An analysis of factors and pathways related to rehabilitation motivation in stroke patients based on self-determination theory

Based on self-determination theory, this study investigates the current state of rehabilitation motivation among stroke patients and its psychosocial correlates, providing evidence for developing a motivation-enhancing intervention model.

Using convenience sampling, 430 stroke patients were recruited from the inpatient wards of the neurology, neurosurgery, and rehabilitation medicine departments at two Grade A Level 3 hospitals in Lanzhou. Data collection employed a demographic questionnaire, Stroke Rehabilitation Motivation Scale, Social Support Rating Scale, General Self-Efficacy Scale, Hospital Anxiety and Depression Scale, and Craig Hospital Inventory of Environmental Factors. Descriptive analysis, correlation analysis, and multiple linear regression analysis were performed using SPSS 26.0, while structural equation modeling was constructed with AMOS 28.0.

The mean rehabilitation motivation score for stroke patients was (105.73 ± 22.03) points, indicating a moderately high level. Multivariate linear regression analysis revealed that monthly household income, family relationships, employment status, rehabilitation duration, self-efficacy, social support, anxiety-depression, and environmental factors were significant predictors of rehabilitation motivation (p < 0.05), explaining 70.4% of total variance. The results of the structural equation modeling indicated that social support (β = 0.17, p = 0.002) and self-efficacy (β = 0.132, p < 0.001) showed a direct positive association with the rehabilitation motivation of stroke patients, while anxiety and depression (β = -0.285, p < 0.001) and environmental factors (β = -0.496, p < 0.001) showed a direct negative association with the level of rehabilitation motivation among stroke patients, while self-efficacy and anxiety and depression demonstrated a significant indirect effect in the relationship between social support and environmental factors, consistent with a mediational role.

Rehabilitation motivation in stroke patients is influenced by multifaceted factors. It is recommended to implement family-centered, psychosocially integrated motivational intervention strategies, incorporating digital technology to enhance the rehabilitation experience and optimize the rehabilitation support system.