Study On The Chinese-version And Application Of The Stroke Rehabilitation Motivation Scale

ObjectiveThe Stroke Rehabilitation Motivation Scale(SRMS)was introduced and translated into Chinese,and its reliability and validity were tested to form a Chinese version of the SRMS and an evaluation tool suitable for the rehabilitation motivation of stroke patients in China.To investigate the level of rehabilitation motivation of stroke patients in Qingdao and analyze its influencing factors by using the SRMS formed after the Chinese version.The intermediary effect model between knowledge,attitude and rehabilitation motivation of stroke patients was constructed.Methods1.Translate,and evaluate the reliability and validity of the SRMS:After contacting the original author of the scale and obtaining the Chinese authorization,the SRMS was translated in strict accordance with the modified Brislin translation model,and the expert correspondence method and pretest method were used for cross-cultural debugging of the contents of the translated SRMS to form the first draft of the Chinese version of the SRMS.Convenience sampling,429 stroke patients undergoing rehabilitation treatment from three third-class A hospitals in Qingdao were selected to conduct face-to-face questionnaire survey,and the survey results were statistically analyzed using Excel,SPSS,and AMOS software to complete the test of item analysis,internal consistency,content validity,convergent validity and structural validity of the Chinese version of the SRMS.2.Research on the application of the Chinese version of SRMS:The Chinese version of the SRMS,the knowledge and attitude questionnaire of stroke patients,and the general social demographic questionnaire were selected to conduct a face-to-face questionnaire survey on 429 stroke patients undergoing rehabilitation treatment in three third-class first-class hospitals in Qingdao.Analyze the level of rehabilitation motivation of stroke patients in Qingdao,and the influencing factors,and to construct the intermediary effect model between the knowledge,attitude,and rehabilitation motivation of stroke patients.The general data of the subjects were analyzed by SPSS software;The research on the influencing factors of stroke rehabilitation motivation was completed through analysis of variance,multiple linear regression and independent sample t-test;The mediating effect model was tested by Process.Results1.The Chinese version of the SRMS includes 7 dimensions and 28 items,namely,Amotivation,Extrinsic Motivation Introjected,Extrinsic Motivation Regulation,Extrinsic Motivation Identification,Intrinsic Motivation Knowledge,Intrinsic Motivation Stimulation,Intrinsic Motivation Accomplishment.The I-CVI of each entry level of the Chinese version of SRMS is 0.86～1.00,and the S-CVI/Ave is 0.97.Cronbach’sαis 0.851,the retest reliability is 0.922.and the half-reliability is 0.797.Exploratory factor analysis showed that the KMO value of the scale was 0.838,and seven common factors with feature root>1 were extracted,which was consistent with the original scale.The cumulative variance contribution rate was 54.320%.The standardized regression coefficient of each item in the scale was 0.410～0.926,and the model was suitable for the targetχ~2/DF=1.550,RMSEA=0.050,CFI=0.906,IFI=0.908,TLI=0.892.2.In this study,the score of the rehabilitation motivation scale of the subjects was(108.80±7.98),the score of knowledge and attitude questionnaire of 429 stroke patients was(8.76±3.73)and(30.92±9.50)respectively.Univariate analysis showed that the occupation,education level,monthly income,stroke frequency and self-care ability of stroke patients affected their rehabilitation motivation.Multiple linear regression analysis showed that the education level of stroke patients(β=0.216,P<0.001),self-care ability(β=0.085,P=0.041),knowledge of stroke patients(β=0.221,P<0.001),attitude(β=0.260,P<0.001)has a positive effect on the motivation of stroke rehabilitation,and the number of stroke(β=-0.142,P=0.001)has a negative effect on the motivation of stroke rehabilitation.Pearson correlation coefficient analysis showed that there were significant correlations among knowledge and attitude of stroke patients(r=0.279,P<0.001),attitude and rehabilitation motivation of stroke patients(r=0.394,P<0.001),and knowledge and rehabilitation motivation of stroke patients(r=0.339,P<0.001).Using the Process program to examine the mediating effect model of attitudes in stroke patients showed that,when the attitude of stroke patients was not included in the variables,independent variable knowledge could positively affect the rehabilitation motivation,and the path coefficient was 0.564(P<0.001);After incorporating variable attitudes,the independent variable knowledge also had a significant direct impact on the dependent variable’s rehabilitation motivation,with the path coefficient decreasing to 0.433(P<0.001);Meanwhile,attitude also has a significant impact on rehabilitation motivation(β=0.232,P<0.001),indicating that the attitude of stroke patients has a partial mediating effect between knowledge and rehabilitation motivation,and the mediating effect accounts for23%.Conclusions1.The Chinese version of the SRMS has good reliability and validity,and is suitable for measuring the level of rehabilitation motivation of stroke rehabilitation patients in China.2.The higher the level of education,self-care ability,knowledge and attitude of stroke patients,the higher the rehabilitation motivation of stroke patients;On the contrary,the more the number of strokes,the lower the rehabilitation motivation of stroke patients.3.The attitude of stroke patients partially mediates between knowledge and rehabilitation motivation.