Barriers and facilitators to engagement in rehabilitation for people with stroke: A review of the literature

ML Roberts Prize Winner

Abstract

While there is a growing acknowledgement of the significant role that engagement plays in rehabilitation, there is limited knowledge of the factors that may help or hinder engagement in stroke rehabilitation. This review drew on systematic principles and aimed to explore what is currently known about the perceived barriers and facilitators to engagement in stroke rehabilitation. EBSCO, SCOPUS and Google Scholar databases and reference lists were searched for papers that provided insight into the process of engagement or disengagement in stroke rehabilitation. Data were extracted and synthesised thematically from 17 papers. Themes included goal setting, therapeutic connection, personalised rehabilitation, paternalism versus independence, patient centred practice, knowledge is power, and feedback and achievement. None of the papers identified however, explicitly sought to investigate the complexities of engagement in rehabilitation specifically within the stroke population. Future research is needed to explore this topic in more depth from the perspective of all the key stakeholders. A more comprehensive understanding of engagement in stroke rehabilitation may inform the development of interventions to better equip rehabilitation providers with the clinical skills to facilitate engagement and effectively deliver rehabilitation modalities.