Importance: Patient motivation is an important determinant of rehabilitation outcomes. Differences in patients' and clinicians' perceptions of motivational factors can potentially hinder patient-centered care. Objective: To compare patients' and clinicians' perceptions of the most important factors in motivating patients for rehabilitation. Design: This multicenter descriptive cross-sectional survey was conducted from January to March 2022. Setting: Thirteen hospitals with a convalescent rehabilitation ward. Participants: Patients with neurological or orthopedic disorders undergoing inpatient rehabilitation and clinicians, including physicians, physical therapists, occupational therapists, and speech-language-hearing therapists, were selected purposively based on the inclusion criteria. Main Outcomes and Measures: Patients and clinicians were asked to choose the most important factor from a list of potential motivational factors. The main outcome was patients' and clinicians' perceptions of the relative importance of various motivational factors for rehabilitation. Results: We obtained data from 479 patients and 401 clinicians. Response rates in the patient and clinician surveys were 92.1% and 62.2%, respectively. The most common primary reasons for patients' hospitalizations were stroke (45.5%) and fracture (42.2%). Approximately half of the clinicians were physical therapists (49.9%). "Realization of recovery," "goal setting," and "practice related to the patient's experience and lifestyle" were the three factors most frequently selected as most important by both patients and clinicians, chosen by 10.4%-26.5% of patients and 9.5%-36.7% of clinicians. Only five were rated as most important by 5% of clinicians; however, nine factors were selected by 5% of patients. Of these nine motivational factors, "medical information" (odds ratio: 5.19; 95% confidence interval: 2.24-11.60) and "control of task difficulty" (odds ratio: 2.70; 95% confidence interval: 1.32-5.80) were selected by a significantly higher proportion of patients than clinicians. Conclusions and Relevance: The three most frequently endorsed motivational factors were identical for patients and clinicians. The preferences of patients were more diverse than those of clinicians, and some motivational factors were preferred by patients over clinicians. Therefore, when determining motivational strategies, rehabilitation clinicians should consider individual patient preferences in addition to utilizing the core motivational factors supported by both parties.

Background Patient motivation is an important determinant of rehabilitation outcomes. Differences in patients’ and clinicians’ perceptions of motivational factors can potentially hinder patient-centered care. Therefore, we aimed to compare patients’ and clinicians’ perceptions of the most important factors in motivating patients for rehabilitation. Methods This multicenter explanatory survey research was conducted from January to March 2022. In 13 hospitals with an intensive inpatient rehabilitation ward, 479 patients with neurological or orthopedic disorders undergoing inpatient rehabilitation and 401 clinicians, including physicians, physical therapists, occupational therapists, and speech-language-hearing therapists, were purposively selected using inclusion criteria. The participants were asked to choose the most important factor motivating patients for rehabilitation from a list of potential motivational factors. Results Here we show that realization of recovery, goal setting, and practice related to the patient’s experience and lifestyle are the three factors most frequently selected as most important by patients and clinicians. Only five factors are rated as most important by 5% of clinicians, whereas nine factors are selected by 5% of patients. Of these nine motivational factors, medical information (p < 0.001; phi = −0.14; 95% confidence interval = −0.20 to −0.07) and control of task difficulty (p = 0.011; phi = −0.09; 95% confidence interval = −0.16 to −0.02) are selected by a significantly higher proportion of patients than clinicians. Conclusions These results suggest that when determining motivational strategies, rehabilitation clinicians should consider individual patient preferences in addition to using the core motivational factors supported by both parties.

QuestionHow do physiotherapists use different motivational strategies for individuals in stroke rehabilitation?DesignA qualitative study using in-depth semi-structured online interviews.ParticipantsA criterion sample of 15 physiotherapists who have worked in rehabilitation for over 10 years and have an interest in an individual’s motivation.InterventionNot applicable.Outcome measuresPhysiotherapists’ perspectives and experiences regarding motivational strategies used depending on the individual’s condition.ResultsA total of nine themes emerged from the data upon thematic analysis and inductive coding. The participants used different strategies to encourage individuals’ active participation in physiotherapy depending on their (1) mental health problems, (2) physical difficulties, (3) level of cognitive function, (4) personality, (5) activities and participation, (6) age, (7) human environment, and (8) type of rehabilitation service where the individual undergoes treatment. For example, in cases where an individual lost self-confidence, participants offered practice tasks that the individual could achieve with little effort to make them experience success. Conversely, for individuals with overconfidence, participants would provide them with a relatively difficult practice task to help them realize the necessity of practice through the experience of failure. The interviews also revealed (9) motivational strategies used regardless of the individual’s condition. For instance, patient-centred communication was used to build a rapport with individuals, irrespective of their condition.ConclusionThis qualitative study is the first to demonstrate motivational strategies that physiotherapists use based on the individual’s condition. Our findings provide a deeper understanding of the selection of motivational strategies in stroke rehabilitation.