Exploring Engagement in Exercise‐Based Rehabilitation for Patients With Stroke: A Qualitative Study Using the Patient Health Engagement Model

Engagement in exercise-based rehabilitation is crucial for patients with stroke to improve well-being and quality of life. This study aimed to explore the attitudes, perceptions, and experiences of community-dwelling patients with stroke related to engagement in exercise-based rehabilitation. Using the Patient Health Engagement (PHE) model as a theoretical framework, we conducted interviews with patients with stroke. A purposive sampling technique was used to recruit the participants. Data were analyzed using a deductive thematic analysis approach. A total of 20 patients with stroke participated in this study. Based on participant perspectives, four major themes and twelve subthemes were identified. The major themes were: Blackout, Arousal, Adhesion, and Eudaimonic Project. These four stages represent a shift in patient engagement in exercise rehabilitation, from initial disconnection due to denial or unawareness of rehabilitation options to long-term commitment to rehabilitation aligned with identity and future goals. This study demonstrated that engagement in exercise-based rehabilitation for patients with stroke is both a process and a state. Future research should enhance the evaluation and implementation of interventions for patients with stroke engagement in exercise-based rehabilitation.