121 The conceptualization of a Challenging Rehabilitation Environment a visit to the ward, and an informed consent form was signed by the participant and LT. Dutch professionals who were invited for the focus groups of the previous qualitative study were asked to participate in the concept mapping procedure. The selection procedure for these participants is described elsewhere.7 To achieve a sufficient number of professionals, additional participants were invited via the five above-mentioned GR wards. During the recruitment phase, from November 2021 to June 2022, we aimed to obtain input from different professional disciplines in the broad field of rehabilitation, e.g. medical doctors, physical therapists, occupational therapists, psychologists, speech and language therapist, and nurses. The selected professionals were invited by email to participate. Participants who did not respond to the first invitation were sent reminders after 2 weeks and after 6 weeks. We aimed for a sufficient mix of participants, i.e., 20 rehabilitants and informal caregivers, 20 nursing staff and 20 (para)medical staff, in order to give all relevant parties equal input in the analysis and the final conceptualization of CRE. The inclusion of participants continued until interim correlation analyses showed that a stable concept map was achieved. Concept mapping Included professionals were sent a link for participation. Rehabilitants and informal caregivers who were able to participate digitally were also sent a link to participate. Professionals, rehabilitants, or informal caregivers who were unable to participate digitally were visited by LT. They were given paper cards with the statements, and LT transported their results to the digital application Ariadne 3.0 in which the data were stored.13 Participants were asked to rate the statements according to importance for CRE on a five-point scale (1=least important, 5=most important). An equal distribution of 14 statements per assessment category was aimed for. After rating the 5
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