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Dimitriadis T, Mudarris MA, Veldhuijzen DS, Evers AW, Magee WL, Schaefer RS. Music therapy with adults in the subacute phase after stroke: A study protocol. Contemp Clin Trials Commun 2024; 41:101340. [PMID: 39188414 PMCID: PMC11345398 DOI: 10.1016/j.conctc.2024.101340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/07/2024] [Accepted: 07/23/2024] [Indexed: 08/28/2024] Open
Abstract
Stroke is a highly disabling condition, for which music therapy is regularly used in rehabilitation. One possible mechanism for the effects of music therapy is the motivational aspect of music, for example regarding treatment adherence based on improved mood. In this study, changes in motivation related to Neurologic Music Therapy (NMT) techniques during rehabilitation in the subacute phase after stroke will be investigated. Using a randomised within-subjects cross-over design, the effects of two NMT techniques and related motivational indices will be investigated. Data will be collected at three timepoints: baseline (TP1), after being randomised into groups and receiving NMT or standard care (TP2), and then at a third time point after the cross-over and having received both conditions (TP3). This design allows to counteract order effects, time effects due to spontaneous and/or nonlinear recovery, as well as single-subject comparisons in a relatively heterogeneous sample. Twenty adult participants who have experienced a supratentorial ischaemic or haemorrhagic stroke and are experiencing upper-limb impairments and/or cognitive deficits will be included. Behavioural measures of motor function, cognition, and quality of life will be collected, along with self-reported indices of overall motivation. The study outcomes will have implications for the understanding of the underlying mechanisms of music therapy in stroke recovery, more specifically regarding the relevance of motivational states in neurorehabilitation.
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Affiliation(s)
- Theo Dimitriadis
- Health, Medical, and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, P.O. Box 9555, 2300RB, Leiden, the Netherlands
- Amstelring Rehabilitation Centre and Nursing Homes, Saaftingestraat 8, 1069BW, Amsterdam, the Netherlands
| | - Mohammed A. Mudarris
- Health, Medical, and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, P.O. Box 9555, 2300RB, Leiden, the Netherlands
- University of Jeddah, College of Science and Arts at AlKamil, Department of Communication Skills, Jeddah, Saudi Arabia
- Leiden Institute for Brain and Cognition, Leiden University, the Netherlands
| | - Dieuwke S. Veldhuijzen
- Health, Medical, and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, P.O. Box 9555, 2300RB, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, the Netherlands
| | - Andrea W.M. Evers
- Health, Medical, and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, P.O. Box 9555, 2300RB, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, the Netherlands
- Medical Delta Healthy Society, Leiden University, Technical University Delft and Erasmus University Rotterdam, the Netherlands
| | - Wendy L. Magee
- Boyer College of Music and Dance, Temple University, Philadelphia, PA, USA
| | - Rebecca S. Schaefer
- Health, Medical, and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, P.O. Box 9555, 2300RB, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, the Netherlands
- Medical Delta Healthy Society, Leiden University, Technical University Delft and Erasmus University Rotterdam, the Netherlands
- Academy of Creative and Performing Arts, Leiden University, the Netherlands
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Kusec A, Murphy FC, Peers PV, Manly T. Measuring Intolerance of Uncertainty After Acquired Brain Injury: Factor Structure, Reliability, and Validity of the Intolerance of Uncertainty Scale-12. Assessment 2024; 31:794-811. [PMID: 37357954 PMCID: PMC11092298 DOI: 10.1177/10731911231182693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Intolerance of uncertainty (IU) is a risk factor for poor mental health. Acquired brain injury (ABI; for example, stroke, traumatic brain injury) often brings considerable uncertainty and increased mood disorder vulnerability. The Intolerance of Uncertainty Scale-Short Form (IUS-12) is a brief, well-validated IU measure in non-ABI samples, comprising two subscales, namely, Prospective Anxiety and Inhibitory Anxiety. Here, for the first time, we investigated its reliability and validity (N = 118), and factor structure (N = 176), in ABI. Both subscales had high test-retest reliability (intraclass correlation coefficients [ICCs] of .75 and .86) and were significantly associated with mood disorder symptoms. The two-factor model was superior to a one-factor IU model fit. Some fit statistics were less than optimal (standardized root mean square residual [SRMR] = 0.06, root mean square error of approximation [RMSEA] = 0.09); hence, exploration of other factor structures in other ABI samples may be warranted. Nonetheless, the IUS-12 appears suitable in ABI.
