Pub Date : 2020-09-01DOI: 10.1177/2053434520959678
S. Baes, M. Horlait, S. Dhaene, M. Leys
Introduction Coordinating cancer care is challenging because of its complexity. To partly encounter this complexity, multidisciplinary team meetings (MDTMs) were implemented to evaluate diagnosis, discuss treatment options and collectively decide upon the most optimal patient care and treatment plan. In cancer trajectories, medical professionals have a coordinating role and final decision responsibility. As a consequence patient-centred non-biomedical information are easily overlooked during discussions in MDTMs. This study aims to uncover physicians’ perceived barriers regarding the uptake of psychosocial aspects and/or patient preferences in the cancer treatment decision-making process during Multidisciplinary Oncology Consultations (MOCs), a specific type of MDTM in Belgium. Methods Between March 2019 and May 2019 semi-structured interviews were conducted with twenty medical professionals specialized in oncology. Grounded theory principles were used to detect and classify perceived barriers and patterns emerging regarding the uptake of psychosocial information in the cancer treatment decision-making process. Results Although physicians showed an open attitude towards taking into account psychosocial aspects and patient preferences in treatment decisions, the majority of respondents is not convinced the MOC is the best place to discuss these aspects. Physicians reported organisational, work process, and health system related barriers. Discussion The MOC emerges as a medicalized form of team discussion that, in its current form, does not reach its objective of truly integrated multidisciplinarity as cancer care is demanding. The working practices of the MOC can be optimized to evolve towards a truly interdisciplinary approach.
{"title":"Physicians’ attitudes and perspectives regarding the uptake of psychosocial aspects and/or patient preferences during multidisciplinary team meetings in oncology","authors":"S. Baes, M. Horlait, S. Dhaene, M. Leys","doi":"10.1177/2053434520959678","DOIUrl":"https://doi.org/10.1177/2053434520959678","url":null,"abstract":"Introduction Coordinating cancer care is challenging because of its complexity. To partly encounter this complexity, multidisciplinary team meetings (MDTMs) were implemented to evaluate diagnosis, discuss treatment options and collectively decide upon the most optimal patient care and treatment plan. In cancer trajectories, medical professionals have a coordinating role and final decision responsibility. As a consequence patient-centred non-biomedical information are easily overlooked during discussions in MDTMs. This study aims to uncover physicians’ perceived barriers regarding the uptake of psychosocial aspects and/or patient preferences in the cancer treatment decision-making process during Multidisciplinary Oncology Consultations (MOCs), a specific type of MDTM in Belgium. Methods Between March 2019 and May 2019 semi-structured interviews were conducted with twenty medical professionals specialized in oncology. Grounded theory principles were used to detect and classify perceived barriers and patterns emerging regarding the uptake of psychosocial information in the cancer treatment decision-making process. Results Although physicians showed an open attitude towards taking into account psychosocial aspects and patient preferences in treatment decisions, the majority of respondents is not convinced the MOC is the best place to discuss these aspects. Physicians reported organisational, work process, and health system related barriers. Discussion The MOC emerges as a medicalized form of team discussion that, in its current form, does not reach its objective of truly integrated multidisciplinarity as cancer care is demanding. The working practices of the MOC can be optimized to evolve towards a truly interdisciplinary approach.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520959678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48131199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-27DOI: 10.1177/2053434520954619
R. V. D. van der Velden, A. Hermans, N. Pluymaekers, M. Gawalko, Bianca Vorstermans, H. Martens, Saskia Buskes, H. Crijns, D. Linz, J. Hendriks
During the coronavirus 2019 (COVID-19) pandemic, outpatient visits for patients with atrial fibrillation (AF), were converted into teleconsultations. As a response to this, a novel mobile health (mHealth) intervention was developed to support these teleconsultations with AF patients: TeleCheck-AF. This approach incorporates three fundamental components: 1) “Tele”: A structured teleconsultation. 2) “Check”: An app-based on-demand heart rate and rhythm monitoring infrastructure. 3) “AF”: comprehensive AF management. This report highlights the significant importance of coordination of the TeleCheck-AF approach at multiple levels and underlines the importance of streamlining care processes provided by a multidisciplinary team, using an mHealth intervention, during the COVID-19 pandemic. Moreover, this report reflects on how the TeleCheck-AF approach has contributed to strengthening the health system in maintaining management of this prevalent sustained cardiac arrhythmia, whilst keeping patients out of hospital, during the pandemic and beyond.
