Measuring surgical patient engagement: A scoping review

Abstract

Background: Patient engagement is a patient’s capacity and willingness to participate and collaborate in their own health care. This scoping review aimed to identify tools used to measure engagement among surgical patients, the levels of engagement and the association between engagement and surgical outcomes. We hypothesise that highly engaged patients are more likely to achieve better surgical outcomes.

Review methods: MEDLINE/PubMed, CINAHL, SCOPUS and Embase were searched for studies
that assessed adult perioperative patients for engagement. Analysis from charting the data identified the measurement tools, levels of capacity to engage and relationships between engagement and surgical outcomes.

Results: Twelve studies were selected out of 3975 identified; three valid and reliable tools to measure surgical patient engagement – Patient activation measure (PAM®), Patient health engagement scale (PHE-s) and Hopkins rehabilitation engagement rating scale (HRERS) – were identified, as well as levels of engagement. The capacity to engage was categorised into two, three or four levels. High levels of engagement were associated with enhanced patient satisfaction, better adherence to physical therapy, and decreased pain and disability.

Conclusion: There are valid and reliable tools to measure the capacity of surgical patients
to engage in their post-operative recovery; PAM® is the most frequently used tool. Patients with higher engagement are more likely to report better physical health and greater satisfaction with their surgery. Using these tools could assist health care providers in the early identification of patients at risk of poor recovery and provide tailored support.