Abstract
This study aimed to determine whether improvement in motivation for activities of daily living during hospitalization is associated with toilet independence in patients with hip fractures. Eighty-five patients with first-ever hip fractures and decreased motivation were included. Improvement in motivation during the first month after admission was measured using a vitality index (VI). Logistic regression and propensity score matching were used to examine the association between improved motivation and toilet independence at discharge. Adjustment variables included age, sex, Berg balance scale score, revised Hasegawa dementia scale score, toilet use score on the Barthel index, and VI at admission. Logistic regression analysis showed that VI improvement was significantly associated with toilet independence at discharge (P < .01), even after adjusting for covariates. Propensity score matching also showed that the toilet item of the Barthel index and the independence rate at discharge were significantly higher in the improved motivation group than in the non-improved motivation group (P < .05). Two analyses suggest that improved motivation during hospitalization and toilet independence at discharge are associated in patients with hip fracture. This finding implies the necessity of continuous assessment of motivation and the potential for promoting toilet independence by increasing motivation.