International Journal of Integrated Care最新文献

{"title":"Using Governance to Elevate Voluntary and Community Sector Representation.","authors":"Andrea Bentz, Elizabeth Tanguay, Dania Versailles, Sylvie Lefebvre","doi":"10.5334/ijic.9121","DOIUrl":"10.5334/ijic.9121","url":null,"abstract":"<p><p>Archipel Ontario Health Team (OHT) developed as part of the provincial call to organize health and social service providers into integrated care delivery systems. With nearly 70 multi-disciplinary and multi-sectoral partners, unequal power dynamics must be considered when creating governance structures. With the aim of collaboratively elevating the voice of voluntary and community sector partners, Archipel OHT deliberately implemented a sustainable integrated governance strategy that encourages community and voluntary sector leadership and equitable shared decision-making. This perspective paper describes applied strategies, lessons learned, and efforts to maintain an environment that prioritizes their representation.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"15"},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12292038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Caregivers' Experiences of Formal Peer Support in a Finnish Setting - a Socioecological Understanding.","authors":"Sarah Åkerman, Fredrica Nyqvist, Annika Wentjärvi, Laura Coll-Planas","doi":"10.5334/ijic.9104","DOIUrl":"10.5334/ijic.9104","url":null,"abstract":"<p><strong>Introduction: </strong>Peer support programmes are important complementary support forms in integrated care. This study investigates formal peer support experiences among family caregivers in Finland by scrutinising multidimensional input and output mechanisms of emotional, informational, and appraisal support.</p><p><strong>Methods: </strong>Seventeen family caregivers were interviewed through focus group and individual interviews. The qualitative data was analysed using a socioecological model for formal peer support.</p><p><strong>Results: </strong>The family caregivers described their caregiving situation as a source of pain enabling receiving emotional support from peer support participants with similar experiences - although norms of privacy and taboo hindered participation. Organisational aspects of programme delivery such as setting expectations, rules of confidentiality, environmental setting, group dynamics and leadership influenced experiences of informational and appraisal support. Overburden created barriers to receiving emotional and informational peer support. The participants wanted to influence society and contribute to other family caregivers through formal peer support - highlighting its socioecological nature.</p><p><strong>Conclusions: </strong>Each attribute of peer support [emotional, informational, and appraisal support] formed its own, yet interlinked, ecosystem. Experiences of peer support are beyond programme delivery, and future studies could employ a socioecological framework when further delving into attributes of formal peer support among family caregivers in specific target groups and/or settings.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"14"},"PeriodicalIF":2.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12292041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the Intersectoral Care Reported by Patients Survey for Primary and Oral Healthcare.","authors":"Kirsten P J Smits, Marieke M van der Zande, Reanne Hek, Pim W J J Assendelft, Fred R Rozema, Kenneth R Wright, Maria C Dolce, Christine A Riedy, Jane R Barrow, Fabian Hüttig, Stefan Listl","doi":"10.5334/ijic.8933","DOIUrl":"10.5334/ijic.8933","url":null,"abstract":"<p><strong>Introduction: </strong>Oral and general health are closely related, and many oral and chronic-systemic diseases have the same risk factors. However, in most countries dental and general health care systems are separated. Integration of care for patients with closely related, multiple conditions is therefore important to ensure they receive the best quality of care. We aimed to develop a short and easy-to-understand survey to be used by patients to assess integration of dental and primary health care through their perceptions.</p><p><strong>Methods: </strong>This study used both qualitative and quantitative methods. A modified online Delphi method was used for development of the survey. A panel consisting of seven experts assessed the survey in three rounds. The experts were based in the United States, Germany and the Netherlands and had different professional backgrounds, including general practice and dentistry. The initial framework and set of proposed questions were based on a previous survey with a similar focus. During two discussion rounds and one online round the framework and the questions were assessed and modified by the experts. The survey was then assessed for understandability among 18 patients and thereafter piloted among 199 patients.