Patient and professional views of motivation for rehabilitation of subacute stroke

Despite its importance, both patients and rehabilitation staff lack knowledge about the motivation for rehabilitation. This qualitative study aimed to identify factors related to motivation for rehabilitation in patients with subacute stroke. Semi-structured interviews were performed with 20 patients with subacute stroke (mean age: 65.8 years) as well as with rehabilitation staff (10 physical therapists, 10 occupational therapists, and 10 nurses). Individual interviews were recorded in a quiet room. Text data were subjected to content analysis. The local ethics committee approved the research protocol and all participants provided prior written informed consent. The average patient interview time was 19 minutes, with total interview time of 370 minutes. The average staff interview time was 20 minutes, with total interview time of 590 minutes. For both patients and staff, the same 7 core categories were considered as factors influencing motivation: rehabilitation goals, relationships with staffs, relationships with other patients, support of patients, success and failure experiences, physical and cognitive status, and resilience of patients. Additional factors of "patient behavior related to motivation" and "labeling patient motivation" were identified as categories for patients and rehabilitation staff, respectively. This study found that the motivation for rehabilitation in patients with subacute stroke is influenced by multiple internal and external factors. In addition, motivation may change patient behavior, and rehabilitation staffs tend to label patient motivation.