International Journal of Integrated Care最新文献

{"title":"An International Competency Framework for High-Quality Workforce Development in Integrated Care (IC): A Modified Delphi Study Among Global Participants.","authors":"Frances Barraclough, Jennifer Smith-Merry, Viktoria Stein, Sabrina Pit","doi":"10.5334/ijic.8258","DOIUrl":"https://doi.org/10.5334/ijic.8258","url":null,"abstract":"<p><strong>Introduction: </strong>There have been increasing calls in the literature recommending training in integrated care (IC) for health and social care professionals. Although studies have focused on different stakeholders' perceptions of education and training, there is no consistent definition of the key competencies or approach to implementing these competencies among health and social care providers. This study used a modified Delphi consensus-building method with global panellists with experience in delivering and designing training in IC to ascertain which competencies are important in an international framework guiding workforce development in IC.</p><p><strong>Methods: </strong>A four-step methodological process was used. First, a scoping review identified a potential list of competencies and features of education and training in IC. Second, predefined criteria were used to identify global panellists with IC education experience. Third, two anonymous iterative Delphi rounds were conducted to (1) reach a consensus on the level of importance of the competencies and key themes to be included and (2) identify existing models of training in IC. This was followed by the analysis of the Delphi study and presentation of the results.</p><p><strong>Results: </strong>A list of eight domains and 40 competencies was generated. Twenty-one panellists reviewed the competencies in the first and second round. The highest importance rankings were allocated to person-centred care, interprofessional teamwork and care coordination. The lower-ranking domains focused on professional workforce attributes.</p><p><strong>Discussion and conclusion: </strong>The study provides a global consensus on the competencies required for workforce training and development in IC and offers recommendations on how these competencies can be implemented in higher education and vocational institutions and workplace settings. The results will be useful for developing policy and curriculum by health and education providers and accreditation bodies.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 2","pages":"11"},"PeriodicalIF":2.4,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863082","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":"Integrated Health and Social Home Care Services in Catalonia: Professionals' Perception of its Implementation, Barriers, and Facilitators.","authors":"Pilar Hilarión, Anna Vila, Joan C Contel, Sebastià J Santaeugènia, Jordi Amblàs-Novellas, Rosa Suñol, Conxita Barbeta, Aina Plaza, Emili Vela","doi":"10.5334/ijic.7530","DOIUrl":"https://doi.org/10.5334/ijic.7530","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the implementation of integrated social and health home care services (HCS) offered by the Government of Catalonia, and to identify the main barriers and facilitators of integrated HCS.</p><p><strong>Methods: </strong>Analysis of the degree of implementation of integrated social and health HCS perceived by social care services (SCS) and primary health care centers (PHCs) between December 2020 and June 2021 in two phases. First, the perception of integration by social workers within SCS and PHCs was assessed using a screening questionnaire. Then, SCS in counties with the highest integration scores received a customized questionnaire for an in-depth assessment.</p><p><strong>Results: </strong>A total of 105 (100%) SCS and 94 (25%) PHCs answered the screening questionnaire, and 48 (45.7%) SCS received a customized questionnaire. The most frequent barrier identified was the lack of shared protocols, with the most frequent facilitator being the recognition of the importance of integrated HCS.</p><p><strong>Conclusions: </strong>Our study showed that the degree of implementation of integrated health and social HCS offered by the Government of Catalonia was perceived as low. The identified barriers and facilitators can be used to facilitate such implementation. Further studies should include professionals other than social workers in PHC assessments.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 2","pages":"10"},"PeriodicalIF":2.4,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11049598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860098","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":"Implementation of Interprofessional Pharmaceutical Care Initiatives: Lessons Learned from Successful Bottom-Up Initiatives in Primary Care.","authors":"Indira Coenen, Elyne De Baetselier, Veerle Foulon, Tinne Dilles","doi":"10.5334/ijic.7581","DOIUrl":"https://doi.org/10.5334/ijic.7581","url":null,"abstract":"<p><strong>Introduction: </strong>Although there is evidence that interprofessional, person-centred, integrated care is important for optimising pharmaceutical care of older people with polypharmacy, this way of working is often not implemented in practice. The aim of this study was to identify common characteristics of successful interprofessional initiatives and factors influencing their implementation, in order to close this know-do gap.