Abstract
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Purpose
This study investigated the relationships of autonomy, self-efficacy, and social support with rehabilitation motivation in patients who had undergone acute stroke management.
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Methods
A cross-sectional descriptive correlational study was conducted at a tertiary university hospital in Suwon, South Korea. Data were collected from June 1, 2023, to June 1, 2024, using structured self-reported questionnaires administered to patients scheduled for discharge after their first-ever acute stroke management. A total of 231 patients diagnosed with stroke participated in the study. Hierarchical multiple regression analysis was performed to identify predictors of rehabilitation motivation.
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Results
Positive bivariate relationships were observed between autonomy (r=.26, p<.001), self-efficacy (r=.26, p<.001), social support from family (r=.22, p<.001), social support from medical teams (r=.26, p<.001), and rehabilitation motivation. In the hierarchical multiple regression analyses, patients with paralysis (β=−.21, p=.001), higher autonomy (β=.19, p=.003), and higher social support from the medical team (β=.22, p<.001) demonstrated higher rehabilitation motivation.
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Conclusion
Based on these findings, nursing interventions and educational strategies that enhance patient autonomy and strengthen support from medical teams should be developed and implemented to improve rehabilitation motivation, engagement, and health outcomes in acute stroke care.
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Key Words: Motivation; Personal autonomy; Self efficacy; Social support; Stroke rehabilitation
INTRODUCTION
Stroke is a neurological condition caused by either obstruction or rupture of cerebral blood vessels, resulting in impaired blood flow, damage to brain cells, and subsequent neurological deficits [
1]. It is considered a chronic condition, and as its duration increases, patients often experience more severe physical disabilities and limitations in daily activities. These impairments hinder independent living, reduce social role functioning, and diminish overall quality of life [
2]. Therefore, once the acute medical condition stabilizes, early and active rehabilitation is essential to minimize functional impairment, prevent secondary complications, and maintain an optimal quality of life [
3].
Stroke phases are commonly categorized as acute (<7 days after onset), subacute (7 days to 6 months), and chronic (>6 months) [
4]. Neurological recovery is most active within the first 2 to 3 months after stroke, with maximal recovery typically occurring within 6 months [
5]. Thus, the acute phase represents a critical window for promoting functional and neurological recovery. Stroke rehabilitation involves individualized interventions tailored to onset timing and neurological severity, along with strategies to prevent secondary complications and recurrence [
6]. Current clinical guidelines emphasize early intervention and recommend initiating rehabilitation evaluations within 72 hours of hospitalization [
5], underscoring the importance of timely therapeutic interventions during the acute phase.
Stroke rehabilitation requires extensive time and effort, and active, sustained patient participation is needed to minimize long-term disability [
6]. Although not all patients are discharged with residual symptoms, it remains essential to foster rehabilitation motivation during the acute phase to support effective engagement and reduce recurrence risk. Rehabilitation motivation is defined as the psychological willingness to participate in rehabilitation activities [
7] and functions as a key driving force that enhances patient commitment, participation, and self-management during recovery [
8]. A previous study demonstrated that group exercise nursing interventions significantly improved rehabilitation motivation and reduced depression in stroke patients [
9]. Rehabilitation motivation is essential for initiating, sustaining, and achieving successful rehabilitation outcomes [
10]. Furthermore, promoting motivation is particularly important for patients experiencing negative psychological states, as it can improve adherence and overall rehabilitation outcomes [
11]. Assessing motivation at discharge after acute treatment may therefore be important for guiding nursing interventions that enhance patient engagement. Accordingly, it is necessary to examine rehabilitation motivation in the acute phase of stroke and identify factors associated with patients’ willingness to participate in rehabilitation.
