Chan DK, Lonsdale C, Ho PY, Yung PS, Chan KM. Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: the influence of physiotherapists' autonomy-supportive behaviors.
To investigate the impact of physiotherapists' autonomy-supportive behaviors on patients' motivation and rehabilitation adherence after anterior cruciate ligament (ACL) reconstruction surgery.
Outpatient orthopedic clinic of a university medical center.
Postsurgery ACL reconstruction patients (N=115; minimum postsurgery interval, 6mo; mean ± SD postsurgery interval, 1.77±0.8y).
Main Outcome Measures
Questionnaires measuring autonomy support from physiotherapists (Health Care Climate Questionnaire), treatment motivation (Treatment Self-Regulation Questionnaire), and rehabilitation adherence (adapted from the Sport Injury Rehabilitation Adherence Scale and the Patient Self-Report Scales of Their Home-Based Rehabilitation Adherence).
Structural equation modeling analyses revealed that patients' treatment motivation mediated the relationship between physiotherapists' autonomy-supportive behaviors and rehabilitation adherence. Autonomy-supportive behavior positively predicted autonomous treatment motivation (β=.22, P<.05). Rehabilitation adherence (R2=.28) was predicted positively by autonomous motivation (β=.64, P<.05) and negatively predicted by controlled motivation (β=−.28, P<.05).
These preliminary findings are promising and provide an empirical basis for further research to test the efficacy of autonomy support training designed to increase patients' rehabilitation adherence.
List of Abbreviations:ACL (anterior cruciate ligament), CFI (comparative fit index), HCCQ (Health Care Climate Questionnaire), RMSEA (root mean squared error of approximation), SDT (self-determination theory), SEM (structural equation modeling), SRMR (standardized root mean square residual), TLI (Tucker-Lewis index), TSRQ (Treatment Self-Regulation Questionnaire)
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