1 Centre for Person Centred Research, School of Clinical Sciences, AUT University, Auckland, New Zealand.
2 Communication Disability Centre, CCRE-Aphasia and School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Clin Rehabil. 2017 Oct;31(10):1396-1405. doi: 10.1177/0269215517694678. Epub 2017 Feb 1.
To explore how practitioner engagement and disengagement occurred, and how these may influence patient care and engagement.
A qualitative study using the Voice Centred Relational Methodology. Data included interviews, focus groups and observations.
Inpatient and community stroke rehabilitation services.
Eleven people experiencing communication disability after stroke and 42 rehabilitation practitioners.
Not applicable.
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.
Practitioner engagement influenced patient engagement in stroke rehabilitation. Practitioner disengagement was reported by most practitioners but was often a source of shame.
探索从业者的参与和脱离是如何发生的，以及这些因素如何影响患者的护理和参与。
采用以声音为中心的关系方法进行的定性研究。数据包括访谈、焦点小组和观察。
住院和社区脑卒中康复服务。
11 名脑卒中后出现沟通障碍的患者和 42 名康复从业者。
不适用。
从业者的参与对患者的参与和服务提供很重要。当患者认为从业者参与时，这有助于他们的参与。当他们认为从业者不参与时，他们的参与就会受到负面影响。从业者认为他们的参与很重要，但也很复杂。它影响着他们的工作方式以及他们对患者的看法。脱轨是禁忌。当从业者感到没有自信，当没有对结果产生积极影响，或对患者或互动产生情绪反应时，就会出现脱轨。双方的参与都影响着对方，这表明它是共同构建的。
从业者的参与影响了脑卒中康复患者的参与。大多数从业者都报告了从业者的脱轨，但这往往是一种耻辱的来源。
