International Journal of Integrated Care最新文献

{"title":"Integrating Non-Clinical Supports into Care: A Systematic Review of Social Prescribing Referral Pathways for Mental Health, Wellbeing, and Psychosocial Improvement.","authors":"Samantha Spanos, Shalini Wijekulasuriya, Louise A Ellis, Maree Saba, Tanja Schroeder, Charlotte Officer, Yvonne Zurynski","doi":"10.5334/ijic.9127","DOIUrl":"10.5334/ijic.9127","url":null,"abstract":"<p><strong>Introduction: </strong>Social prescribing (SP) involves person-centred integration of non-clinical supports into care, which is critical for addressing mental health and psychosocial needs and enhancing wellbeing. This systematic review evaluated the impact of SP referral pathways on mental health, wellbeing, and psychosocial outcomes.</p><p><strong>Methods: </strong>Four databases (Medline, Embase, PsycINFO and Scopus) were searched for empirical studies of referral pathways to community-based SP interventions targeting mental health, psychosocial factors and/or wellbeing. Data from studies published from January 2010 to April 2024 were extracted; referral pathways, interventions, and their resultant outcomes were synthesised and tabulated.</p><p><strong>Results: </strong>Across the 30 included studies, 27 SP interventions and two main referral pathways were identified, involving providers across health, community, social, and voluntary care sectors. Quantitative outcomes (<i>n</i> = 21, 70%) most frequently measured were wellbeing, anxiety, depression and quality of life. Findings were mixed, and widely varying methodological approaches limited study comparability. Qualitative outcomes (<i>n</i> = 16, 53%) were mostly associated with social interactions (e.g., increased sense of belonging) and self-concepts and feelings (e.g., increased sense of purpose).</p><p><strong>Discussion and conclusion: </strong>Research on SP referral pathways supporting mental health, wellbeing and psychosocial outcomes is proliferating, but high heterogeneity in the evidence base limits conclusive inferences about effectiveness. Standardised quantitative measurement of core outcomes, supplemented by rigorous qualitative designs, will enhance capacity to demonstrate the value of an SP approach to integrated care for mental and psychosocial health and wellbeing.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"21"},"PeriodicalIF":2.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953173","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":"Charting the Course Together: Municipal Top-Level Managers' Perspectives on Fostering Safe and Integrated Care for Older Adults Living at Home.","authors":"Heidi Hagerman, Mirjam Ekstedt, Mia von Knorring, Cecilia Fagerström, Sara Tolf, Lisa Smeds Alenius","doi":"10.5334/ijic.8916","DOIUrl":"10.5334/ijic.8916","url":null,"abstract":"<p><strong>Introduction: </strong>Top-level managers in municipal social care administration play a central role in ensuring high-quality care through coordination within and between organisations. However, there is limited understanding of the specific tasks and responsibilities they undertake in this regard. Therefore, this study aimed to explore municipal top-level managers' perspectives on fostering safe and integrated care for older adults with complex care needs living at home.</p><p><strong>Methods: </strong>Thirteen top-level managers in municipal social care administration were interviewed. Interview data were analysed thematically.</p><p><strong>Results: </strong>One theme 'Leading through trust and empowerment, and encouraging collaborations within and between organisations to foster safe and integrated care' and five subthemes were identified: 'Creating conditions for seamless care by minimising cross-organisational barriers', 'Using the mandated role when navigating the bigger picture', 'Empowering middle managers and nursing staff', 'Fostering trust in working towards a common goal' and 'Leveraging successful partnerships across organisations'.</p><p><strong>Conclusion: </strong>Top-level managers see themselves as parts of a larger system that requires them to collaborate with others. Empowering middle managers and nursing staff to thrive in their roles, through leadership based on trust, promotes a unified effort toward the common goal of safe and integrated care for older adults with complex care needs.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"20"},"PeriodicalIF":2.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953141","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":"Third Sector Organisations' Contributions to the Health and Care Ecosystem.","authors":"Sanna Tuurnas, Henna Paananen, Anna-Aurora Kork","doi":"10.5334/ijic.9813","DOIUrl":"10.5334/ijic.9813","url":null,"abstract":"<p><strong>Introduction: </strong>In integrated care models, third sector organisations (TSOs) are essential but often undervalued parts of the health and care ecosystem to address care fragmentation and inequity of access. In this study, we illustrate the value contributed by TSOs in a co-production setting.</p><p><strong>Methods: </strong>In this qualitative study, frame analysis was used to explore the varied interpretations of TSOs' value contributions at different levels of the ecosystem. The qualitative interview data were collected from 16 informants in the context of a Nordic welfare state, Finland. The interviewees represented a variety of health and care TSOs.</p><p><strong>Results: </strong>The resulting frames were seen as organising principles that are socially shared. The analysis revealed a threefold interpretative schema of TSOs' value contributions: strengthening the ideals of civil society, advancing the public service system and connecting people to communities.</p><p><strong>Discussion: </strong>The findings demonstrate that TSOs contribute values in health and care ecosystems at all levels-micro, meso and macro-by integrating short- and long-term policy objectives, ensuring that their actions result in meaningful and sustainable benefits across all levels of the public service ecosystem.</p><p><strong>Conclusions: </strong>This study underlines the need to integrate civil society into the health and care ecosystem and, specifically, to acknowledge the holistic contribution of TSOs when developing integrated care models. The key contribution of this study is demonstrating the diverse ways in which TSOs can contribute value for integrated care.