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Affiliation(s)
- Andrea Kusec
- University of Cambridge, UK
- University of Oxford, UK
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Hocking J, Maeder A, Powers D, Perimal-Lewis L, Dodd B, Lange B. Mixed methods, single case design, feasibility trial of a motivational conversational agent for rehabilitation for adults with traumatic brain injury. Clin Rehabil 2024; 38:322-336. [PMID: 38058144 PMCID: PMC10829423 DOI: 10.1177/02692155231216615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/02/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Rehabilitation for adults with traumatic brain injury (TBI) incorporates client-centred goal-setting and motivational support to achieve goals. However, face-to-face rehabilitation is time-limited. New therapy approaches which leverage care are warranted. Conversational agents (CAs) offer a human-computer interface with which a person can converse. This study tested the feasibility, usability and acceptability of using a novel CA - RehabChat - alongside brain injury rehabilitation. DESIGN Mixed methods, single case design, feasibility pilot trial. SETTING Ambulatory and community brain injury rehabilitation. PARTICIPANTS Adults with TBI receiving brain injury rehabilitation and clinicians providing this care. INTERVENTION Following 1:1 training, client-clinician dyads used RehabChat for two weeks alongside usual care. MAIN MEASURES Pre-post clinical measures (Motivation for Traumatic Brain Injury Rehabilitation Questionnaire, Rehabilitation Therapy Engagement Scale, Brain Injury Rehabilitation Trust Motivation Questionnaire-Relative, Brain Injury Rehabilitation Trust Motivation Questionnaire-Self) repeated measures (Hospital Anxiety and Depression Scale, researcher-developed wellbeing screening questions); and post-intervention (System Usability Scale (SUS), semi-structured 1:1 interview). RESULTS Six participants (two clients and four clinicians) completed training. Two client-clinician dyads completed the intervention. Two other clinicians used RehabChat in a mock client-clinician session. SUS scores indicated good usability. Client well-being did not deteriorate. No adverse events were experienced. Interviews indicated RehabChat was feasible, acceptable and easy to use; and supported motivation, goal-setting and completing practice activities. CONCLUSIONS RehabChat was feasible and acceptable to use alongside usual ambulatory and community brain injury rehabilitation, had good usability and supported client needs. Further testing of RehabChat with a larger cohort for longer duration is warranted.
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Affiliation(s)
- Judith Hocking
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Anthony Maeder
- Flinders Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - David Powers
- College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - Lua Perimal-Lewis
- College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - Beverley Dodd
- South Australian Brain Injury Rehabilitation Services, Adelaide, South Australia, Australia
| | - Belinda Lange
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Kusec A, Murphy FC, Peers PV, Bennett R, Carmona E, Korbacz A, Lawrence C, Cameron E, Bateman A, Watson P, Allanson J, duToit P, Manly T. Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): results from a randomised controlled pilot feasibility trial for low mood in acquired brain injury. BMC Med 2023; 21:445. [PMID: 37974189 PMCID: PMC10655452 DOI: 10.1186/s12916-023-03128-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Acquired brain injury (ABI) is linked to increased depression risk. Existing therapies for depression in ABI (e.g., cognitive behavioural therapy) have mixed efficacy. Behavioural activation (BA), an intervention that encourages engaging in positively reinforcing activities, shows promise. The primary aims were to assess feasibility, acceptability, and potential efficacy of two 8-week BA groups. METHODS Adults (≥ 18 years) recruited from local ABI services, charities, and self-referral via social media were randomised to condition. The Activity Planning group (AP; "traditional" BA) trained participants to plan reinforcing activities over 8 weeks. The Activity Engagement group (AE; "experiential" BA) encouraged engagement in positive activities within session only. Both BA groups were compared to an 8-week Waitlist group (WL). The primary outcomes, feasibility and acceptability, were assessed via recruitment, retention, attendance, and qualitative feedback on groups. The secondary outcome, potential efficacy, was assessed via blinded assessments of self-reported activity levels, depression, and anxiety (at pre- and post-intervention and 1 month follow-up) and were compared across trial arms. Data were collected in-person and remotely due to COVID-19. RESULTS N = 60 participants were randomised to AP (randomised n = 22; total n = 29), AE (randomised n = 22; total n = 28), or re-randomised following WL (total n = 16). Whether in-person or remote, AP and AE were rated as similarly enjoyable and helpful. In exploring efficacy, 58.33% of AP members had clinically meaningful activity level improvements, relative to 50% AE and 38.5% WL. Both AP and AE groups had depression reductions relative to WL, but only AP participants demonstrated anxiety reductions relative to AE and WL. AP participants noted benefits of learning strategies to increase activities and learning from other group members. AE participants valued social discussion and choice in selecting in-session activities. CONCLUSIONS Both in-person and remote group BA were feasible and acceptable in ABI. Though both traditional and experiential BA may be effective, these may have different mechanisms. TRIAL REGISTRATION Clinicaltrials.gov, NCT03874650. Protocol version 2.3, May 26 2020.
