Re@home - Evaluation of home rehabilitation for older people: A realist evaluation design

Facts

Academic Partners:

Karolinska Institutet, Luleås Tekniska Universitet.

Project duration: 2021-2026

Research team:

Sofi Fristedt, principal investigator at JU

Elisabeth Rydwik, project owner at KI

Maria Ranner, principal investigator at Lunds Tekniska Universitet

Marie Ernsth Bravell, co-researcher

Anette Johansson, co-researcher

Financier: Familjen Kamprads Stiftelse and FORTE.

Re@Home is a project on how home-rehabilitation interventions can and should be adapted to the specific needs of older people with disabilities to improve participation and well-being.

Purpose of the study

Home rehabilitation for older people is widely implemented, but research on the content and effectiveness of rehabilitation interventions used in practice is scarce. Additionally, there is a lack of knowledge of how home-rehabilitation units collaborate with social and health care services.

The aim of this study is to evaluate the state of home rehabilitation in relation to scientific evidence and the effectiveness on older people's well-being, participation and ability in daily activities as well as the older people's satisfaction with the interventions, the collaboration between social service and health care providers, and level of service utilization.

The design is based on the realist evaluation method, where a defined program theory is used as a base for the evaluation. The main characteristic is to identify context, mechanism and outcomes of the target process.

Material and method

The project will be conducted in Jönkoping, Luleå and Stockholm which reflects different parts of the country in relation to size and care organisations.

During phase 1, a program theory is established through systematic searches of scientific and grey literature; extracting data, analyzes and synthesizing will be conducted and discussed during four workshops.

During phase 2, the context and mechanisms of impact is explored at home-rehabilitation units at the three sites, through observations of interaction between staff and patients, patient record auditing, and focus groups and interviews.

During phase 3, the effectiveness of home rehabilitation will be evaluated by patient record auditing, register data, questionnaires and interviews and will be analyzed In relation to the described program theory.

An overarching analysis of what, for whom and under which circumstances that home rehabilitation leads to change will be conducted with data from all three phases using mixed methods. The results of identified mechanisms and relevant context factors will be related to the outcomes of effectiveness to identify outcome patterns.