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. 2023 Jun 6;3(1):78.
doi: 10.1038/s43856-023-00308-7.

A multicenter explanatory survey of patients' and clinicians' perceptions of motivational factors in rehabilitation

Kazuaki Oyake  1   2 , Katsuya Yamauchi  3 , Seigo Inoue  2 , Keita Sue  4 , Hironobu Ota  5 , Junichi Ikuta  6 , Toshiki Ema  7 , Tomohiko Ochiai  8 , Makoto Hasui  9 , Yuya Hirata  10 , Ayaka Hida  11 , Kenta Yamamoto  12 , Yoshihiro Kawai  13 , Kiyoto Shiba  14 , Akihito Atsumi  15 , Tetsuyuki Nagafusa  3 , Satoshi Tanaka  16
Affiliations

A multicenter explanatory survey of patients' and clinicians' perceptions of motivational factors in rehabilitation

Kazuaki Oyake et al. Commun Med (Lond). .

Abstract

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.

Plain language summary

Rehabilitation is the interventions needed to restore the abilities required for daily life following illness or injury. Patients and clinicians who provide these interventions may have different ideas about what encourages patients to engage in rehabilitation. It is important to understand what motivates patients and any differences in opinion between patients and clinicians. We asked patients and clinicians about the most important motivational factors. All agreed that realizing recovery is possible, setting goals or targets for the stages of recovery, and targeting interventions relevant to the patient’s experience and lifestyle were the most important motivational factors. The patients also found access to medical information and being able to control the difficulty of tasks required during rehabilitation motivating. These findings could help clinicians provide rehabilitation care that is more specifically tailored to each patient’s needs and preferences.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Distribution of participants’ answers regarding the most important motivational factor.
a Distribution of patients’ answers (n = 476). b Distribution of clinicians’ answers (n = 401). The potential motivational factors are arranged in descending order by the percentage of participants who selected each factor as the most important. The vertical dashed line represents 5% of participants.
Fig. 2
Fig. 2. Comparison of patients’ and clinicians’ perceptions of the most important motivational factors.
The total number of patient and clinician participants were 476 and 401, respectively. The potential motivational factors are arranged in ascending order regarding the value of the Phi coefficient. Filled diamonds and error bars represent phi coefficients and 95% confidence intervals, respectively. Values are the number (%) unless indicated. CI confidence interval.
Fig. 3
Fig. 3. Distribution of participants’ answers regarding the three most important motivational factors.
a Distribution of patients’ answers (n = 479). b Distribution of clinicians’ answers (n = 401). The potential motivational factors are arranged in descending order by the percentage of participants who selected each factor as the most important. The vertical dashed line represents 5% of participants.
Fig. 4
Fig. 4. Comparison of patients’ and clinicians’ perceptions of the three most important motivational factors.
The total number of patient and clinician participants were 479 and 401, respectively. The potential motivational factors are arranged in ascending order regarding the value of the phi coefficient. Filled diamonds and error bars represent phi coefficients and 95% confidence intervals, respectively. Values are the number (%) unless indicated. CI confidence interval.
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