Table 1
Process evaluation outcome measures.
| ELEMENT | OPERATIONALISATION | PROCESS EVALUATION QUESTIONS | EVALUATION FORMS PARTICIPANTS | INTER-VIEWS PARTICIPANTS | INTER-VIEWS AND FOCUS GROUPS CASE MANAGERS | COMMUNICATION REPORTS |
|---|---|---|---|---|---|---|
| Fidelity | The extent to which the intervention was implemented consistent with the underlying theory and philosophy of CM |
| x | x | x | x |
| Dose delivered | The extent to which the CM elements were provided to participants |
| x | x | x | x |
| Dose received – exposure | The extent to which participants were engaged in the CM activities |
| x | x | x | |
| Dose received – satisfaction | Participants and CMs’ satisfaction with CM (expected to be >7 on a scale 1–10) |
| x | x | x | |
| Reach | The proportion of the target audience that participated in the intervention |
| x | |||
| Recruitment | The procedures used for recruitment and engagement of participants and CM. |
| x | |||
| Context | Factors in the organisation, community, social/political context, or other situational issues that potentially affect implementation or outcomes. |
| x | x |
Table 2
Demographic and injury-related information.
| PWABI (n = 62) | FAMILY MEMBERS (n = 36) | |
|---|---|---|
| Age, mean years ± SD [range] | 53.79 ± 15.08 | 56.67 ± 10.65 |
| Gender, F/M | 29/33 | 29/7 |
| Education level, % | ||
| Low (1–4) | 19.4 | 13.9 |
| Middle (5) | 50.0 | 55.6 |
| High (6–7) | 30.6 | 30.6 |
| Type of brain injury, % | ||
| Cerebrovascular accident | 33 (53.2) | |
| Cerebral infarction | ||
| Intracerebral haemorrhage | ||
| Intracranial haemorrhage | ||
| Transient ischaemic attack | 6 (9.7) | |
| Traumatic brain injury | 17 (27.4) | |
| Concussion/contusion | ||
| Other head trauma (trauma capitis) | ||
| Other cerebrovascular disorder | 1 (1.6) | |
| Meningitis | 1 (1.6) | |
| Encephalitis | – | |
| Hypoxia | 2 (3.2) | |
| Brain tumour | 2 (3.2) | |
| Time since injury, mean years (SD) | 5.69 ± 7.74 | |
| Hospital admission, n (%) | 44 (74.6) | |
| Prior brain injury, n (%) | 22 (35.5) | |
| Living situation, % | ||
| Alone | 26.2 | |
| With partner | 37.7 | |
| With partner and children | 24.6 | |
| With children | 4.9 | |
| With other people | 6.6 | |
| Unknown | 1.6 | |
| Relationship with PwABI, % | ||
| Partner | 66.7 | |
| Parent | 16.7 | |
| Child | 8.3 | |
| Friend | 8.3 | |
| Living together w/ PwABI, % | 77.8 |
[i] PwABI = people with acquired brain injury.
Table 3
Quotes illustrating the components of the process evaluation.
| COMPONENT | QUOTE NUMBER | QUOTE |
|---|---|---|
| Fidelity | 1 | “It’s nice, of course […], if at some point […] someone becomes self-reliant and no longer needs you, that you make yourself redundant. But with brain injury it’s like, something happens again and the balance they have [is disturbed] – and then you’re still needed again” – CMr7 |
| 2 | “And that’s bound to happen, because another phase will come and then you have to arrange all kinds of things again. And a healthcare system like that doesn’t change that quickly. So then I’m not going to try 10 times myself first, because that just doesn’t make sense.” – Z034n (mother) | |
| 3 | “With a case manager, of course you get a different relationship with her. So she knows me, and sometimes a few words were enough for her [to know what I meant]” – Z020p (PwABI) | |
| Dose delivered | 4 | “Connecting [care providers] in time and action and making sure that the right things happen at the right time. No one else can do that. Because nobody else takes charge” (CMr3) |
| 5 | Example of engagement: “She [the CMr] came to our house to get acquainted. And then she really, really just sat there for at least two hours. I think even longer. And she just sat and listened” – Z049n (mother) | |
| 6 | Example of planning: “That’s actually how it started, [the CMr asked: …] ‘imagine a year from now or two years from now, how would you want things to go with your mother? And that’s where we started working toward, what I wanted, and what my mother wanted. And those are then little steps that they were then going to take, and that they were then trying to achieve with me.” – Z01n (daughter) | |
| Dose received – exposure | 7 | “I was able to take the steps to the UWV (Netherlands Employees Insurance Agency) […], to do that myself. Yes, [my CMr] had given me enough ammunition so to speak, she supported me enough to just continue to do that myself” – Z014p (PwABI) |
| 8 | “And then they were also like ‘well then you could start thinking about this. You don’t have to’, they said. ‘But try it for a while when you have time for it’. So I think they had a plan, like this or that, but not that they said that to me, like ‘you have to go there’. I came up with it myself.” – Z01n (daughter) | |
| Dose received – satisfaction | 9 | “Then there is a case manager and you think – a burden falls off of you, you no longer have to proactively figure out everything yourself, there is someone who is going to take you by the hand in that process. And I experienced that as an enormous relief.” (Z014n – partner) |
| 10 | “If you don’t have a case manager, someone who keeps an eye on you… For a long time I didn’t have to do anything for [PwABI and partner]. I really didn’t have much contact for months, and then suddenly it’s there again, and they know where to find you and you can get on with it right away.” – CMr8 | |
| 11 | “Also appreciating [the process of family], and saying like: ‘Your husband or your partner has an [ABI], has a process, but you also have a process.’ And that is usually not seen [by others]. And often the process of the person it happened to is very different [from that of the partner]. The partner is generally in that grieving period.” (CMr9) | |
| 12 | “How feasible would it be, if you soon have 20 clients who want to call you for 10 minutes once every two weeks, and you also still have 10 new clients […]. At some point your schedule will be filled with just people you have to call every so many weeks.” – CM2 | |
| Context – diverse backgrounds | 13 | “Whatever question you get, there is always someone [another CM] who knows more about it or is more in that side of the field that you can approach.” (CM2) |
| 14 | “[another cm] pretty much delivers treatment, with those conversations, and in a systematic way, I can’t do all that, so I don’t do that either. So, I do very different things, and that makes that […] the case manager is not uniform either.” (CM8) |