International Journal of Integrated Care最新文献

{"title":"Behavioural Change in Practice: Primary Care Providers' Journey Towards Goal-Oriented Care.","authors":"Reini Haverals, Sibyl Anthierens, Peter Pype, Carolyn Steele Gray, Kris Van den Broeck, Pauline Boeckxstaens","doi":"10.5334/ijic.9067","DOIUrl":"10.5334/ijic.9067","url":null,"abstract":"<p><strong>Introduction: </strong>The demand for person-centred integrated care (PC-IC) requires health services focused on patients' individual needs. Strengthening primary care is crucial in promoting PC-IC. Goal-oriented care (GOC) prioritizes patient goals and fosters interprofessional team-based care, optimizing PC-IC. GOC requires healthcare providers to shift from problem- to goal-oriented practices. However, how providers change their daily practice to align care with what matters most to patients remains unclear.</p><p><strong>Aim: </strong>This qualitative study explores how primary care providers (PCPs) experience behaviour change when implementing GOC in daily work after an interprofessional GOC-training.</p><p><strong>Method: </strong>Six months post-training, focus groups with PCPs were organized. A theoretical thematic analysis was conducted using the Capability, Opportunity, Motivation, and Behaviour (COM-B) model.</p><p><strong>Results: </strong>Twenty-two PCPs participated in five focus groups. Motivational factors catalysed behaviour change towards GOC, including developing awareness on care actions through reflective practice. PCPs identified capabilities such as asking person-centred questions, maintaining a broad knowledge and enhancing their advocacy for patients. Opportunities stressed team support, care continuity, and reflexivity-promoting workplaces as vital for enabling behavioural change in GOC.</p><p><strong>Conclusion: </strong>Reflective practice is vital for aligning PCPs' behaviour with GOC. Involvement of all colleagues and dedicated time for reflection promote team alignment and consistency in achieving patients' personal goals.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"22"},"PeriodicalIF":2.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804433","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":"How Do Older People Experience Person-Centred Integrated Care? An Integrative Review of the Evidence.","authors":"Sarah Murphy, Tanya McCance, P J White","doi":"10.5334/ijic.9066","DOIUrl":"10.5334/ijic.9066","url":null,"abstract":"<p><strong>Background: </strong>'Person-centred integrated care' (PCIC) emerged in literature, policy and practice to meet the increasing care needs of an older population living longer with increased levels of chronic illness, multimorbidity and at enhanced risk of care fragmentation. Most evaluations of PCIC have been service-centred, rather than person-centred, and there is a lack of research on the effects of integrated care on patients, especially older people.</p><p><strong>Methods: </strong>This integrative review explored evidence regarding older people's PCIC experiences, synthesising empirical literature from five databases: Medline, PsycInfo, CINAHL, Embase and Web of Science.</p><p><strong>Results: </strong>Findings included: i) definitions and components of integrated care and conceptualisations of person-centredness in the context of integrated care; ii) older people's positive PCIC experiences featured: coordination; continuity and relational care; involvement in care, including effective communication and information about care; and holistic care; iii) integrated care optimises care when successfully delivered, however, older people's experiences were mixed; and iv) barriers included a lack of integrated care frameworks developed from patients' perspectives, poor communication and information and staff shortages and turnover leading to discontinuity, limited time for meaningful interactions and follow-up care.</p><p><strong>Conclusion: </strong>While PCIC optimises care experiences, its evaluation is challenged by multiple conceptualisations and lack of engagement with service users.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"21"},"PeriodicalIF":2.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804508","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":"Older People and Unpaid Carers' Experiences of Hospital-at-Home.","authors":"Mark Tompkins, Robin Miller, Denise Tanner","doi":"10.5334/ijic.10181","DOIUrl":"10.5334/ijic.10181","url":null,"abstract":"<p><p>Hospital-at-Home (HaH) delivers hospital-level treatment in the home, whether people's own dwelling or a care home. Its intention is to replicate medical interventions available in hospitals in familiar and less distressing surroundings for older people and better coordinate care around the needs of the individuals and their unpaid carers. This study set out to hear directly from those most closely involved, older people themselves, the unpaid carers who support them, and the professionals delivering the service. Drawing on forty-three in-depth interviews, the research highlights both advantages and tensions within the model. Many participants described HaH as respectful, personal, and more attentive than hospital care. Carers welcomed the speed and attentiveness of the service but often found their responsibilities increased, sometimes to a challenging degree. Professionals valued the opportunity to work in a more person-centred way while also pointing to practical obstacles around risk, resources, and coordination with wider services.