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Affiliation(s)
- Andrea Kusec
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
| | - Fionnuala C Murphy
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Polly V Peers
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Ron Bennett
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Patient and Public Involvement Representative, University of Cambridge, Cambridge, UK
| | - Estela Carmona
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Aleksandra Korbacz
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Cara Lawrence
- School of Allied Health, Anglia Ruskin University, Cambridge, UK
| | - Emma Cameron
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Andrew Bateman
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Peter Watson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Judith Allanson
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Pieter duToit
- School of Health and Social Care, University of Essex, Colchester, UK
- The Disabilities Trust, Fen House, Ely, UK
| | - Tom Manly
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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Yoshida T, Otaka Y, Kitamura S, Ushizawa K, Kumagai M, Kurihara Y, Yaeda J, Osu R. Development and validation of new evaluation scale for measuring stroke patients' motivation for rehabilitation in rehabilitation wards. PLoS One 2022; 17:e0265214. [PMID: 35298513 PMCID: PMC8929594 DOI: 10.1371/journal.pone.0265214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/24/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study aimed to develop the Motivation in stroke patients for rehabilitation scale (MORE scale), following the Consensus-based standards for the selection of health measurement instruments (COSMIN). METHOD Study participants included rehabilitation professionals working at the convalescent rehabilitation hospital and stroke patients admitted to the hospital. The original MORE scale was developed from an item pool, which was created through discussions of nine rehabilitation professionals. After the content validity of the scale was verified using the Delphi method with 61 rehabilitation professionals and 22 stroke patients, the scale's validity and reliability were examined for 201 stroke patients. The construct validity of the scale was investigated using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and item response theory analysis. Cronbach's alpha confirmed its internal consistency. Regarding convergent, discriminant, and criterion validity, Spearman's rho was calculated between the MORE scale and the Apathy Scale (AS), Self-rating Depression Scale (SDS), and Visual Analogue Scale (VAS), which rates the subjective feelings of motivation. RESULTS Using the Delphi method, 17 items were incorporated into the MORE scale. According to EFA and CFA, a one-factor model was suggested. All MORE scale items demonstrated satisfactory item response, with item slopes ranging from 0.811 to 2.142, and item difficulty parameters ranging from -3.203 to 0.522. Cronbach's alpha was 0.948. Regarding test-retest reliability, a moderate correlation was found between scores at the beginning and one month after hospitalization (rho = 0.612. p < 0.001). The MORE scale showed significant correlation with AS (rho = -0.536, p < 0.001), SDS (rho = -0.347, p < 0.001), and VAS (rho = 0.536, p < 0.001), confirming the convergent, discriminant, and criterion validity, respectively. CONCLUSIONS The MORE scale was verified as a valid and reliable scale for evaluating stroke patients' motivation for rehabilitation.
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Affiliation(s)
- Taiki Yoshida
- Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Yohei Otaka
- Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Department of Rehabilitation Medicine Ⅰ, Fujita Health University School of Medicine, Aichi, Japan
| | - Shin Kitamura
- Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Kazuki Ushizawa
- Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Department of Rehabilitation Medicine Ⅰ, Fujita Health University School of Medicine, Aichi, Japan
| | | | - Yuto Kurihara
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
| | - Jun Yaeda
- Graduate School of Comprehensive Human Science, University of Tsukuba, Tokyo, Japan
| | - Rieko Osu
- Faculty of Human Sciences, Waseda University, Saitama, Japan
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Psychometric properties of the BIRT Motivation Questionnaire (BMQ), a self-measure of avolition in individuals with schizophrenia. J Psychiatr Res 2022; 147:274-282. [PMID: 35074744 DOI: 10.1016/j.jpsychires.2022.01.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/20/2021] [Accepted: 01/13/2022] [Indexed: 11/21/2022]
Abstract
AIMS Avolition defined as a lack of interest or engagement in goal-directed behavior plays a key role in everyday functioning in schizophrenia and is considered as one of the main contributors to the burden of disease. The aim of this study was to 1) validate the self-report BIRT Motivation Questionnaire (BMQ-S) seldom used before in schizophrenia 2) examine the degree of agreement between the BMQ-S and its informant-report version 3) to assess its ability to predict real-world outcome at 12 month follow-up. METHODS One hundred and twenty-two (51.9% inpatients) adults with a diagnosis of schizophrenia were included. Exploratory Factor analysis was performed on the BMQ-S to identify the underlying structure. Real life functioning was measured with the Global Assessment of Functioning scale (GAF). Convergent validity was assessed with the Scale for Assessment of Negative Symptom (SANS) and the Lille Apathy Rating Scale (LARS). RESULTS The main psychometric properties of the BMQ-S (internal consistency, test-retest reliability) were satisfactory. Exploratory factorial analysis revealed a 4-factor model which explained 76% of the overall variance. The BMQ-S correlated significantly with the LARS and the SANS avolition subscore suggesting adequate convergent validity. The correlation between the BMQ-S and the clinician-report version was 0.48. The global score and in particular the Initiation/disorganisation dimension was a significant predictor of global functioning at 12-months even when adjusted for age, chlorpromazine intake and depression. CONCLUSION Our findings indicate that the BMQ-S has satisfactory psychometric properties and that schizophrenia patients can reliably assess their lack of motivation. Self-evaluation of avolition should be considered in the overall prediction of real-world functioning in schizophrenia.
