The black box of the home situation

In rehabilitation centers, people receive significant assistance with physical activity. Once they return home, this support is no longer available. This project investigated what clients need to remain physically active at home. Through a co-creation process, an intervention agenda was developed that prioritizes not only physical activity goals but also the client's personal values.

Every day, people return home after a hospital or rehabilitation stay to continue their recovery. Inpatient care supports and prepares clients to function as well as possible in their own home environments and to participate in society. In practice, however, physical activity levels often decline upon returning home. This project aimed to change that situation.

Goal

This project had the following objectives:

1. To gain a better understanding of how a rehabilitation patient experiences the process of establishing and maintaining physical activity during the transition from inpatient care to the home environment;
2. To develop an intervention agenda for the partners involved to support physical activity in the home environment;
3. To determine what is required to better organize collaboration within the care continuum.

Target group

The project's target group consisted of rehabilitation patients—both neurological and orthopedic.

Methodology

The project comprised four work packages in which the following information was gathered and developed: 

1. perspectives of rehabilitation patients on physical activity in the home environment, using storytelling;
2. a prioritization of key themes based on reflection sessions with healthcare professionals;
3. an initial version of an intervention agenda based on focus group interviews;
4. a version of this intervention agenda with broad support, following public review by partners across the healthcare chain.

Results

The project has yielded the following results:

Result 1: strengthened, positive collaboration among all consortium participants.

Result 2: a series of personal stories from rehabilitation patients – the article covering this is currently being written.

Result 3: a prioritized list of themes derived from these stories, classified as those most amenable to influence:

• daily life and participation in one’s own living environment as the primary focus of rehabilitation;
• personal resilience and individual responsibility regarding physical activity;
• facilitation or hindrance of physical activity and participation by the physical and social environment;
• collaboration and patient-centered support regarding physical activity across the entire rehabilitation continuum.

Result 4: an outline for an intervention agenda featuring the following ideas:

• having clients create their own plan to achieve a participation goal;
• identifying the patient’s personal values and integrating them into a support process to foster participation;
• offering daily activities as a treatment option to encourage self-management;
• developing videos featuring clients’ recovery stories;
• organizing a ‘Healthy Together’ consultation hour;
• involving loved ones in promoting physical activity during the care process;
• deploying an exercise coach for neighborhood exploration;
• using technology to map social dynamics;
• connecting peers and informal caregivers for support.
• The next step is to translate potential interventions into daily practice.

Duration

The project lasted one year; it started in September 2023 and ran until the end of August 2024.

Team

• Ester de Jonge
• Jorit Meesters

Collaboration

For this project, the Rehabilitation and Technology research group at The Hague University of Applied Sciences collaborated with:

• Leiden University of Applied Sciences
• Hanze University of Applied Sciences, Groningen
• Nij Smellinghe Hospital
• Basalt Rehabilitation Centre
• Medifit | Centre for Sports & Physiotherapy
• Havenfysio

Funding 

The project was funded by KIEM, part of Regieorgaan SIA.

Contact

Ester de Jonge ([email protected])