Associations Between Basic Psychological Need Satisfaction and Motivation Underpinning Daily Activity Participation Among Community-Dwelling Survivors of Stroke: An Ecological Momentary Assessment Study

  • Stephen C.L. Lau
    Corresponding author Stephen C.L. Lau, PhD, Program in Occupational Therapy, Washington University School of Medicine, 600 S. Taylor Ave 00163, St Louis, MO.
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
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  • Lisa Tabor Connor
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO

    Department of Neurology, Washington University School of Medicine, St. Louis, MO
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  • Carolyn M. Baum
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO

    Department of Neurology, Washington University School of Medicine, St. Louis, MO

    Brown School of Social Work, Washington University in St. Louis, St. Louis, MO
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Published:August 03, 2022DOI:



      Grounded in the self-determination theory (SDT), this study aimed to examine the real-time associations between basic psychological need satisfaction and motivation underpinning daily activity participation among survivors of stroke.


      Repeated-measures observational study involving 7 days of ambulatory monitoring; participants completed ecological momentary assessment (EMA) surveys via smartphones 8 times daily. Multilevel models were used to analyze EMA data for concurrent (same survey) and lagged (next survey) associations.


      General community.


      Forty community-dwelling survivors of stroke (N=40).


      Not applicable.

      Main Outcome Measures

      EMA measures of basic psychological needs (autonomy, competence, relatedness) and motivation (autonomous motivation, controlled motivation).


      In concurrent analyses, increased autonomy (B=0.21; 95% confidence interval, 0.16-0.26; P<.001), competence (B=0.10; 95% confidence interval, 0.02-0.19; P=.021), and relatedness (B=0.10; 95% confidence interval, 0.06-0.13; P<.001) were momentarily associated with higher autonomous motivation. Conversely, increased autonomy (B=−0.19; 95% confidence interval, −0.27 to −0.10; P<.001) and competence (B=−0.09; 95% confidence interval, −0.17 to −0.01; P=.020) were momentarily associated with lower controlled motivation. Contrary to SDT, increased relatedness was momentarily associated with higher controlled motivation (B=0.10; 95% confidence interval, 0.05-0.14; P<.001). In lagged analyses, no momentary associations were detected between basic psychological needs and motivation (Ps>.05).


      Findings suggest that basic psychological need satisfaction is momentarily associated with motivation for daily activity participation. Additional research is warranted to examine the associations of different orientations of relatedness with autonomous and controlled motivation. Supporting basic psychological needs may foster autonomous motivation of survivors of stroke to enhance daily activity participation after stroke.


      List of abbreviations:

      EMA (ecological momentary assessment), MLM (multilevel modeling), SDT (self-determination theory)
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