Single-Subject and Realist Evaluation of Adult Rehabilitation Programmes

Mansoor Kazi
Centre for Evaluation Studies, University of Huddersfield
Harold Wilson Building, Queensgate
Huddersfield West Yorkshire HD1 3DH
England
+44 1484 472076
m.a.f.kazi@hud.ac.uk
 
Robert Taylor
Centre for Evaluation Studies, University of Huddersfield
 
Kathleen Firth
Oakes Villa Rehabilitation unit
 
Avril Henson
Barton Day Centre
 
Sandra Lickess
Barton Day Centre
Purpose
The paper reports on a study involving the integration of single-subject design procedures in the daily practices of adult rehabilitation programmes in the Huddersfield NHS Trust, West Yorkshire in England (Kazi 1998), up to the year 2001. The programmes provide services for people aged over 65 years who suffer acute conditions affecting their ability to live independently.
 
Method
The method included the integration of single-subject designs into the practice of three teams, to systematically track outcomes using standardised measures, including the recently validated Oakes Villa Activities of Daily Living Scale. One of the teams has used this scale for five years in over 400 patients, and the others have developed the use of outcome measures in the year 2001. Each case is systematically tracked, and the results across the larger numbers of cases are aggregated using sub group and factor analysis which enables comparisons between different types of interventions, client characteristics and contexts.
 
Results
Single-subject designs have been integrated into the practices of the three programmes as part of a partnership between academics, practitioners and service users. This paper will present an analysis of the findings from nearly 500 cases, with examples of intensive research in single cases as well as the aggregated results across the cases using SPSS. For example, the analysis indicates the types of client medical conditions associated with improved rehabilitation outcomes across different types of interventions.
 
Implications for Practice
The integration of evaluation research procedures into practice represents a significant advance in evidence-based practice approaches, and provides a solution to the problems of 1) the divide between research and practice, and 2) the use of research findings to inform future practice.

References