Adherence and satisfaction in Argus II prosthesis users: a self determination theory model

Self-determination theory (SDT) of human motivation was used to examine associations between different forms of motivation in Argus II retinal prosthesis users and their engagement and satisfaction with the Argus device. Nine subjects were administered: 1) a Situational Motivation Scale (SIMS) questionnaire to measure intrinsic motivation, identified regulation, external regulation, and amotivation, and 2) the Argus questionnaire (AQ) which was organized into 5 categories to measure ‘Decision to get an Argus implant,’ ’Self-perception as an Argus user’, ‘Utility of Argus,’ ‘Perceived competence,’ and ‘Family support.’ Spearman correlations (<i>r_s</i>) were used to find associations between measures from SIMS and AQ. Nine subjects completed both questionnaires. Statistically significant associations were observed between identified regulation and AQ items from categories: Decision to get Argus, Self-perception, Utility of Argus, and Perceived competence; and between intrinsic motivation and AQ items from Self-perception and Utility. External regulation was negatively associated with Family support, and amotivation was associated with one item from Self-perception. Engagement with the device and satisfaction were associated to both identified regulation and intrinsic motivation. There was no significant relationship between external regulation and adherence to the device. The SDT model can be used to investigate the types of motivation that influence uptake and engagement of the Argus device. Clinicians can use this knowledge to improve outcomes by supporting confidence in users and by encouraging them to maintain internalization and continued commitment to adherence.

本研究采用人类动机的自我决定理论（Self-determination theory, SDT），探究Argus II视网膜假体（Argus II retinal prosthesis）使用者的不同动机类型与他们对Argus设备的使用投入度及满意度之间的关联。研究共对9名受试者施测了两类问卷：其一为情境动机量表（Situational Motivation Scale, SIMS），用以评估内在动机、整合调节、外部调节与无动机；其二为Argus问卷（Argus questionnaire, AQ），该问卷分为5个维度，分别测量「选择接受Argus植入手术」「作为Argus使用者的自我认知」「Argus设备的实用性」「感知到的能力」以及「家庭支持」。研究采用斯皮尔曼相关系数（Spearman correlation, r_s）分析SIMS与AQ各量表得分间的关联，最终共有9名受试者完成全部两份问卷。结果显示，整合调节与「选择接受Argus植入手术」「自我认知」「设备实用性」及「感知能力」维度下的AQ条目存在显著统计学关联；内在动机则与「自我认知」和「设备实用性」维度下的AQ条目存在显著关联。外部调节与「家庭支持」维度呈负相关，无动机则与「自我认知」维度下的某一条目存在关联。设备使用投入度与满意度均与整合调节和内在动机存在关联，而外部调节与设备使用依从性未发现显著关联。自我决定理论模型可用于探究影响Argus设备接受度与使用投入度的动机类型。临床医护人员可依托这一研究结论，通过提升使用者的自信心、鼓励其维持动机内化与持续的使用依从性，从而改善干预效果。