This paper reports on an evaluation of a 'social participation' improvement project in a mental health care and care for the intellectually disabled setting. The main research question is how sociality (i.e. clients' social lives) was constructed and what consequences this had for the project and for the clients. We undertook a dual approach: investigating the predefined outcomes and analysing the improvement processes in terms of how these processes construct sociality. As to the predefined outcomes, clients' social networks were not widened, but clients felt significantly less lonely at the end of the project. In a bottom-up analysis of data gathered on the improvement processes, we articulated two ways of constructing sociality: individualization, in which clients had to verbalize their wishes (verbalization) and to act upon them more actively (enterprising); and normalization, in which a good social life was one embedded in 'normal' community. We argue that this (explorative) way of conceptualizing change corresponds with some of the quantitative findings but also brings to light aspects that would have gone unnoticed by using only the predefined outcomes. Therefore, a mixed methods approach in studying effectiveness is a fruitful addition to the quality improvement literature.

Community participation, Intellectual disability, Loneliness, Mental health services, Programme evaluation, Quality of health care,
Journal of Psychiatric and Mental Health Nursing
Erasmus MC: University Medical Center Rotterdam

Broer, T, Nieboer, A.P, Strating, M.M.H, Michon, H.W.C, & Bal, R.A. (2011). Constructing the social: An evaluation study of the outcomes and processes of a 'social participation' improvement project. Journal of Psychiatric and Mental Health Nursing, 18(4), 323–332. doi:10.1111/j.1365-2850.2010.01669.x