Relational Empowerment in Peer‐Mediated Rehabilitation for People With Disabilities: A Constructivist Grounded Theory Study

BACKGROUND: People with disabilities often need rehabilitation support that extends beyond functional recovery to participation, self-management and community living. We examined how empowerment was generated through peer relationships in China's Self-help and Peer Support for People with Disabilities (SHPSPD), a peer-mediated rehabilitation program in the community-based rehabilitation context. METHODS: Using constructivist grounded theory, we analysed 14 semi-structured interviews and two focus groups with 24 purposively sampled people with disabilities from SHPSPD. Analysis involved initial and focused coding, constant comparison, memo-writing, category development and theoretical integration. RESULTS: The core process was regaining a sense of agency in peer relationships. Participants often began from narrowed life worlds shaped by impairment, stigma, dependence and uncertainty. Entry into peer spaces enabled safe comparison and made change imaginable. Three interrelated mechanisms drove this process: peer mirroring made change believable through embodied evidence of similar others; experiential reciprocity made change actionable through practical knowledge, emotional recognition and resource navigation; and role transformation made change sustainable through helping roles, skill acquisition and participatory engagement. These mechanisms produced outcomes across the intrapersonal, interactional and behavioural dimensions of psychological empowerment and, for some participants, at an emergent community level. This process could be interrupted by limited service reach, accessibility barriers, uneven resources, professional knowledge gaps, cross-disability boundaries and role burden. CONCLUSIONS: SHPSPD can convert lived disability experience into credible knowledge, practical capacity, participation and contribution when peer spaces are accessible, credible and adequately supported. The findings offer a service-contextual process explanation of empowerment across psychological and community levels. LIVED EXPERIENCE OR PUBLIC CONTRIBUTION: People with disabilities who participated in SHPSPD were invited to comment on the interpretation of the findings rather than treated only as research participants. Preliminary findings and the emerging theoretical model were shared with them for feedback (member checking), and this feedback was incorporated into the final analysis. The local government assisted with recruitment and access. In this way, the study treated participants' lived experience as a contribution to knowledge.