Objective:To investigate the short-term effects of the life goal concept on subjective well-being and treatment engagement, and to determine the sample size required for a larger trial.Design:A quasi-randomized controlled trial that was not blinded.Setting:A subacute rehabilitation ward.Subjects:A total of 66 patients were randomized to a goal-setting intervention group with the life goal concept (Life Goal), a standard rehabilitation group with no goal-setting intervention (Control 1), or a goal-setting intervention group without the life goal concept (Control 2).Interventions:The goal-setting intervention in the Life Goal and Control 2 was Goal Attainment Scaling. The Life Goal patients were assessed in terms of their life goals, and the hierarchy of goals was explained. The intervention duration was four weeks.Main measures:Patients were assessed pre- and post-intervention. The outcome measures were the Hospital Anxiety and Depression Scale, 12-item General Health Questionnaire, Pittsburgh Rehabilitation Participation Scale, and Functional Independence Measure.Results:Of the 296 potential participants, 66 were enrolled; Life Goal (n = 22), Control 1 (n = 22) and Control 2 (n = 22). Anxiety was significantly lower in the Life Goal (4.1 ±3.0) than in Control 1 (6.7 ±3.4), but treatment engagement was significantly higher in the Life Goal (5.3 ±0.4) compared with both the Control 1 (4.8 ±0.6) and Control 2 (4.9 ±0.5).Conclusions:The life goal concept had a short-term effect on treatment engagement. A sample of 31 patients per group would be required for a fully powered clinical trial.

Purpose Exercise motivation (EM) is related to individual capabilities and social support. However, in support facilities for people with disabilities, it is susceptible to a lack of social support. In this study, we classified EM into Autonomous Motivation (AM) and controlled motivation (CM) and then examined the influence of social support. Method Thirty-three residents from a support facility for people with disabilities in Japan participated in this study. We conducted a hierarchical multiple regression analysis in which age, gender and time since admission were entered in Step 1, mobility and self-efficacy as individual capabilities in Step 2, and family support, facility support and peer support as social support in Step 3. Result A significant increase in variance from Step 2 to Step 3 was found for both AM (Δ R 2 = 0.504, Δ F = 12.18, p < .001) and CM (Δ R 2 = 0.269, Δ F = 3.491, p = .031). The results also showed that AM was higher among those with high family and facility support, and CM was higher among those with low family and high peer support. Conclusions Social support was a more significant predictor of EM among participants than individual capabilities. KEY MESSAGES Among residents of support facilities for people with disabilities, assessing not only individual capabilities but also social support status can lead to better understandings of exercise motivation (EM). To enhance facility residents’ autonomous motivation (AM), it is necessary to intervene after evaluating family and facility support. When family support is not readily available among facility residents, efforts should be made to encourage residents to interact with each other to increase peer support.

This study assessed the perceived barriers to and facilitators of patient participation in shared decision making through a focus group interview of physical and occupational therapists. [Subjects and Methods] Five clinical therapists participated in the focus group interview. The focus group interview was conducted using semi-structured interview protocols. The protocol questions were as follows: 1) What do you think of patients' participation? 2) What are the barriers to patients' participation? and 3) What are the facilitators of patients' participation? A qualitative content analysis was used to summarize and label these questions. [Results] Facilitators included patients' autonomy in decision making, patients' literacy, patients' knowledge, sharing of knowledge between patients and therapists, and taking evidence into practice. Barriers included patients' delegating attitudes, lack of therapists' accountability, and therapists' paternalism. [Conclusion] Physical/occupational therapists thought patients' literacy and knowledge facilitated their participation in decision making regarding their treatment.