</p><p><strong>Methods: </strong>A qualitative, explorative design with in-depth semi-structured interviews was used. Flemish primary healthcare professionals (HCPs) and patients aged over 75, involved in successful initiatives of interprofessional pharmaceutical care for older people with polypharmacy, were included. Inductive analysis was conducted to identify main topics.</p><p><strong>Results: </strong>Fifteen HCPs and four patients, involved in nine interprofessional initiatives, were interviewed. In all initiatives the HCPs had interprofessional consultations about older people with polypharmacy. The interaction between the characteristics of the initiatives and the context had an important impact on the implementation. These context factors were positioned under the micro-, meso- and macro context. Implementation strategies, actions to enhance the initiatives' adoption, corresponded with three themes: communication and influence, coordination by different stakeholders, and (dis)incentives.</p><p><strong>Conclusion: </strong>The identification of these success factors might inspire HCPs, providers of interprofessional education and policymakers to facilitate interprofessional pharmaceutical care.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 2","pages":"5"},"PeriodicalIF":2.4,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11012220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862170","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 Women Exit Sex Work: A Contribution Analysis of the Exit Doors Here Integrated Care Program in Toronto, Canada.","authors":"Martine Shareck, Pearl Buhariwala, Maha Hassan, Ermelina Balla, Patricia O'Campo","doi":"10.5334/ijic.7700","DOIUrl":"10.5334/ijic.7700","url":null,"abstract":"<p><strong>Introduction: </strong>Exiting sex work is a complex process which can be facilitated by integrated action on health and its social determinants such as housing and employment. Few programs offer such coordinated support, and even fewer have been evaluated. We assessed if and how Exit Doors Here, a program anchored in the Critical Time Intervention (CTI) model, facilitated women's progress towards their goals, and exit from sex work.</p><p><strong>Description: </strong>We performed a contribution analysis by combining pre-post questionnaire and administrative data from 55 women enrolled in the program (2018-2021), yearly interviews with program staff and peer mentors, and literature reviews to assess program outcomes and mechanisms as described in the theory of change.</p><p><strong>Discussion: </strong>We found evidence that the program contributed to participants progressing on their pre-employment, housing, income, and sex work exiting goals. We identified four \"key ingredients\" facilitating success: trust building, collaborative goal setting, connecting with community supports and weekly drop-in sessions.</p><p><strong>Conclusion: </strong>This rigorous theory-based evaluation provides much needed evidence on the process and effectiveness of an integrated sex work exiting program. Findings regarding key program ingredients can inform other interventions serving similarly marginalized populations.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"22"},"PeriodicalIF":2.4,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318247","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":"Leading by Example: IJIC's Journey to Strengthen Lived Experience in Research, Improvement, and Scientific Publishing.","authors":"Robin Miller, Viktoria Stein, Heather Penwarden, Eskil Degsell, Ghislaine Rouly, Ivette Fullerton, Susan Royer","doi":"10.5334/ijic.8622","DOIUrl":"10.5334/ijic.8622","url":null,"abstract":"","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"21"},"PeriodicalIF":2.4,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206834","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 a Qualitative Data Analysis Codebook for Arterial Hypertension and Type-2-Diabetes Integrated Care Evaluation.","authors":"Črt Zavrnik, Nataša Stojnić, Majda Mori Lukančič, Monika Martens, Katrien Danhieux, Savina Chham, Matic Mihevc, Tina Virtič Potočnik, Zalika Klemenc Ketiš, Josefien van Olmen, Antonija Poplas Susič","doi":"10.5334/ijic.7691","DOIUrl":"10.5334/ijic.7691","url":null,"abstract":"<p><strong>Introduction: </strong>Non-communicable diseases, such as arterial hypertension (HTN) and type-2 diabetes (T2D), pose a global public health problem. Integrated care with focus on person-centred principles aims to enhance healthcare quality and access. Previous qualitative research has identified facilitators and barriers for scaling-up integrated care, however the lack of standardized terms and measures hinder cross-country comparisons. This paper addresses these gaps by presenting a generic codebook for qualitative research on integrated care implementation for HTN and T2D.