Patients' Experiences of Barriers and Facilitators to Participating in Multidisciplinary Rehabilitation: A Qualitative Study

Abstract

Effective multidisciplinary rehabilitation requires active participation, and patients often face physical, psychological, interpersonal, social, and organizational influences that affect their ability to participate consistently. Although obedience and involvement within the context of patients' behavioral characteristics are often seen as personalized, modern rehabilitation models emphasize that involvement results from the interplay among individual ability, motivation, therapeutic relationships, social support, and opportunities provided by rehabilitation services. This paper examined how patients experience conditions that hinder or support engagement in multidisciplinary rehabilitation, with a specific focus on physical symptoms, motivation, goal setting, contact with rehabilitation professionals, family support, service organization, and how rehabilitation activities translate to daily life. A qualitative descriptive design was used with 15 adults who had participated in multidisciplinary rehabilitation for a range of disabling health conditions, including neurological, musculoskeletal, post-surgical, respiratory, and other health disorders. Each participant completed a semi-structured interview. Patterns within the interview data were identified using reflexive thematic analysis. The Capability-Opportunity-Motivation-Behavior framework and the International Classification of Functioning, Disability and Health informed interpretation without imposing predetermined coding patterns. Five themes were formulated, which are interdependent: (1) the body provides the terms under which participation works, (2) visible progress generates momentum as it is eroded, (3) participation is conditional on being treated as a partner, (4) participation can be replicated socially and (5) participation can be exhausted. Factors that hindered participation included pain, fatigue, fear, an unstable crisis, professional conflict, transport problems, time constraints, and poor continuity. Engagement was supported by meaningful goals, observable improvement, a trusting therapeutic relationship, coordinated multidisciplinary communication, family support, peer support, flexible services, and clear home-management plans. Individual motivation or compliance is not the only concern related to participation in multidisciplinary rehabilitation. It is dynamically influenced by physical capacity, confidence, relationships, social circumstances and rehabilitation services design. Effective rehabilitation must therefore include symptom-responsive intervention, purposeful collaborative goal-setting, ongoing multidisciplinary communication, family and peer support, and flexible service delivery. Rehabilitation systems that lessen the practical onus yet enhance autonomy and self-efficacy could be better placed to maintain patient engagement throughout the rehabilitation spectrum.