bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the role of diversity in informal care
Authors: Wittenberg Yvette , Hengelaar Rieke 
Published: January 2024

Introduction: In the Netherlands, professionals in social work and healthcare are increasingly involved in care networks in which informal caregivers, volunteers and professionals need to collaborate in a relationship of equality to support care recipients. At the same time, there is a growing consciousness that the diversity among Dutch citizens should be taken into account within this collaboration. In order to achieve good collaboration, it is important that professionals pay attention to the informal caregiver: who is this person and what views does this person have about providing informal care? Informal caregivers and their views are often very different from each other. In this presentation, we will discuss how professionals can create space for this diversity among informal caregivers.
Public involvement: This presentation is part of two PhD studies in which informal caregivers, care recipients and professionals in social work and healthcare are involved and determined the necessity for these studies and are involved in the participatory analysis and the dissemination of the results in educational programs and practice.
Methods: As part of our PhD studies, several projects were conducted in which both quantitative and qualitative methods were used. All projects used an intersectional perspective to better understand the role of diversity in informal caregiving experiences. Next to that, a scoping review on this topic was conducted. During the presentation, we will combine insights of several projects to discuss the importance of creating space for diversity in care situations.
Results: We discovered the added value of an intersectional perspective to look into diversity among informal caregivers. This perspective helps to get to know the person behind the informal care better, but also to gain a better understanding of the context in which informal care is provided and what people need to be able to continue to provide informal care in a pleasant way. Additionally, this lens provides insight in the necessity for reflexivity amongst professionals about their own positionality and views on providing informal care. Reflecting on professionals’ own frames of reference helps to recognize blind spots and assumptions about the other. Avoiding such assumptions enables professionals to make informal caregivers feel safe and understood.
Implications for practice and further research: Adopting an intersectional perspective to look into diversity among informal caregivers and working reflexively stimulates professionals to analyse which views, but also assumptions about informal caregivers exist among professionals in teams. This encourages organizations and professionals to improve accessibility of their support and to create space for differences in views and needs in the support they provide. Using intersectionality in informal care research helps to understand the role of diversity in caregiving needs and experiences.
Neighbourhood approach as a leverage for municipal integrated mental health care, Ghent
Authors: Symoen Sara , Gillis Steven , Dierinck Peter 
Published: January 2024

Problem Statement: Psychological problems are common in Flanders (Belgium). 33% of Flemish people report experiencing problems such as stress, anxiety, depressive feelings, etc. 14% have a mental disorder and 1 to 2% of the population a severe psychiatric problem. However, about half of those who could use help do not find appropriate help (unmet need) or avoid help. Partly because of the decrease in residential mental health services, some neighbourhoods, especially in a metropolitan context, experience more pressure related to mental and psychiatric problems. The recognition of the importance of supporting people in their own environment is stimulating a search for more integrated work between mental health care and social organisations, person tailored, and within neighbourhoods.
Objective: Although not a core mission of an urban government, the City of Ghent chooses to make mental health a policy priority by giving space to experiment with new initiatives that are anchored within neighbourhoods in cooperation with a wide variety of organisations. These should be exemplary for other cities and municipalities, but also for supra-local policymakers. The initiatives focus on four core objectives: making mental vulnerability discussable, empowering people, lowering barriers to care and inclusion of people with mental vulnerabilities.
Target group: With integrated thinking as a point of view, we approach people as citizens, establishing methodologies to support both people with moderate to severe mental health difficulties.
Actions:
- Citywide organisation of resilience-building initiatives, embedded in neighbourhoods (psycho-educational work in collaboration with Recovery Colleges, front-line mental health workers)
- Connecting mental health organizations with neighbourhood networks to make care both more accessible and more personalized (through quarter making, mobile workers, open dialogue).
- Deploying caring neighbourhoods in which methodologies such as quarter making, multilogem and open dialogue are leverages for inclusion of vulnerable neighbourhood residents.
Impact:
-At the moment, in 8 out of 10 more vulnerable neighbourhoods, mental health projects are running with a neighbourhood focus.
-Yearly around 30 psycho-educational trainings are given, reaching over 400 participants.
-4 psychiatric hospitals joined forces with the city to launch the mobile workers project, which focuses on neighbourhood networks and a person-centred approach for people under the care radar.
Over 500 EPA persons have already been reached by 4 mobile workers working within networks of more than 40 organizations.
Nb) The results of the evaluation study are expected by May 2023 and can be presented at the conference.
Implementation of interprofessional pharmaceutical care initiatives: lessons learned from successful bottom-up initiatives in primary care
Authors: Coenen Indira , De Baetselier Elyne , Foulon Veerle , Dilles Tinne 
Published: January 2024

Background: Although there is evidence that interprofessional, person-centred, integrated care is important for optimising pharmaceutical care of older persons with polypharmacy, this way of working is often not implemented in practice. Identification and description of successful initiatives between physicians, pharmacists and nurses, their context and implementation strategies are important to close this know-do gap.
Objective: The aim of this study was to identify common characteristics of successful interprofessional initiatives and factors influencing the implementation of these initiatives.
Methods: A qualitative, explorative design with in-depth semi-structured interviews was used. Flemish primary healthcare professionals and patients aged over 75, involved in successful initiatives for interprofessional pharmaceutical care of older persons with polypharmacy, were included. Inductive analysis was conducted to identify main topics.
Results: Several interprofessional initiatives, successfully implemented in primary healthcare, were explored. Fifteen healthcare professionals and four patients involved in these initiatives were interviewed. In all initiatives the healthcare professionals had interprofessional consultations about older persons with polypharmacy. Five common characteristics could be identified in these initiatives: a) bottom-up design with voluntary participation of healthcare professionals, b) team made decisions, c) the presence of a project coordinator d) consultation with older persons and e) the availability of supporting documents. The interaction between the characteristics of the initiatives and the context had an important impact on the implementation. These context factors were positioned under a) the micro context – including personal characteristics of healthcare professionals and interprofessional relations, b) the meso context - including a culture of cooperation, scale and available time, and c) the macro context, including the political context and ICT possibilities. Implementation strategies, actions to enhance the adoption of the initiatives, were identified and corresponded with three themes: communication and influence, coordination of different stakeholders, and incentives or disincentives.
Discussion: Raising the visibility of these success stories will inspire healthcare professionals, providers of interprofessional education and policymakers to facilitate interprofessional pharmaceutical care. Since patients seemed to have limited interest in collaboration strategies of their healthcare professionals, more in-depth research to explore patients’ expectations is suggested.
Speed dating in Primary Care Zone Klein-Brabant Vaartland
Authors: Tilley Lore , De Koker Kris 
Published: January 2024

There are 60 Primary Care Zones in Flanders where different partners from the health and welfare sector work together. The goal is to help people with care or assistance needs in the best possible way.
Our Primary Care Zone works for 3 municipalities being Puurs-Sint-Amands, Bornem and Willebroek.
We are convinced that we can only help people with tailor-made care when the care providers work together more smoothly and better. So we know where to go with a care question.
To stimulate cooperation and integrated care, our Primary Care Zone organizes 3 speed dating events every year with health and welfare professionals. With these speed dates, professionals get to know each other. In this way, we encourage warm referrals and cooperation between different professional groups.
Why and how Flanders wants to roll out goal-oriented, integrated care based on life goals.&nbsp; A reflection between policymakers and policy organizations.
Authors: Boeckx Thomas 
Published: January 2024

