Tracking and predicting the treatment adherence of patients under rehabilitation: a three-wave longitudinal validation study for the Rehabilitation Adherence Inventory

Alfred S Y Lee; Shebe Siwei Xu; Patrick S H Yung; Michael T Y Ong; Chetwyn C H Chan; Joan S K Chung; Derwin K C Chan

doi:10.3389/fpsyg.2024.1284745

Tracking and predicting the treatment adherence of patients under rehabilitation: a three-wave longitudinal validation study for the Rehabilitation Adherence Inventory

Front Psychol. 2024 Apr 12:15:1284745. doi: 10.3389/fpsyg.2024.1284745. eCollection 2024.

Authors

Alfred S Y Lee^{1

2}, Shebe Siwei Xu³, Patrick S H Yung⁴, Michael T Y Ong⁴, Chetwyn C H Chan⁵, Joan S K Chung³, Derwin K C Chan^{3

4}

Affiliations

¹ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
² Centre for Child and Family Science, The Education University of Hong Kong, New Territories, Hong Kong SAR, China.
³ Department of Early Childhood Education, The Education University of Hong Kong, New Territories, Hong Kong SAR, China.
⁴ Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
⁵ Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong SAR, China.

Abstract

This study aimed to develop and validate a new measurement tool, the Rehabilitation Adherence Inventory (RAI), to measure patients' rehabilitation adherence. We recruited 236 patients with anterior cruciate ligament (ACL) ruptures from the United Kingdom (Mage = 33.58 ± 10.03, range = 18 to 59; female = 46.2%). Participants completed a survey, that measured their rehabilitation adherence, rehabilitation volume, psychological needs support, autonomous motivation, and intention at baseline, and at the 2nd and 4th month. Factorial, convergent, discriminant, concurrent, predictive, ecological validity and test-retest reliability of the RAI were tested via exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modelling (SEM). All the EFAs, CFAs, and SEMs yielded acceptable to excellent goodness-of-fit, χ2 = 10.51 to 224.12, df = 9 to 161, CFI > 0.95, TLI > 0.95, RMSEA <0.09 [90%C I < 0.06 to 0.12], SRMR <0.04. Results fully supported the RAI's factorial, convergent, discriminant, and ecological validity, and test-retest reliability. The concurrent and predictive validity of the RAI was only partially supported because the RAI scores at baseline was positively associated with rehabilitation frequency at all time points (r = 0.34 to 0.38, p < 0.001), but its corresponding associations with rehabilitation duration were not statistically significant (p = 0.07 to 0.93). Overall, our findings suggest that this six-item RAI is a reliable and valid tool for evaluating patients' rehabilitation adherence.

Keywords: ACL; rehabilitation adherence; self-determination theory; sports medicine; theory of planned behavior.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. The project was funded by grants [#16172201] from the Health and Medical Research Fund awarded to DC, Faculty of Education and Human Development, The Education University of Hong Kong, derwin@eduhk.hk.