Social Support, Hope and Autonomy to Keep Patients Committed

Andrew explains that perceived social support predicts rehab adherence, and that emotional challenge, questioning a patient's beliefs about the injury, is rarely offered. Information at each stage reduces anxiety. He writes the explanation on a whiteboard and films it so patients can share it at home, since people forget much of what clinicians tell them, and he cites the Kieran O'Sullivan test of whether a patient can repeat the explanation to a partner. Hope matters from day one. Hope pathways combined with social support predicted wellbeing, while hope agency predicted better rehab adherence. Four habits support return to sport: empowerment, with the patient as CEO of the injury; autonomy, competence and relatedness for motivation; goal setting built on written commitment and a clear daily process; and broadening identity beyond sport or work. Feedback, including data for patients who like it, improves coping and motivation, and task appreciation from someone who understands hard training supports late-stage adherence. He closes with Louis Gifford's point that effective reassurance relieves pain.