Abstract
The main focus of this paper is to discuss the importance of “evaluating the process of change” (i.e., process evaluation) in people with disability by studying their lived experiences. Detailed discussion is made about “why and how to investigate the process of change in people with disability?” and some specific examples are provided from studies on patient journey of persons with hearing impairment (PHI) and their communication partners (CPs). In addition, methodological aspects in process evaluation are discussed in relation to various metatheoretical perspectives. The discussion has been supplemented with relevant literature. The healthcare practice and disability research in general are dominated by the use of outcome measures. Even though the values of outcome measures are not questioned, there seems to be a little focus on understanding the process of change over time in relation to health and disability. We suggest that the process evaluation has an additional temporal dimension and has applications in both clinical practice and research in relation to health and disability.
Highlights
Disability and impairment have been defined in a number of ways, with either narrow or wider criteria
What sort of factors may have positively or negatively influenced the journey? Even though most people may consider reaching to place B as a success, some may decide not to undertake that journey again because of the difficult experiences they had through this journey or the opposite. This example may suggest that the process evaluation may to some extent highlight various factors that may not be understood through outcome measures
Our studies further developed these models by considering perspectives of persons with hearing impairment (PHI) and their communication partners (CPs) [21,22,23,24]
Summary
Disability and impairment have been defined in a number of ways, with either narrow or wider criteria. Various metatheoretical perspectives (i.e., philosophical standpoint) have been applied to disability research, for example, external realism (naıve realism), antirealism, and critical realism [10]. Whilst the values of outcome measures are not at question, there seems to be a little focus on understanding the process of change over time in relation to health and disability. A recent study by Laplante-Levesque et al provides an example of study with a focus on process of change over time in adults with hearing impairment seeking.
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