82 Chapter 4 (4) family participation; (5) task-oriented training; (6) enriched environment; and (7) team dynamics.11 Although internationally there is a growing interest in the principles of this relatively new concept, there is no official scientific-based definition of the CRE. This results in considerable differences between rehabilitation wards in the interpretation of rehabilitation in general and the execution of a CRE specifically. Because of these differences in interpretation, the seven mentioned components are not guaranteed to cover all aspects of the CRE, and the question emerges regarding which aspects are found to be relevant by stakeholders besides the seven aspects found in the literature. To date, no evidence-based conceptualization of CRE has been developed, and empirical evidence for the added value of CRE for rehabilitants is lacking. The current study is part of the CREATE study (Challenging REhAbiliTation Environment).13 In this part of the CREATE study, we explore the perspectives of professionals regarding CRE. Methods Study Design To explore the perspectives of professionals on the concept of the CRE, a qualitative study consisting of focus groups and workshops was performed between September 2018 and January 2020. The primary aim of qualitative research is to gain a better understanding of a phenomenon through the experiences of those involved.14 As not all components relevant to CRE are identified, a qualitative study is indicated to gain a better understanding of the concept of the CRE. A waiver of consent was issued by the Medical Ethical Committee of the Leiden University Medical Center. This study did not apply to the Medical Research Involving Human Subjects Act (N19.024).11,13 We adhered to the consolidated criteria for reporting qualitative research (COREQ), which aim to improve the quality of reporting this type of research (see Supplemental table).15
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