motivational interviewing is a brief, client-centered directive intervention designed to enhance intrinsic motivation for behavior change through the exploration and reduction of patient ambivalence.13 Based on a number of social and behavioral principles, including decisional balance, self-perception theory, and the transtheoretical model of change,14 motivational interviewing combines rogerian and strategic techniques into a directive and yet patient-centered and collaborative encounter. Assessment from a motivational interviewing perspective involves addressing the patient's ambivalence about making a change in behavior, exploring the negative and positive aspects of this choice, and discussing the relationship between the proposed behavior change (e.g., compliance with mediations) and personal values (e.g., health). This information is elicited in an empathic, accepting, and nonjudgmental manner and is used by the patient to select goals and create a collaborative plan for change with the provider.

The effectiveness of motivational interviewing with children and young adolescents has not been established. However, there is emerging evidence of its utility with adolescents and young adults, particularly in the areas of risk behavior, program retention, and substance abuse.15,16

Inference Approaches

Rather than effortfully examining and thinking about all of the issue-relevant information available, people can make an evaluative inference based on some meaningful subset of information. One popular inference approach is based on ‘attribution theory’ and holds that people come to infer underlying characteristics about themselves and others from the behaviors that they observe and the situational constraints imposed on these behaviors. Bem suggested that people sometimes have no special knowledge of their own internal states and simply infer their attitudes in a manner similar to that by which they infer the attitudes of others. In his self-perception theory, Bem reasoned that just as people assume that the behavior of others and the context in which it occurs provides information about the presumed attitudes of these people, so too would a person's own behavior provide information about the person's own attitude. Thus, a person might reason, ‘since I signed Candidate Smith's petition, I must be in favor of her election.’

The attribution approach has also been useful in understanding the persuasion consequences of making inferences about relatively simple cues. For example, when external incentives (e.g., money) provide a salient explanation for a speaker's advocacy (‘he was paid to say it’), the message is less effective than when a discounting external attribution is not possible. Research indicates that these simple attribution processes are most likely to influence attitudes when people are relatively unmotivated or unable to think carefully about the issue, such as when they have relatively little knowledge on the topic and the issue has few anticipated personal consequences.

Like the attributional framework, the heuristic-systematic model of persuasion postulates that, when people are not motivated or able to process all of the relevant information available, attitude change can result from the use of certain heuristics or rules of thumb that people have learned on the basis of past experience and observation. To the extent that various persuasion heuristics are available in memory, they may be invoked to evaluate persuasive communications. For example, either because of prior personal experience or explicit training, people can evaluate a message with many arguments by invoking the heuristic ‘the more arguments, the more valid it is.’ If so, no effortful learning or evaluation of the actual arguments presented is necessary for influence to occur.

4.1 Inference Approaches

Rather than effortfully examining all of the issue-relevant information available, people can make an evaluative inference based on some meaningful subset of information. One popular inference approach is based on ‘attribution theory’ and holds that people come to infer underlying characteristics about themselves and others from the behaviors that they observe and the situational constraints imposed on these behaviors (e.g., Kelley 1967). Bem (1965) suggested that people sometimes have no special knowledge of their own internal states and simply infer their attitudes in a manner similar to that by which they infer the attitudes of others. In his self-perception theory, Bem reasoned that just as people assume that the behavior of others and the context in which it occurs provides information about the presumed attitudes of these people, so too would a person's own behavior provide information about the person's own attitude. Thus, a person might reason, ‘since I signed Candidate Smith's petition, I must be in favor of her election.’

The attribution approach has also been useful in understanding the persuasion consequences of making inferences about relatively simple cues. For example, when external incentives (e.g., money) provide a salient explanation for a speaker's advocacy (‘he was paid to say it’), the message is less effective than when a discounting external attribution is not possible. Research indicates that these simple attribution processes are most likely to influence attitudes when people are relatively unmotivated or unable to think carefully about the issue, such as when they have relatively little knowledge on the topic and the issue has few anticipated personal consequences.