</p><p><strong>Results: </strong>The final questionnaire derived from the consensus procedure contains thirteen questions which address the following five domains: patients' wishes, expectations, awareness and concerns regarding communication between health care providers; patients' perception of health care providers' knowledge; health care provider-patient communication about health status; utilization of health care; and self-rated health. The consensus procedure also yielded improvements in the understandability of survey items: one survey item was changed from a multiple-choice question into a yes/no question, answer options were added to three other survey items, four survey items were slightly changed in wording, and five items remained unchanged.</p><p><strong>Conclusion: </strong>We developed the short, easy-to-understand Integrated Care Reported by Patients Survey to assess integration of dental and primary health care as perceived by patients. In the future, the developed survey is intended to be tested for validity and translated to other languages. The survey provides opportunities for usage in research and as a tool in quality improvement and feedback systems for health care providers.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"13"},"PeriodicalIF":2.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12292054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the Paradox of Intercultural Collaboration in Integrated Community Care: An Interpersonal Dialogue.","authors":"Mina Ishimaru, Naonori Kodate, Sanae Murai, Ghislaine Rouly, Antoine Boivin","doi":"10.5334/ijic.8596","DOIUrl":"10.5334/ijic.8596","url":null,"abstract":"<p><strong>Introduction: </strong>Intercultural collaboration in integrated community care faces a paradox. Some view community care as a 'local craft', intimately embedded within its socio-cultural context, and therefore it cannot be exported. Others view it as 'interventions' that are transferable and scalable, like other health innovations. This article proposes a middle-ground approach, highlighting the role of interpersonal relationships as a foundation for intercultural collaboration in integrated community care.</p><p><strong>Description: </strong>Over a five-year period, we pursued an intercultural collaboration between two integrated community care initiatives in Canada and Japan. Both initiatives are grounded in the principles of community empowerment, linkages across health and social care, and complementarity of lived experience and professional knowledge. Our collaboration evolved in three interrelated phases: 1) intercultural discovery and exploration; 2) intercultural relationship-building and strengthening; and 3) intercultural explicitation and influence.</p><p><strong>Discussion: </strong>While the implementation science literature largely focuses on cognitive processes of knowledge exchange, our experience highlights deeper relational dimensions that are essential to intercultural learning and impact across community care initiatives, including socialisation among collaborators, beyond their professional roles and identities.</p><p><strong>Conclusion: </strong>Relational and socialisation processes should be recognised, nurtured and valued as integral components of intercultural collaborative efforts in integrated community care. Knowledge gained from this experience can inform cross-cultural efforts to support the global integrated community care movement.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"11"},"PeriodicalIF":2.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12292058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trusted Professional Multi-Agency Transitions for Young People Facing Multiple Disadvantage - Learning from Co-Production by a Third Sector Partner in the Plymouth Alliance, UK.","authors":"Gemma Doyle, Sean Mitchell, Sue Hawley, Katy Krysiak, Felix Gradinger","doi":"10.5334/ijic.9055","DOIUrl":"10.5334/ijic.9055","url":null,"abstract":"<p><strong>Introduction: </strong>This case study provides practice-based reflections on challenges and potential solutions for young people with multiple disadvantages across housing, substance misuse, mental health, criminal justice, and domestic abuse systems, informed by 4 local principles: trauma informed, learning based, an alliance commissioning ethos, and workforce development.</p><p><strong>Description: </strong>To improve the current experiences of 17-25-year-olds in service transition iterative insights drew from networking staff across sectors, clinical audit and following live cases, and appreciative enquiries with young people. This was conducted by a practitioner researcher in a local Young Person's charity and was supported by peer researchers with lived experience and embedded researchers-in-residence.</p><p><strong>Discussion: </strong>This describes the scale of the challenge where compound need and intersectional disadvantage, wider determinants, complex pathways, and public and third sector service systems collide. Relational practices were tested to support navigating system challenges, better tailor to young people's abilities and needs and improve integrated care partnership working and workforce development.</p><p><strong>Conclusion: </strong>Plymouth has a history of integration with the Alliance for Complex Needs. Context and localised solutions matter for integrating care, yet remain underreported especially for underserved, and marginalised young people and using whole systems approaches co-produced with the third sector. Investment into academia-practice partnerships is crucial to make learning portable.