Department of Physiotherapy, University of Applied Sciences, Favoritenstraße 226, 1100, Vienna, Austria.
Vienna Social Services, Vienna, Austria.
BMC Health Serv Res. 2022 Jul 28;22(1):959. doi: 10.1186/s12913-022-08355-x.
Reablement is a multi-professional and internationally established home-based health care service for mainly older people with the aim to reduce the need for long-term care and to promote self-determination. However, it is unknown which factors would facilitate the implementation of reablement in health care services. Therefore, the aim of this work was to identify relevant factors for the implementation process and to elucidate their importance based on the perspectives of experts.
Within an exploratory sequential mixed-methods design, a literature search followed by framework analysis was carried out using the five domains of the Consolidated Framework of Implementation Research (CFIR) to collect potentially relevant factors for implementation of reablement. A survey was then drawn up encompassing the factors identified. Within the survey international reablement - experts were asked to rate the relevance of these factors .
The literature search identified 58 publications that served as sources for the framework analysis, where 40 potentially relevant factors were clustered into the five CFIR domains. These 40 factors were rated by experts in an online-survey. Based on the analysis of survey-data, 35 factors were considered as relevant for implementation of reablement services. The CFIR-domain characteristics of individuals, including teamwork and communication skills, was seen as most relevant.
The implementation of reablement services is complex and requires the consideration of numerous factors, especially regarding the CFIR-domain characteristics of individuals. From the perspective of the survey´s participants one important factor of a successful implementation was the engagement of the persons involved. It requires team members with a strong, shared vision. Communication skills are highly important to promote teamwork and intensive training is needed to establish these skills. Further research on the implementation of reablement services is essential to realize its full potential.
康复是一种多专业的、国际上建立的、以家庭为基础的医疗保健服务,主要针对老年人,旨在减少长期护理的需求,促进自主决策。然而,目前尚不清楚哪些因素有助于康复服务的实施。因此,本研究的目的是确定实施过程中的相关因素,并根据专家的观点阐明其重要性。
在探索性顺序混合方法设计中,使用实施研究综合框架(CFIR)的五个领域进行文献检索和框架分析,以收集与康复实施相关的潜在因素。然后,根据确定的因素制定了一项调查。在调查中,国际康复专家被要求评估这些因素的相关性。
文献检索确定了 58 篇作为框架分析来源的出版物,其中 40 个潜在因素被聚类到 CFIR 的五个领域中。这些 40 个因素在在线调查中由专家进行了评估。基于调查数据分析,35 个因素被认为与康复服务的实施相关。个人的 CFIR 领域特征,包括团队合作和沟通技巧,被认为是最相关的。
康复服务的实施是复杂的,需要考虑众多因素,特别是个人的 CFIR 领域特征。从调查参与者的角度来看,成功实施的一个重要因素是相关人员的参与。这需要具有强烈共同愿景的团队成员。沟通技巧对于促进团队合作非常重要,需要进行密集的培训来建立这些技能。进一步研究康复服务的实施对于充分发挥其潜力至关重要。