Enhancing Physical Adaptation and Functional Independence in Post-Stroke Patients Through Motivational Interviewing-Based Health Coaching
DOI:
https://doi.org/10.26911/jepublichealth.2026.11.01.05Abstract
Background: Stroke is a leading cause of long-term disability worldwide and is highly prevalent in Indonesia, especially in underserved and geographically isolated regions such as riverside communities. Many stroke survivors struggle with impaired physical adaptation and low functional independence. This study aimed to evaluate the effectiveness of motivational interviewing-based health coaching, guided by the Roy Adaptation Model, on improving physical adaptation and functional independence among post-stroke patients in Banjar Regency.
Subjects and Method: A quasi-experimental study with a pre-test and post-test control group design was conducted from January to April 2025 in two riverside subdistricts of Banjar Regency, South Kalimantan. A total of 90 post-stroke patients aged ≥45 years were recruited through purposive sampling. Participants were assigned to either the intervention (n=45) or control group (n=45). The intervention group received six sessions of structured health coaching based on motivational interviewing principles, while the control group received routine care. Physical adaptation was measured using the Roy Adaptation Assessment Guide (RAAG), and functional independence was assessed using the Barthel Index. Data were analyzed using the paired t-test and Mann–Whitney U test.
Results: The intervention group showed significant improvements in physical adaptation (Mean pre-test=54.87; post-test=66.02; p<0.001) and functional independence (Mean pre-test=60.44; post-test=78.91; p<0.001). In contrast, the control group showed no significant changes in physical adaptation (p=0.062) or functional independence (p=0.084). Between-group comparisons at post-test showed significantly higher scores in the intervention group for both physical adaptation (p<0.001) and functional independence (p<0.001).
Conclusion: Motivational interviewing-based health coaching significantly improves physical adaptation and functional independence among post-stroke patients in riverside communities. Integrating this approach into community-based rehabilitation may enhance recovery outcomes in underserved areas.
Keywords:
motivational interviewing, health coaching, stroke, physical adaptationHow to Cite
References
Agianto A, Aridamayanti BG, Setiawan H, Irawan A, Wibowo D, Silarat M, Amin M (2024). Clinical Learning for Students with the Caregiver Empowerment Program Based on Adaptation Model (CEP- BAM) in Improving the Quality of Life and Family Ability in Helping the Adaptation of Stroke Patient Training. Indones Nurs J Educ Clin. 9(2): 30–38. doi: 10.24990/injec.v9i2.630.
Alfarisi NR, Lestari D, Sujianto, U (2025). Motivational Interviewing in Patients with Chronic Conditions. Indones J Glob Health Res. 2(4): 529–536. https://doi.org/10.37287/ijghr.v7i3.4482.
Aridamayanti B G, Prayoga DH, Trisnawati I, Ronalia MF (2019). Telerehabilitation System in Nursing Post Stroke - A Systematic Review. Jurnal Ners. 14(3): 182. https://doi.org/10.20473/jn.v14i3.17017.
Aridamayanti B G, Septiany M, Agianto, Diani N (2023). Prevention of Hypertension and Diabetes Mellitus Based on Health Education in the Community of Sungai Rangas Village, West Martapura. Jurnal Mandala Pengabdian Masyarakat. 4(1): 261–267. https://doi.org/10.35311/jmpm.v4i1.231.
Day P, Gould J, Hazelby G (2024). The use of motivational interviewing in community nursing. J of Community Nursing. 31(3): 59–63.
Feigin V, Braining M, Norrving B, Martins S (2025). World Stroke Organization (WSO): Global Stroke Fact Sheet 2025. Int J Stroke. 17(1): 18–29. https://doi.org/10.1177/17-474930211065917.
Fu Y, Zhang Y, Deng Q, Wang Y, Su S, Wang Z, Xi L, et al., (2025). The effect of motivational interviewing on patients with early post-stroke depression: a quasi-experimental study. BMC Psychiatry. 25(1). https://doi.org/10.1186/s12888-025-06673-y.
Marudhar M, Josfeena M (2019). Roy’s Adaptation Model of Nursing. Int J Sci Dev Res. 4(1): 283–287.
Ministry of Health of the Republic of Indonesia (2023) Indonesian Health Survey 2023 in Numbers.
Ni’mah, S L K, Tamtomo D, Murti B (2023). Effectiveness of Telehealth in Improving Quality of Life and Lowering Depression in Post-Stroke Patients: A Meta-Analysis. J Epidemiol Public Health. 8(1): 63–76.https://doi.org/10.26911/jepublichealth.2023.08.01.06.
Parelangi A, Aridamayanti BG, Tamrin I N, Netti, Harsoyo IT, Luthfa I (2025). The Role of Nursing in the Rehabilitation of Stroke Patients (In Indonesia). PT Optimal untuk Negeri.
Watkins C L, Wathan J V, Leathley M J, Auton M F, Deans C F, Dickinson H A, Jack A I A (2021). The 12-month effects of early motivational interviewing after acute stroke: A randomized controlled trial. Am Heart Assoc. 42(7): 1956–1961. https://doi.org/10.1161/STROKEAHA.110.602227.
Yunara Y, Aridamayanti B G, Fajriyah N, Rohmah U N, Maskur A, Dahoklory D F, Lestar W A E (2025). Early Detection and Management of Non-Communicable Diseases (In Publish). Dewa Publishing.
Zamzam M, Tamtomo DG, Widyaningsih V (2020). Biopsychosocial factors affecting quality of life in post-stroke patients: A path analysis evidence from Surakarta Hospital, Central Java. J Epidemiol Public Health. 5(1): 1–14. https://doi.org/10.26911/jepublichealth.2020.05.01.01.
Zhang L, Yan YN, Sun ZX, Yan DR, Chen YW, Lin KC, Ge XJ, et al., (2022). Effects of coaching-based teleoccupational guidance for home-based stroke survivors and their family caregivers: A pilot randomised controlled trial. Int J Enviro Res Public Health. 19(23). https://doi.org/10.3390/ijerph192316355.
Zhu S F (2024). Effectiveness of behavioural interventions with motivational interviewing on physical activity outcomes in adults: Systematic review and meta-analysis. BMJ. https://doi.org/10.1136/bmj2023078713.
1.jpg)
