Factors influencing compliance with home exercise programs among patients with upper-extremity impairment.
OBJECTIVE
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).


METHODS
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.


RESULTS
Stepwise regression identified two predictors of compliance: perceived self-efficacy and internal HLOC, R2 = .16.


CONCLUSIONS
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.
Chen
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Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
Neufeld
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Feely
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CA
Skinner
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CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001134:Arm Injuries / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri; D009788:Occupational Therapy / Q000523:psychology / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome