Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: the influence of physiotherapists' autonomy-supportive behaviors.
Chan DK, Lonsdale C, Ho PY, Yung PS, Chan KM. Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: the influence of physiotherapists' autonomy-supportive behaviors.


OBJECTIVE
To investigate the impact of physiotherapists' autonomy-supportive behaviors on patients' motivation and rehabilitation adherence after anterior cruciate ligament (ACL) reconstruction surgery.


METHODS
Retrospective study.


METHODS
Outpatient orthopedic clinic of a university medical center.


METHODS
Postsurgery ACL reconstruction patients (N=115; minimum postsurgery interval, 6mo; mean +/- SD postsurgery interval, 1.77+/-0.8y).


METHODS
Not applicable.


METHODS
Questionnaires measuring autonomy support from physiotherapists (Health Care Climate Questionnaire), treatment motivation (Treatment Self-Regulation Questionnaire), and rehabilitation adherence (adapted from the Sport Injury Rehabilitation Adherence Scale and the Patient Self-Report Scales of Their Home-Based Rehabilitation Adherence).


RESULTS
Structural equation modeling analyses revealed that patients' treatment motivation mediated the relationship between physiotherapists' autonomy-supportive behaviors and rehabilitation adherence. Autonomy-supportive behavior positively predicted autonomous treatment motivation (beta=.22, P<.05). Rehabilitation adherence (R(2)=.28) was predicted positively by autonomous motivation (beta=.64, P<.05) and negatively predicted by controlled motivation (beta=-.28, P<.05).


CONCLUSIONS
These preliminary findings are promising and provide an empirical basis for further research to test the efficacy of autonomy support training designed to increase patients' rehabilitation adherence.
Chan
Derwin K
DK
Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Lonsdale
Chris
C
Ho
Po Y
PY
Yung
Patrick S
PS
Chan
Kai M
KM
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D009042:Motivation; D010349:Patient Compliance; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D017009:Professional Autonomy; D011369:Professional-Patient Relations; D012189:Retrospective Studies; D011795:Surveys and Questionnaires