The motivation of chronic stroke survivors’ continuing engagement in rehabilitation at medical institutes

• Main Authors: Yu-Hsuan Lin, 林侑萱
• Other Authors: Chang-Chih Kuo
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/98518281032663707971

碩士 === 高雄醫學大學 === 職能治療學系碩士在職專班 === 104 === Abstract Previous studies have demonstrated that the motivation of stroke survivors’ long-term engagement in rehabilitation affects the outcome of their recovery. Due to different delivery systems of rehabilitation between Taiwan and other countries, the majority of chronic stroke survivors participate in home rehabilitation in other countries, while higher proportion of them engage in outpatient rehabilitation program at medical institutions in Taiwan. In addition, studies that focused on stroke survivors’ motivation of rehabilitation are mostly regarding inpatients and they often have inconsistent perspectives of rehabilitation motivation when compared to clinical professionals; furthermore, a lack of researches done on motivation of “continuing” engagement in rehabilitation is also observed. The purpose of this study, hence, is to investigate the motivation of chronic stroke survivors’ continuing engagement in rehabilitation at medical institutes and the determinants of motivation. Based on the results of this study, professionals not only are able to achieve clinical consensus among the stroke survivors and them in the interventional process, but also are able to help enhance stroke survivors’ perceived control on recovery and health promotion. The study recruited 20 chronic stroke survivors with onset of more than six months, aged 60 to 86 years old. The participants must be able to understand the interview questions and can articulate and answer questions accordingly. Additionally, they have already engaged in rehabilitation program at medical institutes for more than six months and had 80% attendance rate. Through 1 to 2 times semi-structured in-depth individual interviews and recordings, the researcher applied “grounded theory” to code, analyze, compare qualitative data and produce a theoretical framework for understanding the motivation of stroke survivors’ continuing engagement in rehabilitation at medical institutes. In the process of data analysis, the researcher adopts strategies to ensure the reliability of information and reduce the threat credibility. The results show that there are five major themes: the positive attitude toward life, good interaction between families, perceived rehabilitational benefits, good rehabilitation experiences and rehabilitation activities as the main occupational habit of daily living. While “the positive attitude toward life”, “good interaction between families”, “perceived rehabilitational benefits” are the three main types of motivation, each of which is able to directly influence the formation of engagement in rehabilitation as an occupational habit. However, sometimes the three types of motivation would interact with each other and then affect the formation. Another important finding is that “rehabilitation activities as the main occupational habit of daily living” is the theme that every participant experienced at last, and, “good experiences of rehabilitation” produce a positive impact on this. Thus, during the formation of continuing participation in rehabilitation, not one type of motivation exists alone; rather, it is a multi-dimensional model of motivation. Therefore, we could now understand that those who are willing to participate in rehabilitation continuously not only have a positive attitude toward life but also value perceived rehabilitational benefits. Additionally, the family expectations and interaction is also an important factor in Chinese culture, and, not surprisingly, our female participants care more about whether they can meet the traditional gender- role-expectations in order to maintain the family. In summary, these conclusions provide important insights for clinical practicing that it is necessary to utilize a family-centered interventional approach and to pay attention to stroke survivors’ overall physical, psychological and social function in order to enhance their capacity of occupational adaptation and well-being.