Rehabilitation, collaboration and aging – Elisabeth Rydwik's research group

In this group, the research focus is on pre- and rehabilitation for frail older person in their home environment, how collaboration within the health and social care organizations work and how care transitions affect different outcomes. A consistent theme is a multi-professional approach and/or component in all projects.

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Research focus

The focus of our research is on pre- and rehabilitation for frail older persons in their home environment, how collaboration within the health and social care organizations work and how care transitions affect different outcomes. A consistent theme is a multi-professional approach and/or component in all projects.

Read more about our ongoing projects under the Projects tab.

Publications

Selected publications

All publications from group members

Funding

Grants

  • Re@home: Evaluation of home rehabilitation for older adults- what works for whom under what circumstances.
    FORTE
    1 November 2026 - 31 December 2028
    Research problem and specific questions Rehabilitation is fundamental to all health care, as good care and public health cannot be achieved without access to rehabilitation (WHO). Despite this, research on the effectiveness of home rehabilitation to improve older adults’ ability in performing activities of daily living (ADL) and health-related quality of life (HRQL) is scarce. This project aims to address this knowledge gap by evaluating the effects of a structured home rehabilitation intervention for older adults, called Re@home. Research questions (RQ): 1. What is the effectiveness of the Re@home in comparison to usual rehabilitation among older on a) ability in ADL performance, b) HRQL, c) care utilization, and significant others’ d) perceived caregiver burden? 2. How do older adults and significant others experience their participation in the Re@home? 3. What facilitators and barriers influence the implementation process and the outcome of the Re@home? Data and methods This is a randomised controlled cluster trial that will be conducted in Stockholm, Jönköping and Luleå reflecting differences in population, urban and rural areas, and approaches to organize home rehabilitation. The project adheres to the Medical Research C ouncil framework for complex interventions. The intervention is based on several pre-studies funded by Forte (Dnr 2021-01791)(literature review, field observations, interviews, a feasibility evaluation, a concluded in a mixed-method synthesize of data from the pre-studies). 180 participants over the age of 65 will be recruited from 12 home rehabilitation units (4 clusters /each site). The principles of Re@home consist of content (person-centred assessment and activities), strategies used to engage the older adults in a shared decision-making process, duration and context, taking the home environment into consideration. Occupational therapists and physiotherapists at the units will participate in a preparation training course and receive reminders about the intervention to ensure consistency in delivery. Primary outcome
    performance in ADL. Secondary outcomes
    HRQL, satisfaction with the intervention, use of care and social services and caregiver burden (RQ1). Interviews with the older adults and their significant others will be performed to grasp their experiences of Re@home (RQ2). Barriers and facilitators of the implementation will be evaluated with focus groups and questionnaires (RQ3). Societal relevance and utilisation Rehabilitation is vital to improve performance in ADL and HRQL. Therefore, it is central that older adults are invited to shared decision-making throughout the intervention process in line with person-centred rehabilitation and integrated care (SOU 2019:29). This project addresses the importance of scientific-based home rehabilitation interventions to improve care and social services for older adults. Effective rehabilitation reducing costs for care and social services is important given the demographic challenges, including an increasing number of people over the age of 80 with potential health issues (SoU 2016: 2). This is combined with fewer people working and contributing taxes to society, as well as the shortage of and difficulties in recruiting staff. This project will contribute to address these societal challenges, and the results can be implemented to counteract these challenges. Plan for project realization The multi-professional project group (i.e. occupational therapists, physiotherapists, social worker, nurse, an implementation scientist), are all well experienced researchers in the design used in this project. We are applying for funding (4.9 million SEK) for three years with costs mainly related to research staff, enabling staff at rehabilitation units to participate, data collection, analysis and dissemination of findings. The ongoing collaboration with rehabilitation units at all sites in the pre-studies will be further deepened, which is vital to proceed with the proposed project plan.
  • Re@home – Evaluation of home rehabilitation for older adults: unraveling the black box
    Kamprad Family Foundation
    1 September 2025 - 31 August 2028
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2025 - 31 December 2027
    Research problem and specific questionsCoordination of healthcare activities is of particular importance for older people in need of geriatric care as they often have multiple conditions and health related needs, requiring  care from several providers. The overall aim of this research project is to introduce and evaluate a person-centered care transition model that is currently being developed through co-creation with end-users to improve the coordination of care after discharge from geriatric inpatient care. The project is divided in three phases with the following research questions: (1) is the new care transition model feasible in a local setting? (2) is the care transition model effective when evaluated in a cluster randomized-controlled trial (RCT)? (3) what are the prerequisites for implementation and how do patients, next of kin and staff experience the care transitions process?Data and methodPhase I is a feasibility study where the new model will be evaluated in terms of fidelity, applicability and acceptability using focus groups, individual interviews and questionnaires. We will also evaluate the model’s preliminary effect on total costs after discharge, their distribution between payers, and rate of readmission using register data. In phase II and III a refined model (based on the results from the feasibility study) will be introduced and evaluated with an effect and process evaluation using the same type of methods as in phase I. The primary outcome in the cluster RCT will be total costs.Societal relevance and utilizationThis proposal targets the societal challenge of providing coordinated services between social services and healthcare to an aging population in a fragmented system. If coordination of care between different responsible providers of health and social care is improved, it may have significant positive impact for the older adults, involved staff, and the society. This project takes an overarching approach and evaluates costs across the health and social care system.Plan for project realizationFOU nu (asset manager) has a close collaboration with the geriatric departments in the region, the primary care centres and units within the municipalities as well as with patient representative organizations that we are collaborating with in the ongoing project. This, as well as ongoing collaborations with other R&D-units within the region, gives us an excellent possibility to ensure that the project is realized as described.
  • PoPEx: Evaluation of a digital tool for preoperative exercise before abdominal cancer surgery and exploring prerequisites for implementation
    Karolinska Institutet, SFO-V
    9 September 2023 - 31 August 2025
  • CANOPTIPHYS/mHealth: OPTimizing preoperative PHYSical function in older persons undergoing abdominal C ANcer surgery
    Karolinska Institutet, Research school in health science
    1 September 2023 - 31 August 2024
  • CANOPTIPHYS/mHealth - OPTImizing PHYSical function before CANcer surgery: development and evaluation of mHealth support for older people
    Karolinska Institutet, SFO-V
    1 December 2021 - 31 December 2023
  • Swedish Research Council for Health Working Life and Welfare
    1 November 2021 - 31 October 2025
  • Swedish Research Council for Health Working Life and Welfare
    1 November 2021 - 31 October 2025
  • CANOPTIPHYS: OPTImizing PHYSical function before surgery: effects on complications and quality of life after gastrointestinal CANcer surgey in older people at risk – a randomized controlled trial
    Cancer Research Foundation
    1 January 2020 - 31 December 2024
  • Swedish Research Council
    1 January 2020 - 31 December 2022
  • Swedish Research Council for Health Working Life and Welfare
    1 December 2014 - 30 November 2017