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Yoshida T, Otaka Y, Osu R, Kumagai M, Kitamura S, Yaeda J. Motivation for Rehabilitation in Patients With Subacute Stroke: A Qualitative Study. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:664758. [PMID: 36188821 PMCID: PMC9397769 DOI: 10.3389/fresc.2021.664758] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
Background: Motivation is essential for patients with subacute stroke undergoing intensive rehabilitation. Although it is known that motivation induces behavioral changes toward rehabilitation, detailed description has been lacking. Motivation can be intrinsic or extrinsic; however, it is unclear which type of factors mainly motivates patients' daily rehabilitation. Purpose: This study aimed to examine the factors influencing patients' motivation and to explore the behavioral changes induced by motivation, especially age-related differences. Method: Twenty participants (mean age 65.8 years [standard deviation 13.7]) who had a subacute stroke and underwent rehabilitation at a convalescent hospital were recruited using convenience sampling. Semi-structured interviews were conducted by an occupational therapist with an interview topic guide regarding factors influencing motivation and how it affects behavioral change. Interviews were recorded, transcribed to text, and analyzed by three occupational therapists using thematic analysis. The participants were divided into two groups: aged patients (aged ≥ 65 years) and middle-aged patients (aged < 65 years), and data were analyzed according to the groups. This study was conducted according to the consolidated criteria for reporting qualitative research. Results: Seven core categories were identified as factors influencing patients' motivation: patients' goals, experiences of success and failure, physical condition and cognitive function, resilience, influence of rehabilitation professionals, relationships between patients, and patients' supporters. The first four and last three core categories were further classified as personal and social-relationship factors, respectively. The categories related to intrinsic motivation such as enjoyment of rehabilitation itself were not derived. In both age-groups, motivation affected the frequency of self-training and activity in daily lives. In some aged patients, however, high motivation restrained their self-training to conserve their physical strength for rehabilitation by professionals. Some aged patients do not express their high motivation through their facial expressions and conversations compared to middle-aged patients; therefore, motivation is not always observable in aged patients. Conclusions: Interventions tailored to extrinsic factors are important for maintaining patients' motivation. Observational evaluation may lead to mislabeling of their motivation, especially for aged patients. Rehabilitation professionals should use validated evaluation scales or patients' narratives to assess patients' motivation.
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Affiliation(s)
- Taiki Yoshida
- Tokyo Bay Rehabilitation Hospital, Narashino, Japan
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Tokyo Bay Rehabilitation Hospital, Narashino, Japan
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Toyoake, Japan
- *Correspondence: Yohei Otaka
| | - Rieko Osu
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | | | - Shin Kitamura
- Tokyo Bay Rehabilitation Hospital, Narashino, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Jun Yaeda
- Graduate School of Comprehensive Human Science, University of Tsukuba, Tokyo, Japan
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Hosseini F, Alavi NM, Mohammadi E, Sadat Z. Scoping Review on the Concept of Patient Motivation and Practical Tools to Assess it. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:1-10. [PMID: 33954092 PMCID: PMC8074736 DOI: 10.4103/ijnmr.ijnmr_15_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 01/20/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022]
Abstract
Background: In this scoping review, the concept of patients' motivation and the tools that have been designed to measure this concept in clinical settings are presented. Materials and Methods: Arksey and O'Malley's framework was used in conducting the current scoping review. Google Scholar, PubMed, Scopus, and Web of Science databases were searched for relevant English articles published between January 1995 and January 2020 using the keywords motivation and tool, and their synonyms. Out of 2820 articles, 34 articles were chosen and were entered into the final analysis. Definitions of patients' motivation were determined using Kyngäs et al., content analysis method. Results: The findings showed that new tools had been developed in 38% of the studies and other studies had revised or translated existing questionnaires. Moreover, 62% of the tools were used to measure patient motivation in mental disorders. Most of the studies did not clearly define the concept of patient motivation in the clinical environment. The findings of content analysis outlined the 3 categories of motivation determinant factors, decisions, and behaviors that determine overall levels of motivations and its consequences. Conclusions: Motivation is a dynamic concept and is a result of internal and external motives that lead to decisions and behaviors. There are limited tools for measuring motivation in clinical settings. This addresses the need to design specific tools in various diseases, especially chronic diseases. By the concept defined in this study, it is possible to design a short tool with general application that can be used in all diseases.
