So what they do can be seen - A realist-informed evaluation of and theory refinement for a digital counseling tool to support family caregivers in Austria.
- 1Department Nursing Science with Focus on Person-centred Care Research, Karl Landsteiner University, Dr. Karl-Dorrek-Straße 30, Krems, 3500, Austria.
- 2Department Nursing Science with Focus on Person-centred Care Research, Karl Landsteiner University, Dr. Karl-Dorrek-Straße 30, Krems, 3500, Austria. [email protected].
Abstract
Background
Family Caregivers (FC) make a significant contribution to maintaining our care system and must be supported in their vital roles. Alles Clara (AC) is a digital service in Austria that addresses FCs, their challenges, and needs. This study aimed at evaluating the intended impact of AC and to refine its underlying program theory explaining how the impact comes about.Methods
Following a realist approach to evaluation, we considered multiple perspectives and data sources, including four online surveys (S1 n = 52, S2 n = 16, S3 n = 89, S4 n = 169), in-app tracking data, narrative interviews with FCs (n = 8) and two focus group interviews with counselors (n = 10). Quantitative data were analyzed using descriptive statistics, qualitative data were analyzed thematically and interpretatively. A confirmatory approach to theory building was chosen to test and refine the initial program theory.Results
The theory on how AC unfolds its impact is presented in two configurational models. FCs can access the digital service anonymously and independently of time and place. In digital counseling, FCs can build a trusting relationship with the counselors and thus receive person-centred counseling. They no longer feel alone with their situation, move on from problems to next steps and exit the counseling room strengthened. AC also has an impact on counselors, especially nursing staff. The counselors are empowered to provide person-centred counseling and can recognize the quality of their actions, make an impact from a distance and see meaning in their actions. They can show what nursing is and can do and thus develop pride in their work and profession.Conclusion
AC reveals a way to introduce the concept of person-centredness into a digital context. In this study, we explored counseling as a nursing intervention that takes place anonymously and distantly in digital space - a space in which what they do can be seen.
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BibTeX
@article{gabl2026what,
title = {{So what they do can be seen - A realist-informed evaluation of and theory refinement for a digital counseling tool to support family caregivers in Austria.}},
author = {Katharina Gabl and Theresa Clement and Jasmin Eppel-Meichlinger and Hanna Mayer},
journal = {BMC health services research},
year = {2026},
month = jul,
doi = {10.1186/s12913-026-15218-2},
url = {https://europepmc.org/article/MED/42928179},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - So what they do can be seen - A realist-informed evaluation of and theory refinement for a digital counseling tool to support family caregivers in Austria.
AU - Katharina Gabl
AU - Theresa Clement
AU - Jasmin Eppel-Meichlinger
AU - Hanna Mayer
PY - 2026
DA - 2026/07/28
JO - BMC health services research
DO - 10.1186/s12913-026-15218-2
UR - https://europepmc.org/article/MED/42928179
AB - Background Family Caregivers (FC) make a significant contribution to maintaining our care system and must be supported in their vital roles. Alles Clara (AC) is a digital service in Austria that addresses FCs, their challenges, and needs. This study aimed at evaluating the intended impact of AC and to refine its underlying program theory explaining how the impact comes about.Methods Following a realist approach to evaluation, we considered multiple perspectives and data sources, including four online surveys (S1 n = 52, S2 n = 16, S3 n = 89, S4 n = 169), in-app tracking data, narrative interviews with FCs (n = 8) and two focus group interviews with counselors (n = 10). Quantitative data were analyzed using descriptive statistics, qualitative data were analyzed thematically and interpretatively. A confirmatory approach to theory building was chosen to test and refine the initial program theory.Results The theory on how AC unfolds its impact is presented in two configurational models. FCs can access the digital service anonymously and independently of time and place. In digital counseling, FCs can build a trusting relationship with the counselors and thus receive person-centred counseling. They no longer feel alone with their situation, move on from problems to next steps and exit the counseling room strengthened. AC also has an impact on counselors, especially nursing staff. The counselors are empowered to provide person-centred counseling and can recognize the quality of their actions, make an impact from a distance and see meaning in their actions. They can show what nursing is and can do and thus develop pride in their work and profession.Conclusion AC reveals a way to introduce the concept of person-centredness into a digital context. In this study, we explored counseling as a nursing intervention that takes place anonymously and distantly in digital space - a space in which what they do can be seen.
SN - 1472-6963
ER -