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"20"},"PeriodicalIF":2.6,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12686338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145722514","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":"Supporting Transitions from Hospital to Home by Engaging Volunteers of Third Sector Organizations: A Scoping Review.","authors":"Michelle L A Nelson, Alana Armas, Marianne Saragosa, Evan MacEachern, Simrit Jhajj, Rachel Thombs, Shannon Thom, Rambel Palsis, Oya Pakkal, Hardeep Singh, Heather Cunningham","doi":"10.5334/ijic.9796","DOIUrl":"10.5334/ijic.9796","url":null,"abstract":"<p><strong>Introduction: </strong>The transition from hospital to home is a critical clinical juncture marked by significant risks. Third Sector Organizations (TSOs) are well-positioned to support these transitions through volunteer-based programs. Given the increasing complexity of patient needs and the push for reduced hospital lengths of stay, the integration of community resources into transitional care becomes vital.</p><p><strong>Objective: </strong>Study objectives were i) to identify where TSOs are engaged in supporting post-hospital transitions, ii) to document the characteristics of transitional care models delivered by TSOs, and iii) to characterize the clients participating in these volunteer-supported programs.</p><p><strong>Methods and results: </strong>Forty-eight articles that reported on a community-based program delivered by a third-sector organization supporting adults transitioning from hospital to home were included. Study results suggest that TSOs can fill critical gaps in transitional care by leveraging local knowledge and providing personalized, practical, and psychosocial support. TSOs leveraged volunteers to offer personalized, community-based support that addressed both practical and psychosocial needs during care transitions; however, significant variability in program structure and limited evaluation data hindered the assessment of effectiveness and transferability. All programs were time-limited, engaged volunteers in service delivery, and provided home-based and community-based services.</p><p><strong>Conclusions: </strong>This review highlights the importance of integrating volunteers and TSOs into health systems to develop a more comprehensive approach to transitional care. However, the scalability of volunteer and third-sector-facilitated programs may be challenged by a lack of consistency in programs and reporting, which can undermine transferability and evidence-based practice.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"19"},"PeriodicalIF":2.6,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12680005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145700716","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":"Correction: Exploring the Role of Volunteer Organizations in Developing Italy's Community-Based Care Model.","authors":"Federico De Luca, Giuliana Costa, Cristina Masella","doi":"10.5334/ijic.10219","DOIUrl":"10.5334/ijic.10219","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.5334/ijic.7881.].</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"18"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12679981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145700677","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 New Zealand System Level Measures Programme - a New Policy to Implement a Whole of System Performance Framework Using Health Alliances.","authors":"Kanchan M Sharma, Peter B Jones","doi":"10.5334/ijic.9043","DOIUrl":"10.5334/ijic.9043","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;In 2016, the New Zealand Ministry of Health (MoH) introduced a whole of system performance policy known as the System Level Measures (SLM) programme to deliver integrated care using health alliances. Alliances were trust-based collaborative networks introduced in 2013 to integrate the planning and delivery of health care between primary care and hospital settings. The SLM programme attempted to move away from narrow target-based and pay-for-performance approaches focused on single organisations to a shared responsibility and decision-making approach using alliances.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description: &lt;/strong&gt;The SLM programme was co-designed by the MoH and health sector clinicians, analysts, and managers. It consisted of six system level measures, each supported by a suite of contributory measures. System level measures were outcome focused while contributory measures focused more on process and activity. Alliances were responsible for leading the implementation of the SLM programme in their districts. Implementation of the programme required alliances to share health information and resources, identify priorities for their district, agree an improvement plan, and commit to delivering it. The MoH assisted the implementation process, provided access to data, approved the plan, monitored progress against the plan, and administered incentive funding for Primary Health Organisations. At the end of each year, alliances were expected to review and reflect on their successes and failures to inform the following year's plan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Success with implementation of the programme varied and was influenced by two key factors. First, there was a lack of sponsorship from the centre. This meant that although there was sector support for the programme, there was a lack of leadership and adequate resourcing from the centre to sustain the programme. Second, the MoH expected alliances to use the SLM programme to improve their local relationships, develop their capacity and capability for improvement and improve their maturity as a network. Reflection and evaluation of the SLM programme found that these were necessary pre-conditions for alliances to succeed with implementation of the programme. In the end, this improvement programme could not be reconciled with an accountability framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;New Zealand's SLM programme was a unique experiment with a new system performance framework to improve integration across the health system. Its implementation provides important lessons on the role of centre to create the right conditions for integrated care initiatives, such as the SLM programme, to succeed. We conclude that successful implementation of integrated care initiatives requires sponsorship and leadership from senior leaders, adequate and appropriate resourcing, right incentives, and most importantly a strong platform for a collaborative way of working which nurtures high-trust re","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"16"},"PeriodicalIF":2.