Bright 2015a

Bright, F., Kayes, N., Worrall, L., &McPherson, K. M. (2015). A conceptual review of engagement in healthcare and rehabilitation. Disability & Rehabilitation, 37(8), 643-654.

Contact corresponding author: Nicola Kayes


Purpose: 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.
Methods: 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. Results: 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.
Conclusion: 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.