Like the attributional framework, the heuristic–systematic model of persuasion postulates that when people are not motivated or able to process all of the relevant information available, attitude change can result from the use of certain heuristics or rules of thumb that people have learned on the basis of past experience and observation (see Eagly and Chaiken 1993). To the extent that various persuasion heuristics are available in memory, they may be invoked to evaluate persuasive communications. For example, either because of prior personal experience or explicit training, people may evaluate a message with many arguments by invoking the heuristic ‘the more arguments, the more valid it is.’ If so, no effortful learning or evaluation of the actual arguments presented is necessary for influence to occur.

4 Theories of Controlling: Reinforcement Theories

The core social motive to perceive some contingency between one's actions and one's outcomes is a sense of effectance, White's term, or control, in other formulations, drives a set of social psychology theories concerned with people's desire to effect certain outcomes. These theories often predict people's behavior from the economics of reinforcements (rewards and costs). People aware of situational contingencies act to maximize or at least improve their outcomes, in this view.

5.1 The Structure of Attitudes

Attitudes are generally not thought of as monolithic constructs; they are made up of conceptually and empirically distinct components. At a very basic level of analysis, attitudes have three important components: affective, behavioral, and cognitive. Affect refers to feelings and emotional components of attitudes. Behavior, of course, refers to behavior that an individual takes with regard to a target. Cognition refers to the beliefs or thoughts that an individual has about a target.

Affective, behavioral, and cognitive processes help to form attitudes. The mere exposure effect suggests one way in which positive affect may arise. Classical conditioning and operant conditioning are two additional ways in which affective processes influence people's attitudes. The continuous pairing of some stimulus and a reward (or punishment) creates positive (or negative) affect. In advertising, brands of clothing are nearly always paired with attractive models. The models are intended to create affectively positive feelings, and advertisers hope that people will be conditioned to like their brands of clothing.

Behavior also contributes to the formation of attitudes in that sometimes people infer their attitudes on the basis of their previous behavior. Self-perception theory posits that people infer their attitudes on the basis of their past behavior, particularly when they believe that their behavior has been freely chosen. For example, if someone points out that Jane always wears green, she may infer that she has some affinity for green. But if Jane always wears green because her school has a strict dress code requiring her to wear green, she is unlikely to infer that she has a favorable attitude toward green.

Cognition is another important antecedent of people's attitudes. A cognitively based learning process occurs when people acquire information about attitude objects. People may gain information through direct experience such as when a free trial product is sent in the mail or when a free sample is offered in a store. Or, people may gain information indirectly, for example, when a television commercial shows them the benefits of owning a particular make and model of automobile. People's beliefs about attitude objects have been proposed as a central determinant of attitudes. Indirect learning, or observational learning, is an important tool for advertisers. Consider any advertisement that shows a model using a product to benefit in some way. It is hoped that viewers will develop favorable attitudes toward the product by learning how others have benefited from the product.

So, attitudes generally have affective, behavioral, and cognitive components. However, it is not necessary for all attitudes to have all three components. Some attitudes may be based primarily on affective factors (e.g., attitudes toward tequila), and others may be based primarily on cognitive factors (e.g., most people probably feel mildly positive about photosynthesis due to the important functions performed by the process, but they probably do not have strong emotions about it).

One very influential model of the structure of attitudes is Martin Fishbein's expectancy-value model. Fishbein proposed that attitudes are a multiplicative function of two things: (a) the beliefs that an individual holds about a particular attitude object and (b) the evaluation of each belief. According to the expectancy-value model, beliefs are represented as the subjective probability that the object has a particular attribute. The model can be expressed as a mathematical function:

Ao=∑i=1nbiei,

where Ao is the attitude toward the object, bi is a belief about the object, and ei is the evaluation of that belief. According to Fishbein, people's attitudes are typically based on five to nine salient beliefs. So, if a researcher wanted to know someone's attitude toward a particular brand of clothing, the researcher might ask that person to estimate the likelihood that a particular brand has a variety of attributes (e.g., fashionable, durable, well priced) and how positive or negative each of those attributes is. The researcher could then compute an estimate of the person's attitude by multiplying the pairs of scores and then summing the products.