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Affiliation(s)
- Fatemeh Hosseini
- PhD Candidate of Nursing, Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Negin Masoud Alavi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Eesa Mohammadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zohreh Sadat
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Pellicciari L, Piscitelli D, Basagni B, De Tanti A, Algeri L, Caselli S, Ciurli MP, Conforti J, Estraneo A, Moretta P, Gambini MG, Inzaghi MG, Lamberti G, Mancuso M, Rinaldesi ML, Sozzi M, Abbruzzese L, Zettin M, La Porta F. 'Less is more': validation with Rasch analysis of five short-forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). Brain Inj 2020; 34:1741-1755. [PMID: 33180650 DOI: 10.1080/02699052.2020.1836402] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Previous analyses demonstrated a lack of unidimensionality, item redundancy, and substantial administrative burden for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). OBJECTIVE To use Rasch Analysis to calibrate five short-forms of the BIRT-PQs, satisfying the Rasch model requirements. METHODS BIRT-PQs data from 154 patients with severe Acquired Brain Injury (s-ABI) and their caregivers (total sample = 308) underwent Rasch analysis to examine their internal construct validity and reliability according to the Rasch model. RESULTS The base Rasch analyses did not show sufficient internal construct validity according to the Rasch model for all five BIRT-PQs. After rescoring 18 items, and deleting 75 of 150 items, adequate internal construct validity was achieved for all five BIRT-PQs short forms (model chi-square p-values ranging from 0.0053 to 0.6675), with reliability values compatible with individual measurements. CONCLUSIONS After extensive modifications, including a 48% reduction of the item load, we obtained five short forms of the BIRT-PQs satisfying the strict measurement requirements of the Rasch model. The ordinal-to-interval measurement conversion tables allow measuring on the same metric the perception of the neurobehavioral disability for both patients with s-ABI and their caregivers.
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Affiliation(s)
- Leonardo Pellicciari
- Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana , Rome, Italy
| | - Daniele Piscitelli
- School of Physical and Occupational Therapy, McGill University , Montreal, Canada.,School of Medicine and Surgery, University of Milano Bicocca , Milan, Italy.,School of Physical Therapy and Athletic Training, Pacific University , Hillsboro, OR, USA
| | - Benedetta Basagni
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Antonio De Tanti
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Lorella Algeri
- UOC Psicologia, ASST Papa Giovanni XXIII , Bergamo, Italy
| | - Serena Caselli
- Unità Operativa di Medicina Riabilitativa, Dipartimento di Neuroscienze, Azienda Ospedaliero-Universitaria di Modena , Modena, Italy.,Scuola di Dottorato in Sanità Pubblica, Università degli Studi di Milano-Bicocca , Milano, Italy
| | | | - Jessica Conforti
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Anna Estraneo
- Severe Brain Injury Department, IRCCS Don Gnocchi Institute , Florence, Italy.,Neurology Unit, Santa Maria della Pietà General Hospital , Nola, Italy
| | - Pasquale Moretta
- Maugeri Scientific and Clinical Institutes, IRCCS, Department of Neurorehabilitation, Institute of Telese Terme , Telese Terme, Italy
| | - Maria Grazia Gambini
- Dipartimento di Riabilitazione, Ospedale Sacro Cuore- Don Calabria , Verona, Italy
| | | | | | - Mauro Mancuso
- Department of Rehabilitation, National Health Service South-Est Tuscany , Grosseto, Italy.,Research Centre, Tuscany Rehabilitation Clinic , Montevarchi, Italy
| | - Maria Luisa Rinaldesi
- Santo Stefano Riabilitazione, Istituto di Riabilitazione Santo Stefano , Porto Potenza Picena, Italy
| | - Matteo Sozzi
- Neurology Unit, "A. Manzoni" Hospital , Lecco, Italy
| | - Laura Abbruzzese
- Research Centre, Tuscany Rehabilitation Clinic , Montevarchi, Italy
| | - Marina Zettin
- Centro Puzzle , Turin, Italy.,Dipartimento di Psicologia, Università di Torino , Turin, Italy
| | - Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurorehabilitation Unit , Bologna, Italy
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Kusec A, Murphy FC, Peers PV, Lawrence C, Cameron E, Morton C, Bateman A, Watson P, Manly T. Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): a randomised controlled pilot feasibility trial for low mood in acquired brain injury. Pilot Feasibility Stud 2020; 6:135. [PMID: 32974044 PMCID: PMC7507282 DOI: 10.1186/s40814-020-00660-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/03/2020] [Indexed: 11/22/2022] Open
Abstract
Background Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here, we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the activity planning group (traditional BA), the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The activity engagement group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method This study outlines a parallel-arm pilot feasibility trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs waitlist controls. Adults (≥ 18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation and sense of control over one’s life. Ethics and dissemination The trial has been approved by the Health Research Authority of the NHS in the UK (East of England—Cambridge Central, REF 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations and social media. Trial registration ClinicalTrials.gov, NCT03874650 pre-results. Protocol version 2.1, March 5, 2019
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Affiliation(s)
- Andrea Kusec
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF UK
| | - Fionnuala C Murphy
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF UK
| | - Polly V Peers
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF UK
| | - Cara Lawrence
- Evelyn Community Head Injury Services, Cambridgeshire Community Services, Dynamic Health Building, Brookfields Hospital, 351 Mill Road, Cambridge, CB1 3DF UK
| | - Emma Cameron
- The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, Post Box 113, Queen Square, London, WC1N 3BG UK
| | - Claire Morton
- Evelyn Community Head Injury Services, Cambridgeshire Community Services, Dynamic Health Building, Brookfields Hospital, 351 Mill Road, Cambridge, CB1 3DF UK
| | - Andrew Bateman
- School of Health and Social Care, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ UK
| | - Peter Watson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF UK
| | - Tom Manly
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF UK
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Kusec A, Panday J, Froese A, Albright H, Harris JE. Getting motivated: long-term perspectives on engaging in community-based programs after acquired brain injury. Brain Inj 2020; 34:1331-1338. [PMID: 32780592 DOI: 10.1080/02699052.2020.1802657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Low motivation is a common problem after acquired brain injury (ABI) and can persist for years after injury. Little is known, however, about perspectives of motivation with respect to engaging in the community, many years after ABI. PURPOSE To explore the client with ABI perspective of motivation and engagement in individuals based in community ABI programs. METHOD Interpretive description methods were utilized. Semi-structured interviews were conducted with 21 individuals with an ABI. FINDINGS Participants felt that both internal factors, such as feelings of hope, and external factors, such as social support, influence levels of motivation to engage. When positive internal and external motivators were enhanced, and negative internal and external motivators reduced, this gave rise to a sense of choice and control, which led to increased engagement. IMPLICATIONS Fostering positive aspects of rehabilitation and increasing choice and control may promote engagement. External motivators, such as reducing repetitiveness and promoting peer support, are motivators that community and clinical settings can implement relatively easily, whilst internal motivators such as attitudes toward therapy may need to be addressed continuously to enhance motivation and engagement.
