A conceptual review of engagement in healthcare and rehabilitationPurpose: This review sought to develop an understanding of how engagement in healthcare has been conceptualized in the literature in order to inform future clinical practice and research in rehabilitation. A secondary purpose was to propose a working definition of engagement.Method: EBSCO and SCOPUS databases and reference lists were searched for papers that sought to understand or describe the concept of engagement in healthcare or reported the development of a measure of engagement in healthcare. We drew on a Pragmatic Utility approach to concept analysis.Results: Thirty-one articles met the criteria and were included in the review. Engagement appeared to be conceptualized in two inter-connected ways: as a gradual process of connection between the healthcare provider and patient; and as an internal state which may be accompanied by observable behaviors indicating engagement. Conclusion:Our review suggests engagement to be multi-dimensional, comprising both a coconstructed process and a patient state. While engagement is commonly considered a patient behavior, the review findings suggest clinicians play a pivotal role in patient engagement. This review challenges some understandings of engagement and how we work with patients, and highlights conceptual limitations of some measures. Introduction'Patient engagement' is a term increasingly used in rehabilitation and the broader healthcare context [1]. Several authors have argued the benefits of rehabilitation are limited if the patient is not fully engaged in the process [2,3]. For example, levels of engagement have been associated with improved functional improvement during inpatient rehabilitation and levels of functioning after discharge. Levels of engagement have also been associated with lower levels of depression and with higher levels of affect, adherence and attendance [2,4]. In addition, within clinical rehabilitation practice, the 'engaged patient' is perhaps identified as being the 'desirable patient', one who is easy for providers to work with [5]. On the face of it, these findings suggest that patient engagement is both positive and desirable.While the term 'engagement' is increasingly used in clinical practice and research, there has been relatively little critical exploration of what 'engagement' means and the underpinning concept/s the term may represent. Research of engagement appears to be in its early days, with little consensus on what engagement is, what leads to a patient being perceived as engaged or disengaged or indeed, how engagement occurs. The term engagement is used in multiple ways in the literature, variably referring to patient actions and behaviors such as accessing services [6], retention within services [7,8], enthusiasm [2] and self-management of health conditions [8], or referred to a hospital's provision of health resources and social media usage [9], and to the interaction between the patient and healthcare provider [10].It could be argued that it does not matt...
Purpose: Client-centred practice is widely considered a key element of rehabilitation.However, there is limited discussion of how it should be implemented. This study explored how client-centred practice was operationalised during a clinical trial of innovative goalsetting techniques.Method: This study drew on principles of co-autoethnography. The personal experiences of three clinical researchers were explored to identify insights into client-centred practice, and seek understanding of this within the broader socio-cultural context. Data were collected through group discussions and written reflections. Thematic analysis and coding were used to identify the dominant themes from the data. Results:The primary way that client-centred practice was operationalised was through listening in order to get to know, to uncover and to understand what was meaningful. Four strategies were identified: utilising mindful listening, allowing time, supporting clients to prioritise what is meaningful and viewing the therapists' role differently.Conclusion: Whilst technical competence in rehabilitation is important, our study suggested a starting point of 'being with' rather than 'doing to' may be beneficial for engaging people in their rehabilitation. We have highlighted a number of practical strategies that can be used to facilitate more client-centred practice. These approaches are consistent with what clients report they want and need from rehabilitation services.
Background: Hope is considered to be important for health, recovery and rehabilitation
Background: Engagement is commonly considered important in stroke rehabilitation, with some arguing it is essential for positive patient outcomes. An emerging body of research indicates the practitioner influences engagement through their ways of relating, communicating and working with the patient. People experiencing communication disability may face particular challenges with engagement as a practitioner's communication and interactional patterns may limit their ability to engage. Aim:To understand how rehabilitation practitioners worked to engage people experiencing communication disability throughout the course of rehabilitation. Methods and Procedures:A qualitative study using the Voice Centred Relational Approach.Longitudinal observational and interview data were gathered from 28 practitioners and three people experiencing communication disability in inpatient and community stroke rehabilitation services. Data were analysed using the Listening Guide. Outcomes and Results:Engagement was a relational practice on the part of the rehabilitation practitioner. It was underpinned by a relational philosophy and was characterised by three core processes: embedding relational work throughout rehabilitation; getting to know the patient and working in ways valued by the patient; and communicating using relational dialogue and supported conversation. Practitioners wove these together with their technical, disciplinary-based work and rehabilitation tasks. What this study addsWe demonstrate how patient engagement is a relational process and practice, occurring through the relationship between the person experiencing communication difficulties and their rehabilitation practitioner/s. Our study elucidates the core components of engaging practices. We argue that relational work is a valid, legitimate form of rehabilitation work that needs to be valued and supported in education, practice and policy. Clinical implications of this studyPractitioners need to critically reflect on how they engage patients in rehabilitation. They may consider which processes are present and privileged in their own practice, and in their broader clinical context. Speech-language therapists may consider how they support other members of the multi-disciplinary team to enact relational practices. Engaging people in stroke rehabilitation 4 IntroductionPatient engagement is increasingly discussed in healthcare literature and clinical services.Our recent conceptual review argued engagement involves a process of the patient and practitioner engaging with each other and the healthcare process, as well as being engaged in the healthcare services . The process of the patient and practitioner engaging with each other occurred through the relationship and communication between them, and in particular, through the sense of being in an authentic respectful relationship where patients feel they can talk and what they say is respected, listened to, and acted upon. This can create an atmosphere of collaboration and connection which supports the patient to activ...
This novel approach to analysis has furthered the understanding of hope. It has proposed a working model of hope that could be used by clinicians in considering hope with their clients and patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.