{"title":"Coordination of a remote mHealth infrastructure for atrial fibrillation management during COVID-19 and beyond: TeleCheck-AF","authors":"R. V. D. van der Velden, A. Hermans, N. Pluymaekers, M. Gawalko, Bianca Vorstermans, H. Martens, Saskia Buskes, H. Crijns, D. Linz, J. Hendriks","doi":"10.1177/2053434520954619","DOIUrl":"https://doi.org/10.1177/2053434520954619","url":null,"abstract":"During the coronavirus 2019 (COVID-19) pandemic, outpatient visits for patients with atrial fibrillation (AF), were converted into teleconsultations. As a response to this, a novel mobile health (mHealth) intervention was developed to support these teleconsultations with AF patients: TeleCheck-AF. This approach incorporates three fundamental components: 1) “Tele”: A structured teleconsultation. 2) “Check”: An app-based on-demand heart rate and rhythm monitoring infrastructure. 3) “AF”: comprehensive AF management. This report highlights the significant importance of coordination of the TeleCheck-AF approach at multiple levels and underlines the importance of streamlining care processes provided by a multidisciplinary team, using an mHealth intervention, during the COVID-19 pandemic. Moreover, this report reflects on how the TeleCheck-AF approach has contributed to strengthening the health system in maintaining management of this prevalent sustained cardiac arrhythmia, whilst keeping patients out of hospital, during the pandemic and beyond.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520954619","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43092618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-27DOI: 10.1177/2053434520954362
Augustine E Okoh, O. Akinrolie, H. Bell-Gam, Isreal Adandom, M. Ibekaku, M. Kalu
Introduction There is a growing interest in collaborative care for older adults in Nigeria; however, little is known about the application of a transdisciplinary approach to care in a typical Nigerian geriatric unit. Therefore, we described healthcare professionals’ (HCPs’) perception of a transdisciplinary approach to older adults’ care in Southern Nigeria. Methods Using Stakian’s approach to a qualitative case study, we purposively invited 16 HCPs working in the geriatric unit of a teaching hospital in Nigeria to a single, in-depth, semi-structured interview. We analysed data using Stakian’s approach of categorical aggregation and direct interpretation. Results Our participants identified five-key features of a transdisciplinary approach to care: consolidated consultation, consolidated care documentation, care files accessibility, shared care decision and a designated care manager. HCPs stated that transdisciplinary approach to care allowed for a consolidated consultation of patients, with all the HCPs (in the same room or via telehealth/telemedicine) and care decisions should be shared between all stakeholders and documented in an accessible unified electronic care document that is managed by a care manager. Factors ranging from lack of consensus on time for a consolidation consultation to inter-professional conflicts were perceived as possible hindrances to a transdisciplinary approach to older adults’ care. Discussion The features of transdisciplinary care described in this study partly aligned with the WHO’s integrated care for older people (ICOPE). Additional components not captured in ICOPE were found. While the description of transdisciplinary was from the perceptive of our study participant, caution should be applied when interpreting these findings.