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Affiliation(s)
- Andrea Kusec
- MRC Cognition and Brain Sciences Unit, University of Cambridge , Cambridge, UK
| | - Janelle Panday
- School of Rehabilitation Science, McMaster University, Institute for Applied Health Sciences Room 403 , Hamilton, Ontario, Canada
| | - Amanda Froese
- School of Rehabilitation Science, McMaster University, Institute for Applied Health Sciences Room 403 , Hamilton, Ontario, Canada
| | - Hailey Albright
- School of Rehabilitation Science, McMaster University, Institute for Applied Health Sciences Room 403 , Hamilton, Ontario, Canada
| | - Jocelyn E Harris
- School of Rehabilitation Science, McMaster University, Institute for Applied Health Sciences Room 403 , Hamilton, Ontario, Canada
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12
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Basagni B, Piscitelli D, De Tanti A, Pellicciari L, Algeri L, Caselli S, Formisano R, Conforti J, Estraneo A, Moretta P, Gambini MG, Inzaghi MG, Lamberti G, Mancuso M, Quinquinio C, Sozzi M, Abbruzzese L, Zettin M, La Porta F. The unidimensionality of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs) may be improved: preliminary evidence from classical psychometrics. Brain Inj 2020; 34:673-684. [PMID: 32126842 DOI: 10.1080/02699052.2020.1723700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To assess the internal construct validity (ICV) of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQ) with Classical Test Theory methods.Methods: Multicenter cross-sectional study involving 11 Italian rehabilitation centers. BIRT-PQs were administered to patients with severe Acquired Brain Injury and their respective caregivers. ICV was assessed by the mean of an internal consistency analysis (ICA) and a Confirmatory Factor Analysis (CFA).Results: Data from 154 patients and their respective caregivers were pooled, giving a total sample of 308 subjects. Despite good overall values (alphas ranging from 0.811 to 0.937), the ICA revealed that several items within each scale did not contribute as expected to the total score. This result was confirmed by the CFA, which showed the misfit of the data to a unidimensional model (RMSEA ranging from 0.077 to 0.097). However, after accounting for local dependency found within the data, fitness to a unidimensional model improved significantly (RMSEA ranging from 0.050 to 0.062).Conclusion: Despite some limitations, our analyses demonstrated the lack of ICV for the BIRT-PQ total scores. It is envisaged that a more comprehensive ICV analysis will be performed with Rasch analysis, aiming to improve both the measurement properties and the administrative burden of each BIRT-PQ.
