A scoping review protocol of Complexity in Rehabilitation - An international evidence review and practice implications.

<ns3:p>Background Complexity is used to describe patient characteristics, service delivery challenges, and system-level factors, yet there is limited clarity regarding how it is defined, conceptualised, operationalised, and applied across rehabilitation contexts. This lack of conceptual coherence presents challenges for the design, organisation, and delivery of rehabilitation services within increasingly integrated health and social care systems. Aim This review aims to examine how complexity is conceptualised, defined, and operationalised in the international rehabilitation literature at the level of the person, service, and health and social care system. It will also explore how varying conceptualisations of complexity influence the design, delivery, organisation, and resourcing of rehabilitation services, pathways, and models of care. Methods A scoping review methodology will be employed to map the breadth and nature of the evidence. Studies published in English since 2015 examining complexity in rehabilitation populations, services, or systems will be included. Eligible sources will include any study design, population, and setting. Studies must explicitly conceptualise, define, or operationalise complexity at the level of the person, service, or health and social care system. The search will cover five academic databases and grey literature sources. The review will follow updated Joanna Briggs Institute guidance, aligned with the PRISMA-ScR framework. Data will be charted and synthesised to identify patterns across contexts and levels. Results The review will map the extent and scope of conceptualisations of complexity and examine how these shape rehabilitation service delivery and organisation. It will also identify gaps in the literature, particularly in relation to multi-level understandings of complexity. Conclusion Findings will contribute to greater conceptual clarity and inform future research, policy, and practice in the development of responsive, integrated rehabilitation systems.</ns3:p>