Correlation Between Treatment Motivation and Activity of Daily Living Improvement in Patients With Stroke
Date Issued
2015
Date
2015
Author(s)
How, Mon-Jane
Abstract
Background and purposes: Patient’s treatment motivation might affect rehabilitation outcome, but no related studies have been done in Taiwan. The purpose of this study is to investigate the correlation between treatment motivation at discharge and activities of daily living (ADL) improvement during inpatient rehabilitation in patients with stroke through chart review. Methods: Electronic charts of stroke patients in National Taiwan University Hospital rehabilitation ward between January 2012 and December 2014 were reviewed, and data from Occupational Therapy note was abstracted. Barthel Index score was used to represent patient’s actual performance in ADL, Basic Activities of Daily Living Ability Scale score was used to represent patient’s ability in ADL, Motivation Level Scale was used to represent patient’s treatment motivation, Mini Mental State Examination score was used to represent patient’s cognitive ability, Brunnstrom Recovery Stage score was used to represent patient’s motor recovery, Postural Control Scale score was used to represent patient’s postural control ability. Analysis of covariate was used to test whether there is significance difference between treatment motivation and ADL improvement. Progress index of ADL actual performance and ADL ability using the formula (discharge score-initial score)/(total score-initial score) was used for ADL improvement. Initial ability such as ADL performance, ADL ability, cognitive ability, motor recovery, postural control ability was used as covariates. Results: 161 stroke patients’ data was included in this study. Analysis of covariance (using 5 different initial ability scores as covariates to control differences in initial ability between subjects with fair and good treatment motivation) revealed a significant difference for both ADL ability (F=7.53; p<0.05; η2=0.05 and ADL actual performance (F=6.36; p<0.05; η2=0.04) progress index between subjects with fair and good treatment motivation. The progress index for ADL ability and ADL performance is lower in patients with fair motivation. Discussion and Conclusion: According to data from clinical records, stroke patients with good treatment motivation had more improvements in both ADL ability and performance progress index, but with small clinical effect. Preliminary results from this study could provide information for further research and are important for clinical occupational therapists to enhance treatment motivation in order to improve stroke patient’s ADL improvement.
Subjects
Treatment motivation
Stroke
Activities of daily living
Rehabilitation
Chart review
Type
thesis