The expectancy-value model also implies that persuasion is largely a function of message content. That is, favorable attitudes can be produced by making people believe that an object is very likely to have some desirable trait, by making people believe that some trait is very favorable, or by both. For example, an advertiser might endeavor to make people believe that its automobile is very reliable (i.e., influence the subjective probability of beliefs) or to make people believe that its automobile's ability to take turns at very high speeds is highly desirable (i.e., influence the evaluation of a particular attribute).

Although the expectancy-value model seems to be perfectly logical, it may seem surprising to suggest that all attitudes are based on a series of beliefs. Consider, for example, the mere exposure research discussed earlier. According to Zajonc, preferences need no inferences (i.e., people may like something without having any beliefs about it). Under some conditions, attitudes may be formed outside of people's conscious awareness, or attitudes may be directly retrieved from memory rather than “computed” based on a mental review of salient beliefs. However, it is generally accepted that highly elaborated attitudes are more influential than poorly elaborated attitudes. So far, the discussion of attitude structure has considered how different aspects of a single attitude relate to one another. Next, the discussion considers how different attitudes relate to one another.

One of the most enduring psychological principles developed during the 20th century is the simple notion that people have a desire for cognitive consistency. Cognitive consistency is the simple notion that beliefs and actions should be logically harmonious. If an individual believes that cats make good pets but hates her pet cat, she has beliefs that are inconsistent; if an individual believes that cats make good pets and she loves her cat, she has beliefs that are consistent. For most people, cognitive inconsistency is unpleasant, so they take steps to achieve consistency.

One consistency theory with many advertising-related applications is Heider's balance theory. Balance theory was initially applied to cognitive consistency between dyads (two units) and among triads (three units), but because most research has examined triads, this article focuses on this arrangement. The triad arrangement pertains to the attitudinal relationships among a perceiver (p), an other (o), and an attitude object (x). Consider the example where Cody has recently met an individual named Sam, and Cody likes Sam quite a bit. One afternoon, Cody learns that Sam loves to listen to country music. However, Cody cannot stand country music. How does the fact that Sam loves country music make Cody feel? Probably not very good; the triad of Cody, Sam, and country music is not balanced. However, if Cody loved country music, Cody liked Sam, and Sam loved country music, all would be simpatico. These ideas illustrate the basic tenets of Heider's balance theory. As can be seen in Fig. 1, there are eight possible sets of relationships among the triads: four balanced and four imbalanced. One simple way in which to identify whether a triad is balanced or not is to calculate the product of the three relationships. If the product is positive, the triad is balanced; if the product is negative, the triad is imbalanced.

The efficacy of well-liked, or celebrity, endorsers may be explained at least in part by evoking balance theory. The viewers of the advertisement are expected to have a favorable attitude toward the endorser (e.g., Britney Spears), and the endorser is clearly portrayed as having a positive attitude toward the advertised product (e.g., cola). To maintain balance, viewers also should adopt a positive attitude toward the cola. Alternatively, viewers could decide to dislike the cola and change their attitude toward Spears so as to maintain a balanced triad. Balance theory also helps to explain one way in which consumer trends migrate. People who become friends with one another often adopt attitudes similar to their friends' attitudes. A classic study by Theodore Newcomb illustrated this point with women who lived together at college; over time, the women's political attitudes became more and more similar.

Another theory that has roots in cognitive consistency, and has been very influential in advertising and consumer behavior, is cognitive dissonance theory. Leon Festinger proposed cognitive dissonance theory in 1957, and it spurred more research than perhaps any other social psychological theory. Cognitive dissonance has been defined as a feeling of discomfort that arises as a result of one's awareness of holding two or more inconsistent cognitions. Often, dissonance is aroused when one behaves in a manner that is inconsistent with his or her beliefs. For example, Greg may believe that Japanese cars are superior to cars made in America, but if he buys an American car, he will likely experience cognitive dissonance. Because cognitive dissonance is uncomfortable, people are motivated to reduce the feeling of dissonance by changing their behavior, trying to justify their behavior by changing their beliefs, or trying to justify their behavior by adding new beliefs. Having purchased an American car, Greg might try to reduce cognitive dissonance by investing in Japanese auto manufacturers, by changing his belief in the superiority of Japanese cars, or by adding a new belief to help regain consistency, for example, “My car may be American, but many of the engine parts are from Japan.”

