Realist evaluation of social outcomes in community care: the application of affordance theory to the Lindsay Leg Clubs

Abstract

a n d H a r di n g, Keit h 2 0 2 1. R e alis t e v al u a tio n of s o ci al o u t c o m e s in c o m m u ni ty c a r e : t h e a p plic a tio n of affo r d a n c e t h e o ry t o t h e Lin d s ay Le g Cl u b s. Jou r n al of C ri tic al R e alis m 2 0 (3) , p p .

Journal of Wound Management November 2022

“…Although all articles reviewed reported credible findings that offered faithful descriptions of members' attendance at the LLC, 15 of them presented findings whose 'fittingness', could have been improved by greater incorporation of adequate and appropriate data to warrant the claims (24). In this respect, direct member quotes were deemed to be of the highest rigour, but few studies contained such quotes and only one study (25) acknowledged that where such quotes were offered, they had been paraphrased rather than reported verbatim. Therefore, paraphrased quotes could reflect the researchers' recall bias, affecting the strength of the narrative evidence.…”

“…Aspects of the empowerment of members with chronic wounds through health education were reported in nine articles. (25,29,33,34,39,42,43,47,49).…”

“…One member explained 'it is good to meet other members in the same position as yourself' (34), another that 'it was good to be in surroundings with people with similar problems, who were making progress' (44). The importance of chatting to 'other people who understand' (48) was also stressed, elsewhere linked to a reduction in the feeling of being stigmatized as 'everyone has the same' so there was ''nothing to hide' (25).…”

“…However, proximity to other members and their wounds was sometimes upsetting, as one member reported seeing how 'horrible legs can be' (25).…”

“…The search was performed in June 2021. Most of the evidence on LLC members' experiences is described in qualitative and mixed methods publications (25). Such studies tend to have smaller sample sizes and, generally, richer but non-generalisable findings about behaviours and experiences conceptualised with use of subjective constructs; therefore, to standardise the strategy, we used the SPIDER tool developed by Cooke et al (23).…”