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Affiliation(s)
- Benedetta Basagni
- Centro Cardinali Ferrari, Santo Stefano Riabilitazione, Fontanellato, Italy
| | - Daniele Piscitelli
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Antonio De Tanti
- Centro Cardinali Ferrari, Santo Stefano Riabilitazione, Fontanellato, Italy
| | | | - Lorella Algeri
- UOC Psicologia, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Serena Caselli
- Unità Operativa di Medicina Riabilitativa, Dipartimento di Neuroscienze, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.,Scuola di Dottorato in Sanità Pubblica, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Rita Formisano
- Unità Post-Coma Ospedale di Riabilitazione Fondazione Santa Lucia, Rome, Italy
| | - Jessica Conforti
- Centro Cardinali Ferrari, Santo Stefano Riabilitazione, Fontanellato, Italy
| | - Anna Estraneo
- IRCCS; Fondazione Don Carlo Gnocchi, Severe Brain Injury Department, Florence, Italy
| | - Pasquale Moretta
- Maugeri Scientific and Clinical Institutes, IRCCS Department of Neurorehabilitation, Institute of Telese Terme, Telese Terme, Italy
| | - Maria Grazia Gambini
- Dipartimento di riabilitazione, Ospedale Sacro cuore- Don Calabria, Negrar, Verona
| | | | - Gianfranco Lamberti
- Unità Spinale e Medicina Riabilitativa Intensiva, AUSL Piacenza, Piacenza, Italy
| | - Mauro Mancuso
- Department of Rehabilitation, National Health Service South-Est Tuscany, Grosseto, Italy.,Research Centre, Tuscany Rehabilitation Clinic, Montevarchi, Italy
| | - Cristina Quinquinio
- Santo Stefano Riabilitazione, Istituto di Riabilitazione Santo Stefano, Porto Potenza Picena, Italy
| | - Matteo Sozzi
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Laura Abbruzzese
- Research Centre, Tuscany Rehabilitation Clinic, Montevarchi, Italy
| | - Marina Zettin
- Centro Puzzle, Turin, Italy.,Dipartimento di Psicologia, Università di Torino, Turin, Italy
| | - Fabio La Porta
- Neurorehabilitation Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Kusec A, Velikonja D, DeMatteo C, Harris JE. Motivation in rehabilitation and acquired brain injury: can theory help us understand it? Disabil Rehabil 2018; 41:2343-2349. [PMID: 29693464 DOI: 10.1080/09638288.2018.1467504] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: In acquired brain injury (ABI) populations, low motivation to engage in rehabilitation is associated with poor rehabilitation outcomes. Motivation in ABI is thought to be influenced by internal and external factors. This is consistent with Self-determination Theory, which posits that motivation is intrinsic and extrinsic. This paper discusses the benefit of using Self-determination Theory to guide measurement of motivation in ABI. Methods: Using a narrative review of the Self-determination Theory literature and clinical rehabilitation research, this paper discusses the unique role intrinsic and extrinsic motivation has in healthcare settings and the importance of understanding both when providing rehabilitation in ABI. Results: Based on the extant literature, it is possible that two independently developed measures of motivation for ABI populations, the Brain Injury Rehabilitation Trust Motivation Questionnaire-Self and the Motivation for Traumatic Brain Injury Rehabilitation Questionnaire, may assess intrinsic and extrinsic motivation, respectively. Conclusion: Intrinsic and extrinsic motivation in ABI may be two equally important but independent factors that could provide a comprehensive understanding of motivation in individuals with ABI. This increased understanding could help facilitate behavioural approaches in rehabilitation. Implications for Rehabilitation Conceptualization of motivation in ABI would benefit from drawing upon Self-determination Theory. External factors of motivation such as the therapeutic environment or social support should be carefully considered in rehabilitation in order to increase engagement. Assessing motivation as a dual rather than a global construct may provide more precise information about the extent to which a patient is motivated.
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Affiliation(s)
- Andrea Kusec
- a School of Rehabilitation Science, Institute for Applied Health Sciences , McMaster University , Hamilton , Canada
| | - Diana Velikonja
- b Hamilton Health Sciences , Acquired Brain Injury Program , Hamilton , Canada.,c Department of Psychiatry and Behavioural Neurosciences, DeGroote School of Medicine , McMaster University , Hamilton , Canada
| | - Carol DeMatteo
- a School of Rehabilitation Science, Institute for Applied Health Sciences , McMaster University , Hamilton , Canada
| | - Jocelyn E Harris
- a School of Rehabilitation Science, Institute for Applied Health Sciences , McMaster University , Hamilton , Canada
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Honan CA, McDonald S, Tate R, Ownsworth T, Togher L, Fleming J, Anderson V, Morgan A, Catroppa C, Douglas J, Francis H, Wearne T, Sigmundsdottir L, Ponsford J. Outcome instruments in moderate-to-severe adult traumatic brain injury: recommendations for use in psychosocial research. Neuropsychol Rehabil 2017; 29:896-916. [DOI: 10.1080/09602011.2017.1339616] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Cynthia A. Honan
- Department of Psychology, School of Medicine, University of Tasmania, Newnham, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
| | - Skye McDonald
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Robyn Tate
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- Sydney Medical School, Northern Clinical School, The University of Sydney, Sydney, Australia
- John Walsh Centre for Rehabilitation Studies, Sydney, Australia
| | - Tamara Ownsworth
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Leanne Togher
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Jennifer Fleming
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Vicki Anderson
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- Murdoch Childrens Research Institute, Psychological Sciences & Paediatrics, University of Melbourne, Melbourne, Australia
| | - Angela Morgan
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- Murdoch Childrens Research Institute, Centre for Neuroscience of Speech, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- Murdoch Childrens Research Institute, Psychological Sciences & Paediatrics, University of Melbourne, Melbourne, Australia
| | - Jacinta Douglas
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- School of Allied Health, Department of Community and Clinical Allied Health, LaTrobe University, Melbourne, Australia
| | - Heather Francis
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia
| | - Travis Wearne
