With Ajzen s theory came a number of criticisms and alternate theories. Psychologists such and Bentler and Speckart (1979, 1981) highlighted the importance of habits when attempting to predict and explain people s intention to behave. Other variables investigated and found to have influencing behaviour are the experienced moral obligation to show certain behaviour or the relevance of this behaviour for self-identity outcomes (Gorsuch and Ortberg, 1983; Granberg and Holmberg, 1990). Alternate structures have been hypothesized. Fazio s MODE model (motivation and opportunity as determinants of how attitudes influence behaviour) was suggested as Fazio believed that the Theory of Reasoned Action was only useful when dealing with situations where people are highly motivated and capable of thinking deliberately about the attitude and/or the behaviour relevant to this attitude (Fazio, 1990) The crux of this idea was that in a situation were there is a lack of motivation or reasonable ability to access decision on an attitude behaviour dependant issue then highly accessible attitudes will influence behaviour as they affect the persons perception and judgment of the situation. The assumption of intention to behave was critised by many including Eagly and Chaiken (1993). They wrote the concept of intentions remains underdeveloped in the reasoned action model. Intention might . . . be conceptualized as a continuum running from vaguely formulated thoughts about future behaviour to clear-cut plans that one is going to engage in a particular behaviour at a particular point in time (p. 185). Simon (1981) questioned the assumption of human rational decision-making, which Azjen postulated was one of the assumptions the Theory of Reasoned Action took into account. According to Simon given the capacity limitations of human information processing, people do not try to optimise outcomes through their behavioural decisions but are in general satisfied with any outcome that is above a subjective level of aspiration . Individuals strive not for maximum utility but for satisfying outcomes that can be far short of a theoretically achievable maximum.
Interesting evolutions of the TRA and TPB have been suggested by a number of psychologists. These lie in the expansion of the original premise Azjen made about the self. In these recent theoretical re-formulations, it is argued that the self can be deconstructed into a number of different arenas, such as private self, personal self, and interpersonal self and other broader social identities. The private self can be seen in terms of one s own experiences and personality traits. The interpersonal self can be broadly regarded as a form of social identity and self-categorisation, within a group scenario. The foundations of the Theory of Reasoned Action still hold in these alternate proposed ideas. Social norms can be translated into the vernacular of social influence in which a group exerts social pressure upon the subject to conform to a given social ideal or behaviour. These ideas provide ways of explaining the varying degrees of influence both attitudes and norms affects one intention to behave. For example if a behaviour (assuming the direct correlation with intent) is the product of a situation with personal relevance to the individual then attitudes will play a larger role than the social norms. If the opposite is true and the situation is borne out from depersonalisation then the norms are the better indication of intention.
Theory of Planned Behaviour and Health Care
The theory of Reasoned Action has been influential on a number of past studies focused on the attitudes of nurses (Carter & MacInnes ,1996; Hope ,1994; J Snape,1989). A number of studies across the breadth of healthcare have used the Theory of Reasoned Action and Theory of Planned Behaviour as support for their findings (e.g. Conner and Sparks, 1996; Godin, Valois, Lepage and Deshamais, 1992; Schifter and Ajzen, 1985; Terry, Gallois and McCamish, 1993). With the domain of nurse healthcare and their form of work it is unclear as of yet if attitudes or subjective norms are of greater influence. Past studies have perhaps wrongly taken this subjective theorization. There are arguments for both attitudes being more important due to the large proportion of interpersonal involvement on the part of a nurse. Subjective norms can also claim to have a greater influence due to the structure of our healthcare system as a responsibility hierarchy. The Theory of Planned behaviour has not been used before to model nurses behaviour in respect to elderly patients. Previously the assumption has that nurses have volitional control whilst working on a ward with patients. There are however a myriad of nonvolitional influences, which may well have a significant effect on a nurses behaviour. These nonvolitional factors such as the working environment and hospital policy, which in a hieratically organized environment such as a hospital may play an influential role. Past research in health care has often over looked these variables. Certainly the high level of interpersonal care and contact in nurses day-to-day work is directly influenced by the nurses own self identity (Farley, Lehmann and Ryan 1981), so therefore attitudes are expected to be significantly predictive of behavioural intentions. Perceived behavioural control has been shown to be of greatest influence when a person has previous experience and knowledge of the target behaviour and environment ( Bentler & Speckart,1979; Fredricks & Dossett, 1983; Manstead et al. 1983). Gerontology is a large specialist field in healthcare and a large proportion of nursing education from the outset of 1st year training. The theory of planned behaviour offers a better architecture in which to incorporate these influencing factors.
Hypotheses
H1 = The theory of Planned Behaviour can be used to predict Nurses intentions to behave towards elderly people.
H2 = Behavioural beliefs and evaluations directly correlate with attitudes.
H3 = Normative beliefs and evaluations directly correlate with subjective norms.
H4 = Control beliefs and control power directly correlate with perceived behavioural controls.