Self-determination theory (SDT) explains human behavioral motivation by emphasizing autonomous motivation as a driver of positive behavioral change when three basic psychological needs—autonomy, competence, and relatedness—are satisfied [
12]. Autonomy refers to perceived volition and self-regulation of one’s actions [
13], whereas competence reflects the effective use of one’s abilities within the environment [
14]. In prior research, competence and self-efficacy, defined as the belief in one’s ability to successfully perform a task [
15], have been used interchangeably [
16]. Relatedness, the need for meaningful social connections [
13], aligns with the concept of social support, specifically the emotional and practical assistance provided by family members and healthcare providers [
17]. Social support plays a crucial role in stroke recovery by reducing recovery time and enhancing rehabilitation outcomes [
18]. Although SDT has been widely applied to investigate rehabilitation motivation in patients in the chronic phase of stroke undergoing outpatient rehabilitation, less is known about how these psychological needs function in the acute phase, when patients are at a critical point in initial recovery. Using the SDT framework, this study sought to clarify whether autonomy, self-efficacy, and social support are associated with rehabilitation motivation among patients at the early stages of recovery, thereby addressing a key gap in the existing literature. Therefore, this study aimed to investigate the relationships between autonomy, self-efficacy, and social support (from family and medical teams) and rehabilitation motivation among patients with acute-phase stroke at discharge, using SDT as the guiding framework.
METHODS
1. Study Design
This cross-sectional descriptive correlational study was developed using SDT as the theoretical framework, with the aim of identifying levels of autonomy, self-efficacy, and social support in patients with acute-phase stroke and examining their relationships with rehabilitation motivation. The study is reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.
2. Setting and Sample
The participants were patients who had been diagnosed with stroke for the first time and were scheduled for discharge within 1 month of hospitalization. The selection criteria for research participants were as follows: (1) adults older than 19 years; (2) patients diagnosed with a first-ever stroke within the past month who were currently hospitalized with planned discharge; and (3) patients diagnosed with one of the following conditions as classified by the Korean Standard Classification of Diseases (KCD): subarachnoid hemorrhage (I60), intracerebral hemorrhage (I61), other nontraumatic intracranial hemorrhage, cerebral infarction (I63), and stroke not specified as hemorrhage or infarction (I64). Patients were excluded if they had communication difficulties resulting from reduced consciousness, defined as having a Glasgow Coma Scale score of 12 or below. However, patients who had difficulty communicating verbally because of stroke-related symptoms but were able to communicate in writing were included in the study. The required sample size was calculated using G*Power 3.1, based on an effect size of 0.15 reported in a previous study on rehabilitation adherence in stroke patients [
6]. Using a significance level of .05, statistical power of .95, and 19 independent variables, the minimum required sample size was 217 participants. To account for possible attrition or incomplete responses, a total of 231 participants were recruited. All 231 questionnaires were returned fully completed with no dropouts or missing responses. Accordingly, the entire dataset was included in the analysis with no missing data.
A structured questionnaire was used in this study, with permission obtained from the authors of both the original and revised versions of the instruments. Specifically, permission to use the self-efficacy questionnaire was granted by the author of the revised version, whereas authorization for the social support questionnaire was obtained from the author of the original form. The final instrument consisted of 63 items, including 15 items on demographic and disease-related characteristics, six items measuring autonomy, 10 items measuring self-efficacy, 16 items assessing social support (including family and medical team support), and 16 items evaluating rehabilitation motivation.
1) General characteristics and disease characteristics
General characteristics included 10 items regarding participants’ sex, age, education level, marital status, primary caregiver, employment status, monthly income, smoking and alcohol consumption, and physical exercise prior to hospitalization. Disease characteristics consisted of five items on the frequency of stroke occurrence, type of stroke, presence of paralysis, presence of other diseases, and presence of language disorders.
2) Autonomy
Autonomy was measured using a 6-item scale related to autonomy from the Korean version of the Basic Psychological Needs Scale (BPNS), adapted by Lee and Kim [
19] based on Deci and Ryan [
13]. Each item was scored on a 5-point Likert scale ranging from “strongly disagree” (1 point) to “strongly agree” (5 points), with four reverse-coded items. Total scores range from 6 to 30, with higher scores indicating greater fulfillment of autonomy needs. The reliability of the autonomy scale at the time of development was Cronbach’s α=.90 [
19], and in this study, Cronbach’s α was .87 for the study participants.
