Background 

To improve the health outcomes of survivors of stroke, it is critical that they are highly motivated to engage in rehabilitation activities. Despite the increasing prevalence of strokes among middle-aged adults, there is limited knowledge regarding factors that may affect survivors' motivation to engage in rehabilitation.

Objective 

The aim of this study was to examine the relationship among factors that predict the rehabilitation motivation of middle-aged survivors after a stroke through structural equation modeling.

Methods 

A total of 200 middle-aged (40–64 years) survivors of stroke from 9 rehabilitation hospitals in Korea completed questionnaires on depressive symptoms, self-efficacy, social support, and rehabilitation motivation. Information on clinical characteristics, including physical function (activities performed during daily life), was collected through the review of medical records. Structural equation modeling was used to construct a prediction model of rehabilitation motivation.

Results 

The average subject's age was 56.2 ± 6.6 years, and the mean time since the event of their stroke was 15.02 ± 8.95 months. Subjects' self-efficacy (being able to live everyday life) after their stroke (β = .500, P < .001) and the social support provided by family and medical personnel (β = .284, P < .010) directly affected their rehabilitation motivation. The bootstrapping method showed that depressive symptoms indirectly affected rehabilitation motivation through self-efficacy, as did physical function.

Conclusions 

In middle-aged survivors of stroke, self-efficacy and social support play a critical role in maintaining intrinsic motivation to engage in rehabilitation activities. Self-efficacy should be evaluated periodically and improved by encouraging individuals to achieve goals, emphasizing their self-regulation, especially among those who reported depressive symptoms and low physical function.

中文翻译：

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韩国康复设施中年卒中幸存者康复动机预测模型。

背景 

为了改善中风幸存者的健康状况，他们积极参与康复活动至关重要。尽管中年人中风的患病率越来越高，但关于可能影响幸存者参与康复动机的因素的知识有限。

客观的 

本研究的目的是通过结构方程模型研究预测中年幸存者康复动机的因素之间的关系。

方法 

来自韩国 9 家康复医院的 200名中年（40-64 岁）中年患者完成了关于抑郁症状、自我效能、社会支持和康复动机的问卷。通过查阅病历收集有关临床特征的信息，包括身体功能（日常生活中进行的活动）。采用结构方程模型构建康复动机预测模型。

结果 

受试者的平均年龄为 56.2 ± 6.6 岁，自中风事件发生后的平均时间为 15.02 ± 8.95 个月。受试者中风后的自我效能感（能够过上日常生活）（β = .500，P < .001）以及家庭和医务人员提供的社会支持（β = .284，P < .010）直接影响他们的康复动机。自举法表明，抑郁症状通过自我效能感间接影响康复动机，身体机能也是如此。

结论 

在中年卒中幸存者中，自我效能感和社会支持在保持参与康复活动的内在动机方面发挥着关键作用。应定期评估自我效能，并通过鼓励个人实现目标、强调自我调节来提高自我效能，尤其是那些报告有抑郁症状和身体机能低下的人。