Investigators from Cal State University – Northridge, with in-state colleagues from the Veterans Administration Healthcare System, published a scoping review of articles that mention the concept of ‘motivation’ in discussions of aphasia rehabilitation research or clinical work. The authors’ purpose was to identify and characterize the range of beliefs and practices that inform such uses of the term ‘motivation’ by those actively engaged in aphasia rehabilitation.
To conduct this study, the authors searched four publication databases, including PubMed and Google Scholar, for the keywords ‘aphasia’, ‘motivation’, and related terms to find articles that were published during the period 2009 to 2020 inclusive. Initial queries returned over 19,000 candidate articles, but these were whittled down to 365 by eliminating duplicates and then screening against inclusionary criteria. The articles that qualified focused on treatment of adults with stroke-induced aphasia, and discussed motivation as a psychological state of the persons with aphasia (PWA). The investigators then reviewed these articles, highlighed text surrounding each occurrence of the term ‘motivation’, and applied thematic analysis to the flagged passages.
That analysis yielded sixteen themes associated with the term ‘motivation’, which fell broadly into two groups. The smaller group, containing 5 themes, focused on addressing reasons why patient motivation is important to research and clinical activities. For example, it is important because it influences research decisions of investigators, or intervention decisions of clinical therapists, or the clinical outcomes in PWA receiving treatment. The other group, comprising 11 themes, identified the variety of beliefs and practices around patient motivation in the conduct of aphasia rehabilitation research or clinical practice. Illustrative thematic topic areas include: [i] overt assessment of patient motivation; [ii] clinician responsibility for promoting patient motivation; [iii] influences of social support on motivation; and [iv] the influences of feedback and of measuring progress on patient motivation.
In their discussion, the authors make two overarching observations. First, the concept of motivation was found to exert influence broadly across many aspects of treatment research and clinical practice. For example, it may influence patient selection, intervention design, or outcome interpretations. Second, however, most statements about motivation were only mentions in passing, and lacked reference either to theory or research. The authors suggest the value of incorporating established theories, such as ‘self-determination theory’, to provide more fully elaborated contexts for deeper discussions.
For further reading: M. Biel, H. Enclade, A. Richardson et al., 2022, Motivation theory and practice in aphasia rehabilitation: a scoping review. AJSLP, 31: 2421-2443, https://doi.org/10.1044/2022_AJSLP-22-00064