3) Self-efficacy
Self-efficacy was measured using a tool developed by Park [
20] and later modified and supplemented by Kim [
21] to assess specific self-efficacy in stroke patients. The tool consists of 10 items addressing confidence in health responsibility (four items), dietary control (two items), exercise (two items), and stress management (two items). Each item was rated on a Likert scale ranging from “not confident at all” (1 point) to “very confident” (4 points), with total scores ranging from 10 to 40, where higher scores indicate higher self-efficacy. In Kim’s study [
21], Cronbach’s α was .88, and in this study, Cronbach’s α was also .88 for the study participants.
4) Social support
Social support was measured using a tool developed by Tae [
22] to assess social support in patients with cancer, which was later modified and supplemented by Kim [
23] for use in stroke patients. The tool consists of 16 items, with eight items assessing family support and eight items assessing medical team support. Each item was scored on a 5-point Likert scale, ranging from “strongly disagree” or “never provided” (1 point) to “always agree” or “always provided” (5 points). Family and medical team support were each scored from 8 to 40, with higher scores indicating greater social support. The reliability of the original tool was high, as shown by Cronbach’s α values of .87 for both family support and medical team support [
22]. In Kim’s study [
23], the reliability of the modified medical team support tool was demonstrated by a Cronbach’s α value of .90. In this study, Cronbach’s α was .92 for family support and .88 for medical team support.
5) Rehabilitation motivation
The Rehabilitation Motivation Tool developed by Han and Lim [
7] to measure rehabilitation motivation in individuals with disabilities was modified by Lee [
24] to better reflect the characteristics of rehabilitation motivation in stroke patients. The tool consists of five subtypes of motivation, with each subtype comprising eight items. Each item was scored on a 4-point Likert scale, where “strongly disagree” was assigned 1 point and “strongly agree” was assigned 4 points, with two items assessing lack of motivation being reverse-coded. Total scores range from 16 to 64, with higher scores indicating greater rehabilitation motivation. The reliability of the tool was shown by Cronbach’s α values of .86 in Han and Lim’s study [
7] and .89 in Lee’s study [
24]. In this study, Cronbach’s α was .80 for the participants.
Data collection was conducted over a 1-year period, from June 1, 2023, to June 1, 2024, at a tertiary general hospital located in Suwon, South Korea. Before data collection began, approval and permissions were obtained from the hospital’s nursing director and head nurses of the relevant wards. Participants were recruited from the neurosurgery, neurology, and rehabilitation wards. These units were selected because patients were typically in the recovery phase after active treatment and were preparing for discharge. The researcher reviewed electronic medical records to identify potential participants diagnosed with stroke. Individuals were screened according to the inclusion criteria, and eligible participants were then recruited. The researcher provided a detailed explanation of the purpose and procedures of the study to all prospective participants, and informed consent was obtained. The questionnaire required approximately 20 minutes to complete. For participants unable to complete the questionnaire independently because of physical impairments such as hemiplegia or visual disturbances, the researcher read the questions aloud and recorded the participants’ responses.
5. Ethical Considerations
This study was approved by the Institutional Review Board (IRB) of Seoul National University Bundang Hospital (IRB No. B-2304-820-301). Informed consent was obtained from all participants, and ethical standards were upheld throughout the study. Participants received a written explanation assuring confidentiality and the exclusive use of their data for research purposes. They were informed of their right to refuse or withdraw from participation at any time. Participants were also assured that withdrawal would not negatively affect the quality of their healthcare. All completed questionnaires were stored in a locked cabinet accessible only to the research team, and electronic files were password-protected. In accordance with institutional guidelines, all research data will be destroyed three years after study completion.
6. Data Analysis
Data analysis was performed using IBM SPSS/WIN ver. 29.0 (IBM Corp., Armonk, NY, USA). For descriptive statistics, continuous variables were evaluated for normality, and assumptions of normality were met, with skewness and kurtosis values less than 2. Categorical variables were summarized using frequencies and percentages, and continuous variables were described using means and standard deviations. Levels of autonomy, self-efficacy, social support, and rehabilitation motivation were also summarized using means and standard deviations. Differences in rehabilitation motivation according to general and clinical characteristics were examined using the independent t-test and one-way analysis of variance, with the Scheffé post-hoc test. Pearson’s correlation coefficients were calculated to analyze the relationships among autonomy, self-efficacy, social support, and rehabilitation motivation. Hierarchical multiple regression analysis was then conducted to identify predictors of rehabilitation motivation. The regression assumptions of multicollinearity and independence of residuals were confirmed with a tolerance value greater than 0.1, a variance inflation factor below 10, and a Durbin–Watson statistic close to 2.
