Qualitative elucidation of factors relating to motivation for rehabilitation in convalescent rehabilitation ward inpatient
Purpose: The purpose of this study was to qualitatively investigate factors related to motivation in highly motivated and low motivated patients admitted to a convalescent rehabilitation ward, and to clarify the relationships between these factors.Methods: The subjects were patients who were hospita...
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Published in | Physical Therapy Research in Mental Health Vol. 2; no. 1; pp. 11 - 22 |
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Main Authors | , , , |
Format | Journal Article |
Language | Japanese |
Published |
Japanese Society of Physical Therapy in Mental Health
01.03.2025
日本精神・心理領域理学療法研究会 |
Subjects | |
Online Access | Get full text |
ISSN | 2758-6103 |
DOI | 10.60361/ptrmh.2.1_11 |
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Abstract | Purpose: The purpose of this study was to qualitatively investigate factors related to motivation in highly motivated and low motivated patients admitted to a convalescent rehabilitation ward, and to clarify the relationships between these factors.Methods: The subjects were patients who were hospitalized in a convalescent rehabilitation ward. The method used was the Structure construction qualitative research method. A total of 7 patients with high motivation, and 7 patients with low motivation were interviewed. The data collected from these interviews was analyzed using the Steps for Coding and Theorization.Results: In the high-motivation group, motivation was influenced by the synergistic effects of patient factors, therapist factors, and third-party factors. This structure reduced the negative experiences caused by hospitalization, which were a factor that reduced motivation. In the low-motivation group, patient factors, therapist factors, and third-party factors had mutual effects on motivation to undergo rehabilitation. These factors counteracted motivation-promoting factors.Conclusion: This study found that in both groups, motivation for rehabilitation does not belong only to the individual patients, but is created by the interactions between the patient, the people around them, and the circumstances surrounding them. |
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AbstractList | Purpose: The purpose of this study was to qualitatively investigate factors related to motivation in highly motivated and low motivated patients admitted to a convalescent rehabilitation ward, and to clarify the relationships between these factors.Methods: The subjects were patients who were hospitalized in a convalescent rehabilitation ward. The method used was the Structure construction qualitative research method. A total of 7 patients with high motivation, and 7 patients with low motivation were interviewed. The data collected from these interviews was analyzed using the Steps for Coding and Theorization.Results: In the high-motivation group, motivation was influenced by the synergistic effects of patient factors, therapist factors, and third-party factors. This structure reduced the negative experiences caused by hospitalization, which were a factor that reduced motivation. In the low-motivation group, patient factors, therapist factors, and third-party factors had mutual effects on motivation to undergo rehabilitation. These factors counteracted motivation-promoting factors.Conclusion: This study found that in both groups, motivation for rehabilitation does not belong only to the individual patients, but is created by the interactions between the patient, the people around them, and the circumstances surrounding them. Purpose: The purpose of this study was to qualitatively investigate factors related to motivation in highly motivated and low motivated