Lindström Maria
Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
Front Psychiatry. 2022 Aug 16;13:954068. doi: 10.3389/fpsyt.2022.954068. eCollection 2022.
This paper describes the initial phases of the design and development of the Everyday Life Rehabilitation (ELR) intervention, and it presents preliminary findings on usefulness and implementation aspects derived from an ongoing larger trial exploring the effect, cost-effectiveness, and usefulness of ELR. ELR is a model designed to meet the absence of meaningful activities and challenges with integrated, activity- and recovery-oriented rehabilitation in sheltered and supported housing facilities for persons with extensive psychiatric disabilities. The aim of the present study was to examine early experiences of implementing the ELR model from the perspectives of managers, housing staff, and occupational therapists. The paper will sum up preliminary findings based on process data included in an internal pilot prior to a full-scale pragmatic clustered RCT. Four Swedish municipalities with 19 housing facility units were involved and provided process data for the study. Thematic analysis were applied. The informants perceived the methodology to be well suited to the target group and context and to contribute to positive changes in participants' lives. The web-based training was also experienced as relevant and easily accessible to staff, as well as elements of collegial learning and feedback. However, they reported that their municipalities lacked basic conditions for making the whole concept work in such a short time. The ELR is overall perceived as useful, but experiences also make complex difficulties visible regarding integrated, coordinated rehabilitation and organizational readiness. Based on findings, a recommendation on basic prerequisites will be added to the ELR guidance for leadership and management.
[ClinicalTrials.gov, 24 September 2021], identifier [NCT05056415].
本文描述了日常生活康复（ELR）干预措施设计与开发的初始阶段，并呈现了来自一项正在进行的更大规模试验的关于有用性和实施方面的初步结果，该试验旨在探究ELR的效果、成本效益和有用性。ELR是一种旨在通过在为患有严重精神疾病的人提供庇护和支持的住房设施中开展综合的、以活动和康复为导向的康复，来应对有意义活动和挑战缺失问题的模式。本研究的目的是从管理人员、住房工作人员和职业治疗师的角度审视实施ELR模式的早期经验。本文将基于在全面务实的整群随机对照试验之前进行的内部试点中纳入的数据，总结初步结果。四个瑞典直辖市的19个住房设施单元参与其中，并为该研究提供了过程数据。采用了主题分析法。信息提供者认为该方法非常适合目标群体和背景，并有助于参与者生活产生积极变化。基于网络的培训也被认为与工作人员相关且易于获取，以及具有团队学习和反馈的元素。然而，他们报告称，他们所在的直辖市缺乏在如此短的时间内使整个概念发挥作用的基本条件。ELR总体上被认为是有用的，但经验也揭示了在综合、协调的康复和组织准备方面存在的复杂困难。基于研究结果，将在ELR领导力和管理指南中添加关于基本前提条件的建议。
[ClinicalTrials.gov，2021年9月24日]，标识符[NCT05056415]
