Editorials

Environmental factors in stroke rehabilitation

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7301.1501 (Published 23 June 2001) Cite this as: BMJ 2001;322:1501

Being in hospital itself demotivates patients

  1. Lotta Widén Holmqvist, senior lecturer,
  2. Lena von Koch, senior lecturer
  1. Department of Physiotherapy, Karolinska Institutet, S-141 57, Huddinge, Sweden
  2. Unit of Neuroepidemiology and Health Services Research, NEUROTEC, Karolinska Institutet, S-141 86, Stockholm, Sweden

    Rehabilitation after stroke has been described as a process in which the patient and the healthcare system, through interaction and negotiation, try to reach agreement about activities to be emphasised and goals to be pursued.1 Involvement and empowerment of the patient are implicit in, and integral to, this process. Participation in setting goals seems to have a positive impact on patients' motivation, and there is now consensus among professionals in stroke rehabilitation that the patient's degree of motivation will influence the outcome of an intervention. Consequently, an important element of any proposed intervention should be an assessment of what the patient is motivated to achieve as well as the promotion of a high level of motivation.

    The World Health Organization's International Classification of Functioning and Disability defines motivation as a global mental function—a conscious or unconscious drive—that produces the incentive to act.2 Essential components of the classification are those contextual conditions, such as personal and environmental factors, that …

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