A qualitative exploration of professionals' perspectives on the implementation of reablement intervention programs in community care.

Reablement is considered a complex intervention due to its multicomponent, person-centered, holistic approach promoting older adults' active participation in daily activities. It is important to consider the unique context in which complex interventions are implemented, as contextual factors may interact and influence implementation outcomes. As part of the European TRANS-SENIOR project, this qualitative study aimed to gain insight into professionals' experiences with reablement implementation in Dutch community care. Using the Consolidated Framework for Implementation Research, four focus groups were conducted comprising 32 professionals. Two groups were formed: one at operational level, including therapists, nursing staff, social workers, and domestic support; and one at organizational/strategic level, including project leaders, managers, directors, municipality representatives and health insurers. Participating care organizations had at least 6 months of experience with deploying and implementing reablement. Findings reflected three themes: (1) strength of interdisciplinary collaboration; highlighting significance of sharing goals and beliefs, (2) integrating the reablement philosophy into the organization; underscoring managements role in fostering support across all organizational layers, and (3) achieving a culture change in the healthcare system; emphasizing current funding models impeding value-based care tailored to the individual's goals and needs. The results offer valuable insights for implementation of complex interventions, like reablement.

Effects on clients' daily functioning and common features of reablement interventions: a systematic literature review.

This systematic review aimed to provide an overview of reablement interventions according to the recently published ReAble definition and their effect on Activities of Daily Living (ADL). In addition, the most common and promising features of these reablement interventions were identified. Four electronic bibliographic databases were searched. Articles were included when published between 2002 and 2020, which described a Randomised or Clinical Controlled Trial of a reablement intervention matching the criteria of the ReAble definition, and had ADL functioning as an outcome. Snowball sampling and expert completion were used to detect additional publications. Two researchers screened and extracted the identified articles and assessed methodological quality; discrepancies were resolved by discussion and arbitration by a third researcher. Twenty relevant studies from eight countries were included. Ten of these studies were effective in improving ADL functioning. Identifying promising features was challenging as an equal amount of effective and non-effective interventions were included, content descriptions were often lacking, and study quality was moderate to low. However, there are indications that the use of more diverse interdisciplinary teams, a standardised assessment and goal-setting method and four or more intervention components (i.e. ADL-training, physical and/or functional exercise, education, management of functional disorders) can improve daily functioning. No conclusions could be drawn concerning the effectiveness on ADL functioning. The common elements identified can provide guidance when developing reablement programmes. Intervention protocols and process evaluations should be published more often using reporting guidelines. Collecting additional data from reablement experts could help to unpack the black box of reablement. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-022-00693-3.