Search results

Research partnerships between ‘thinkers’ and ‘doers’ are now thought likely to deliver more useful and useable knowledge for health and social care. So far there is little guidance about making these academic/operational links work on the ground. We have used our own experiences of this approach, together with evidence from existing literature, to explore such partnerships. We conclude that, while they are fine in principle, it is difficult in practice to balance the twin demands of operational relevance and academic rigour. Such links may need rather different and better resourcing if they are to work properly.

This is the third in a series of articles about trying to develop better evidence for a service on the health/social care interface. All are based on our experiences of carrying out a comparative study of residential rehabilitation for older people. The first two dealt with methodology and implementation. Now we reflect on the completion of the project and the first stages of dissemination.

This is the second article about our comparative study of joint health and social care rehabilitation for older people. We discuss what has worked well so far, and how we have tackled the various obstacles to doing systematic research across two complex organisations. We describe our sample group and report on data collection so far.

This paper reports key messages for policy makers, drawn from a workshop held for local health and social care staff with responsibilities for running or setting up short‐term residential rehabilitation for elderly and disabled people. The aim was to learn from each other's experiences and to provide a nuts‐and‐bolts framework for the development of local joint investment plans.

This is the first of two articles about evaluating a residential rehabilitation service for older people. It highlights some key principles about research on the health/social care interface, which may be useful to others doing similar work. Here we describe the methodology and how it was chosen. In the next article we will discuss the baseline data findings.

Long-term health problems put great pressures on health and social care services. Supporting ‘self-care’ has measurable benefits in helping patients cope better, but is difficult to do in practice. This review aims to help improve services by exploring existing evidence about the views of patients and GPs.

The search terms were identified following detailed discussion with service users. Five databases (PUBMED, CINAHL, TRIP, SCIE and PSYCINFO) were interrogated against pre-set questions and criteria. The data were managed in EndNote v6 and analysed in a series of Word tables.

37 community-based studies were identified, covering diverse chronic illnesses. Analysis of ‘barriers and enablers’ showed a very complex picture, with health systems often actively inhibiting the responsiveness and flexibility which support self-care. Directly seeking service user and practitioner views could shape more effective services

Further research is needed into: the purpose and outcomes of user involvement, the relationship between integrated care and self-care, how patient motivation and resilience can be encouraged in primary care and the effect of current incentive schemes on self-care support Due to organisational changes, eligible studies were reviewed by one researcher only and these were mainly qualitative studies lacking generalisability. However, the results spanned a range of settings and health conditions. They are also clearly supported by later primary research findings

Several evidence-based, achievable opportunities to improve self-care support in primary care settings are identified

This service-user study, offers detailed analysis of what helps or hinders self-care in everyday life

This paper aims to report verbatim the voices of older people describing their experiences of rehabilitation services in community hospitals and local authority short‐term residential units followed by “usual care” services at home. It aims to contribute directly to the implementation of the DH Section 256 “reablement guidance”.

The paper is a qualitative study, based on semi‐structured face‐to‐face interviews in 2002/3, with 42 participants (mean age 81.4 years) using interpretative phenomenological analysis (IPA).

Four main themes emerged from users' comments: the complexity of rehabilitative need, the influence of the setting, the role of the staff and the availability of reablement support back at home.

Qualitative studies have limited generalisability, but these findings are consistent both with other studies of user experience and with earlier related evidence about assessment, institutionalisation and psychological factors.

The findings clearly demonstrate changing rehabilitative needs along the care pathway, with implications for commissioners and providers of reablement services. The findings bring a user perspective to current debates about the integration of services and the use of pooled budgets.

Effective reablement is critically dependent on service users' co‐operation and motivation. It therefore needs to be highly responsive to their needs and views. This study offers specific user views about their experiences in different settings and at different stages of reablement, together with their ideas for how it might work better. The data are analysed within a single framework, offering an example of the type of local evaluation currently sought by the Department of Health.