Pilot reliability and validity of the stroke rehabilitation motivation scale

AimsThis study aimed to demonstrate reliability and validity of the Stroke Rehabilitation Motivation Scale, a novel instrument designed to assess internal and external contributions to motivation. Many studies recognise motivation, in the everyday sense, as a factor affecting stroke rehabilitation, but there is no standard measure. There is also no agreement as to whether motivation in the post-stroke period is the same as the absence of depression, anxiety or stress; hence the need for an independent measure of motivation.MethodThe Stroke Rehabilitation Motivation Scale was adapted from the 28-item Sports Motivation Scale, which in turn was developed according to the intrinsic and extrinsic contributions to motivation identified by Self-Determination Theory.The resulting Stroke Rehabilitation Motivation Scale was tested in two stages. In the 28-item reliability stage, in a sample of 18 stroke patients from the stroke ward of Bankstown-Lidcombe Hospital, the scale was tested for Inter-rater reliability, scale reliability, and validity via comparison of high vs. low motivation groups according to a novel ‘motivation score’. The scale was shortened from 28-items (four per subscale) to 7 items (one per subscale) by selecting the most reliable items.The three intrinsic and extrinsic subscales were summed and averaged, and the amotivation score was subtracted from this to produce a ‘motivation score’, such that a person with a positive score had more motivation, either extrinsic or intrinsic, than they had amotivation.e.g. [ ( E + I )/2 – A ]In the 7-item reliability stage, a further 13 patients were recruited from Bankstown-Lidcombe and Liverpool Hospitals. The 7-item scale was tested for scale reliability, and for validity by comparison of high vs. low motivation groups as well as correlations between motivation score, anxiety, depression and stress, and rehabilitation outcomes.ResultsIn both the 28-item and 7-item stages the scale demonstrated adequate to very good reliability. There was a lack of significant mean differences or correlations to demonstrate validity in either stage; this study does not represent a convincing demonstration of validity of the SRMS. However, it would appear that motivation is conceptually distinct from depression, anxiety and stress, and the scale definitely warrants further testing in a larger sample