Complex systems, complex practice, complex outcomes: A call for the development of complexity-informed implementation models (CIIM) for traditional, complementary, and integrative medicine.

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE European Journal of Integrative Medicine Pub Date : 2023-11-03 DOI:10.1016/j.eujim.2023.102314
Kim D. Graham, Hope Foley, Jon Adams, Amie Steel
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Abstract

Introduction

Implementation science is the vehicle for ensuring that research evidence informs and shapes clinical practice. However, implementation models structured along linear and mechanistic lines are not necessarily aligned with the complexity of clinical practice. In this article we explore the development and value of a complexity informed implementation model primarily for use in traditional, complementary, and integrative medicine.

Discussion

Conventional linear mechanistic models of knowledge translation may be insufficient to address the needs of real-life clinical practice. Existing implementation models may pose particular challenges for use in traditional, integrative, and complementary systems of medicine due to their holistic orientation and perspective of human organisms as whole complex systems nested within other complex systems. This paper discusses how a complexity informed implementation model, non-linear in nature and founded on iterative processes, may better reflect the complex nature of the traditional, integrative, and complementary medicine clinical encounter and patient as a complex adaptive system.

Conclusion

The emergence of complexity science provides an opportunity to re-imagine implementation models and processes to support the translation of evidence into traditional, complementary, and integrative systems of medicine. We propose a complexity-informed implementation model to better meet the complex needs of real-life clinical practice.

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复杂系统、复杂实践、复杂结果:呼吁为传统医学、补充医学和中西医结合医学开发基于复杂性的实施模式(CIIM)。
实施科学是确保研究证据告知和塑造临床实践的工具。然而,沿着线性和机械线结构的实施模型不一定与临床实践的复杂性相一致。在本文中,我们探讨了主要用于传统医学、补充医学和综合医学的复杂性知情实现模型的发展和价值。传统的知识转化的线性机制模型可能不足以解决现实临床实践的需要。现有的实施模式可能对传统、综合和补充医学系统的使用构成特别的挑战,因为它们的整体取向和人类有机体作为嵌套在其他复杂系统中的整体复杂系统的观点。本文讨论了基于迭代过程的非线性复杂知情实施模型如何更好地反映传统、综合和补充医学临床治疗和患者作为复杂适应系统的复杂性。复杂性科学的出现为重新设想实施模式和流程提供了机会,以支持将证据转化为传统的、互补的和综合的医学系统。我们提出了一个复杂知情的实施模式,以更好地满足现实生活中临床实践的复杂需求。
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来源期刊
European Journal of Integrative Medicine
European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
4.70
自引率
4.00%
发文量
102
审稿时长
33 days
期刊介绍: The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.
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