The effects of motivation-based instruction on disabled persons' self -care behavior

Martha Scotzin Shaver, Fordham University


Health care providers concerned with chronic health problems that require active patient involvement are using educational programs to improve patient compliance with regimens. Patient compliance is generally unsatisfactory, even for short-term health care regimens. Programs to teach independent self-care are now addressing the individual's motivations for compliance as an important part of the educational process.^ Improving motivations to care for skin and avoid skin breakdowns is particularly important for those who have spinal cord injuries or spinal impairments. In the present study, a skin care education program was tested against a standard rehabilitation education format to determine whether patients' motivations can be influenced for improved performance of skin care behaviors.^ Subjects for the study were paraplegic and quadriplegic inpatients at two Eastern rehabilitation hospitals. All subjects underwent skin inspections prior to skin care education, and four weeks after rehabilitation discharge. Performance of pressure relief behaviors was observed during sedentary rehabilitation classes early in rehabilitation and before discharge. Treatment group subjects received a comprehensive skin care education program; control group subjects received one session of skin care as part of a rehabilitation education series.^ Paraplegics in the treatment group initially had significantly more pressure sores, which were also more severe, than sores of control subjects. There were no initial differences between the groups in performance rates of pressure relief. After education, treatment subjects performed significantly more pressure relief behaviors than controls (p $<$.001). Patients at both hospitals had excellent skin care outcomes at follow-up. There were no significant differences between the groups in either the number or severity of pressure sores on follow-up.^ The evidence from the present study suggests that the specialized skin care educational program was successful in changing patients' thinking about self-care, as evidenced by significant changes in self-care behaviors and improvements in skin care integrity. Individuals whose motivations for health care are considered and developed in the context of health care educational programs can drastically increase performance of health related behaviors and have excellent health outcomes. A longer follow-up period could determine whether the positive outcomes of treatment and control subjects are maintained. ^

Subject Area

Educational psychology|Special education|Health education

Recommended Citation

Shaver, Martha Scotzin, "The effects of motivation-based instruction on disabled persons' self -care behavior" (1990). ETD Collection for Fordham University. AAI9109242.