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"19"},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799035","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":"Assessing Readiness and Sustainability for Integrated Care in Ontario, Canada with the Integrated Care Leadership Survey.","authors":"Ruth E Hall, Kevin Walker, Nusrat S Nessa, Walter P Wodchis","doi":"10.5334/ijic.7539","DOIUrl":"10.5334/ijic.7539","url":null,"abstract":"<p><strong>Introduction: </strong>Ontario, Canada, is shifting to a more integrated healthcare delivery system through the Ontario Health Team (OHT) initiative. The extent to which OHTs have the capabilities to engage in integrated care is unknown and important to designing implementation supports. This article describes the development and psychometric testing of the Ontario Integrated Care Leadership Survey (OICLS), in 30 OHTs. The OICLS was informed by the Context and Capabilities for Integrated Care framework (CCIC).</p><p><strong>Methods: </strong>The 42-item survey was distributed electronically to 765 eligible leaders across 30 OHTs; 480 (63%) responded representing approximately 600 organizations. Item analyses and scale psychometric analyses were undertaken to reduce the number of items in the CCIC survey tool while maintaining validity and reliability.</p><p><strong>Results: </strong>The OICLS survey is comprised of 10 domains covering 12 of 17 capabilities identified in the CCIC. In the total sample, Cronbach's alpha exceeded 0.7 for nine of the ten domains. Descriptive responses to each of the 39 OICLS closed-ended survey questions illustrate the areas of strength and weakness and where supports are warranted to advance the formation of integrated care delivery systems.</p><p><strong>Conclusion: </strong>The OICLS offers a brief and valid assessment of foundational aspects of multi-organizational integrated care initiatives.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"18"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775343","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 Potential: The Potential Impact of 'Happymakers' in Alleviating the Labor Shortage in Dementia Care Work: The Paradigm Shift From Care To Well-Being At An Amsterdam-Based Long-Term Care Facility.","authors":"Caroline Van Dullemen, Petra Boersma, Henk Nies","doi":"10.5334/ijic.8579","DOIUrl":"10.5334/ijic.8579","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to identify success factors and challenges of an integrated care model, with an underlying goal of addressing the labor shortage in dementia care. The research investigates the interdisciplinary communication in a long-term care facility in Amsterdam, focusing on the collaboration between the so-called 'Happymakers' (non-medically trained staff) and qualified personnel. The Relational Coordination Theory serves as theoretical framework, emphasizing the need for shared goals, knowledge, and mutual respect for effective communication.</p><p><strong>Methods: </strong>Using qualitative methods, the research involved interviews with thirty staff members in 2022.</p><p><strong>Results: </strong>Work satisfaction was rated very positively. The collaboration between the 'Happymakers' and qualified care workers was generally positive, perspectives on risk perception and task alignment varied. Trust and a culture allowing mistakes were deemed crucial.</p><p><strong>Discussion conclusion: </strong>Overall, the findings suggest that the integration model which includes the paradigm shift from care to well-being, positively influences care quality as well as job satisfaction potentially alleviating the labor market shortage. The study suggests further research on strategies for integrating formal with informal care work and comparative research between integrated dementia care and more traditional, medical oriented types of care.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"17"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775344","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 Mixed-method Study on the Implementation of a Medical Psychiatric Care Unit.","authors":"Chedwa Pinto, Maaike Meeder, Jan Busschbach, Witte Hoogendijk, Jelmer Alsma, Isabelle Fabbricotti, Maarten van Schijndel","doi":"10.5334/ijic.8964","DOIUrl":"10.5334/ijic.8964","url":null,"abstract":"<p><strong>Introduction: </strong>Medical Psychiatry Units (MPUs) offer integrated care for patients needing both medical and mental healthcare in hospitals. MPUs provide unique care not covered by Psychiatric Consultation-Liaison Services (PCS). Despite their increasing number, little research exists on why referrers choose MPUs, though their perspectives shape patient populations and reflect MPU goals.</p><p><strong>Aims: </strong><b>1.</b> Asses physician satisfaction with the Erasmus Medical Center MPU and its alignment with initial expectations.<b>2a.</b> Evaluate whether referrals match the intended patient population needing disruptive behavior management and compare this with PCS referrals.<b>2b.</b> Identify unintended reasons for MPU referrals.</p><p><strong>Method: </strong>We conducted interviews with physicians and analyzed questionnaires on MPU or PCS referrals from November 2020 to May 2021.</p><p><strong>Results: </strong><b>1.</b> Physicians report that the MPU improves care quality, job satisfaction, collaboration, safety, educational value and reduces stigmatization.<b>2a.</b> Among 62 referrals, the MPU admitted nearly twice the disruptive patients.<b>2b.</b> Common MPU referral reasons included nursing care load, department expertise and suicidality, while PCS referrals were more often due to delirium.</p><p><strong>Conclusion: </strong>The Erasmus MC MPU meets its founding goals. Physicians recognize its added value, particularly in managing patients with disruptive behaviors and high care needs. The integration of medical and psychiatric expertise has fulfilled expectations.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 3","pages":"16"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775342","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":"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}