Study On Influencing Factors Of Occupational Therapy Participation Behavior Of Stroke Patients Based On Capability,Opportunity,Motivation-Behavior Model

ObjectiveIn this study,Capability,Opportunity,Motivation-Behavior Model was used as the theoretical framework to prepare the capability-opportunity-motivation questionnaire for occupational therapy participation in stroke patients,so as to provide an evaluation tool for investigating the status quo and influencing factors of occupational therapy participation in stroke patients.To construct a structural equation model of influencing factors on occupational therapy participation behavior of stroke patients,and to explore the effect path of each factor in the model on occupational therapy participation behavior of stroke patients.Methods1.Based on the Cpability,Opportunity,Motivation-Behavior Model,the questionnaire entry pool was constructed by literature analysis,and the initial version of the questionnaire was formed by expert correspondence consultation and small sample presurvey.A total of 402 stroke patients were selected from May 2022 to October 2022 for project analysis,reliability and validity test of the initial version of the questionnaire.2.A cross-sectional study was conducted to select 324 stroke patients who received operational therapy in the rehabilitation department of Class A tertiary hospital in Qingdao from October 2022 to January 2023 as the research objects.The general data questionnaire,the capability-opportunity-motivation questionnaire for occupational therapy participation in stroke patients,the occupational therapy engagement scale for patients with stroke,self-rating depression scale,stroke rehabilitation self-efficacy scale,social support scale,and Barthel Index rating scale were used to investigate.SPSS 26.0software was used for statistical description and analysis.Pearson correlation or Spearman correlation analysis was used to analyze the correlation between variables and occupational therapy participation.One-way analysis of variance,multiple linear regression analysis and other statistical methods were used to analyze the status quo and influencing factors of occupational therapy participation.AMOS 26.0 was used to construct the structural equation model of influencing factors of occupational therapy participation behavior in stroke patients,and to clarify the influencing mechanism of occupational therapy participation behavior in stroke patients.Results1.Finally,the capability-opportunity-motivation questionnaire for occupational therapy participation in stroke patients composed of 34 items was developed,including participation capability(11 items),participation opportunity(11 items)and participation motivation(12 items).A total of 3 common factors were obtained from the questionnaire,which were named as occupational therapy participation capability,participation opportunity and participation motivation of stroke patients.The contributing rate of accumulated sums of squares was 84.309%.Cronbach’s α coefficient of the total questionnaire was 0.958,and Cronbach’s α coefficient of each factor was 0.989,0.981 and 0.972,respectively.The retest reliability of the total questionnaire was 0.878,and the retest reliability of each factor was 0.832,0.935,0.868;Confirmatory factor analysis results were as follows: X2/df=1.658,RMSEA=0.057,IFI=0.931,TLI=0.904,CFI=0.931.2.The score of occupational therapy participation of stroke patients was(18.31±7.89)points;The scores of occupational therapy participation behavior of stroke patients were statistically significant in age,marital status,educational level,current living status and per capita monthly family income(P< 0.001).There was positive correlation between occupational therapy participation behavior and participation ability,participation opportunity and participation motivation of stroke patients.The participation motivation in occupational therapy for stroke patients was positively correlated with participation capability and participation opportunity.The results of multivariate analysis showed that education level,ability of activities of daily living,social support,self-efficacy of rehabilitation,per capita monthly family income,post-stroke depression and age were influencing factors of occupational therapy participation behavior of stroke patients,which could explain 75.10% of the total variation of occupational therapy participation behavior of stroke patients.3.The structural equation model showed that the total effect of the participation capability on the participation behavior of stroke patients in occupational therapy was0.6421,and there were two influencing paths:(1)The participation capability to participate in occupational therapy directly affected the participation behavior of stroke patients,and the direct effect value was 0.5280;(2)Participation motivation is the intermediate variable of participation ability and participation behavior,and the indirect effect value is 0.1141,accounting for 17.77% of the total effect.The total effect of participation opportunity in occupational therapy on participation behavior of stroke patients was 0.6565,and there were two influencing paths:(1)The participation opportunity in occupational therapy directly affected the participation behavior of stroke patients,and the direct effect value was 0.5290;(2)The participation motivation is the mediating variable of participation opportunity and participation behavior,and the indirect effect value is 0.1275,accounting for 19.42% of the total effect.Conclusions1.The capability-opportunity-motivation questionnaire for occupational therapy participation in stroke patients has good reliability and validity,and can evaluate the participation capability,opportunity and motivation of stroke patients in occupational therapy.2.The scores of occupational therapy participation behavior of stroke patients were at a low level.Education level,ability of activities of daily living,social support,selfefficacy of rehabilitation,per capita monthly family income,post-stroke depression and age were the influencing factors of occupational therapy participation behavior of stroke patients.3.The structural equation model of influencing factors of occupational therapy participation behavior of stroke patients based on Cpability,Opportunity,MotivationBehavior Model can better explain the occupational therapy participation behavior of stroke patients.The participation capability,opportunity and motivation of stroke patients in occupational therapy can directly affect their participation behavior.The participation capability and opportunity in occupational therapy of stroke patients can indirectly affect participation behavior through participation motivation.