Department of Rehabilitation, Akita Prefectural Center for Rehabilitation and Psychiatric Medicine, Graduate School of Health Sciences, Hirosaki University

Purpose: Patients with dementia suffer from behavioral limitations due to factors such as cognitive and physical decline, physical restraints, and side effects of polypharmacy. These factors affect motor function and activities of daily living (ADL); however, factors related to the degree of walking independence remain unclear. This study aimed to elucidate the factors associated with walking independence in patients with dementia hospitalized in psychiatric wards.

Methods: This study included 98 patients with dementia who underwent physical therapy. The patients were classified into two groups according to their walking independence at discharge from our hospital: independent walkers (n=63) and dependent walkers (n=35). Multiple logistic regression analysis was performed with walking independence as the dependent variable, and factors affecting motor function and ADL as independent variables.

Results: Both Short Physical Performance Battery (SPPB) and antidementia drug-dose rate were significantly higher in the independent walker group than in the dependent walker group (p<0.05). Multiple logistic regression analysis extracted the Mini-Mental State Examination, SPPB, and total number of antidementia drugs, sleeping drugs, antipsychotic drugs, antidepressant drugs, and antiparkinsonian drugs were identified as significant variables.

Conclusion: These results suggest the importance of assessing cognitive functions, lower limb function, and medication status for evaluating walking independence in hospitalized patients with dementia.

Purpose: The purpose of this study was to qualitatively investigate factors related to motivation in highly motivated and low motivated patients admitted to a convalescent rehabilitation ward, and to clarify the relationships between these factors.

Methods: The subjects were patients who were hospitalized in a convalescent rehabilitation ward. The method used was the Structure construction qualitative research method. A total of 7 patients with high motivation, and 7 patients with low motivation were interviewed. The data collected from these interviews was analyzed using the Steps for Coding and Theorization.

Results: In the high-motivation group, motivation was influenced by the synergistic effects of patient factors, therapist factors, and third-party factors. This structure reduced the negative experiences caused by hospitalization, which were a factor that reduced motivation. In the low-motivation group, patient factors, therapist factors, and third-party factors had mutual effects on motivation to undergo rehabilitation. These factors counteracted motivation-promoting factors.

Conclusion: This study found that in both groups, motivation for rehabilitation does not belong only to the individual patients, but is created by the interactions between the patient, the people around them, and the circumstances surrounding them.