物理治疗师针对个体状况为脑卒中康复使用不同的定制化激励策略：一项定性研究。
Physical Therapists Use Different Motivational Strategies for Stroke Rehabilitation Tailored to an Individual's Condition: A Qualitative Study.
机构信息
Department of Physical Therapy, School of Health Sciences, Shinshu University, Nagano, Japan.
Department of Rehabilitation, Kakeyu-Misayama Rehabilitation Center Kakeyu Hospital, Nagano, Japan.
出版信息
Phys Ther. 2023 Jun 5;103(6). doi: 10.1093/ptj/pzad034.
OBJECTIVE
Various strategies are used to motivate individuals with stroke during rehabilitation. However, how physical therapists select the motivational strategies that they use for each individual is yet to be established. Therefore, this study aimed to explore how physical therapists use different motivational strategies for individuals in stroke rehabilitation programs.
METHODS
A criterion sample of 15 physical therapists who have worked in rehabilitation for over 10 years and were interested in an individual's motivation participated in one-on-one semi-structured online interviews. The interviews explored their perspectives and experiences regarding the motivational strategies used depending on each individual's condition. The collected data were analyzed with thematic analysis.
RESULTS
A total of 9 themes emerged from the data upon thematic analysis and inductive coding. Participants used different strategies to encourage individuals' active participation in physical therapy depending on (1) their mental health, (2) their physical difficulties, (3) their level of cognitive function, (4) their personality, (5) their activities and participation, (6) their age, (7) their human environment, and (8) the type of rehabilitation service where the individual underwent treatment. For example, in cases where an individual lost self-confidence, participants offered practice tasks that the individual could achieve with little effort to make them experience success. The interviews also revealed (9) motivational strategies used regardless of the individual's condition. For instance, patient-centered communication was used to build rapport with individuals, irrespective of their condition.
CONCLUSION
This qualitative study suggests that physical therapists use different strategies depending on the individual's mental health conditions, physical problems, level of cognitive function, personality, activities and participation, age, human environment, and the type of rehabilitation service where the individual undergoes treatment to motivate individuals with stroke during physical therapy.
IMPACT
The findings of this study can provide experience-based recommendations regarding the selection of motivational strategies for stroke rehabilitation.
目的
在康复过程中，各种策略被用于激励脑卒中患者。然而，物理治疗师如何为每个个体选择他们使用的激励策略尚未确定。因此，本研究旨在探讨物理治疗师如何在脑卒中康复计划中为个体使用不同的激励策略。
方法
本研究采用标准样本，包括 15 名从事康复工作超过 10 年且对个体动机感兴趣的物理治疗师，他们接受了一对一的半结构化在线访谈。访谈探讨了他们根据每个个体的情况使用激励策略的观点和经验。收集的数据采用主题分析进行分析。
结果
通过主题分析和归纳编码，从数据中总共出现了 9 个主题。参与者根据（1）心理健康状况、（2）身体困难程度、（3）认知功能水平、（4）个性、（5）活动和参与程度、（6）年龄、（7）人文环境以及（8）个体接受治疗的康复服务类型，使用不同的策略来鼓励个体积极参与物理治疗。例如，在个体丧失自信的情况下，参与者提供个体可以轻松完成的练习任务，使他们体验成功。访谈还揭示了（9）无论个体状况如何都使用的激励策略。例如，无论个体的状况如何，都使用以患者为中心的沟通来与个体建立融洽关系。
结论
本定性研究表明，物理治疗师根据个体的心理健康状况、身体问题、认知功能水平、个性、活动和参与程度、年龄、人文环境以及个体接受治疗的康复服务类型，使用不同的策略来激励脑卒中患者在物理治疗中积极参与。
影响
本研究的结果可为脑卒中康复中激励策略的选择提供基于经验的建议。
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