Co-constructing Engagement in Stroke Rehabilitation: a Qualitative Study Exploring How Practitioner Engagement Can Influence Patient Engagement

Bright, FAS
Kayes, N
Cummins, C
Worrall, L
McPherson, K
Item type
Journal Article
Degree name
Journal Title
Journal ISSN
Volume Title

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: 11 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.

Patient participation; Attitude of health personnel; Rehabilitation; Professional-patient relations
Clinical rehabilitation, 31(10), 1396-1405.
Rights statement
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (