The capability approach in rehabilitation: lessons learned from a process evaluation.

Abstract

Interest in the potential significance of the capability approach for healthcare has grown rapidly. In this study, we developed, implemented and evaluated a clinical intervention based on the capability approach. The aim of the process evaluation, described in this article, is to understand how capability care was delivered and how healthcare professionals experienced delivering capability care. Participants with neuromuscular diseases received usual (<i>n</i> = 29) or capability care (<i>n</i> = 28). We used a mixed methods approach guided by the Medical Research Council framework for process evaluation of complex interventions, collecting and analysing data from electronic health records, audio recordings of consultations with healthcare professionals, and focus groups and interviews with healthcare professionals (<i>n</i> = 13). Healthcare professionals found implementation of capability care challenging and they only partially implemented it. Results showed that especially underlying values were discussed more often in capability care. Although healthcare professionals had different views on the added value of capability care, some healthcare professionals found that using capability care did change the care they provided. The capability approach seems to have potential in healthcare, although implementation challenges need to be addressed. Practical recommendations for future implementation and evaluation are provided.