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12662163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648514","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 Impact of Health and Social Care Integration on Children and Young People's Outcomes: What Can Be Determined from Scotland's Administrative Data?","authors":"Joanna Soraghan, Alexander McTier, Micky Anderson, Carol Ann Anderson, Emma Young, Adrian Bowman, Heather Ottaway","doi":"10.5334/ijic.9145","DOIUrl":"10.5334/ijic.9145","url":null,"abstract":"<p><strong>Introduction: </strong>The integration of services is often driven by the belief that integration will lead to better outcomes for service users. However, there is a paucity of robust evidence exploring the relationship between integration and outcomes. This study sought to determine whether the integration of health and social care services via Health and Social Care Partnerships has led to a measurable change in outcomes for Scotland's children and young people.</p><p><strong>Methods: </strong>Multilevel models were applied to routinely collected administrative data to determine whether different approaches to structural integration were related to changes in a range of outcomes for children and young people. The modelling approach accounted for confounding factors such as economic conditions and the COVID-19 pandemic.</p><p><strong>Results: </strong>The analysis found no consistent evidence of an association between the structural integration of services and changes in outcomes for children and young people. However, external factors such as deprivation and the COVID-19 pandemic were found to be linked to changes in outcomes across various areas of children's lives.</p><p><strong>Conclusions: </strong>The findings highlight the complexity in attributing changes in outcomes to a specific intervention or reform, particularly in the presence of wider socio-economic factors. Understanding the influence of systems-level change may not be fully possible using routinely collected data alone, and any methods used to assess impact should be underpinned by an underlying theory of change.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"17"},"PeriodicalIF":2.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12662158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648427","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":"Including People With Lived Experience in Research From Design to Publication: The Next Steps for the IJIC Community.","authors":"K Viktoria Stein, Robin Miller, Edelweiss Aldasoro, Michelle Nelson, Eskil Degsell","doi":"10.5334/ijic.10240","DOIUrl":"10.5334/ijic.10240","url":null,"abstract":"","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"15"},"PeriodicalIF":2.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12636276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587336","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":"Reimagining Intermediate Care: Reflections From the Community Hospital of the Future (CHoF) Pilot in Singapore.","authors":"Justin Guang Jie Lee, Qin Xiang Ng, Richard Wing Hong Chan, Jeffrey Jiang, Kelvin Wee Boon Koh","doi":"10.5334/ijic.9850","DOIUrl":"10.5334/ijic.9850","url":null,"abstract":"<p><p>As Singapore's population ages, community hospitals must evolve to meet increasingly complex care needs. In this perspective, we share reflections from leading the Community Hospital of the Future (CHoF) pilot at Jurong Community Hospital-a national initiative to enhance intermediate care. The pilot introduced proactive screening, expanded diagnostic capabilities, and intensified rehabilitation services. We reflect on the operational and policy challenges encountered, including fragmented data systems, workforce limitations, and financing gaps. The CHoF experience offers practical insights for other health systems seeking to strengthen sub-acute care as part of an integrated care strategy for ageing populations.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"14"},"PeriodicalIF":2.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12636278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587344","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 Ethnography of Caring Networks: Disentangling a Governance Order <i>In-the-Making</i>.","authors":"Oemar van der Woerd","doi":"10.5334/ijic.10221","DOIUrl":"10.5334/ijic.10221","url":null,"abstract":"<p><p>This thesis shifts attention from networks as well-demarcated governance structures to seeing networks as dynamic and emerging social phenomena. Drawing on ethnographic fieldwork in Dutch older person and hospital care, it explores how networking unfolds in everyday governance actions and interactions of affected actors, and with which consequences for their role and work. This thesis calls for a recalibration of network thinking, highlighting the multiple, ongoing, place-based, multi-layered, and multi-purpose nature of networking. Rather than romanticizing network governance, this thesis offers a critical-pragmatist perspective, inviting a 'romantic-realist' engagement with the lived messiness of networks as a governance order-in-the-making amidst healthcare reforms.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 4","pages":"13"},"PeriodicalIF":2.6,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648464","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}