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

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

The aim is to evaluate the state of home rehabilitation in relation to scientific evidence and the effectiveness on older persons’ well-being, participation and ability in daily activities as well as the older persons 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.

The project will be conducted in Jönköping, 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.