The Nature, Value, and Experience of Engagement in Pediatric Rehabilitation: Perspectives of Youth, Caregivers, and Service Providers

ABSTRACT

Purpose: To conduct a qualitative investigation of engagement in pediatric rehabilitation therapy.

Methods: Interviews were conducted with 10 youth, 10 caregivers, and 10 service providers. Transcripts were analyzed thematically using an inductive approach.

Results: Themes illustrated three perspectives: engagement as a connection with components of the therapy process, engagement as working together, and engagement as an affective and motivational process. Engagement created valued connections with therapy components and forward momentum for therapy.

Conclusions: The themes supported a view of engagement as complex, transactional, and multidimensional. Participants focused on different, yet not discrepant, aspects of engagement. Youth focused on having fun and personal connection with service providers. Caregivers provided a more complex perspective encompassing both their own and their child’s engagement, with an emphasis on relationship, understanding what is taking place, and feeling valued in the process. Service providers highlighted goal attainment and the value of engagement in bringing about outcomes.

KEYWORDS:

• Client experience
• client involvement
• client investment
• disengagement
• in-session
• motivation
• therapy

Acknowledgments

We extend our thanks to the participating youth, caregivers, service providers, and Holland Bloorview Kids Rehabilitation Hospital. We acknowledge the contributions of Melody Yuen, Donya Mosleh, Sarah Keenan, Jesiqua Rapley, Heidi Schwellnus, Anne Poulsen and other members of the Pediatric Rehabilitation Intervention Measure of Engagement (PRIME) research team.

Disclosure Statement

The authors alone are responsible for the content and writing of this paper. This work was funded by an operational grant from the Canadian Institutes of Health Research (CIHR) [MOP-133397]. Gillian King holds the Canada Research Chair (Tier 1) in Optimal Care for Children with Disabilities, funded by the Canadian Institutes of Health Research. This chair is supported by matching funds from the Kimel Family Opportunities Fund through the Holland Bloorview Kids Rehabilitation Hospital Foundation.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research [MOP-133397].