RESULTS
1. General and Disease-Related Characteristics of the Participants
The characteristics of the 231 participants are summarized in
Table 1. Among the participants, 62.3% were male, and the mean age was 64.81 years. Approximately 46.3% had completed high school or higher, and 77.9% were married or cohabiting with a partner. Primary caregivers were spouses (48.1%), other family members (28.6%), and non-family caregivers (23.4%). Regarding health-related behaviors, 22.1% of participants were current smokers, and 67.1% reported alcohol use. For clinical characteristics, 75.8% had experienced ischemic stroke, whereas 24.2% had hemorrhagic stroke. Paralysis was reported in 26.4% of participants, 55.4% had comorbidities, and 13.4% had language disorders.
The levels of autonomy, self-efficacy, social support, and rehabilitation motivation are presented in
Table 2. The mean autonomy score was 24.78±4.34 (range, 6–30), and the mean self-efficacy score was 34.53±4.69 (range, 10–40). For social support, the mean scores were 36.14±5.98 (range, 8–40) for family support and 31.77±6.88 (range, 8–40) for medical team support. The mean rehabilitation motivation score was 46.30±8.78 (range, 16–64).
Differences in rehabilitation motivation according to general and clinical characteristics are summarized in
Table 3. Significant differences were found for sex, education, employment status, income, smoking, alcohol consumption, physical activity, and paralysis. Male participants exhibited higher motivation than females (t=−2.08,
p=.019). Participants with a high school education or higher showed greater motivation than those with a middle school education or less (t=−3.07,
p=.002). Employed participants had higher motivation than those who were unemployed (t=3.48,
p<.001), and individuals earning more than 3 million KRW reported higher motivation than those earning less (t=−2.05,
p=.042). Smokers (t=2.31,
p=.022) and alcohol users (t=2.06,
p=.041) demonstrated higher motivation than non-users. Participants who exercised more than five times per week showed significantly higher motivation than those who did not exercise (F=6.03,
p=.003). Those with paralysis exhibited higher motivation (48.98±10.18) than those without paralysis (45.34±8.04) (t=2.82,
p=.005).
Correlations among autonomy, self-efficacy, social support, and rehabilitation motivation are provided in
Table 4. Rehabilitation motivation was positively correlated with autonomy (r=.26,
p<.001), self-efficacy (r=.26,
p<.001), family support (r=.22,
p<.001), and medical team support (r=.26,
p<.001). Autonomy was positively correlated with self-efficacy (r=.30,
p<.001) and family support (r=.18,
p=.006). Self-efficacy was positively correlated with family support (r=.33,
p<.001) and medical team support (r=.17,
p=.010). In addition, family support and medical team support were positively correlated (r=.37,
p<.001).
To identify factors associated with rehabilitation motivation, a hierarchical multiple regression analysis was conducted in two steps (
Table 5). In step 1, general and clinical characteristics significantly associated with rehabilitation motivation—sex, education level, employment status, monthly income, smoking status, alcohol use, physical exercise, and paralysis—were converted into dummy variables and included in the model. The analysis showed that more frequent physical exercise prior to hospitalization (β=.18,
p=.012) and the presence of paralysis (β=−.15,
p=.021) were significantly associated with rehabilitation motivation. The model explained 8.3% of the variance and was statistically significant (F=3.60,
p<.001).
In step 2, psychological and social variables—autonomy, self-efficacy, family support, and medical team support—were added. The results indicated that higher autonomy (β=.19, p=.003), greater medical team support (β=.22, p<.001), and the presence of paralysis (β=−.21, p=.001) were significantly associated with rehabilitation motivation. The explanatory power of the model increased to 20.6%, and the model remained statistically significant (F=5.97, p<.001).