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Linda Sigmundsdottir
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- Sydney Medical School, Northern Clinical School, The University of Sydney, Sydney, Australia
- John Walsh Centre for Rehabilitation Studies, Sydney, Australia
| | - Jennie Ponsford
- Moving Ahead Centre for Research Excellence in Brain Recovery, Australia
- School of Psychological Sciences, Monash University, Melbourne, Australia
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15
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O’Neil-Pirozzi TM, Hsu H. Feasibility and benefits of computerized cognitive exercise to adults with chronic moderate-to-severe cognitive impairments following an acquired brain injury: A pilot study. Brain Inj 2016; 30:1617-1625. [DOI: 10.1080/02699052.2016.1199906] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Therese M. O’Neil-Pirozzi
- Northeastern University, Boston, MA, USA
- Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
| | - Henry Hsu
- Northeastern University, Boston, MA, USA
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16
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Tatla SK, Jarus T, Virji-Babul N, Holsti L. The development of the Pediatric Motivation Scale for rehabilitation. The Canadian Journal of Occupational Therapy 2014; 82:93-105. [DOI: 10.1177/0008417414556884] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Clinicians recognize that client motivation is key to optimizing rehabilitation; however, they are limited in its assessment by a paucity of motivation measures. Purpose. This paper presents the preliminary psychometrics of the Pediatric Motivation Scale (PMOT) designed to measure motivation from a child’s perspective. Method. Content validity of the PMOT was measured through expert feedback ( n = 12), and field testing ocurred with 41 children, 21 in rehabilitation and 20 healthy. Pearson product-moment correlations were used to analyze subscale correlations, test-retest reliability, and convergent validity with the Pediatric Volitional Questionnaire (PVQ). Internal consistency was measured using Cronbach’s alpha. Findings. Preliminary psychometric evaluation indicates strong internal consistency for PMOT total (α = .96) and subscales (α = .79–.91). The PMOT and PVQ moderately correlated in the rehabilitation subsample ( r = .71, p < .01); no correlation was found in the healthy subsample ( p > .05). Test-retest reliability was excellent ( r = .97). Implications. This study provides preliminary psychometric evidence of the PMOT for children undergoing rehabilitation. These pilot findings warrant ongoing scale development.
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17
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Nikopoulos CK, Nikopoulou-Smyrni P, Konstantopoulos K. Effects of video modelling on emerging speech in an adult with traumatic brain injury: preliminary findings. Brain Inj 2013; 27:1256-62. [PMID: 23909660 DOI: 10.3109/02699052.2013.809550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE Research has shown that traumatic brain injury (TBI) can affect a person's ability to perform previously learned skills. Dysexecutive syndrome and inattention, for example, alongside a number of other cognitive and behavioural impairments such as memory loss and lack of motivation, significantly affect day-to-day functioning following TBI. This study examined the efficacy of video modelling in emerging speech in an adult male with TBI caused by an assault. RESEARCH DESIGN In an effort to identify functional relations between this novice intervention and the target behaviour, experimental control was achieved by using within-system research methodology, overcoming difficulties of forming groups for such an highly non-homogeneous population. METHODS AND PROCEDURES Across a number of conditions, the participant watched a videotape in which another adult modelled a selection of 19 spoken words. When this modelled behaviour was performed in vivo, then generalization across 76 other words in the absence of a videotape took place. MAIN OUTCOMES AND RESULTS It was revealed that video modelling can promote the performance of previously learned behaviours related to speech, but more significantly it can facilitate the generalization of this verbal behaviour across untrained words. CONCLUSIONS Video modelling could well be added within the rehabilitation programmes for this population.
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Affiliation(s)
- Christos K Nikopoulos
- School of Health Sciences and Social Care, Brunel University, Uxbridge , Middlesex , UK
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Abstract
A temporal discounting paradigm was used to examine decision making for hypothetical monetary reward following traumatic brain injury (TBI). A case-control design compared individuals following moderate or severe TBI with a healthy control group matched for age and gender. The impact of intelligence, impulsivity, and mood on temporal discounting performance was examined. A within-subjects design for the TBI group determined the influence of a range of neuropsychological tests on temporal discounting performance. Both patients and controls demonstrated temporal discounting. However, the TBI group discounted more than controls, suggesting that their decision making was more impulsive, consistent with ratings on the impulsiveness questionnaire. Discounting performance was independent of neuropsychological measures of intelligence, memory, and executive function. There was no relationship between temporal discounting and ratings of everyday executive function made by patients' relatives. Low mood did not account for discounting performance. The results of this study suggest that temporal discounting may be a useful neuropsychological paradigm to assess decision making linked to monetary reward following TBI. Performance was relatively independent of intelligence, memory and standard tests of executive ability and may therefore assist when assessing a patient's mental capacity to manage their financial affairs.
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Cattran CJ, Oddy M, Wood RL, Moir JF. Post-injury personality in the prediction of outcome following severe acquired brain injury. Brain Inj 2011; 25:1035-46. [DOI: 10.3109/02699052.2011.607787] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Broomfield NM, Laidlaw K, Hickabottom E, Murray MF, Pendrey R, Whittick JE, Gillespie DC. Post-stroke depression: the case for augmented, individually tailored cognitive behavioural therapy. Clin Psychol Psychother 2010; 18:202-17. [DOI: 10.1002/cpp.711] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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