</p><p><strong>Description: </strong>The codebook serves as a tool for deductive or deductive-inductive qualitative analysis, organizing concepts and themes from qualitative data. It consists of nine first level and 39 second level themes. First level codes cover core issues; and second level codes provide detailed insights into facilitators and barriers.</p><p><strong>Discussion: </strong>This codebook is more widely applicable than previously developed tools because it includes a broader scope of stakeholders across micro, meso, and macro levels, and the themes being derived from highly diverse health systems across high- and low-income countries.</p><p><strong>Conclusion: </strong>The codebook is a useful tool for implementation research on integrated care for HTN and T2D at global scale. It facilitates cross-country learning, contributing to improved implementation, scale-up and outcomes.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"20"},"PeriodicalIF":2.6,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206833","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":"Legal Needs Arising in Mental Health Settings and Staff Capability and Support to Respond.","authors":"Suzie Forell, Sarah O'Connor","doi":"10.5334/ijic.7693","DOIUrl":"10.5334/ijic.7693","url":null,"abstract":"<p><strong>Introduction: </strong>Legal issues are known to affect and be affected by mental health. But to what extent do legal issues surface in mental health settings and what do staff feel they need to support clients experiencing these issues? These questions were explored by a national mental health service interested in the potential for health justice partnership with local community based legal services.</p><p><strong>Methods: </strong>A survey of 999 frontline staff of a national mental health organisation. 146 staff (15%) responded from 70 service sites across Australia, including peer support workers (47%), support workers (20%), team leaders (17%) and clinicians (15%).</p><p><strong>Results: </strong>Staff identified a wide range of legal issues experienced by their clients (commonly referred to by staff as consumers), most commonly credit, debt and social security issues, housing, family law and family violence. Two-thirds (67%) of respondents indicated that they spent around 50% <i>or more</i> of their time 'responding to these types of issues'. Respondents indicated that they need more support to address legal issues facing their clients, particularly more knowledge of other services, connections with professionals in other organisations and connections with community. They also felt they could benefit from additional processes, tools, and resources, and time to manage their case load.</p><p><strong>Originality: </strong>While there is an emerging field of research exploring the legal capability of citizens, this study explores what mental health service staff feel they need to support consumers experiencing legal issues that can interact with mental health.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"19"},"PeriodicalIF":2.4,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206835","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":"Examining the Role of Third Sector Organization Volunteers in Facilitating Hospital-to-Home Transitions for Older Adults - a Collective Case Study.","authors":"Michelle L A Nelson, Marianne Saragosa, Hardeep Singh, Juliana Yi","doi":"10.5334/ijic.7670","DOIUrl":"10.5334/ijic.7670","url":null,"abstract":"<p><strong>Introduction: </strong>With increasing attention to models of transitional support delivered through multisectoral approaches, third-sector organizations (TSOs) have supported community reintegration and independent living post-hospitalization. This study aimed to identify the core elements of these types of programs, the facilitators, and barriers to service implementation and to understand the perspectives of providers and recipients of their experiences with the programs.</p><p><strong>Methods and analysis: </strong>A collective case study collected data from two UK-based 'Home from Hospital' programs. An inductive thematic analysis generated rich descriptions of each program, and analytical activities generated insights across the cases.</p><p><strong>Results: </strong>Programs provided a range of personalized support for older adults and addressed many post-discharge needs, including well-being assessments, support for instrumental activities of daily living, psychosocial support, and other individualized services directed by the needs and preferences of the service user. Results suggest that these programs can act as a 'safety net' and promote independent living. Skilled volunteers can positively impact older adults' experience returning home.