DISCUSSION
This study aimed to examine the relationships between autonomy, self-efficacy, social support, and rehabilitation motivation among patients with acute-phase stroke at discharge. Factors associated with rehabilitation motivation in this population included the presence of paralysis, autonomy, and social support from the medical team. Because rehabilitation motivation is a critical factor that can enhance rehabilitation outcomes, it is essential to consider both general characteristics, such as prehospitalization exercise habits, and disease-specific factors, such as the degree of paralysis. Support from the medical team plays a central role in fostering patient autonomy based on individual needs. Therefore, our findings provide partial support for SDT as a framework for understanding rehabilitation motivation among patients in the acute phase of stroke, particularly given the limited associations observed for self-efficacy and family support.
Patients with paralysis in the acute phase of stroke exhibited higher rehabilitation motivation than those without paralysis. This finding contrasts with previous research involving patients in the chronic phase, which reported that individuals with less paralysis tend to demonstrate higher rehabilitation motivation [
25]. This discrepancy may be explained by differences in recovery stages. In the acute phase, paralysis is perceived as a visible and potentially reversible symptom of stroke recovery. Patients experiencing acute-phase paralysis may demonstrate increased motivation to engage in rehabilitation to prevent deterioration and promote functional improvement [
26]. Thus, the findings suggest that salient physical limitations may heighten patients’ motivation for rehabilitation. This underscores the importance of early rehabilitation for improving both the speed and extent of recovery.
In this study, autonomy was a significant predictor of rehabilitation motivation, with higher autonomy associated with stronger rehabilitation motivation among patients in the acute phase of stroke. These findings align with previous studies indicating that greater autonomy enhances intrinsic motivation and supports engagement in behavioral change [
14]. This result suggests that patients who perceive a higher level of autonomy in managing their recovery are more inclined to actively participate in rehabilitation. This highlights the value of nursing interventions that promote patient decision-making and self-regulation during the acute phase of stroke. An intervention study examining autonomy support combined with an information technology device among individuals in the subacute or chronic phases of stroke found that autonomy support improved the use of the more affected arm [
27]. From a clinical perspective, nursing practices aimed at enhancing autonomy can be applied in the acute stroke care setting. For example, nurses may create opportunities for patients to make choices regarding their self-care routines, such as selecting the sequence of rehabilitation exercises or daily activities, involving patients in shared decision-making about treatment goals and rehabilitation plans, and tailoring educational materials to health literacy levels and individual needs. Even small opportunities for choice, such as deciding the timing of specific activities or the use of assistive devices, may strengthen patients’ sense of control. These autonomy-supportive strategies can empower patients, reduce passivity within the hospital environment, and ultimately enhance motivation to actively participate in rehabilitation.
Among the types of social support, support from medical teams was significantly associated with rehabilitation motivation. According to a scoping review, patients in the acute phase of stroke, faced with an abrupt diagnosis, may have heightened expectations and strong motivation, which increases their dependence on and need for support from healthcare teams [
28]. A previous systematic review also demonstrated that professional support from medical staff or structured support from community systems can be critical for strengthening rehabilitation motivation [
29]. Therefore, support from medical teams can promote rehabilitation motivation and encourage active patient engagement in self-care activities. In particular, emotional support delivered through consistent feedback, empathic communication, and encouragement has been suggested to reinforce patients’ motivation and perceived autonomy. A review study reported that supportive and empathic communication from healthcare providers improves treatment adherence and psychological adjustment among patients with chronic illnesses [
30]. In the context of stroke care, motivational interviewing has been shown to reduce low mood and improve rehabilitation engagement in the early post-stroke period [
31]. Furthermore, social-emotional factors such as empathy and emotional support have been linked to better functional recovery and enhanced quality of life in stroke survivors [
32]. However, direct evidence on how these factors influence rehabilitation motivation in the acute phase remains limited, underscoring the need for further research to clarify the mechanisms through which emotional support from medical teams affects rehabilitation motivation.
