Understanding General Activity Motivation for Persons with Stroke—A Reversal Theory Perspective

Introduction: Motivation is the barrier identified for clients with stroke to reintegrate community living. Reversal Therapy may help to understand the pattern of bipolar variations of motivational factors. This study analyzed the general activity motivation of clients with stroke and their relationship with community participation and mental wellbeing. Methodology: Sampling of 115 subjects including 30 stroke clients and 85 normal subjects. Measurements included the validated Chinese version of General Activity Motivation Measure (GAMM), Community Integration Questionnaire (CIQ) & Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS). Results: In GAMM, the normal group scores (Mean 50.09 SD 5.79) higher then clients with stroke (Mean 46.09; SD 8.00) (p < 0.05). GAMM correlated positively with CIQ and SWEMWBS (p < 0.05). Four factors identified under GAMM namely Means-end, Relationship, Rules and Transactions that identified with Reversal Theory. Reversals between poles of each domain evidenced between two groups. “Acquiring new experiences” was strong predictor for community integration. Conclusion: Reversal Theory is useful to explain motivational changes among clients with stroke. To develop chances of “new experiences”, “feel accomplishment every day”, “get out of house regularly” and “to do the things that they can enjoy” at “their own pace” are the motivators for reintegrate into community living

Reliability and Validity of the Monitored Functional Task Evaluation (MFTE) for Patients with Chronic Obstructive Pulmonary Disease (COPD)

This article describes the development of a new functional measure — the Monitored Functional Task Evaluation (MFTE) — a symptom-limited evaluation that is used to measure the functional performance of an individual with chronic obstructive pulmonary disease (COPD), and to document a client's physiological changes through repeated testing. Stage I of the study included developing the content validity of the instrument. Stage II consisted of establishing the performance profile, test-retest and inter-rater reliability using a convenience sample of 27 inpatients and outpatients who had COPD. In stage III, the criterion-related and discriminative validity of the instrument was verified in a retrospective sample of 124 inpatients and day patients who had COPD. Results indicated that there was high intra- and inter-rater reliability for the total score of MFTE. Significant correlation of the MFTE was found with parameters such as Moser's Activities of Daily Living (ADL) class, COPD disability class, 6-minute walking distance, work capacity in terms the ratio of the metabolic rate associated with a given activity to the resting metabolic rate, and the fatigue dimension of the Chronic Respiratory Disease Questionnaire. In addition, prediction of group membership to Moser's ADL class revealed that 52.4% of the original grouped cases could be correctly classified by the MFTE alone. In conclusion, the MFTE is a useful measure to evaluate functional performance as well as document physiological changes in patients with moderate-to-severe COPD from both conceptual and empirical perspectives