Cardiff School of Management, University of Wales Institute, Colchester Avenue, Cardiff, CF23 9XR, UK.
Int J Integr Care. 2009 Dec 22;9:e100. doi: 10.5334/ijic.509.
Two central themes permeate this paper-the interplay between structure and agency in integration processes and the extent to which this is mediated through sensemaking by individual actors.
The empirical base for the paper is provided by case study research from Wales which draws on examples of different types of integration in health and social care. The individual case studies highlight different interpretations of integration set against a background of the resources involved, processes employed and outcomes achieved.
A wide ranging discussion exposes the complex interplay and dynamics between structural factors and the manner in which they enable or constrain integration, and individual actors realising their potential agency through leadership, professionalism and boundary spanning to influence outcomes. The importance of structure and agency complementing each other to determine effective integration is emphasised, together with the scope that is available for interpretation and meaning by individual actors within the contested discourse of integration.
本文有两个核心主题——整合过程中结构与能动者的相互作用，以及个体能动者通过意义建构对此进行调节的程度。
本文的经验基础来自于威尔士的案例研究，该研究借鉴了卫生和社会保健领域不同类型的整合范例。各个案例研究突出了在涉及的资源、采用的过程和取得的成果背景下，对整合的不同解释。
广泛的讨论揭示了结构因素之间复杂的相互作用和动态关系，以及它们如何使整合成为可能或受到限制，以及个体能动者通过领导力、专业性和跨越边界来影响结果，从而实现其潜在的能动性。强调了结构和能动者相互补充以确定有效整合的重要性，以及个体能动者在整合的有争议话语中进行解释和赋予意义的范围。
