Co-constructing engagement in stroke rehabilitation: a qualitative study exploring how practitioner engagement can influence patient engagement.
Felicity As Bright, Nicola M Kayes, Christine Cummins and 2 others
PMID 28653548WHAT IT FOUND
Patients with communication disabilities perceived practitioner engagement through personalisation and persistence.
Disengagement, often driven by practitioner powerlessness or stigma, led to reduced service access and patient isolation. Engagement was co-constructed, with practitioner attitudes directly influencing patient participation.
Key findings
01Patients perceived practitioners as disengaged when they focused on service requirements rather than the individual, leading to feelings of isolation.
02Practitioner disengagement was often linked to feelings of powerlessness or lack of confidence, sometimes resulting in reduced or avoided interactions.
03Engagement was dynamic and reciprocal, with practitioner and patient engagement levels influencing each other within the relationship.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was conducted in one city in New Zealand, so findings may not generalise to other healthcare systems or cultural contexts. The sample size was small (11 patients), which limits the breadth of patient perspectives captured. The study did not explore the relationship between specific patient or practitioner variables and engagement levels. Communication impairments may have limited patients' ability to fully articulate their perceptions of engagement.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Stroke Association of New Zealand.
The easy way to misread this
Do not interpret these findings as evidence that specific practitioner behaviours cause improved clinical outcomes. This qualitative study describes perceptions and interactions, not the effectiveness of interventions. It highlights how engagement is experienced, not how to measure its impact on recovery.