International Journal of Integrated Care最新文献

Background: This study aimed to develop consensus on the core elements of the Community Specialist Teams for Older People (CST OP) service model.

Methods: This study utilised a modified Delphi approach. World Café Focus Groups (n = 97) were facilitated to develop and refine statements which were included in a Real-Time Delphi survey.

Results: Four key themes were produced from the World Café Focus Groups data: Fundamentals of service design, Access and transitions of care, Team Functions and Quality improvement. Themes produced informed the CST OP Real-Time Delphi survey, which was completed by 77 participants, representing a response rate of 78%.

Conclusion: The modified Delphi approach has resulted in the refinement and agreement of a set of core CST OP statements that outline the key components of the CST OP service model which will guide future implementation and delivery of the CST OP model of care, ensuring consistency in the design and implementation of the CST OP model.

While the benefits of mentorship programs are well established, their effective design, implementation, and sustainability remain complex and challenging. This perspective paper contributes to the mentorship literature by presenting key lessons learned from the implementation of a mentorship program in the emerging field of integrated health and social care. We suggest that prioritizing thoughtful mentor-mentee matching, promoting flexible and adaptable mentoring meeting formats, offering clear guidance for structured mentoring meetings, and acknowledging the reciprocal value of mentoring relationships can inform strategic approaches to strengthening mentorship programs in integrated care and beyond.

Background: Cancer survival rates vary significantly between low and high-income areas. By leveraging community assets, healthcare inequities may be addressed. Nationally, Macmillan Cancer Support (Macmillan) (a national cancer charity) is working with local Voluntary and Community Sector (VCS) organisations to improve cancer care.In Plymouth, where cancer mortality is above average, Macmillan has partnered with the Zebra Collective (Zebra) (a community cooperative), Age UK Plymouth (a local charity), The Wolseley Trust (Social Prescribing team), and General Practice (GP) surgeries. In Spring 2024, the Plymouth Cancer Champions' Project (PCCP) launched to address these inequities through community-led approaches via peer-to-peer community engagement and volunteer recruitment.

Approach: This Integrated Care Case is a practice-based account of how through an embedded ethnographic action research approach, a small community cooperative (Zebra) is influencing its' local low-income community's understanding of and engagement with cancer care services from an asset-based community development approach.

Findings: The PCCP prioritises involving individuals with lived experience, including those from lower socio-economic status backgrounds, minoritised ethnic groups, and cancer-affected backgrounds, in leadership roles. This collaborative, community-driven approach fosters inclusivity, empowerment, and engagement, and a deep contextual understanding of the community context including barriers and strengths. Through an innovative asset-based community development approach, the deficit narrative is countered- enabling people-led change, influence and learning within cancer care inequity and integrated care.

Background: Integration of voluntary and statutory mental health services may address gaps in mental health care. The Community Mental Health Framework for Adults and Older Adults 2019 provided impetus for integration within England. It was unknown how, why, or under what circumstances integration would occur.

Methods: A realist evaluation of Framework implementation in Somerset was undertaken. The extent of change, and how, why and under what circumstances change occurred were evaluated. Embedded researchers collected observational and interview data, and reviewed internal records. Realist qualitative analysis created and tested a programme theory exploring the extent, cause, and impact of change.

Results: Services worked together to create an integrated mental health service using a cultural change model: new language prompted new ways of thinking and working. Programme theory testing demonstrated good extent of change. Voluntary sector integration helped address treatment gaps: all service users were offered a service. Mechanisms of change included: new language, relationship building, flexible working, and valuing voluntary sector services. Contextual factors affecting the extent of change included: balances of power, rigidity of statutory services, and trusting management.

Conclusions: Integrating services using a culture change model addresses gaps in mental health care. Optimal implementation requires addressing contextual barriers.

Introduction: Despite ongoing efforts to integrate health and social services, achieving integration in front-line practice remains challenging. This study explored collaboration in a multidisciplinary development group aimed at improving collaboration in one co-located health and social services centre in Helsinki, Finland. Drawing on the notion of knowledge practices as means for solving complex issues, the study analysed how collaboration and co-development are enacted within the group.

Description: Observational data collected from 11 development workshops were analysed using an abductive approach. The analysis identified three modes of collaboration: 1) one-sided knowledge sharing, 2) collaborative knowledge sharing, and 3) collaborative knowledge creation.

Discussion: Shared concepts and a new multidisciplinary service process supported collaborative modes for working, while some facilitation practices seemed to hinder them. The findings revealed a gap between the ideal of bottom-up development and the organisational conditions influencing it. A clear mandate and purposeful facilitation are critical to achieving the intended goals of such development initiatives.

