Table 2 Factors according to the CFIR domains
Code | Factor |
|---|---|
Intervention characteristics (IC) | |
IC 01 | Social issues, the need of "being" and "belonging" in the community are addressed; Reablement may take place in the wider community, not only in people´s homes |
IC 02 | Social environment (family, friends, neighbours) is included in the Reablement-team |
IC 03 | Client´s own goals serve as a common interdisciplinary platform; there is an agreement on the process for reaching these goals with the client, family and informal carers |
IC 04 | Care professional and therapist together carry out initial goal setting interview with clients |
IC 05 | Common, thorough and consistent assessments and documentation, e.g., development and implementation of a unified treatment-plan |
IC 06 | Evaluation on the basis of outcome and goal attainment instead of evaluation on time and tasks |
IC 07 | Care workers are exclusively employed in Reablement, so they don´t have to switch between Reablement and traditional home care |
IC 08 | Physiotherapists are part of the core team |
IC 09 | Occupational Therapists are part of the core team |
IC 10 | Physicians (gerontologist) are part of the core team |
IC 11 | Access to specialists` skills (e.g., dietician, substance abuse counsellor, mental health nurse, speech therapist…) is assured |
IC 12 | Access to equipment (e.g. aids, assistive technology, home adaptation and telecare) is given |
IC 13 | Face to face contact is minimised (use of phone calls and telecare instead) to avoid the chance that clients will become dependent on team members` visits and to ensure the program is as cost efficient as possible |
IC 14 | Reablement service is cost-free for clients |
Outer setting (OS) | |
OS 01 | Political pressure to develop cost-effective solutions in response to demographic developments |
OS 02 | There is peer-pressure: other home care services are providing Reablement |
OS 03 | A selective approach to the Reablement service is used (that means excluding people who are unlikely to benefit from Reablement) |
OS 04 | The client has few or no previous experiences with traditional homecare |
OS 05 | The client has realistic expectations based on an understanding of the difference between traditional home care und Reablement |
OS 06 | The client has capacity to consent and has rehabilitation potential (e.g. not requiring total assistance with care and not bedridden) |
OS 07 | The client has willpower and motivation to work with the Reablement team towards autonomy |
OS 08 | The client has sufficient language skills to be able to communicate in the local language |
Inner setting (IS) | |
IS 01 | There is a commitment to the philosophy and concept of Reablement as well as the value of occupation in the whole organisation |
IS 02 | Within the Reablement-team everyone is more or less at the same hierarchical level |
IS 03 | There is an agreement on the process for reaching client-centred goals within the Reablement-team |
IS 04 | The service has the capacity to provide flexible and prompt interventions (e.g. flexible use of working hours, goal-orientated planning of visits in terms of duration and frequency, adjust intervention quickly in response to improvements in clients´ abilities) |
IS 05 | Subsequent services after Reablement are provided in a way that maintains any progress the client has made |
Characteristics of individuals (CI) | |
CI 01 | Reablement team members share a strong vision of the service (shared understanding of the aims and objectives of Reablement, especially to prevent inappropriate referrals) |
CI 02 | Reablement team members have individual qualities and social skills to perform teamwork / multidisciplinary collaboration / learning from each other |
CI 03 | Reablement team members use patterns of communication that encourage clients and their families to participate in all care decisions (that means promoting their sense of autonomy rather than exerting power or control over the client) |
CI 04 | Careworkers are trained on the principles of delivering a Reablement service (e.g., learning to “stand back”, principles of self-management, healthy aging…) |
CI 05 | Careworkers work on reaching the goals without focus on time and task and plan the duration of home visits individually |
CI 06 | Staff has less experience in traditional home care and is able to adapt more easily to the Reablement approach |
Process (P) | |
P 01 | Communities design their own individual model of Reablement (including the structure of the team) |
P 02 | Rehabilitation experts are included in the planning and implementation of Reablement |
P 03 | Reablement initiatives should be individually tailored and flexible with opportunities for employees to be creative |
P 04 | Start-up costs and training for home care workforce are planned and calculated |
P 05 | Reablement pilot projects start with small teams of selected, motivated team-members |
P 06 | Success stories of selected users are promoted within the team |
P 07 | A high level of work satisfaction among the team is secured by planning and conducting appropriate measures |