Article

Active participation is considered to be a key factor in stroke
rehabilitation. Patient engagement in learning is an important part of this
process. This study sets out to explore how active participation and engagement
are 'produced' in the course of day-to-day multi-disciplinary stroke
rehabilitation. METHOD: Ethnographic observation, analytic concepts drawn from
discourse analysis (DA) and the perspective and methods of conversation analysis
(CA) were applied to videotaped data from three sessions of rehabilitation
therapy each for two patients with communication impairments (dysarthria,
aphasia). FINDINGS: Engagement was facilitated (and hindered) through the
interactional work of patients and healthcare professionals. An institutional
ethos of 'right practice' was evidenced in the working practices of therapists
and aligned with or resisted by patients; therapeutic activity type (impairment,
activity or functional focus) impacted on the ways in which patient engagement
was developed and sustained. CONCLUSIONS: This exploration of multi-disciplinary
rehabilitation practice adds a new dimension to our understanding of the barriers
and facilitators to patient engagement in the learning process and provides scope
for further research. Harmonising the rehabilitation process across disciplines
through more focused attention to ways in which patient participation is enhanced
may help improve the consistency and quality of patient engagement.

Langue : ANGLAIS