Patients’ and Clinicians’ Perceptions of Motivational Factors in Rehabilitation

Abstract

AbstractImportancePatient motivation is an important determinant of rehabilitation outcomes. Differences in patients’ and clinicians’ perceptions of motivational factors can potentially hinder patient-centered care.ObjectiveTo compare patients’ and clinicians’ perceptions of the most important factors in motivating patients for rehabilitation.DesignThis multicenter descriptive cross-sectional survey was conducted from January to March 2022.SettingThirteen hospitals with a convalescent rehabilitation ward.ParticipantsPatients 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 MeasuresPatients 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.ResultsWe 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 RelevanceThe 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.Key PointsQuestionWhat are the similarities and differences between patients’ and clinicians’ perceptions of the relative importance of factors motivating patients for rehabilitation?FindingsIn this multicenter descriptive cross-sectional survey of 479 patients and 401 clinicians, the three most endorsed motivational factors—realization of recovery goal setting, and practice related to the patient’s experience and lifestyle—were identical for patients and clinicians. However, patients had more diverse preferences for motivational factors than clinicians.MeaningIn addition to utilizing the three core motivational factors, rehabilitation clinicians should consider individual patient preferences when determining which motivational strategies to use for enhancing patient-centered care.