In addition to emphasizing the importance of medical team support, it is necessary to consider concrete strategies that can be implemented in clinical practice. Structured multidisciplinary interventions that involve collaboration among physicians, nurses, therapists, social workers, and psychologists can provide comprehensive and individualized rehabilitation care. Regular patient–provider counseling sessions may also reinforce motivation by helping set realistic goals, monitor progress, and address emotional challenges faced by patients and their families. Furthermore, psychosocial education programs tailored to stroke patients and caregivers can enhance understanding of the disease, promote self-management, and strengthen resilience throughout the rehabilitation process. Incorporating such strategies into acute stroke care may maximize the positive impact of medical team support on patients’ rehabilitation motivation and overall health outcomes.
In the present study, self-efficacy was not significantly associated with rehabilitation motivation, which differs from the findings of previous research. Although self-efficacy has been shown to influence behavioral change, health behaviors, and rehabilitation adherence in stroke patients [
6], it did not significantly affect rehabilitation motivation in this sample of acute-phase participants, despite demonstrating a positive bivariate correlation. This suggests that the relative contributions of the SDT components may differ depending on the stage of recovery. It may reflect the fact that participants were diagnosed within a month, and their readiness for behavior change likely differs from individuals in later stages of recovery. It is possible that increasing autonomy during the acute phase may subsequently strengthen self-efficacy as patients transition to chronic care, thereby improving rehabilitation motivation.
Similarly, family support was not significantly associated with rehabilitation motivation in this study. However, previous research has reported a positive relationship between family support and rehabilitation motivation [
33], suggesting that the impact of family support may vary across different phases of stroke recovery. In this study, the nonsignificant association between family support and motivation suggests that support from the medical team may be more influential for patients in the acute phase of stroke. As patients transition to home-based rehabilitation after discharge, family support becomes increasingly important. Therefore, both families and medical professionals are essential contributors to patient recovery and successful rehabilitation [
34]. Another study suggested that family and medical team support may function jointly and contribute to motivation [
35]. In this study, family support was not a significant predictor of rehabilitation motivation. This finding suggests that although family support becomes critical after discharge or in the chronic phase, medical team support may play a more decisive role during the acute stage.
This study had several limitations. First, it was conducted among patients with acute stroke in a single region of South Korea, limiting the generalizability of the findings. Second, because this was a descriptive study based on self-reported surveys, causality could not be established. Third, the place of discharge, which could influence rehabilitation motivation, was not considered. Fourth, variations in rehabilitation services based on the presence of residual symptoms may have influenced the outcomes. The participants included patients who initially presented with such symptoms upon admission, some of whom later recovered, while others continued to experience them, which may have shaped their perceptions of rehabilitation motivation. However, other common post-stroke sequelae—such as dysphagia, sensory disturbances, cognitive impairment, depression, and fatigue—were not assessed. Considering only paralysis and language impairment may oversimplify the complex relationship between functional limitations and rehabilitation motivation. The finding that patients with paralysis had higher motivation should therefore be interpreted cautiously, as the functional status of patients without paralysis was not fully evaluated. Future studies should incorporate a broader range of stroke-related sequelae to provide a more comprehensive understanding of how residual disabilities influence rehabilitation motivation. Furthermore, the measurement tool used in this study focused primarily on physical rehabilitation, potentially overlooking broader aspects such as stroke recurrence prevention. Therefore, future research should include larger sample sizes, differentiate between patients who received rehabilitation and those who did not, and employ assessment tools that capture broader conceptualizations of rehabilitation motivation.
CONCLUSION
This descriptive cross-sectional study aimed to examine the relationships between autonomy, self-efficacy, social support, and rehabilitation motivation among patients with acute-phase stroke at discharge. The findings indicated significant positive relationships between residual symptoms of paralysis, autonomy, medical team support, and rehabilitation motivation among patients in the acute phase of stroke. Despite several limitations, these results suggest that fostering patient autonomy and reinforcing support from medical teams—particularly for patients with paralysis—are essential strategies for promoting rehabilitation motivation in acute stroke care. These findings emphasize the need to develop nursing interventions and educational programs that enhance autonomy and strengthen medical team support, thereby facilitating greater rehabilitation engagement and improving health outcomes in the acute phase of stroke care.
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CONFLICTS OF INTEREST
The authors declared no conflict of interest.
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AUTHORSHIP
Study conception and/or design acquisition - SJH; analysis - SJH; interpretation of the data - SJH and MJ; and drafting or critical revision of the manuscript for important intellectual content - SJH and MJ.
