Realistic Evaluation of Brønderslev Kommunes home rehabilitation program

Student thesis: Master thesis (including HD thesis)

  • Mie Jeanette Sørensen
  • Mette Dyrholm Hundsholt
  • Pia Noekjær Jensen Gunvald
4. term, Public Health, Master (Master Programme)
Introduction: In Denmark, it is estimated that 430,000 are living with Chronic Obstructive Pulmonary Disease (COPD), of which 40,000 are living with severe and very severe COPD, GOLD 3-4. COPD is the third leading cause of death in Denmark. Patients’ with COPD have increased risk of developing anxiety and depression and have worse self-rated health than the general population. Evidence shows that rehabilitation of COPD increases quality of life and decreases the symptoms of the disease. There is, however, no documented effect of home-based rehabilitation for patients who cannot participate in group rehabilitation, according to the Danish recommendations. Therefore, home rehabilitation in patients with COPD, are examined in this project.
The aim, of this project, is to examine the effect, that Brønderslev Kommunes home rehabilitation have on patients with COPD, who cannot participate in group-rehabilitation, and make recommendations for the development of this rehabilitation program.
Method: This project used realistic evaluation to examine the effect Brønderslev Kommunes home rehabilitation have on patients who cannot participate in group-rehabilitation. The projects theories is based on Aaron Antonovskys theory on Sense of coherence, which is used to examine patients’ assessment of their own health. Dag Ingvar Jacobsen and Jan Thorsviks theory on goal achievement, and George T. Dorans S.M.A.R.T.-model are used to examine the rehabilitation program numerous objectives, goals and derived effects by using qualitative methods. In addition, the project examine the pro-grams overall goal – participating ingroup rehabilitation – using patient records through quantitative methods.
Results: It is estimated that the rehabilitation program increase patients understanding and management of their disease, but they do not experience a sense of coherence. Likewise, it is estimated that the rehabilitations programs goals do not meet the criteria described in the theory on goal achievement. The derived effects are measures based on the staff’s professional assessments and not measured through qualitative or quantitative measurement tools. In conclusion, it is estimated that the rehabilita-tion program occur mechanisms as mutual trust, individuality and physical presence which influence the programs effect.
Conclusion: The intended effect, more people participate in the usual rehabilitation program, happens to 18 percent of the patients, who participated in the homebased rehabilitation, in the period 2011-2014. There occure unintended effects in terms of understanding and managing the disease. Likewise, there are mechanisms, such as mutual trust, individuality and physical presence, which influences the programs effects.
Publication date1 Jun 2015
Number of pages113
External collaboratorBrønderslev Kommune
Helle Rasmussen
ID: 213307625