Outcomes of a Self-Assessment Intervention Approach Based on the Scale for Achievement Motive in Rehabilitation and Interview Methods in Patients After Total Hip Arthroplasty: A Retrospective Case Series

基于成就动机量表和访谈方法的自我评估干预方法在全髋关节置换术后患者中的应用效果:一项回顾性病例系列研究

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Abstract

Introduction In occupational therapy that supports client autonomy, assessment and intervention regarding their psychological state are important. The Scale for Achievement Motive in Rehabilitation (SAMR) is used as an assessment tool for one's motivation to pursue goals. By combining self-assessment with SAMR and a semi-structured interview method, intervention strategies have been developed that can enhance the client's motivation toward their goals and participation in daily activities. Our aim was to compare the changes in achievement motive and activities of daily living before and after this intervention method. Methods This is a retrospective case series involving 11 patients (all female, average age 62.27±5.02 years) who had undergone total hip arthroplasty. An occupational therapy intervention combining SAMR and interview methods was conducted for 6 to 10 weeks, and changes in achievement motivation and activities of daily living before and after the intervention were compared. The measurement used SAMR and the Functional Independence Measure (FIM). Information such as length of hospital stay and mobility methods at admission and discharge was collected. Paired t-tests were conducted for the initial and follow-up SAMR scores, as well as for the FIM at the start of intervention and at discharge. Furthermore, Pearson's correlation analysis was used to examine the relationship between the initial SAMR total score and the change in FIM score.  Results There was a significant improvement in the total SAMR scores in all cases (effect size: Cohen's d = 1.29, 95% confidence intervals: 0.27-2.30). Additionally, while the correlation coefficient between the initial SAMR total score and the changes in the FIM was not statistically significant (p = 0.14), the correlation coefficient was r = 0.476, which represents a medium effect size. Conclusions This report highlights the importance of providing support that aligns with the patient's current level of achievement motive through interviews, allowing patients to consider goal setting and action planning for themselves.

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