Treatment engagement: A concept analysis

Abstract

The concept of "treatment engagement" has been used in many research articles to describe the behavior and process by which patients engage in treatment and medication. However, the term "treatment engagement" is often undefined and used ambiguously, with each researcher using the term, with a different, vague, or broad meaning. Given that many studies have shown that treatment engagement is directly related to clinical outcomes, the concept, should be defined more concretely. This study, therefore, aims to conduct a concept analysis of treatment engagement using Rodgers' evolutionary method of concept analysis. The antecedents of the concept of "treatment engagement" consisted of three elements: individual (i.e., knowledge regarding the disease and treatment, attitudes toward disease and treatment, and acceptance of the disease), situational (i.e., negative experiences in the past and conditions and circumstances that allow patients to focus on treatment), and environmental (i.e., connection with providers, social support, and adaptive treatment system). The attributes of treatment engagement had two elements: behavioral (i.e., initiation of treatment, continuation of treatment, and adherence to recommendations in treatment) and psychosocial (i.e., attitudes that indicate value and expectations toward treatment, cooperation with peers, and collaboration between patient and providers). Consequences of treatment engagement were treatment retention, better clinical outcomes, and coping with disease and treatment. Through this study, we developed the theoretical definition of treatment engagement as the process of initiating and continuing treatment, and adhering to treatment recommendations, in cooperation with peers and in collaboration with supporters, accompanied by a positive attitude toward treatment.