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Att implementera nya arbetssätt i hemrehabiliteringspraxis: Multipel fallstudie
Luleå University of Technology, Department of Health Sciences.
2017 (Swedish)Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesisAlternative title
To Implement New Strategies In Rehabilitation At Home : Multiple Case Study (English)
Abstract [sv]

Titel: Att implementera nya arbetssätt i hemrehabiliteringspraxis - Multipel fallstudie. Syftet med studien var att utvärdera och beskriva implementeringsprocessen av en intervention i hemrehabiliteringen inom Korsholms kommun. Den nya interventionen inom hemrehabiliteringen grundade sig på klientcentrering, multiprofessionellt samarbete samt att jobba aktiverande utgående från gemensamma mål för att stärka klienters självständighet och kvarboende. Metoden som valdes var multipel fallstudie. Både kvalitativa och kvantitativa data samlades in och analyserades. Åtta klienter inkluderades i studien och genomförde en hemrehabiliteringsperiod på fyra veckor. Intervjuer gjordes med dessa klienter och deras vårdpersonal och intervjuerna analyserades med kvalitativ innehållsanalys. Utfallsmått som mättes före och efter interventionen var SPPB, FRAT, Barthel index och måluppfyllelsegrad med GAS. Också följsamhet och bortfall och antalet hemservicebesök registrerades. Som modell för implementering användes PDSA- cykeln. Angående resultatet kan det ssammanfattas med att hemrehabiliteringen upplevdes som positivt av klienterna och av personalen och att klienterna uppnådde goda resultat gällande självständighet, funktionsförmåga och måluppfyllelse samt att det framkom brister i aktiverande arbetssätt och klienternas delaktighet. Personalen upplevde att tidsbrist och klienternas bristande motivation var hinder för hemrehabiliteringen och att kommunikationen och samarbetet mellan hemrehabiliteringspersonal och hemservicepersonal borde utvecklas, eftersom de såg nyttan av interventionen i de fall där det fungerade. I det fortsatta multiprofessionella arbetet inom hemrehabiliteringen och implementeringen av den kommer mer fokus att läggas på dessa faktorer. Detta arbete kan också fungera som ett hjälpmedel för andra som vill implementera nya arbetssätt i praktiken. Vikten av att använda sig av modeller för utvecklingsarbete och studera implementeringen ur ett brett perspektiv lyfts fram med denna studie. Sökord: Hemrehabilitering, Implementering, Multipel Fallstudie, PDSA- cykeln 

Abstract [en]

Title: To Implement New Strategies in Rehabilitation at Home - Multiple Case Study The aim of this study was to evaluate and describe the implementation process of a Home- rehabilitation-intervention. The new intervention was client-focused, used re-ablement with common goals in order to strengthen the clients’ independence and ability to live at home. Multiple case study was chosen as method and both quantitative and qualitative data was collected and analyzed. Eight clients were included in the study and they took part of a four- week long rehabilitation intervention at home. Interviews with these clients and their care staff were conducted and then analyzed with qualitative content analysis. Measurement before and after the intervention were SPPB, FRAT, Barthel and the Goal Attainment scale, GAS. The adherence, loss of clients to the intervention and the amount of home visits from care staff was also analyzed. As a model for implementation the PDSA- cycle was used. The results show that the clients and the staff felt positive about rehabilitation at home, and that the clients achieved goals and got positive results on function and independence, but that there were weaknesses in the implementation of re- ablement and participation. The care- staff saw that lack of motivation amongst the clients and lack of time were barriers to rehabilitation at home. They also wanted to improve the communication and the cooperation between care-staff and rehabilitation-staff because they saw that the rehabilitation at home was valuable when it worked properly. In the future development of the intervention and implementation of these multiprofessional tasks we will start with these factors. This study can also be seen as a guideline for others that wish to implement new strategies in to clinical practice. The use of development tools and the importance of studying the implementation from a broad perspective is emphasized with this study. Searchwords: Rehabilitation At Home, Implementation, Multiple Case Study, PDSA-cycle 

Place, publisher, year, edition, pages
2017.
Keywords [sv]
Hemrehabilitering, implementering, Multipel Fallstudie, PDSA- cykeln
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:ltu:diva-64454OAI: oai:DiVA.org:ltu-64454DiVA, id: diva2:1114654
External cooperation
Korsholms kommun
Subject / course
Student thesis, at least 15 credits
Educational program
Physiotherapy, master's level (120 credits)
Supervisors
Examiners
Available from: 2017-06-26 Created: 2017-06-25 Last updated: 2017-06-26Bibliographically approved

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