Bright Felicity A S, Kayes Nicola M, Worrall Linda, McPherson Kathryn M
Person Centred Research Centre, School of Rehabilitation and Occupation Studies, AUT University , Auckland , New Zealand and.
Disabil Rehabil. 2015;37(8):643-54. doi: 10.3109/09638288.2014.933899. Epub 2014 Jun 27.
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.
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.
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.
Our review suggests engagement to be multi-dimensional, comprising both a co-constructed 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.
Engagement appears to be a multi-dimensional construct, comprising both a co-constructed process and a patient state. Conceptualizing engagement as a co-constructed process may help clinicians be more aware of their role in patient engagement and sees the responsibility to engage shift from the patient to the therapeutic dyad. Challenges in engagement may be a prompt to reflect on how the clinician is working and whether different ways of working may be beneficial.
本综述旨在深入理解医疗保健中的参与度在文献中是如何被概念化的，以便为未来的康复临床实践和研究提供参考。第二个目的是提出参与度的实用定义。
在EBSCO和SCOPUS数据库以及参考文献列表中搜索旨在理解或描述医疗保健中参与度概念或报告医疗保健参与度测量方法发展的论文。我们采用实用效用方法进行概念分析。
31篇文章符合标准并被纳入综述。参与度似乎以两种相互关联的方式被概念化：作为医疗服务提供者与患者之间逐渐建立联系的过程；以及作为一种内在状态，可能伴随着表明参与的可观察行为。
我们的综述表明，参与度是多维的，包括共同构建的过程和患者状态。虽然参与度通常被认为是患者的行为，但综述结果表明临床医生在患者参与度方面起着关键作用。本综述挑战了对参与度的一些理解以及我们与患者合作的方式，并突出了一些测量方法的概念局限性。
参与度似乎是一个多维结构，包括共同构建的过程和患者状态。将参与度概念化为共同构建的过程可能有助于临床医生更加意识到他们在患者参与度中的作用，并使参与的责任从患者转移到治疗二元组。参与度方面的挑战可能促使人们反思临床医生如何开展工作以及不同的工作方式是否有益。
