Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.
Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany.
BMC Geriatr. 2024 Aug 29;24(1):720. doi: 10.1186/s12877-024-05277-7.
Geriatric rehabilitation aims at increasing physical and social activity and maintaining the functional reserve of older people. However, the continuity of geriatric rehabilitation in the outpatient setting is limited due to a lack of structured aftercare programs. In order to overcome this, a three-month multimodal home-based intervention program (GeRas) was implemented. The aim of this early qualitative process evaluation was to assess GeRas in terms of perceived reach, effectiveness/efficacy, adoption/uptake, implementation, and maintenance/sustainability (Domains within the RE-AIM Framework) from the perspective of patients who received the intervention and healthcare providers who were involved in the delivery of the intervention.
In a qualitative process evaluation, 13 healthcare providers and 10 patients were interviewed throughout the beginning of the implementation period of GeRas to capture early experiences using a semi-structured interview guide. The interview guide and qualitative content analysis was guided by the RE-AIM Framework.
The GeRas program was perceived to be largely well implemented and beneficial by healthcare providers and patients. According to healthcare providers, GeRas showed more advantages compared to usual care. Additionally, outcome expectations were mainly met (Domain 1: Effectiveness). However, the implementation of the intervention delivered via the eHealth system was perceived as challenging (Domain 2: Adoption). Nevertheless, the outpatient physical exercise, the outpatient counselling, and the continuous care after discharge improved perceived well-being regardless of the intervention type (Domain 3: Implementation). To facilitate the continued use of GeRas, technical requirements should be created to increase user-friendliness and to motivate patients to continue the training in the long term (Domain 4: Maintenance).
Although initial experiences with the implementation and effectiveness of GeRas were positive in general, organisational and technical issues need to be resolved to enhance sustainable and successful implementation of the GeRas program.
German Clinical Trials Register (DRKS00029559). Registered 5/10/2022.
老年康复旨在增加身体和社会活动，并维持老年人的功能储备。然而，由于缺乏结构化的康复后护理计划，门诊老年康复的连续性受到限制。为了克服这一问题，实施了一项为期三个月的多模式家庭干预计划（GeRas）。本项早期定性过程评估的目的是从接受干预的患者和参与干预实施的医疗保健提供者的角度，根据可感知的覆盖范围、效果/疗效、采用/接受、实施和维持/可持续性（RE-AIM 框架内的领域）评估 GeRas。
在定性过程评估中，在 GeRas 实施初期，对 13 名医疗保健提供者和 10 名患者进行了访谈，使用半结构化访谈指南来获取早期经验。访谈指南和定性内容分析以 RE-AIM 框架为指导。
医疗保健提供者和患者普遍认为 GeRas 计划实施得很好，并且对患者有益。根据医疗保健提供者的说法，GeRas 与常规护理相比具有更多优势。此外，主要实现了预期的结果（领域 1：效果）。然而，通过电子医疗系统实施干预措施被认为具有挑战性（领域 2：采用）。尽管如此，门诊物理治疗、门诊咨询和出院后的持续护理，无论干预类型如何，都改善了患者的幸福感（领域 3：实施）。为了促进 GeRas 的持续使用，应创建技术要求以提高用户友好性，并激励患者长期进行培训（领域 4：维持）。
尽管总体上对 GeRas 的实施和效果的初步经验是积极的，但需要解决组织和技术问题，以增强 GeRas 计划的可持续和成功实施。
德国临床试验注册处（DRKS00029559）。注册于 2022 年 5 月 10 日。
