Implementation of cross-sectoral rehabilitation in the Nordic countries: a scoping review.

Introduction: Rehabilitation needs are rising in the Nordic countries due to an aging population and declining health profiles Methods: This Scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The search strategy aimed to identify published, peer-reviewed primary studies on interventions implemented in adult rehabilitation within Nordic countries. Data were charted following Levac et al.'s framework and analyzed using Elo & Kyngäs' content analysis to identify factors influencing implementation. Key study characteristics and implementation approaches were synthesized narratively and in tables. Results: Thirty-six papers were identified. Most studies described the implementation of rehabilitation transitioning from the secondary to the primary sector. A top-down implementation approach was predominantly reported and appears more facilitating than a bottom-up approach. Implementation of rehabilitation across sectors is influenced by an interplay of factors: (1) Organization & Resources: alignment of context with intervention, involvement from front-line personnel, time & resources, the workplace itself, and managers, and (2) Collaboration & Communication, including knowledge and competence, attitudes, communication, patients, and families. Conclusion: While this scoping review conveys that collaboration, communication, resources, and organization have a central role affecting the implementation of cross-sectoral rehabilitation, it further identifies knowledge gaps, such as the lack of the patients' perspective, the use of a framework or other systematic approach to ensure the success of the implementation.