{"title":"Nigerian healthcare workers’ perception of transdisciplinary approach to older adults’ care: A qualitative case study","authors":"Augustine E Okoh, O. Akinrolie, H. Bell-Gam, Isreal Adandom, M. Ibekaku, M. Kalu","doi":"10.1177/2053434520954362","DOIUrl":"https://doi.org/10.1177/2053434520954362","url":null,"abstract":"Introduction There is a growing interest in collaborative care for older adults in Nigeria; however, little is known about the application of a transdisciplinary approach to care in a typical Nigerian geriatric unit. Therefore, we described healthcare professionals’ (HCPs’) perception of a transdisciplinary approach to older adults’ care in Southern Nigeria. Methods Using Stakian’s approach to a qualitative case study, we purposively invited 16 HCPs working in the geriatric unit of a teaching hospital in Nigeria to a single, in-depth, semi-structured interview. We analysed data using Stakian’s approach of categorical aggregation and direct interpretation. Results Our participants identified five-key features of a transdisciplinary approach to care: consolidated consultation, consolidated care documentation, care files accessibility, shared care decision and a designated care manager. HCPs stated that transdisciplinary approach to care allowed for a consolidated consultation of patients, with all the HCPs (in the same room or via telehealth/telemedicine) and care decisions should be shared between all stakeholders and documented in an accessible unified electronic care document that is managed by a care manager. Factors ranging from lack of consensus on time for a consolidation consultation to inter-professional conflicts were perceived as possible hindrances to a transdisciplinary approach to older adults’ care. Discussion The features of transdisciplinary care described in this study partly aligned with the WHO’s integrated care for older people (ICOPE). Additional components not captured in ICOPE were found. While the description of transdisciplinary was from the perceptive of our study participant, caution should be applied when interpreting these findings.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520954362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48711924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-28DOI: 10.1177/2053434520945087
Paul Wankah, Maxime Guillette, Thomas Lemaître, L. Belzile, Y. Couturier
Introduction The implementation of integrated care models requires significant efforts, especially due to institutional and organisational inertial forces that characterize health and social care systems of developed countries. It is therefore crucial to deploy strategies that promote continuous adjustment to these barriers so as to improve the benefits of integrating care. Measuring the implementation and effects of integrated care models are key component of these strategies. However, measuring integrated care also faces major challenges. This study aims to identify and characterise integrated care measurement challenges. Methods A review of reviews on the measurement of integrated care identified 12 papers. A thematic analysis was conducted to identify and categorize measurement challenges. Document analysis was done on the measurement of an integrated care model for older adults in Québec. Results Eight categories of measurement challenges were identified. These challenges include difficulties in measuring structures, processes, and effects of models; conceptual ambiguity and heterogeneity of organisational forms; involving multiple actors in the measurement strategy; and including multiple data sources, amongst others. These challenges revealed and explained potential gaps in the measurement of integrated care for older adults in Québec. For instance, the Québec measurement strategy did not include effects indicators. Conclusion Although the measurement of integrated care is a complex endeavour, there is a need for adequate measurement strategies that allow to appreciate important elements of integrate care. The findings of this study could be used as a reflexive tool in advancing research and practice of measuring integrated care.
{"title":"Challenges in measuring integrated care models: International knowledge and the case of Québec","authors":"Paul Wankah, Maxime Guillette, Thomas Lemaître, L. Belzile, Y. Couturier","doi":"10.1177/2053434520945087","DOIUrl":"https://doi.org/10.1177/2053434520945087","url":null,"abstract":"Introduction The implementation of integrated care models requires significant efforts, especially due to institutional and organisational inertial forces that characterize health and social care systems of developed countries. It is therefore crucial to deploy strategies that promote continuous adjustment to these barriers so as to improve the benefits of integrating care. Measuring the implementation and effects of integrated care models are key component of these strategies. However, measuring integrated care also faces major challenges. This study aims to identify and characterise integrated care measurement challenges. Methods A review of reviews on the measurement of integrated care identified 12 papers. A thematic analysis was conducted to identify and categorize measurement challenges. Document analysis was done on the measurement of an integrated care model for older adults in Québec. Results Eight categories of measurement challenges were identified. These challenges include difficulties in measuring structures, processes, and effects of models; conceptual ambiguity and heterogeneity of organisational forms; involving multiple actors in the measurement strategy; and including multiple data sources, amongst others. These challenges revealed and explained potential gaps in the measurement of integrated care for older adults in Québec. For instance, the Québec measurement strategy did not include effects indicators. Conclusion Although the measurement of integrated care is a complex endeavour, there is a need for adequate measurement strategies that allow to appreciate important elements of integrate care. The findings of this study could be used as a reflexive tool in advancing research and practice of measuring integrated care.