Conclusion: Stronger theoretical foundations and explicit theories of change could enhance development efforts. This study identified theoretical concepts that illuminate collaboration as a contextually shaped set of social practices. These insights can contribute to the design and facilitation of practice-based development efforts.

Background: Persons with knee osteoarthritis suffer from a prevalent chronic condition requiring comprehensive treatment approaches. To effectively cater to their needs, healthcare professionals must adopt an integrated health perspective and collaborate across disciplines. This study aimed to understand the viewpoints of patients and healthcare professionals and identify factors influencing collaborative care for persons with knee osteoarthritis.

Methods: Semi-structured interviews were conducted with knee osteoarthritis persons and healthcare professionals involved in their care. Data analysis involved identifying common themes, patterns, and discrepancies among stakeholders. Interviews were coded using NVivo, and inductive analysis was employed to determine themes.

Results: Nine healthcare professionals from various disciplines and eight patients with knee osteoarthritis participated. Five main themes emerged: diagnostics, communication, training conditions, integrated health perspective, and Perceived collaboration and support from healthcare professionals. Persons with knee osteoarthritis sought comprehensive diagnoses and expressed satisfaction. Healthcare professionals faced barriers like limited integrated health perspective and time constraints, stressing the need for interdisciplinary training and collaboration.

Conclusion: Implementing an integrated healthcare vision is crucial for personalized care in chronic conditions like knee osteoarthritis. Continuous training and curriculum integration for healthcare professionals are necessary to prioritize integrated health perspectives and collaboration, thus better meeting the diverse needs of persons.

Introduction: Many older individuals face complex health and social care issues that require an integrated care approach. However, current health and social care services are often fragmented in terms of financing, organisation, and delivery, and therefore do not fit the needs of older individuals. Reablement is an innovative integrated approach that aims to 'help individuals to help themselves' by providing goal-oriented, person-centred care. An interdisciplinary team works intensively with individuals towards their goals, while considering their capabilities and contextual factors.

Description: The aim of this study was to assess the feasibility of a Dutch reablement programme in terms of acceptability, implementation, practicality, adaptation, integration, and limited efficacy. Using qualitative methods, six clients, three informal caregivers, eight care professionals, and one programme director were interviewed, complemented by data from electronic care files. Findings indicated positive stakeholder experiences.

Discussion: Despite positive experiences, three key challenges emerged: 1) behaviour change; 2) in- and external interprofessional collaboration; and 3) enrolment. The study underscores the complexity of implementing and integrating reablement in community care.

Conclusion: Our findings offer critical insights that could guide future efforts to implement reablement programmes more effectively.

Introduction: Worldwide, exposure to sexual violence has widespread consequences for survivors' health and for their communities. There is still insufficient understanding of how to design support and care services for survivors in a multiorganizational context. This study aims to map and explore support and care for survivors of sexual violence from a multiorganizational perspective in Sweden, to identify and understand common improvement areas.

Method: This study was conducted within a larger project called Survive which aims to improve support and care for survivors of sexual violence in Jönköping County in Sweden. This case study integrates qualitative data from interviews (n = 34) and an electronic survey (n = 95) with participants from eight organizations that provide support and care to survivors of sexual violence. Qualitative data was analysed using thematic analysis. The quantitative data from the electronic survey was evaluated to map the 'organizations' involvement in support and care provision by using descriptive statistics.

Results: The findings encompass four themes to improve support and care: 1) Systematic approaches to identifying exposure to sexual violence; 2) A need to improve the integration of existing supportive resources; 3) Need for an interlinked process for trauma therapy and long-term support; 4) The potential of developing capacity, competence and teamwork in trauma care.

Conclusion: It is essential to improve support and care for survivors of sexual violence by developing systematic approaches for identification of sexual violence, interlinked support and care processes as well as improved access and competence in trauma care.

Introduction: The scope of integrated care has evolved and broadened the past decades from specialist pathways to incorporate a more holistic approach. To identify such trends in evidence and knowledge, we analysed published papers in the International Journal of Integrated Care over a 10-year period.

Methods: From an initial set of 5.075 IJIC papers (2012-2022), 508 articles were selected after excluding several categories such as poster and conference abstracts. As no existing theoretical framework seemed to fit our study aim, we chose to focus specifically on two important areas in integrated care that are known for development; impact measurement and co-production in research.

Results: There was an overall growth of published papers in the journal. The papers predominantly feature contributions from Western regions, including Europe, the Western Pacific and the Americas. Results regarding impact measurement showed no clear overarching pattern over time. Engaging the target population as co-producers in the studies is still low (<5%).

Conclusions: Although the number of papers increased pointing towards more attention for integrated care, we could not identify any significant growth or advancement in the two crucial areas of co-production and impact measurement in integrated care research. These gaps need to be addressed accordingly in both practice and research.