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Motivation and participation in daily and social activities among adults with spinal cord injury: Applying self-determination theory.

BACKGROUND: Individuals with a spinal cord injury (SCI) report decreased participation in daily and social activities. Self-determination theory (SDT) posits that individuals' need satisfaction and frustration predicts participation in health-related behaviours and this relationship is mediated by their motivation.

OBJECTIVES: This study explored the role of psychological needs and motivation in relation to participation in daily and social activities among adults with SCI. It was hypothesized that: a) need satisfaction and need frustration were positively associated with autonomous and controlled motivation, respectively, which, positively and negatively predicted participation in daily and social activities; b) autonomous and controlled motivation mediated the need satisfaction/frustration and participation relationship, respectively; and c) need frustration was positively related to amotivation, with no relationship between amotivation and activity participation.

METHODS: In this cross-sectional study, adults with SCI (N = 131) completed a questionnaire regarding their need satisfaction/frustration, autonomous and controlled motivation, amotivation, and participation in daily and social activities.

RESULTS: Need satisfaction was positively related to autonomous motivation (β = 0.29, 95%bias-corrected confidence interval (bCI): [0.04, 0.67]) and need frustration to controlled motivation (β = 0.28, 95%bCI: [0.09, 0.55]). Autonomous motivation was positively associated with six participation categories: autonomous indoor, autonomous outdoor, family role, health, social life, and work/education. Autonomous motivation also mediated the relationship between need satisfaction and all six participation categories; whereas, neither controlled motivation nor amotivation mediated the relationship between need frustration and participation.

CONCLUSIONS: This study found that SDT provides a meaningful framework for understanding participation among adults with SCI.

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