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"12"},"PeriodicalIF":2.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12292045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Day Care in the Provision of Integrated Services for Older People.","authors":"Ailsa M Cameron, Laura Bennett, Joanna Thorn, Demi Patsios","doi":"10.5334/ijic.9052","DOIUrl":"10.5334/ijic.9052","url":null,"abstract":"<p><strong>Introduction: </strong>Day care services have a long history in the support of older people, both internationally and in England. However, despite their longevity there is no consensus about the aims of day care services and their contribution to integrated care is unrecognised. This paper defines day care as community building-based services that provide care and/or health related services and/or clubs and activities specifically for older people (65+) with care and support needs, which support wellbeing and health, and/or support people to remain living at home and/or enable informal carers to sustain care.</p><p><strong>Methods: </strong>The paper draws on qualitative data collected in a national study to reimagine day care services for older people in England. Eight sites participated, all from the voluntary sector.</p><p><strong>Results: </strong>Day care services act as both a site of, and facilitator to, integrated care and whilst settings experienced many of the challenges faced by voluntary sector organisations, including a reliance on limited and uncertain funding, they had developed a range of strategies to partially manage them.</p><p><strong>Conclusions: </strong>Collective forms of day care services have the potential to play a more significant role in the provision of local place based integrated care in England.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"10"},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Framework for Implementing Integrated HIV and Non-Communicable Disease Care at Primary Health Care Facilities in Southern Africa.","authors":"Maureen Moyo-Chilufya, Tennyson Mgutshini, Charles Hongoro, Alfred Musekiwa","doi":"10.5334/ijic.8944","DOIUrl":"10.5334/ijic.8944","url":null,"abstract":"<p><strong>Introduction: </strong>Comorbidities of HIV/AIDS and non-communicable diseases (NCDs) are increasingly prevalent, affecting up to 30% of individuals living with HIV/AIDS, particularly in Sub-Saharan Africa. Conventional approaches that treat NCDs separately from HIV/AIDS care have been deemed inefficient, highlighting the need for integrated models. This study aims to develop a framework for integrating NCD care into HIV programs at primary healthcare facilities in Southern Africa.</p><p><strong>Methods: </strong>As part of a broader study examining the burden, extent and cost of HIV/NCD integration we employed a modified 'Best fit' framework synthesis method. Thematic analysis was the primary method of analysis used to inform the framework.</p><p><strong>Results: </strong>The study expanded on existing framework themes related to effective team-working, organizational leadership, patient-centered care, community/patient/provider partnerships. It introduced seven additional themes: country specific NCD prioritization, multi stakeholder partnerships, healthcare worker mental wellbeing, unified health information systems, with enhanced privacy, establishing costing databases for HIV/NCD integrated care, robust monitoring and evaluation mechanisms, and opportunities for regional coordination.</p><p><strong>Conclusion: </strong>Improving existing frameworks for integrating HIV/NCD care is feasible by leveraging established HIV care platforms. These enhancements can support more efficient holistic healthcare delivery across primary healthcare facilities in Southern Africa.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"8"},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Health and Health-Related Domains on Professionals' Perceptions of Care Complexity, Their Preferences for Integrated Care Planning and Interprofessional Collaboration.","authors":"Lisa-Maria van Klaveren, Vincent G M Geukers, Rien de Vos","doi":"10.5334/ijic.8997","DOIUrl":"10.5334/ijic.8997","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing healthcare complexity necessitates the integration of perspectives from professionals with diverse expertise, patients, and families for optimal care. However, there is no consensus on 'care complexity', and expectations for integrated care planning vary. This study examines how different health domains influence professionals' perceptions and preferences.</p><p><strong>Methods: </strong>Ninety-eight medical doctors and nursing professionals assessed care complexity, integrated care planning needs, and interprofessional collaboration using thirteen paper cases based on five domains from the International Classification for Functioning (ICF). Conjoint analysis explored perceptions, preferences, and variations by occupation and work experience.