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Use of Protection Motivation Theory, Affect, and Barriers to Understand and Predict Adherence to Outpatient Rehabilitation

EJ Grindley, EdD, is Instructor, Department of Health, Physical Education, Recreation and Dance, University of Idaho, PO Box 2401, University of Idaho, Moscow, ID 83844 (USA).
SJ Zizzi, EdD, is Sport and Exercise Psychology Program Coordinator and Associate Professor, Department of Sport Studies, West Virginia University, Morgantown, West Virginia.
AM Nasypany, EdD, ATC, is Athletic Training Program Director and Clinical Coordinator, University of Idaho.

egrindle{at}uidaho.edu

Background and Purpose: Protection motivation theory (PMT) has been used in more than 20 different health-related fields to study intentions and behavior, albeit primarily outside the area of injury rehabilitation. In order to examine and predict patient adherence behavior, this study was carried out to explore the use of PMT as a screening tool in a general sample of people with orthopedic conditions.

Subjects and Methods: New patients who were more than 18 years old and who were prescribed 4 to 8 weeks of physical therapy treatment (n=229) were administered a screening tool (Sports Injury Rehabilitation Beliefs Scale, Positive and Negative Affect Schedule, and a barriers checklist) prior to treatment. Participants' adherence was assessed with several attendance measures and an in-clinic assessment of behavior. Statistical analyses included correlation, chi-square, multiple regression, and discriminant function analyses.

Results: A variety of relationships among affect, barriers, and PMT components were evident. In-clinic behavior and attendance were influenced by affect, whereas dropout status was predicted by affect, severity, self-efficacy, and age.

Discussion and Conclusion: The screening tool used in this study may assist in identifying patients who are at risk for poor adherence and provide valuable information to enhance provider-patient relationships and foster patient adherence. However, it is recommended that more research be conducted to further understand the impact of variables on patient adherence and that the screening tool be enhanced to increase its predictive ability.

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This article has been cited by other articles:

				C. A Thorstensson Invited Commentary Physical Therapy, December 1, 2008; 88(12): 1541 - 1543. [Full Text] [PDF]

				E. J Grindley, S. J Zizzi, and A. M Nasypany Author Response Physical Therapy, December 1, 2008; 88(12): 1543 - 1544. [Full Text] [PDF]