patients admitted to a convalescent rehabilitation ward, and to clarify the relationships between these factors.Methods: The subjects were patients who were hospitalized in a convalescent rehabilitation ward. The method used was the Structure construction qualitative research method. A total of 7 patients with high motivation, and 7 patients with low motivation were interviewed. The data collected from these interviews was analyzed using the Steps for Coding and Theorization.Results: In the high-motivation group, motivation was influenced by the synergistic effects of patient factors, therapist factors, and third-party factors. This structure reduced the negative experiences caused by hospitalization, which were a factor that reduced motivation. In the low-motivation group, patient factors, therapist factors, and third-party factors had mutual effects on motivation to undergo rehabilitation. These factors counteracted motivation-promoting factors.Conclusion: This study found that in both groups, motivation for rehabilitation does not belong only to the individual patients, but is created by the interactions between the patient, the people around them, and the circumstances surrounding them. 【目的】回復期リハビリテーション病棟(以下,回復期リハ病棟)に入院する高意欲患者と低意欲患者を対象に意欲に関わる要因を質的に調査し,その要因間の関係性を明らかにすることとした.【方法】対象は回復期リハ病棟1施設に入院する患者とした.方法は構造構成的質的研究法を用いた.高意欲患者7名と低意欲患者7名にインタビューを行い,Steps for Coding and Theorizationにて分析した.【結果】高意欲群では,患者要因,セラピスト要因,第三者要因の相乗効果によって意欲に影響し,意欲低下要因である,入院による負の体験を減少させている構造であった.低意欲群では,患者要因,セラピスト要因,第三者要因がリハの意欲に対して相互に影響を及ぼし,意欲促進要因が打ち消されていた.【結論】両群ともにリハビリテーションに対する意欲は,患者個人のみに帰属しているものではなく,その患者自身とその周辺の人々,患者を取り巻く状況による相互作用性によって成立しているものであることが分かった. |
Author | MORISHITA, Motoyosh TERAOKA, Mutsumi KYOUGOKU, Makoto KUWAHARA, Yuya |
Author_FL | 桑原 裕也 森下 元賀 寺岡 睦 京極 真 |
Author_FL_xml | – sequence: 1 fullname: 桑原 裕也 – sequence: 2 fullname: 京極 真 – sequence: 3 fullname: 寺岡 睦 – sequence: 4 fullname: 森下 元賀 |
Author_xml | – sequence: 1 fullname: KYOUGOKU, Makoto – sequence: 1 fullname: KUWAHARA, Yuya – sequence: 1 fullname: MORISHITA, Motoyosh – sequence: 1 fullname: TERAOKA, Mutsumi |
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References_xml | – reference: 2) 石垣智也,尾川達也,他:回復期リハビリテーション病棟入院患者におけるリハビリテーションへの参加意欲が帰結に与える影響.理学療法学.2014; 41: 108-109. 10.15063/rigaku.kj00009352637 – reference: 33) Lequerica AH, Whitman RD, et al. :Psychometric properties of the rehabilitation therapy engagement scale when used among individuals with acquired brain injury. Rehabil Psychol. 2006; 51: 331-337. – reference: 1) 杉浦靖典,田村将良,他:慢性脳卒中患者の訓練に対する意欲と運動機能の関係性.愛知県理学療法学会誌.2010; 22: 42-43. – reference: 9) Brewer BW: Adherence to sport injury rehabilitation programs. J Appl Sport Psychol. 1998; 10: 70-82. – reference: 30) 武内龍伸,大西麻未,他:看護に対する患者の期待.日本看護管理学会誌.2009; 13: 81-88. 10.19012/janap.13.2_81 – reference: 5) Lenze EJ, Munin MC, et al. :The pittsburgh rehabilitation participation scale : reliability and validity of a clinician-rated measure of participation in acute rehabilitation. Arch Phys Med Rehabil. 2004; 85: 380-384. 10.1016/j.apmr.2003.06.001 – reference: 23) 梶谷みゆき,太湯好子,他:在宅療養を希望する脳血管障害後遺症をもつ男性患者と配偶者の発症3か月の心理プロセスと関係性に関する研究.家族看護学研究.2004; 10: 10-20. – reference: 22) Maclean N, Pound P, et al. :Qualitative analysis of stroke patients' motivation for rehabilitation. BMJ. 2000; 321: 1051-1054. 10.1136/bmj.321.7268.1051 – reference: 10) 石垣智也,泉真里恵,他:回復期リハビリテーション病棟における入院初期のリハビリテーションへの参加意欲とFunctional Independence Measureとの関係.理学療法科学.2014; 29: 521-525. – reference: 13) 西條剛央:ライブ講義 質的研究とは何か(SCQRMアドバンス編).新曜社,東京,2008,pp.67-110. – reference: 32) Tuakli-Wosornu YA, Selzer F, et al. :Predictors of exercise adherence in patients with meniscal tear and osteoarthritis. Arch Phys Med Rehabil. 2016; 97: 1945-1952. – reference: 12) Park YS, An CS, et al. :Effects of a rehabilitation program using a wearable device on the upper limb function, performance of activities of daily living, and rehabilitation participation in patients with acute stroke. Int J Environ Res Public Health. 