A Prediction Model of Rehabilitation Motivation in Middle-Aged Survivors of Stroke in Rehabilitation Facilities in Korea

Abstract

Background To improve the health outcomes of survivors of stroke, it is critical that they are highly motivated to engage in rehabilitation activities. Despite the increasing prevalence of strokes among middle-aged adults, there is limited knowledge regarding factors that may affect survivors' motivation to engage in rehabilitation. Objective The aim of this study was to examine the relationship among factors that predict the rehabilitation motivation of middle-aged survivors after a stroke through structural equation modeling. Methods A total of 200 middle-aged (40–64 years) survivors of stroke from 9 rehabilitation hospitals in Korea completed questionnaires on depressive symptoms, self-efficacy, social support, and rehabilitation motivation. Information on clinical characteristics, including physical function (activities performed during daily life), was collected through the review of medical records. Structural equation modeling was used to construct a prediction model of rehabilitation motivation. Results The average subject's age was 56.2 ± 6.6 years, and the mean time since the event of their stroke was 15.02 ± 8.95 months. Subjects' self-efficacy (being able to live everyday life) after their stroke (β = .500, P < .001) and the social support provided by family and medical personnel (β = .284, P < .010) directly affected their rehabilitation motivation. The bootstrapping method showed that depressive symptoms indirectly affected rehabilitation motivation through self-efficacy, as did physical function. Conclusions In middle-aged survivors of stroke, self-efficacy and social support play a critical role in maintaining intrinsic motivation to engage in rehabilitation activities. Self-efficacy should be evaluated periodically and improved by encouraging individuals to achieve goals, emphasizing their self-regulation, especially among those who reported depressive symptoms and low physical function.

Effects of Animal-Assisted Therapy on Gait Performance, Respiratory Function, and Psychological Variables in Patients Post-Stroke

“…AAT has a significant positive effect on patients' general mood and wellbeing [18]. Post-stroke patients often have difficulty during rehabilitation due to negative emotions such as depression [6,7]. However, Theis et al (2020) showed that AAT triggers positive emotions and low levels of arousal in patients with acquired brain injury [39].…”

“…The most typical psychological problem is depression, with a frequency of about 30% or more in patients post-stroke [4,5]. Depression has a negative effect on rehabilitation motivation, leading to missed rehabilitation periods and ongoing physical disabilities, as a result of which a vicious cycle of physical disorders is maintained [6,7]. According to previous studies, physical exercise has a positive effect on depression and rehabilitation motivation [8][9][10][11].…”

Effects of Immersive Virtual Therapy as a Method Supporting Recovery of Depressive Symptoms in Post-Stroke Rehabilitation: Randomized Controlled Trial

“…5 Participants with post-stroke depression have less independence in activities of daily living and motivation for rehabilitation. [6][7][8] Furthermore, depression is associated with a worse functional outcome. 9 To date, PSD has typically been treated with pharmacological and psychotherapeutic therapies.…”

Association between self-esteem and efficacy and mental health in people with disabilities

“…Among individuals with disabilities, self-evaluation related to the day-to-day management of their condition is of interest. Self-efficacy and self-esteem, which are psychological constructs influencing the management of stress and depression [ 5 , 6 ], can be conceived as components of core self-evaluations. These are fundamental assumptions an individual makes about themselves and their agency within their environment [ 7 ].…”