Passage 7
The addition of motivational strategies to a rehabilitation program is thought to
enhance patient adherence and improve outcomes. However, little is known about
how rehabilitation professionals motivate stroke patients during rehabilitation. The
primary objective of this study was to provide a comprehensive and quantitative
list of motivational strategies for stroke rehabilitation. In addition, we aimed to
examine (1) whether professionals with more clinical experience used a higher
number of motivational strategies, (2) the purpose for using each strategy, and (3)
the information considered when choosing strategies.
This descriptive, cross-sectional study was conducted using a web survey with
a convenience sample of 407 rehabilitation professionals including physicians,
nurses, physical therapists, occupational therapists, and speech-language-hearing
therapists.
We received data for 362 participants. Fifteen strategies were found to be used
by more than 75% of the respondents to motivate their patients. Almost all of the
respondents reported that they actively listened to and praised their patients to
increase patient adherence to rehabilitation programs. Respondents with more
clinical experience tended to use a higher number of motivational strategies (rho
= 0.208, p < 0.001). For 11 of the 15 strategies selected by more than 75% of the
respondents, the highest percentage of respondents reported that they used
the strategies to make rehabilitation worthwhile for their patients. The majority of
respondents reported that they decided which motivational strategy to use by
considering comprehensive information regarding the patient health condition,
environmental factors, and personal factors.
The comprehensive list of motivational strategies obtained may be useful for
increasing patient adherence to rehabilitation, especially for professionals with
less clinical experience. Furthermore, our findings regarding the purpose for using
each strategy and the information considered when choose strategies might help
rehabilitation professionals to optimally utilize the motivational strategy list.
Motivational Strategies for Stroke Rehabilitation: A Descriptive Cross-Sectional
Study. Adapted from Oyake et al. (2020).
Suppose a researcher were to study the effects of rehabilitation-related
motivational strategies on a population of individuals who had suffered strokes
and had significant cognitive, emotional, and behavioral deficits as a result.
Which of the following would be important to consider?
A) Ensuring that the tasks presented to participants are appropriate for a
kindergarten grade level, and not too difficult for those included in the study
population
B) Allotting funding for third-party review of all collected data for safety,
quality, and reproducibility
C) Establishing highly objective study protocols with properly-blinded
research scientists
D) Adapting informed consent documentation for ease of understandability by
those with decreased overall cognitive functioning
Correct answer is D
When conducting any sort of research with human participants, it is important that
certain ethical guidelines are followed in order to preserve the safety and well-being
of participants, protect their confidential health information, ensure that research is
conducted in an objective and scientific manner, and ensure that informed consent
and autonomy are maintained.
When working with a vulnerable study population, such as a group of individuals
who have suffered strokes and experience significant deficits as a result, it is even
more important to ensure that the research protocols and standards are designed
with the study population in mind and are specifically tailored to protect study
participants from having their rights violated in the process. Additionally, researchers
should ensure that participants understand their role in the study, their rights as a
participant, their opportunity for full informed consent (and the chance to withdraw
this consent at any time), and have an advocate throughout the process.
Where this scenario is specifically concerned, Answer D is the most appropriate answer
as adapting informed consent documentation for ease of understandability by those
with decreased overall cognitive functioning is the most appropriate consideration. All
study participants have a right to proper informed consent, even if they have decreased
cognitive capabilities, and have a right to receive information about a study and their
proposed participation in a way that is understandable to them. Knowing that the study
population has cognitive deficits makes this the most important consideration among
the four listed, especially since those who have intellectual disabilities can be easily
exploited or coerced due to confusion, a lack of understanding, etc.
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