Does motivation mediate the relationship between competence perceptions and patient outcomes among individuals with chronic low back pain? A multiple mediation analysis

Podlog, Leslie, Burns, Ryan, Dimmock, James a., Jackson, Ben, Hall, Morgan S., and Fritz, Julie M. (2021) Does motivation mediate the relationship between competence perceptions and patient outcomes among individuals with chronic low back pain? A multiple mediation analysis. Disability and Rehabilitation, 43 (7). pp. 953-959.

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Abstract

Purpose: The aim of this study was to examine: (1) motivations of patients with chronic low back pain to attend physical therapy; (2) relationships between competence perceptions, motivational regulations, and pain/disability; and (3) whether patient motivations to attend physical therapy mediate the relationship between competence perceptions and pain/disability.

Methods: A sample of 64 participants completed baseline assessment (1-week prior to initiation of physical therapy) and 6-week follow-up assessment. Differences between motivation variables at baseline were examined using one-way within-person ANOVA. Relationships between competence perceptions, motivation subscales, and pain/disability were calculated using bivariate correlations and multiple mediation analyses.

Results: Participants reported significantly higher levels of autonomous versus controlled motivation (mean difference = 3.5, p < 0.001, d = 2.3) and amotivation (mean difference = 3.6, p < 0.001, d = 2.4). Competence was positively associated with autonomous motivation (r = 0.45, p ≤ 0.05) and negatively associated with controlled motivation (r = −0.26, p ≤ 0.05), amotivation (r = −0.57, p ≤ 0.05), pain (r = −0.35, p ≤ 0.05), and disability (r = −0.34, p ≤ 0.05). Amotivation significantly mediated the competence–pain relationship (Amotivation IE = −0.19, 95% CI (−0.44, −0.06), p < 0.05) and the competence–disability relationship (Amotivation IE = −0.07, 95% CI (−0.17, −0.01), p< 0.05).

Conclusion: Findings highlight the role of competence perceptions in mitigating amotivation for physical therapy and the deleterious implications of amotivation for patient-centered outcomes.

Item ID: 70943
Item Type: Article (Research - C1)
ISSN: 1464-5165
Keywords: Amotivation; pain; disability; physical therapy; Self-Determination Theory
Copyright Information: © 2019 Informa UK Limited, trading as Taylor & Francis Gro
Date Deposited: 25 Nov 2021 01:18
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420318 People with disability @ 50%
52 PSYCHOLOGY > 5203 Clinical and health psychology > 520304 Health psychology @ 50%
SEO Codes: 20 HEALTH > 2003 Provision of health and support services > 200301 Allied health therapies (excl. mental health services) @ 100%
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