Kroeze Eline, Huijsman Robbert
Department Health Services and Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, The Netherlands.
Int J Integr Care. 2022 Aug 17;22(3):10. doi: 10.5334/ijic.6424. eCollection 2022 Jul-Sep.
Cooperation is key to provide integrated dementia care. However, different kinds of (personal and organisational) interests will affect collaboration in integrated dementia care (IDC) networks. Hence, it is crucial to understand how interests influence relations in IDC-networks in order to shape future policies.
A sequential mixed methods single case study design was used, in three phases: a Social Network Analysis (SNA) based on data from questionnaires (n = 24-26), explorative interviews with network partners (n = 14) and a focus group with network coordinators (n = 7) to explore the conceptual generalisability of the single case of the IDC-network.
The SNA revealed that highly connected organisations were often established care organisations that deliver case management, while smaller care organisations or welfare organisations tend to be less connected. Care-related, strategic, and financial interests influence participation of organisations in the IDC-network, while personal intrinsic motivations determine a representative's contribution to the network. Especially conflicting interests strongly influence the network structure.
We conclude that conflicting interests in IDC-networks stand in the way of reaching the collective goal of an IDC-network, i.e., optimising the wellbeing of people with dementia and their informal caregivers in the region. Thus, IDC-networks should act to manage, resolve and prevent disputes arising from conflicting interests.
合作是提供综合痴呆症护理的关键。然而,不同类型的(个人和组织)利益会影响综合痴呆症护理(IDC)网络中的协作。因此,了解利益如何影响IDC网络中的关系对于制定未来政策至关重要。
采用了一种顺序混合方法单案例研究设计,分三个阶段进行:基于问卷调查数据(n = 24 - 26)的社会网络分析(SNA)、对网络合作伙伴的探索性访谈(n = 14)以及与网络协调员的焦点小组讨论(n = 7),以探索IDC网络单案例的概念普遍性。
社会网络分析表明,联系紧密的组织通常是提供病例管理的成熟护理组织,而规模较小的护理组织或福利组织的联系往往较少。与护理相关的、战略的和财务的利益会影响组织参与IDC网络,而个人内在动机决定了代表对网络的贡献。特别是利益冲突对网络结构有强烈影响。
我们得出结论,IDC网络中的利益冲突阻碍了实现IDC网络的集体目标,即在该地区优化痴呆症患者及其非正式护理人员的福祉。因此,IDC网络应采取行动管理、解决和预防因利益冲突产生的争端。