</p><p><strong>Results: </strong>Higher care complexity and need for integrated care planning were linked to impairments of body functions, complex personal factors in terms of chronic health condition and medical needs, and external factors. Allied health, social, and external professionals were more frequently included in multidisciplinary team meetings based on domain-specific complexities. Medical doctors showed a greater tendency than nursing professionals to involve family in integrated care planning.</p><p><strong>Discussion: </strong>The study identifies key drivers of care complexity and integrated care planning, revealing occupation- and experience-based differences. Addressing these differences is crucial for improving interprofessional collaboration.</p><p><strong>Conclusion: </strong>This research provides a multidimensional view of care complexity, highlighting the factors that shape professionals' preferences for integrated care planning.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"9"},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guiding Principles for Transformation Towards Integrated Acute Care for Older Adults Close to Home: Lessons from Nine Dutch Regional Partnerships. A Realist Evaluation.","authors":"Eline D Kroeze, Gercora Hoitinga, Susanne M Smorenburg, Janet L MacNeil Vroomen, Anneke J A H van Vught, Bianca M Buurman","doi":"10.5334/ijic.8967","DOIUrl":"10.5334/ijic.8967","url":null,"abstract":"<p><strong>Background: </strong>Integrated Acute Care for Older People (IACOP) close to home is a promising approach to overcome care fragmentation, but little is know about effective meso- and macro-strategies to foster integration. This Realist Evaluation (RE) explores which strategies were employed and recommended in nine Dutch regional partnerships.</p><p><strong>Methods: </strong>The Rainbow Model, RE-theory, Coleman's boat and ripple effects functioned as theoretical basis. We conducted a document analysis (n = 19), semi-structured interviews (n = 11) and two focus groups (n = 8). Participants were (project) managers, directors and experts. The qualitative data were clustered into guiding principles, underpinned with strategy-context-mechanism-outcome configurations.</p><p><strong>Results: </strong>Six guiding principles for transformation towards IACOP close to home emerged. Meso-level principles included: 1) committing to a shared regional IACOP vision and goals; 2) fostering a culture of collaborative and coordinated action; 3) prioritising, implementing and developing micro-level interventions systematically. Macro-level principles were: 4) ensuring congruent policy; 5) stimulating functional integration and 6) stimulating normative integration.</p><p><strong>Conclusions: </strong>Transforming towards IACOP close to home is complex and requires continuous action across integration levels, health practices and sectors. The meso-level principles guide regional partnerships in applying context-specific strategies; activating the underlying mechanisms for transformation like 'enjoying the process'. Yet, successful transformation also hinges on actions by system stakeholders.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"7"},"PeriodicalIF":2.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Management for People with Acquired Brain Injury with Complex Problems (Part 1): Outcomes of a One-group Trial.","authors":"Annemarie P M Stiekema, Bjorn Winkens, Desiree Bierlaagh, Mireille Donkervoort, Natska Jansen, Kitty H M Jurrius, Judith Zadoks, Caroline M van Heugten","doi":"10.5334/ijic.8649","DOIUrl":"10.5334/ijic.8649","url":null,"abstract":"<p><strong>Introduction: </strong>Many people with acquired brain injury (PwABI) and their family face long-term psychosocial problems and unmet needs. Currently, there are no structural and integrated health care services supporting life after brain injury. We evaluated Case Management (CM) for PWABI which aims to facilitate access to and integration of health care and social services for people with complex problems.</p><p><strong>Methods: </strong>One-group repeated measures study including 62 PwABI and 36 caregivers in the Netherlands. Assessments were conducted every six months for 18-24 months. Primary outcome was psychosocial well-being (Hospital Anxiety and Depression Scale). Secondary outcomes were self-efficacy, participation, life satisfaction, and needs for PwABI and caregivers; and caregiver burden.</p><p><strong>Results: </strong>Anxiety reduced significantly in both PwABI and their caregivers. Over time, PwABI reported significantly fewer unmet needs, but more participation restrictions. Caregivers reported significantly less caregiver burden and more self-efficacy over time.</p><p><strong>Discussion: </strong>CM seems promising for reducing unmet needs in PwABI and improving some psychosocial outcomes in PwABI and caregivers. Lifelong CM may however be necessary. A randomized controlled study is needed to confirm whether the positive outcomes are due to CM.</p><p><strong>Conclusion: </strong>This study warrants further research to establish the effectiveness of CM for PWABI.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"5"},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}