| Description |
Researchers have documented numerous benefits of adherence to physical therapy programs. Unfortunately, patient adherence to physical therapists' (PT) recommendations is notoriously low. Poor adherence influences treatment effectiveness, patients' quality of life, treatment cost, patient's functional abilities, and rehabilitation time. Given the benefits of rehabilitation adherence, as well as the adverse consequences of poor adherence, there is a need to better understand factors that support patient adherence to physical therapy. Research guided by self-determination theory (SDT) has shown that the extent to which individuals experience support for their basic psychological needs will have important implications for health behaviors such as exercise and rehabilitation adherence. Unfortunately, no measurement tool exists to examine psychological need support within a physical therapy context. This dissertation sought to develop and test a questionnaire designed to measure basic psychological needs support in physical therapy. By conducting semistructured interviews with physical therapy patients (n = 9) and practitioners (n = 9) the initial study examined the strategies by which PTs support basic psychological needs. Further, this initial study provided the information to develop candidate items for questionnaire development. Following the development of candidate items, two additional studies were conducted to refine and psychometrically test a measure of patients' perceptions of basic psychological needs support in physical therapy: The Basic Psychological Needs Support in Physical Therapy Questionnaire (BPNS-PT). In Study 2, a panel of self-determination theory academics assessed the candidate items for content relevance, representativeness, and item clarity. In Study 3, responses from 199 physical therapy patients were used to identify the best fitting model through confirmatory factor analysis. A 3-factor 10-item measure displayed good fit to the data and illustrated evidence of internal consistency. Findings from these studies provide initial psychometric support for the BPNSPT as a valid and reliable measure of patient perceptions of basic psychological needs support in a physical therapy context. |