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520945087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44161004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.1177/2053434520937408
M. Kalu, Augustine C Okoh, Henrietha C Nwankwo, E. Anieto, Israel I Adandom, Samuel U. Jumbo, Uduonu Ekezie, Emofe Diameta, O. Akinrolie, Perpetua C Obi, Chidinma A Omeje, Sadiq Mohammad, Michael Ajulo, M. Opara, U. Abaraogu
Introduction Functional deficits such as gait speed, muscle strength or reduced activities in daily living after discharge are predictors for hospital readmission for older adults with hip fractures. However, physiotherapists (PTs) who are inherently mobility experts, do not actively participate during the hospital-to-home transition of older adults with hip fractures in the developing countries, including Nigeria. This qualitative study aims to describe and explore how PTs working within inpatient rehabilitation units prepare older adults (≥60 years) with a hip fracture for transfer to their home in the community. Methods We will adopt Sally Thorne’s Interpretive Description approach to purposively select 25 PTs with 5-years experience of participating in discharging older adults with hip fractures from inpatient rehabilitation-to-home. Data collection will include (a) semi-structured, one-on-one interviews with PTs, (b) discharge summaries of two older adults, and (c) final focus group discussion with PTs. We will ask the physiotherapists to provide discharge summaries of two older adults - one that they described as a “difficult” case and one that they described as an “easy” case during inpatient rehabilitation-to-home transition. Data will be analyzed employing Sally Thorne’s “borrowing techniques”- content and thematic analysis for the patients’ discharge summaries and PT interviews, respectively.
{"title":"Physiotherapists’ role during hospital-to-home transition for older adults with hip fracture and mobility limitation: A research protocol","authors":"M. Kalu, Augustine C Okoh, Henrietha C Nwankwo, E. Anieto, Israel I Adandom, Samuel U. Jumbo, Uduonu Ekezie, Emofe Diameta, O. Akinrolie, Perpetua C Obi, Chidinma A Omeje, Sadiq Mohammad, Michael Ajulo, M. Opara, U. Abaraogu","doi":"10.1177/2053434520937408","DOIUrl":"https://doi.org/10.1177/2053434520937408","url":null,"abstract":"Introduction Functional deficits such as gait speed, muscle strength or reduced activities in daily living after discharge are predictors for hospital readmission for older adults with hip fractures. However, physiotherapists (PTs) who are inherently mobility experts, do not actively participate during the hospital-to-home transition of older adults with hip fractures in the developing countries, including Nigeria. This qualitative study aims to describe and explore how PTs working within inpatient rehabilitation units prepare older adults (≥60 years) with a hip fracture for transfer to their home in the community. Methods We will adopt Sally Thorne’s Interpretive Description approach to purposively select 25 PTs with 5-years experience of participating in discharging older adults with hip fractures from inpatient rehabilitation-to-home. Data collection will include (a) semi-structured, one-on-one interviews with PTs, (b) discharge summaries of two older adults, and (c) final focus group discussion with PTs. We will ask the physiotherapists to provide discharge summaries of two older adults - one that they described as a “difficult” case and one that they described as an “easy” case during inpatient rehabilitation-to-home transition. Data will be analyzed employing Sally Thorne’s “borrowing techniques”- content and thematic analysis for the patients’ discharge summaries and PT interviews, respectively.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520937408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47965193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-24DOI: 10.1177/2053434520937416
J. Hendriks
Integrated care is an emerging approach to manage patients with chronic complex conditions, such as atrial fibrillation (AF). The current international practice guidelines recommend an integrated care approach in AF, which consists of four fundamentals being patient involvement, a multidisciplinary team approach, the use of technology, and comprehensive management focussing on the treatment of AF, prevention of thromboembolic complications, and the management of co-morbid conditions, cardiovascular risk factors and lifestyle modification. Despite the guideline recommendations, the term integrated care is being used inconsistently within the current available literature. This publication aims to contribute to the clarification of the integrate AF care concept and the consequent appropriate use in clinical practice and research, whilst awaiting an upcoming update of international practice guidelines.
