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

  • Stephen C.L. Lau
    Correspondence
    Corresponding Author: Stephen C.L. Lau, PhD, Program in Occupational Therapy, Washington University School of Medicine, 600 S. Taylor Ave 00163, St. Louis, MO 63110, USA
    Affiliations
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
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  • Lisa Tabor Connor
    Affiliations
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA

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

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

    Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
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Published:August 03, 2022DOI:https://doi.org/10.1016/j.apmr.2022.07.011

      Abstract

      Objective

      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 stroke survivors.

      Design

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

      Setting

      General community.

      Participants

      Forty community-dwelling stroke survivors.

      Interventions

      Not applicable.

      Main Outcome Measure

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

      Results

      In concurrent analyses, increased autonomy (B=0.21, 95% CI 0.16 to 0.26, p<0.001), competence (B=0.10, 95% CI 0.02 to 0.19, p=0.021), and relatedness (B=0.10, 95% CI 0.06 to 0.13, p<0.001) were momentarily associated with higher autonomous motivation. Conversely, increased autonomy (B=-0.19, 95% CI -0.27 to -0.10, p<0.001) and competence (B=-0.09, 95% CI -0.17 to -0.01, p=0.020) were momentarily associated with lower controlled motivation. Contrary to SDT, increased relatedness was momentarily associated with higher controlled motivation (B=0.10, 95% CI 0.05 to 0.14, p<0.001). In lagged analyses, no momentary associations were detected between basic psychological needs and motivation (ps>0.05).

      Conclusions

      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 stroke survivors’ autonomous motivation to enhance daily activity participation following stroke.

      Keywords

      List of abbreviations:

      EMA (Ecological momentary assessment), MLM (Multilevel modeling), SDT (Self-determination theory)
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