</p><p><strong>Conclusions: </strong>When the programs under study are considered in tandem with existing evidence, it facilitates a discussion of how TSO services could be made available more widely to support older adults in their transition experiences.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"16"},"PeriodicalIF":2.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10906339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023965","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":"Integration of Dementia Systems in Central America: A Social Network Approach.","authors":"Nereide A Curreri, Dave Griffiths, Louise Mccabe","doi":"10.5334/ijic.7630","DOIUrl":"10.5334/ijic.7630","url":null,"abstract":"<p><strong>Introduction: </strong>Action 3 of the UN Decade of Healthy Ageing plan is to deliver integrated care to improve older adults' lives. Integrated care is vital in meeting the complex needs of people with dementia but little is known about how this is or could be delivered in low and middle income countries (LMIC). This paper provides insights into previously unknown care system structures and on the potential and reality of delivering integrated care in Central America for people with dementia.</p><p><strong>Methods: </strong>A social network analysis (SNA) methodology was adopted to engage with providers of services for older adults and families with dementia in Guatemala, El Salvador, Honduras, Costa Rica and Panama. Sixty-eight (68) semi-structured interviews were completed, 57 with organisations and 11 with families.</p><p><strong>Results: </strong>Across the five countries there was evidence of fragmentation and low integration within the dementia care systems. A variety of services and types of providers are present in all five countries, and high levels of diversified connections exist among organisations of differing disciplines. However, unawareness among network members about other members that they could potentially form active links with is a barrier on the path to integration.</p><p><strong>Conclusion: </strong>This innovative and robust study demonstrates SNA can be applied to evaluate LMIC care systems. Findings provide baselines of system structures and insights into where resources are needed to fortify integration strategies. Results suggest that Central American countries have the building blocks in place to develop integrated care systems to meet the needs of people with dementia, but the links across service providers are opportunistic rather than context based coordinated integration policies.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"15"},"PeriodicalIF":2.4,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10906335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021720","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":"Access to Affordable Health: A Care Delivery Model of GNRC Hospitals in North-Eastern India.","authors":"Nomal Chandra Borah, Priyanka Borah, Satabdee Borah, Madhurjya Borah, Purabi Sarkar","doi":"10.5334/ijic.7587","DOIUrl":"10.5334/ijic.7587","url":null,"abstract":"<p><strong>Introduction: </strong>The healthcare delivery system of Assam faces several challenges to provide affordable, accessible and quality care services. GNRC (Guwahati Neurological Research Center) is the first super-speciality hospital to address many of these gaps by delivering integrated affordable healthcare services to the populations of Assam and other parts of North-eastern India.</p><p><strong>Description & discussion: </strong>This paper describes the implementation of a care delivery model which provides integrated care delivery services through linking hospitals to primary healthcare services, including preventive, promotive, and curative care, along with delivering easily accessible and affordable care to the people of Assam and other parts of North-eastern India.</p><p><strong>Conclusion: </strong>The proposed model is the first innovative approach from North-eastern India, Assam, to deliver affordable, accessible and patient-centric hospital led community-based preventive, promotive, and primary, secondary, and tertiary hospital-based care. It is anticipated that GNRC's \"Affordable Health Mission\" will help redesign and integrate the way primary, secondary and tertiary healthcare is delivered to the population of Assam in helping patients manage their own health and reduce the numbers that needs to be admitted to secondary care and tertiary care by improving patients' independence and well-being as well as dramatically reducing the cost to the overall health system.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"14"},"PeriodicalIF":2.4,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10906341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021719","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}