{"title":"Integrated care in atrial fibrillation – Are we truly integrating?","authors":"J. Hendriks","doi":"10.1177/2053434520937416","DOIUrl":"https://doi.org/10.1177/2053434520937416","url":null,"abstract":"Integrated care is an emerging approach to manage patients with chronic complex conditions, such as atrial fibrillation (AF). The current international practice guidelines recommend an integrated care approach in AF, which consists of four fundamentals being patient involvement, a multidisciplinary team approach, the use of technology, and comprehensive management focussing on the treatment of AF, prevention of thromboembolic complications, and the management of co-morbid conditions, cardiovascular risk factors and lifestyle modification. Despite the guideline recommendations, the term integrated care is being used inconsistently within the current available literature. This publication aims to contribute to the clarification of the integrate AF care concept and the consequent appropriate use in clinical practice and research, whilst awaiting an upcoming update of international practice guidelines.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520937416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46183527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-18DOI: 10.1177/2053434520933433
F. Firoozi, N. Mozaffari, S. Iranpour, B. Molaei, M. Shamshiri
Introduction Culture is an important determinant in providing appropriate and coordinated health care for people from different ethnicities. The present study aimed to evaluate the status of cultural care among nurses working in teaching hospitals affiliated to Ardabil University of Medical Sciences. Methods In this descriptive-correlational study, 350 nurses completed the Persian version of Cultural Care Inventory (PCCI). This tool consists of 51 items and measures cultural care process in four domains including cultural preparation, cultural attitude, cultural awareness and cultural competence. Data were analyzed by IBM SPSS Statistics for Windows, version 22. Results The grand item mean of cultural care was 2.60 ± 0.621, which is considered poor. The grand item mean was 2.64 ± 0.78 in the subscale of cultural preparation, 3.45 ± 0.559 in cultural attitude, 2.81 ± 0.736 in cultural awareness and 2.58 ± 0.834 in cultural competence. Cultural competence was significantly related to cultural preparation (r = 0.80), cultural attitude (r = 0.62) and cultural awareness (r = 0.87). Discussion Based on the present findings, cultural care and its dimensions (with the exception of cultural attitude) were at a poor level. It can also be claimed that there is a direct and strong relationship between the dimensions of cultural care including cultural preparation, awareness, attitude and competence, which indicates the interdependence of these dimensions on each other. Nurses need to improve their cultural competence to ensure of providing patient-centered and culturally coordinated care.
在为不同种族的人提供适当和协调的卫生保健方面，文化是一个重要的决定因素。本研究旨在了解阿达比尔医科大学附属教学医院护士文化关怀的现状。方法在这项描述性相关研究中，350名护士完成了波斯语版文化护理量表(PCCI)。该工具包括51个项目，从文化准备、文化态度、文化意识和文化能力四个领域衡量文化关怀过程。数据采用IBM SPSS Statistics for Windows, version 22进行分析。结果文化关怀的单项平均值为2.60±0.621，为较差。文化准备分项均值为2.64±0.78，文化态度分项均值为3.45±0.559，文化意识分项均值为2.81±0.736，文化能力分项均值为2.58±0.834。文化能力与文化准备(r = 0.80)、文化态度(r = 0.62)和文化意识(r = 0.87)显著相关。基于目前的研究结果，文化关怀及其维度(文化态度除外)处于较差的水平。也可以说，文化关怀的维度包括文化准备、意识、态度和能力之间存在着直接而密切的关系，这表明这些维度相互依存。护士需要提高文化能力，以确保提供以患者为中心和文化协调的护理。
{"title":"The status of cultural care among nurses working in different wards of teaching hospitals in Ardabil, Iran: A cross-sectional survey study","authors":"F. Firoozi, N. Mozaffari, S. Iranpour, B. Molaei, M. Shamshiri","doi":"10.1177/2053434520933433","DOIUrl":"https://doi.org/10.1177/2053434520933433","url":null,"abstract":"Introduction Culture is an important determinant in providing appropriate and coordinated health care for people from different ethnicities. The present study aimed to evaluate the status of cultural care among nurses working in teaching hospitals affiliated to Ardabil University of Medical Sciences. Methods In this descriptive-correlational study, 350 nurses completed the Persian version of Cultural Care Inventory (PCCI). This tool consists of 51 items and measures cultural care process in four domains including cultural preparation, cultural attitude, cultural awareness and cultural competence. Data were analyzed by IBM SPSS Statistics for Windows, version 22. Results The grand item mean of cultural care was 2.60 ± 0.621, which is considered poor. The grand item mean was 2.64 ± 0.78 in the subscale of cultural preparation, 3.45 ± 0.559 in cultural attitude, 2.81 ± 0.736 in cultural awareness and 2.58 ± 0.834 in cultural competence. Cultural competence was significantly related to cultural preparation (r = 0.80), cultural attitude (r = 0.62) and cultural awareness (r = 0.87). Discussion Based on the present findings, cultural care and its dimensions (with the exception of cultural attitude) were at a poor level. It can also be claimed that there is a direct and strong relationship between the dimensions of cultural care including cultural preparation, awareness, attitude and competence, which indicates the interdependence of these dimensions on each other. Nurses need to improve their cultural competence to ensure of providing patient-centered and culturally coordinated care.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520933433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46836603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1177/2053434520909089