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FUNDING
None.
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ACKNOWLEDGEMENT
This article is a condensed form of the first author's master's thesis from Chungnam National University.
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DATA AVAILABILITY STATEMENT
The data can be obtained from the first author.
Table 1.General and Disease-Related Characteristics of the Participants (N=231)
|
Variables |
Categories |
n (%) or M±SD |
|
Sex |
Male |
144 (62.3) |
|
Female |
87 (37.7) |
|
Age (year) |
|
64.81±16.21 |
|
<65 |
99 (42.9) |
|
≥65 |
132 (57.1) |
|
Education level |
≤Middle school |
124 (53.7) |
|
≥High school |
107 (46.3) |
|
Marital status |
Married |
180 (77.9) |
|
Alone |
51 (22.1) |
|
Main caregiver |
Spouse |
111 (48.1) |
|
Family (except spouse) |
66 (28.6) |
|
Care worker |
54 (23.4) |
|
Current employment |
Yes |
108 (46.8) |
|
No |
123 (53.2) |
|
Monthly income (1,000 KRW) |
<3,000 |
179 (77.5) |
|
≥3,000 |
52 (22.5) |
|
Current smoking |
Yes |
51 (22.1) |
|
No |
180 (77.9) |
|
Current alcohol consumption |
Yes |
155 (67.1) |
|
No |
76 (32.9) |
|
Exercise |
None |
52 (22.5) |
|
1–3 times per week |
159 (68.8) |
|
5 or more times per week |
20 (8.7) |
|
Type of stroke |
Ischemic stroke |
175 (75.8) |
|
Hemorrhagic stroke |
56 (24.2) |
|
Hemiplegia |
Yes |
61 (26.4) |
|
No |
170 (73.6) |
|
Dysphasia |
Yes |
31 (13.4) |
|
No |
200 (86.6) |
|
Comorbidity |
Yes |
128 (55.4) |
|
No |
103 (44.6) |
Table 2.Levels of Autonomy, Self-Efficacy, Social Support, and Rehabilitation Motivation (N=231)
|
Variables |
M±SD |
Min |
Max |
|
Autonomy |
24.78±4.34 |
6 |
30 |
|
Self-efficacy |
34.53±4.69 |
10 |
40 |
|
Social support-family |
36.14±5.98 |
8 |
40 |
|
Social support-medical team |
31.77±6.88 |
8 |
40 |
|
Rehabilitation motivation |
46.30±8.78 |
16 |
64 |
Table 3.Differences in Rehabilitation Motivation by General and Disease-Related Characteristics (N=231)
|
Variables |
Categories |
Rehabilitation motivation |
|
M±SD |
t or F |
p (Scheffe) |
|
Sex |
Male |
47.23±8.70 |
–2.08 |
.019 |
|
Female |
44.77±8.77 |
|
|
|
Age (year) |
<65 |
47.06±8.23 |
1.14 |
.257 |
|
≥65 |
45.73±9.17 |
|
|
|
Education level |
≤Middle school |
44.69±9.19 |
–3.07 |
.002 |
|
≥High school |
48.18±7.92 |
|
|
|
Marital status |
Married |
46.94±7.77 |
1.70 |
.094 |
|
Alone |
44.04±11.49 |
|
|
|
Main caregiver |
Spouse |
47.20±8.20 |
1.13 |
.326 |
|
Family (except spouse) |
45.36±9.58 |
|
|
|
Care worker |
45.64±8.93 |
|
|
|
Current employment |
Yes |
48.38±7.91 |
3.48 |
<.001 |
|
No |
44.48±9.13 |
|
|
|
Monthly income (1,000 KRW) |
