Effect of Motivational Autonomy on Rehabilitation in Convalescent Stroke Patients

Abstract

Purpose: To determine the relationship between qualitative factors of motivation for rehabilitation and participants' performance of and satisfaction with self-determined goals, healthrelated quality of life, and functional independence in first-episode stroke patients in a convalescent ward.

Methods: Participants were first-stroke patients admitted to the A Hospital during November 2022–August 2023. Training Motivation Scale score was used as an explanatory variable to assess motivation quality. Canadian Occupational Performance Measure (COPM), MOS 36-Item Short-Form Health Survey (SF-36), and Functional Independence Measure (FIM) scores at baseline and discharge evaluations were used as objective variables for comparison.

Results: Significant differences were found on two factors related to the amount of change in the SF-36 role/social health component score: the controlled motivation score at baseline (p < 0.01) and the amount of change in the controlled motivation score (p < 0.05). Univariate logistic regression analysis showed a significant association between improvement above the minimum important change in COPM-P score and an increase in the controlled motivation score (odds ratio 6.67, 95% confidence interval 1.05-42.40, p = 0.04), but no increase in the non-motivation score (odds ratio 13, 95% confidence interval 1.27-133, p = 0.03). There was no relationship between motivation for rehabilitation and improvement in FIM score.

Conclusions: These findings suggest that focusing on controlled motivation as a qualitative aspect of motivation for rehabilitation promotes patients' motivation to reacquire roles and social life activities, positively affects their goal performance, and improves quality of life.