When people make large-scale purchases, they often experience what is known as postdecisional dissonance. Large expenditures may arouse dissonance because they are inconsistent with the need to save money or make other purchases. Furthermore, making a purchase decision necessarily means giving up some attractive features on the unchosen alternatives (e.g., buying a Sony means not buying a Samsung). In a decision-making context, dissonance may be reduced by revoking the decision, by bolstering the attractiveness of the chosen alternative or undermining the attractiveness of the unchosen alternative, or by minimizing the differences between or among the alternatives. Another important role that advertising can play is in helping to reduce postdecisional dissonance. Advertising can help to reduce the feeling of discomfort that follows a major purchase by changing beliefs (e.g., “The new MP3 player has state-of-the-art technology”) or by adding new beliefs (e.g., “The new MP3 player will make you the envy of your friends”) that enable buyers to feel good about their recent major purchases.

1 Introduction

Young people's perceptions of the nursing profession guide the choice of a career in nursing (Hemsley-Brown and Foskett, 1999; Buchan and Seccombe, 2010; Brodie et al., 2004). The concept of perception has been defined as a mental image (Merriam-Webster, 2016a; Merriam-Webster, 2016b) or interpretation of something, that one creates through knowledge, experiences, attitudes and beliefs (Oxford Dictionaries, 2016).

Furthermore, according to the self-perception theory people's actions are often socially influenced (Bem, 1972). The perception can influence young people's career choices (Brodie et al., 2004), retainment in the education (Harvey and McMurray, 1997), and retention in the nursing profession (Başkale and Serçekuş, 2015). Therefore, to retain motivated and skilled young people in the nursing profession, it is essential that they have a realistic perception of the nursing profession. Career choice is also closely connected with the concept of professional identity, which, for example, refers to acquisition and demonstration of knowledge of the profession (Slay and Smith, 2011). Professional identity is also related to the historical notion of the status of different professions (i.e. social value) (Health and Care Professions Council, 2014) which may have an effect in the career choice.

Nurses form the largest professional group in health care and they have a central role in delivering and strengthening the services. In recent years, nursing shortage has been reported as a global challenge (WHO, 2016a). In addition, the shortage of nurses has been predicted to grow and by the year 2020 there will be a need for 590,000 new nurses in Europe (Sermeus and Bruyneel, 2010) and by the year 2030 a need of 9 million new nurses globally (WHO, 2016b). The phenomenon is often described as a demand and a supply problem. The need for nurses is increasing because of the growing and demanding needs of the aging populations, but also because of the aging and retiring workforce. Moreover, insufficient staffing leads to job dissatisfaction and a growing turnover rate of qualified nurses (AACN, 2014) especially among the young workforce (Flinkman, 2014). Simultaneously, low enrollment rates (AACN, 2014) and increasing attrition rates are causing concern for nursing schools (Stewart et al., 2006; Fraher et al., 2009; Rankin, 2013). The dropout rates of nursing students range from 25% in the UK up to 40% in Canada increasing costs and wasting scarce resources in nursing education (Salamonson et al., 2014).

The perception of the nursing profession is influenced by the public image of nursing (Milisen et al., 2010), which has been recognized to portray nurses in a stereotypical and negative way, presenting nursing as inferior to medicine (Price et al., 2013). The young peoples' perceptions of the nursing profession have been studied for decades, but the studies focus mainly on nursing students (Weaver et al., 2013; Er et al., 2015) and the change in perception of the profession during nursing education (Bolan and Grainger, 2009; Safadi et al., 2011). Some studies also exist about school pupils' perceptions of the nursing profession (Neilson and Lauder, 2008; Beattie et al., 2014). However, little is known about the perceptions of the young people who are choosing a career. More information is needed to understand how they perceive the nursing profession and the factors influencing their perception. Therefore, to describe the topic comprehensively, an integrative review of the existing literature needs to be conducted to direct future studies in this research area.