Patient Engagement in Inpatient Rehabilitation: A Scoping Review of Measures and Evolving Conceptualizations

Objective: This scoping review aims to describe measures of patient engagement in acute inpatient rehabilitation settings, measurement approaches, and conceptualizations of patient engagement. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and the Joanna Briggs Scoping Review Framework, we searched seven databases-PubMed, EMBASE, Cochrane Library, CINAHL Plus, Web of Science, Scopus, and PsychInfo-from inception to May 2024. Inclusion criteria included (a) participants aged 18 or older; (b) conducted in a hospital-based acute inpatient rehabilitation program irrespective of diagnosis; (c) measured patient engagement during rehabilitation; and (d) published in English. Major search concepts included patient engagement, measures, rehabilitation, and inpatient rehabilitation settings. Two independent reviewers assessed eligibility and extracted data, resolving conflicts through consultation with a third reviewer. The initial search identified 8,320 records. Results: Of the 384 studies that underwent full-text review, 37 met inclusion criteria and reported on 10 engagement measures. The Pittsburgh Rehabilitation Participation Scale was the most frequently used, followed by therapy dosage and the Hopkins Rehabilitation Engagement Rating Scale. Most studies used an observer-rated approach. Conceptualizations of engagement varied in depth and integration of theoretical models. Although motivation was a central theme, conceptualizations have evolved, recognizing multiple factors influencing engagement. Conclusion: The lack of consensus on measuring and conceptualizing patient engagement limits efforts to advance research and clinical practices to improve engagement and, ultimately, outcomes in rehabilitation. Future research could explore the clinical utility of existing measures and establish patient-centered best practices for measurement.