S. Kumpunen, N. Edwards, T. Georghiou, G. Hughes
A number of evaluations of models of integrated care have not produced the expected result of reduced hospital admissions, and in some cases have even found people receiving integrated care services using hospitals more than matched controls. We tested three hypotheses for these surprising results with a group of 50 integrated care experts in a seminar: (1) problems with the model; (2) problems of implementation; and (3) problems of evaluation. Our group of experts did not rule out any of these hypotheses and came up with some advice as to manage these issues. For example, model designers should rigorously test the underlying logic; commissioners should seek out advice from experts and patients/professionals; and evaluators should choose outcomes wisely, use mixed methods approaches, and provide regular feedback loops to implementation sites. Evaluating integrated care is a skilled task that requires multiple approaches in terms of the design and implementation of the models. National research funders or other appropriate bodies might consider developing an advisory service to provide support to local systems planning evaluations.
{"title":"Why do evaluations of integrated care not produce the results we expect?","authors":"S. Kumpunen, N. Edwards, T. Georghiou, G. Hughes","doi":"10.1177/2053434520909089","DOIUrl":"https://doi.org/10.1177/2053434520909089","url":null,"abstract":"A number of evaluations of models of integrated care have not produced the expected result of reduced hospital admissions, and in some cases have even found people receiving integrated care services using hospitals more than matched controls. We tested three hypotheses for these surprising results with a group of 50 integrated care experts in a seminar: (1) problems with the model; (2) problems of implementation; and (3) problems of evaluation. Our group of experts did not rule out any of these hypotheses and came up with some advice as to manage these issues. For example, model designers should rigorously test the underlying logic; commissioners should seek out advice from experts and patients/professionals; and evaluators should choose outcomes wisely, use mixed methods approaches, and provide regular feedback loops to implementation sites. Evaluating integrated care is a skilled task that requires multiple approaches in terms of the design and implementation of the models. National research funders or other appropriate bodies might consider developing an advisory service to provide support to local systems planning evaluations.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520909089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47036692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1177/2053434520916172
{"title":"Reviewer's list 2019","authors":"","doi":"10.1177/2053434520916172","DOIUrl":"https://doi.org/10.1177/2053434520916172","url":null,"abstract":"","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434520916172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43948678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1177/2053434519896523
E. Dessers, B. Mohr
The vast majority of research and efforts towards greater care coordination have taken place at the level of single, sovereign organizations, or at the level of networks formed to address the need for cross-organizational collaboration. The recently emerging ecosystem level of analysis and intervention is still under-researched, with few if any available innovation practices that match the complexity experienced at the level of care ecosystems. Beginning with the challenge of care coordination, we discuss what care ecosystems are and how they can be defined and describe the possibilities and opportunities that come when viewing care coordination through an ecosystem lens. We underpin our plea for an ecosystem approach to health and social care coordination with seven lessons, which we draw from an extensive study of 15 care ecosystem cases from seven different countries. We end the paper with an appeal for further research in this promising field.
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