The main objective of this study was to validate Pender’s Health Promotion Model (HPM) as a motivational model for exercise/physical activity self-management for people with spinal cord injuries (SCIs). Quantitative descriptive research design using hierarchical regression analysis (HRA) was used. A total of 126 individuals with SCI were recruited through the National Spinal Cord Injury Association, other SCI support groups, and professors in rehabilitation counseling across the United States. Outcome measures used were the International Physical Activity Questionnaire and the Physical Activity Stages of Change Instrument. The HRA results indicated that preinjury physical activity/exercise level, severity of SCI, and commitment to a plan for exercise and physical activity were predictive of postinjury exercise and physical activity level. In addition, friend/family support, perceived self-efficacy, and perceived benefits were the strongest predictors of commitment to a plan of action for exercise and physical activity. The research findings support the applicability of Pender’s HPM as a motivational model for exercise/physical activity for people with SCI. The information can be used to design health promotion behavioral interventions for people with SCI living in the community.
Purpose: To apply the constructs of social cognitive theory (SCT) and the theory of planned behavior (TPB) to understand the stages of change (SOC) for physical activities among individuals with a spinal cord injury (SCI).Method: Ex post facto design using multivariate analysis of variance (MANOVA). The participants were 144 individuals with SCI who completed an online SCT, TPB, and SOC for physical activities survey.Results: Participants in the preintender, intender, and actor groups differed significantly in functional disability, secondary health conditions, exercise self-efficacy, perceived benefits and barriers, intention, and physical health.Conclusion: Findings support the concept of stage-matching exercise and physical activity cognitive behavioral interventions for people with SCI.
To engage in the community and the workplace requires physical, mental, and social health and wellbeing. Health promotion is a crucial rehabilitation counselling function for the health and wellbeing of people living with chronic illness and disability (CID). This exploratory review seeks to examine theories and models of motivation applicable to health promotion interventions in rehabilitation counselling practice. Although no single theory can address all the potential variables affecting people with CID's health behaviours, Bandura's (1977) concept of self-efficacy and outcome expectancy appear to be the most common factors in the health promotion models we surveyed. Among theories of motivation, only self-determination theory specifically includes a motivation variable, autonomy (internal and external motivation). We developed a diagram to depict a model, including all the theories and models covered in this exploratory review and identify commonalities among their constructs. This diagram can be used by rehabilitation counsellors to apply theories and models of motivation in case conceptualisation, formulating clinical hypotheses, developing treatment plans, and selecting and implementing evidence-based health promotion interventions for their clients.
The field of rehabilitation counseling has long recognized the importance of community integration and participation outcomes for people with disabilities (e.g., Heinemann, 2005). The World Health Organization's International Classification of Functioning and Disability and Health (ICF; 2001) stresses the importance of recognizing functioning and disability from a multidimensional standpoint. Specifically, the ICF proposes a biopsychosocial conceptualization of the experience of disability, positing that interactions among individual and environmental factors impact life experiences, functioning, and outcomes for individuals with disabilities (Dunn & Elliott, 2008; Smart, 2001; Wright, 1983). Community experiences are an integral part of the disability experience. Yet, despite increased focus on community participation in the field of rehabilitation, individuals' sense of community (SOC)-or one's feelings of influence and belonging-has received little attention in the rehabilitation literature. This is a particularly relevant construct for people with brain injury, who are at considerable risk for social isolation, loneliness, and restricted community integration in the years following injury (Stalnacke, 2007). SOC SOC was introduced by Sarason (1974) and has gained status as one of the overarching concepts guiding the field of community psychology. SOC focuses on the individual experience of community rather than its structure, setting, or other features. SOC theory, as posited by McMillan and Chavis (1986), defines SOC as "a feeling that members have of belonging, a feeling that members matter to one another and to the group, and a shared faith that members' needs will be met through their commitment to be together" (p. 9). According to this theory, SOC consists of four elements: 1. Membership refers to the feeling of belonging that comes with being part of a defined community. Membership offers a source of emotional safety, security and sense of identification. 2. Reinforcement of needs refers to the idea that common needs, goals, beliefs, and values provide the integrative force for a cohesive community so that both the needs of the collective and individual are met.
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