Co-constructing engagement in stroke rehabilitation: a qualitative study exploring how practitioner engagement can influence patient engagement.

OBJECTIVE

To explore how practitioner engagement and disengagement occurred, and how these may influence patient care and engagement.

DESIGN

A qualitative study using the Voice Centred Relational Methodology. Data included interviews, focus groups and observations.

SETTING

Inpatient and community stroke rehabilitation services.

SUBJECTS

Eleven people experiencing communication disability after stroke and 42 rehabilitation practitioners.

INTERVENTIONS

Not applicable.

RESULTS

The practitioner's engagement was important in patient engagement and service delivery. When patients considered practitioners were engaged, this helped engagement. When they considered practitioners were not engaged, their engagement was negatively affected. Practitioners considered their engagement was important but complex. It influenced how they worked and how they perceived the patient. Disengagement was taboo. It arose when not feeling confident, when not positively impacting outcomes, or when having an emotional response to a patient or interaction. Each party's engagement influenced the other, suggesting it was co-constructed.

CONCLUSIONS

Practitioner engagement influenced patient engagement in stroke rehabilitation. Practitioner disengagement was reported by most practitioners but was often a source of shame.