Realist evaluation of a nurse case manager function – strengths and limitations

Mette Geil Kollerup, Connie Berthelsen, Marie Germund Nielsen, Mette Leisgaard Riis Rasmussen, Sofie Amalie Guldborg, Birgitte Lerbæk

Research output: Contribution to conference without a publisher/journalAbstractResearchpeer-review


Background: Internationally, hospital settings are experiencing an increased number of patients with multi-morbidity. These patients can be challenging to manage in hospitals due to the highly specialised practices that characterises these settings. Support interventions such as nurse case managers (NCMs) has been developed in response to the change in population demographics and trends of increasing inequality in health. To improve services for patients with complex health and social issues, four registered nurses were employed as NCMs in the North Denmark Region. Due to the diversity and complexity of the targeted patients’ health situations as well as the many actors and processes involved in their healthcare trajectories the NCM function could be characterized as a complex intervention. However, as the intervention is poorly described, the ‘value’ of the intervention is hard to determine.

Methods: A realistic evaluation of the NCM function was conducted in order to improve the intervention description and to gain knowledge of ‘what works for whom, how in what circumstances?’. Researchers and NCMs developed a preliminary Mechanism-Context-Outcome (MCO) configuration based on existing literature, local documents and professional knowledge. New insights were produced through three studies: 1) an ethnographic study of NCMs everyday practices, 2) a population study examining the characteristics of the target group for NCMs, and 3) an interview study examining the perspectives of NCMs’ collaboration partners. Through these studies, the realist evaluation comprises an evidence based specification of the MCO configuration.

Conclusion: This presentation will focus on the strengths and limitations of conducting a realistic evaluation.
Original languageEnglish
Publication date2023
Publication statusPublished - 2023
EventNordic Conference in Nursing Research 2023 - Hilton Hotel, Reykjavik, Iceland
Duration: 2 Oct 20234 Oct 2023
Conference number: 5


ConferenceNordic Conference in Nursing Research 2023
LocationHilton Hotel
OtherThe main theme is “Methods and Networks for the future.” The conference showcases a variety of presentations on how to develop, strengthen and utilize research methods in nursing and healthcare. A cutting-edge topical venue will be assigned to technolog...
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