Staff and contact

Group leader

All members of the group

Other people connected to the group

  • Andersson, Mikael
  • Naseer, Mahwish

Projects

CANOPTIPHYS

The aim of the CANOPTIPHYS RCT is to evaluate the effect of preoperative exercise on complications after gastrointestinal cancer surgery in older persons at risk. It is a joint study between Karolinska University, South General and, Ersta hospital, Academic Primary Care Center and Karolinska Institutet.

PoPEx

The purpose of the PoPEx project is to provide motivational support for preoperative exercise and remote support to monitor complex and time-consuming interventions more efficiently. The service/product will use mHealth solutions, such as mobile applications (for smartphone, iPad, etc.) and accelerometers for providing training instructions, feedback and contribute to increasing the motivation to exercise. The digital solution will also support objective measurement of physical activity and provide the possibility to measure compliance.

Coordination of care after discharge in a complex healthcare landscape

In this research project will address the following five overarching questions that are designed to map and assess the study population and the subject descriptively (I-II), analyse associations statistically (III), generate and refine viable ideas for addressing and improving the situation (IV), and finally start implementing new and improved ways of working (V). 

Re@home - Evaluation of home rehabilitation for older people

The aim of the Re@home project is to evaluate the state of home rehabilitation in relation to scientific evidence and the effectiveness on older persons’ well-being, participation and ability in daily activities as well as the older persons satisfaction with the interventions, the collaboration between social service- and health care providers, and level of service utilization. The design is based on the realist evaluation method, where a defined program theory is used as a base for the evaluation.

SOPHI- Selfcare in Older Persons with Heart failure Intervention

The overall aim of project SOPHI is to evaluate the effects of a selfcare program with individualized physical exercise in combination with dietary advice and symptom management for elderly, frail persons with heart failure. The project is a collaboration between Karolinska Universitetssjukhuset and Karolinska Institutet.