Thomas Paul, While Alison
Centre for the Study of Policy and Practice, Thames Valley University, London, UK.
J Nurs Manag. 2007 Sep;15(6):643-8. doi: 10.1111/j.1365-2834.2007.00806.x.
AIM(S): To examine the role of nurses within integrated health care.
Healthcare planners are overly concerned with the treatment of diseases and insufficiently focused on social cohesion vertical rather than horizontal integration of healthcare effort. These domains need to be better connected, to avoid medicalization of social problems and socialisation of medical problems.
Published literature, related to theories of whole system integration. *When conceptualizing whole system integration it helps to consider research insights to be snapshots of more complex stories-in-evolution, and change to be the result of ongoing community dance where multiple players adapt their steps to each other. *One image that helps to conceptualize integration is that of a railway network. Railway tracks and multiple journeys are equally needed; each requiring a different approach for success. *Traditional nursing values make nurses more attuned to the issues of combined vertical and horizontal integration than medical colleagues.
CONCLUSION(S): Nurses should lead integration at the interface between horizontal and vertical activities.
Nursing managers and universities should support the development of nurses as leaders of whole system integration, in partnership with local healthcare organizations.
探讨护士在综合医疗保健中的作用。
医疗保健规划者过度关注疾病治疗，而对社会凝聚力关注不足，医疗保健工作侧重于纵向而非横向整合。这些领域需要更好地联系起来，以避免社会问题医学化和医学问题社会化。
与全系统整合理论相关的已发表文献。*在将全系统整合概念化时，将研究见解视为更复杂的不断演变的故事的快照，并将变化视为多个参与者相互调整步伐的持续社区舞蹈的结果，这会有所帮助。*一个有助于将整合概念化的形象是铁路网络。铁轨和多条线路同样不可或缺；每条线路的成功都需要不同的方法。*传统的护理价值观使护士比医学同行更能适应纵向和横向整合的问题。
护士应在横向和纵向活动的界面引领整合。
护理管理者和大学应与当地医疗保健组织合作，支持培养护士成为全系统整合的领导者。
