Chen C Y, Neufeld P S, Feely C A, Skinner C S
Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
Am J Occup Ther. 1999 Mar-Apr;53(2):171-80. doi: 10.5014/ajot.53.2.171.
Patient cooperation and satisfaction with home exercise programs are important for successful outcomes of intervention. This study investigated factors from three models to predict increased compliance and satisfaction with home exercise programs: the Model of Human Occupation (MOHO), including the volition subsystem (interests), habituation subsystem (roles), and performance subsystem (reported physical capacity); the Health Belief Model (HBM), including perceived barriers, benefits, self-efficacy, and severity; and the Health Locus of Control (HLOC).
Sixty-two outpatients at an orthopedic upper-extremity rehabilitation facility completed a battery of questionnaires and self-report instruments, including a health belief survey to assess HBM factors, the Multidimensional Health Locus of Control Scale, the Modified Activity Profile to assess the performance subsystem of the MOHO, a demographic questionnaire (including roles), a report of home exercise, and a satisfaction scale of their therapist's treatment. Compliance was determined by comparing participants' report of exercises performed to exercises specified on their medical chart.
Stepwise regression identified two predictors of compliance: perceived self-efficacy and internal HLOC, R2 = .16.
Results supported the role of the MOHO's volition subsystem, but roles and physical capacity--representing the habituation and performance subsystems of the MOHO--did not contribute significantly to the prediction of compliance.
患者对家庭锻炼计划的配合程度和满意度对于干预的成功结果至关重要。本研究从三种模型中探究了预测家庭锻炼计划依从性和满意度提高的因素:人类作业模式(MOHO),包括意志子系统(兴趣)、习惯子系统(角色)和表现子系统(报告的身体能力);健康信念模型(HBM),包括感知到的障碍、益处、自我效能感和严重性;以及健康控制点(HLOC)。
一家骨科上肢康复机构的62名门诊患者完成了一系列问卷调查和自我报告工具,包括一项评估HBM因素的健康信念调查、多维健康控制点量表、用于评估MOHO表现子系统的改良活动概况、一份人口统计学问卷(包括角色)、一份家庭锻炼报告以及一份对其治疗师治疗的满意度量表。通过比较参与者报告的所进行的锻炼与病历上规定的锻炼来确定依从性。
逐步回归确定了依从性的两个预测因素:感知到的自我效能感和内控型HLOC,R2 = 0.16。
结果支持了MOHO意志子系统的作用,但代表MOHO习惯子系统和表现子系统的角色和身体能力对依从性预测的贡献并不显著。