<3,000 |
44.78±4.73 |
–2.05 |
.042 |
|
≥3,000 |
45.51±6.49 |
|
|
|
Current smoking |
Yes |
48.78±8.99 |
2.31 |
.022 |
|
No |
45.60±8.62 |
|
|
|
Current drinking |
Yes |
47.13±8.56 |
2.06 |
.041 |
|
No |
44.62±9.05 |
|
|
|
Frequency of physical activity |
Nonea
|
42.69±10.46 |
6.03 |
.003 (a<c) |
|
1–3 times per weekb
|
47.25±8.15 |
|
|
|
≥5 times per weekc
|
48.20±8.88 |
|
|
|
Type of stroke |
Ischemic stroke |
46.38±9.07 |
.26 |
.794 |
|
Hemorrhagic stroke |
46.04±7.89 |
|
|
|
Hemiplegia |
Yes |
48.98±10.18 |
2.82 |
.005 |
|
No |
45.34±8.04 |
|
|
|
Dysphasia |
Yes |
49.06±10.78 |
1.89 |
.060 |
|
No |
45.88±8.38 |
|
|
|
Comorbidity |
Yes |
45.26±7.73 |
–1.62 |
.106 |
|
No |
47.14±9.50 |
|
|
Table 4.Correlations between Autonomy, Self-Efficacy, Social Support, and Rehabilitation Motivation (N=231)
|
Variables |
Autonomy |
Self-efficacy |
Social support |
Rehabilitation motivation |
|
Family |
Medical team |
|
r (p) |
|
Autonomy |
1 |
|
|
|
|
|
Self-efficacy |
.30 (<.001) |
1 |
|
|
|
|
Social support |
|
|
|
|
|
|
Family |
.18 (.006) |
.33 (<.001) |
1 |
|
|
|
Medical team |
.04 (.508) |
.17 (.010) |
.37 (<.001) |
1 |
|
|
Rehabilitation motivation |
.26 (<.001) |
.26 (<.001) |
.22 (<.001) |
.26 (<.001) |
1 |
Table 5.Factors influencing Rehabilitation Motivation (N=231)
|
Variables |
Model 1 |
Model 2 |
|
B |
SE |
β |
t |
p
|
B |
SE |
β |
t |
p
|
|
Constant |
46.81 |
2.17 |
|
21.62 |
.001 |
19.43 |
5.16 |
|
3.77 |
<.001 |
|
Sex (male) |
–0.59 |
1.29 |
–.03 |
–0.46 |
.649 |
–0.59 |
1.20 |
–.03 |
–0.49 |
.624 |
|
Education level (>middle school) |
1.97 |
1.47 |
.12 |
1.34 |
.182 |
2.34 |
1.39 |
.13 |
1.68 |
.094 |
|
Job Status (no) |
–1.50 |
1.50 |
–.09 |
–1.00 |
.317 |
–0.46 |
1.41 |
–.03 |
–0.32 |
.746 |
|
Monthly income (1,000 KRW) (≥3,000) |
–0.21 |
1.52 |
–.01 |
–0.14 |
.890 |
–0.31 |
1.42 |
–.02 |
–0.22 |
.827 |
|
Smoking (no) |
–2.14 |
1.52 |
–.10 |
–1.40 |
.162 |
–2.35 |
1.44 |
–.11 |
–1.64 |
.103 |
|
Drinking (no) |
1.84 |
1.51 |
.10 |
1.22 |
.224 |
1.51 |
1.42 |
.08 |
1.07 |
.288 |
|
Exercise (no) |
3.82 |
1.51 |
.18 |
2.53 |
.012 |
2.03 |
1.44 |
.10 |
1.41 |
.161 |
|
Paralysis (no) |
–3.06 |
1.31 |
–.15 |
–2.33 |
.021 |
–4.07 |
1.25 |
–.21 |
–3.27 |
.001 |
|
Autonomy |
|
|
|
|
|
0.39 |
0.12 |
.19 |
3.03 |
.003 |
|
Self-efficacy |
|
|
|
|
|
0.21 |
0.12 |
.11 |
1.70 |
.091 |
|
Social support |
|
|
|
|
|
|
|
|
|
|
|
Family |
|
|
|
|
|
0.10 |
0.10 |
.07 |
0.96 |
.338 |
|
Medical team |
|
|
|
|
|
0.28 |
0.08 |
.22 |
3.37 |
<.001 |
|
Adjusted R2
|
.083 |
.206 |
|
F |
3.60 |
5.97 |
|
p
|
<.001 |
<.001 |
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