Nursing Inquiry. 2020;00:e12370. wileyonlinelibrary.com/journal/nin | 1 of 10 https://doi.org/10.1111/nin.12370 © 2020 John Wiley & Sons Ltd 1 | INTRODUCTION Due to a wide range of documented positive outcomes, patient partic- ipation is regarded as a prerequisite for good quality care, treatment and rehabilitation (Castro, Van Regenmortel, Vanhaecht, Sermeus, & Van Hecke, 2016; Coulter & Ellins, 2006; Stacey et al., 2017). Consequently, patient participation has been reported to empower patients to take control over their bodies and their situations during rehabilitation (Castro et al., 2016). Furthermore, it can potentially in- crease patient safety, reduce healthcare costs (Goodridge et al., 2019; Weingart et al., 2011), improve the quality of life (Kwok, Pan, Lo, & Song, 2011) and bridge the knowledge of the patient and the knowl- edge of the health professional leading to better health solutions (Castro et al., 2016). Therefore, it is not surprising that patient and professional organisations, national policies and hospital manage- ments emphasise the need for health professionals to focus on pa- tient participation (Freil, Wandel, Pedersen, Jönsson, & Nyborg, 2014; Jørgensen, 2019; World Health Organization [WHO], 2001). However, due to varying needs for participation from patient to patient and for the same patient over time in their recovery process, patient partic- ipation is a complex issue (Eldh, 2019; Longtin et al., 2010). Despite being a prerequisite for high-quality rehabilitation (Lindberg, Kreuter, Taft, & Person, 2013; Van De Velde, Bracke, Van Hove, Josephsson, & Vanderstraeten, 2010), this complexity is also evident in the reha- bilitation after a severe, life-changing event such as a spinal cord in- jury (Chen & Boore, 2005; Dickson, Allan & O'Carroll, 2008; Geisler et al., 2002; Williams & Murray, 2015). Even though patient participa- tion is described as a central part of nursing and healthcare (Angel & Received: 7 February 2020 | Revised: 7 June 2020 | Accepted: 11 June 2020 DOI: 10.1111/nin.12370 FEATURE Action research as a catalyst for change: Empowered nurses facilitating patient participation in rehabilitation Randi Steensgaard 1,2 | Raymond Kolbaek 2,3 | Julie Borup Jensen 4 | Sanne Angel 5 1 Department of Neurology, Spinal Cord Injury Centre of Western Denmark, Central Region Hospital, Viborg, Denmark 2 Center for Research in Clinical Nursing, Central Region Hospital, Viborg, Denmark 3 Department of Nursing, VIA University College, Viborg, Denmark 4 Higher Education Research Unit, Capacity Building and Evaluation, ReCreate - Research Center for Creative and Immersive Learning Environments, Aalborg University, Aalborg, Denmark 5 Research Unit for Nursing and Healthcare, Institute of Public Health, Aarhus University, Aarhus, Denmark Correspondence Randi Steensgaard, Department of Neurology, Spinal Cord Injury Centre of Western Denmark, Regional Hospital Central Jutland, Viborg, Denmark. Email: Raneil@rm.dk Funding information The study was funded by Novo Nordisk Foundation (no. NNF15OC0017510), Regional Hospital Central Jutland and Spinal Cord Injury Centre of Western Denmark, Department of Neurology. Abstract Based on action research as a practitioner-involving approach, this article commu- nicates the findings of a two-year study on implementing patient participation as an empowering learning process for both patients and rehabilitation nurses. At a reha- bilitation facility for patients who have sustained spinal cord injuries, eight nurses were engaged throughout the process aiming at improving patient participation. The current practice was explored to understand possibilities and obstacles to patient participation. Observations, interviews and logbooks, creative workshops and reflec- tive meetings led to the development and testing of four new rehabilitation initiatives aimed at enhancing patient participation. This study suggests that skills of critical reflection from action research toolbox shed light on both the notion of patient participation and caring in nursing rehabilitation. By actively involving nurses in re- search, the knowledge development stems from practice and the solutions therefore became practice-oriented. In addition, the personal and professional development experienced by the involved nurses points to a secondary gain in the form of an ana- lytical and reflective approach to complex issues in relation to patient participation, rehabilitation in general and the individual nurses' sense of professional pride. KEYWORDS action research, change management, nurse roles, organisational development, patient participation, rehabilitation, rehabilitation nursing