2021; 18: 5524. – reference: 24) Hu J, Wang X, et al. :Peer support interventions for breast cancer patients: a systematic review. Breast Cancer Res Treat. 2019; 174: 325-341. 10.1007/s10549-018-5033-2 – reference: 15) 回復期リハビリテーション病棟ホームページ 回復期リハビリテーション病棟のあり方指針 第1版.http://www.rehabili.jp/organization/guideline.html(2024年6月9日引用) – reference: 17) 西條剛央:ライブ講義 質的研究とは何か(SCQRMベーシック編).新曜社,東京,2008,pp.223-235. 10.11477/mf.1661101322 – reference: 26) Wolters G, Stapert S, et al. :Coping styles in relation to cognitive rehabilitation and quality of life after brain injury. Neuropsychol Rehabil. 2010; 20: 587-600. – reference: 28) Kielhofner G : A model of human occupation : theory and application. 2nd ed, Lippincott Williams & Wilkins, Phiradelphia, 1995,pp.159-173. – reference: 7) Kortte KB, Falk LD, et al. :The hopkins rehabilitation engagement rating scale : development and psychometric properties. Arch Phys Med Rehabil. 2007; 88: 877-884. – reference: 27) Smith-Forbes EV, Howell DM, et al. :Adherence of individuals in upper extremity rehabilitation: a qualitative study. Arch Phys Med Rehabil. 2016; 97: 1262-1268. 10.1016/j.apmr.2015.11.008 – reference: 18) 西條剛央:「構造構成的心理学」の構築 モデル構築的現象心理学の発展的継承.質的心理学研究.2003; 2: 164-186. – reference: 31) Rosewilliam S, Roskell CA, et al. :A systematic review and synthesis of the quantitative and qualitative evidence behind patient-centred goal setting in stroke rehabilitation. Clin Rehabil. 2011; 25: 501-514. – reference: 16) 西條剛央:質的研究論文執筆の一般技法 関心相関的構成法.質的心理学研究.2005; 4: 186-200. 10.24525/jaqp.4.1_186 – reference: 8) Ramanathan-Elion DM, McWhorter JW, et al. :The role of psychological facilitators and barriers to therapeutic engagement in acute, inpatient rehabilitation. Rehabil Psychol. 2016; 61: 277-287. – reference: 20) Campbell R, Evans M, et al. :Why don't patients do their exercises? understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. J Epidemiol Community Health. 2001; 55: 132-138. – reference: 14) 大谷尚:質的研究の考え方─研究方法論からSCATによる分析まで─.名古屋大学出版会,名古屋,2019,pp.270-277. – reference: 29) 宮城惠子,伊佐雅子:患者の視点からみた医療不信とコミュニケーション.Kyushu Communication Studies. 2012; 10: 14-36. – reference: 11) Spiteri C, Ponsford J, et al. :Factors affecting participation in physical therapy during posttraumatic amnesia. Arch Phys Med Rehabil. 2021; 102: 378-375. – reference: 21) Del Baño-Aledo ME, Medina-Mirapeix F, et al. :Relevant patient perceptions and experiences for evaluating quality of interaction with physiotherapists during outpatient rehabilitation : a qualitative study. Physiotherapy. 2014; 100: 73-79. – reference: 19) Yang SY, Kong KH : Level and predictors of participation in patients with stroke undergoing inpatient rehabilitation. Singapore Med J. 2013; 54: 564-568. 10.11622/smedj.2013201 – reference: 25) 小西かおる:脳血管障害患者における障害によるストレスの認知的評価に関する研究.Journal of Japan Academy of Gerontological Nursing. 2001; 6: 40-49. 10.20696/jagn.6.1_40 – reference: 6) Skidmore ER, Whyte EM, et al. :Cognitive and affective predictors of rehabilitation participation after stroke. Arch Phys Med Rehabil. 2010; 91: 203-207. 10.1016/j.apmr.2009.10.026 – reference: 3) Paolucci S, Di Vita A, et al. : Impact of participation on rehabilitation results : a multivariate study. Eur J Phys Rehabil Med. 2012; 48: 455-466. – reference: 4) Kusec A, Velikonja D, et al. :Motivation in rehabilitation and acquired brain injury : can theory help us understand it? Disabil Rehabil. 2019; 41: 2343-2349. 10.1080/09638288.2018.1467504 |
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Title | Qualitative elucidation of factors relating to motivation for rehabilitation in convalescent rehabilitation ward inpatient |
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