Page 101 - Demo

Implementation interventions through the lens of Normalisation Process Theory994The narrative descriptions of the implementation processes in each group home were used to get more insight in the application of implementation interventions with the aim of understanding the relation between these interventions and NPT%u2019s social mechanisms at play. By using the framework method for analysing qualitative health care data (Gale et al., 2013) the content of the adaptations of EPOC professional interventions were mapped on the 16 subconstructs of Normalisation Process Theory. This resulted in a matrix (Table 4) providing insight in what social mechanisms were initiated by professional implementation interventions adapted for MDET. Positionality and reflexivity The first author is a behavioural consultant in care for people with intellectual disabilities, specialised in treatment of residents with challenging behaviour and restrictive measures. Although she worked at the care organisation where the data was collected, she was not involved. She knows the care organisation well, which made it easier to relate to the social mechanisms during implementation of MDET. To counter bias, the data was reviewed by a research assistant and the second author. Both had very limited experience of working in care for people with intellectual disabilities. Mapping the EPOC interventions to NPT constructs was an analysis made by the first author. To further counter bias, the NPT-EPOC matrix was discussed with the project leader. ResultsThe Results section is structured as follows: First, adaptations of EPOC professional implementation interventions are described. Second, an overview is given of the range of implementation interventions across different phases of MDET. Finally, we place the implementation interventions in a NPT-EPOC framework in order to identify the social mechanisms at play.