Flanders believes that integrated care can only be achieved by linking medical care, with welfare and social care, creating local government participation and including the voice of the patient and his or her caregiver in local and central policy processes.
In order to evolve from fragmented primary care to integrated care, a participatory procedure was mapped out in Flanders: since 2020 existing structures were changed and several tools have been developed to transform the way of care into goal oriented care.
The Flemish meso level was thoroughly rearranged: during the covid years population-based approach was rolled out by local care councils. The care council aims to install integrated, goal-oriented care within the local network of medical care providers, social and welfare providers and local authorities, in cooperation with the patient and his or her caregiver. Together with all these partners, the care council takes care of a population of at least 75,000 people.Finally primary care, and by extension the entire care scene, will evolve towards better goal-oriented, integrated care. This evolution is supported by the implementation of the digital care and support plan which is flanked by a the reform traject of palliative care in Flanders,
The main goal of in Flanders care organization is putting the patient in the driving seat of the care-process which will be based on life goals
For policymakers and organizations, this presentation aims to look back at the complex change process, outline future challenges and share lessons learned.
We show how strategically chosen change management creates connection between welfare, social and medical care. How, the interaction between patient and caregivers and local authorities try to achieve integrated care in the local communities
We show our complex challenge of introducing quality thinking and building organizational resilience for future crises within the young care council.
We discuss the complexity of linking local priorities with global policy objectives and vice versa.
Goal-oriented care in an integrated care organization
Authors: Dingemans Ann 
Published: January 2024

i-mens is the largest integrated care organization in Flanders and Brussels with 12,000 employees serving over 70 000 customers yearly. It provides care through all phases of life, with a wide range of services. Providing Goal-Oriented Care is inherently part of the vision of i-mens. However, a clear and standardized opproach is lacking.
By implementing a new framework, a transparent approach is created to help our customers in an equitable way, while keeping into account that everyone has different life goals/needs.
At the beginning of 2022 i-mens started a process, with the support of the King Baudouin Foundation and in collaboration with Steunpunt Mantelzorg, to implement GOC within the organization. The new methodology is to be evaluated by the persons with a care and support needs, our internal staff, as well informal caregivers. i-mens believes it is important to involve the informal caregiver, because they guarantee continuity of care when the professional support ends. European research shows that 80% of long-term care is provided by informal caregivers.
During ICIC23 we wish to highlight the following topics: The choice of methodology based on the following parameters: There are various methods of GOC in Flanders. These methods were evaluated on the parameters: ‘understandable’, ‘personal input’, ‘time investment’, usable in their context, etc. We opted for 2 possible methods. These methodologies were presented to a test audience (focus groups).
The survey from the focus groups: During autumn 2022, we organized three focus groups: clients, informal caregivers and our employees. The two chosen methodologies were presented to a test audience. Based on their findings, we opted for one methodology.
The testings: After the decision has been made about the chosen methodology, we are going to start the implementation (spring 2023). Employees initiate the methodology in collaboration with the client and their informal caregiver.
In a later stage, this methodology will be used as a guideline during multidisciplinary meetings where various stakeholders (general practitioners, home nurses and other primary care actors) participate.
The target audience: The GOC-methodology is aimed at every customer, but due to practical and efficiency reasons we initially focused on the customer living at home. During the presentation, their findings will be communicated.
Challenges: Whitin this topic we explain the various challenges that we encounter along the way: rethinking of the customer, informal caregiver (empowerment), external primary actors and the internal employees.
However it should be stressed that besides choosing a methodology, the basic attitude of professional caregivers plays a key role as well in achieving a successful Goal-Oriented Care. Both elements form the basis of Goal-Oriented Care as you cannot have the one without the other. Since autumn 2022, we have been communicating about GOC to all our 12,000 employees through (digital) newsletters, conversations with the training department, organizing information moments, etc.
Is a unified model for patient empowerment possible or desirable?
Authors: Phillips Jim , Somekh David 
Published: January 2024

Background: Patient empowerment has a history going back to the 1960’s ( Kayser et al. BMC Health Services Research (2019) 19:242) and originates in the movement for greater citizen participation in societal decision-making (e.g. ‘power to the people’). In the decade of the 1970’s there was a related shift in some healthcare thinking.
While there has been a proliferation of terms, such as citizen engagement, patient participation, patient empowerment, patient activation and so forth, the fundamental underlying principle is the shift from the patient/citizen as a passive recipient of services to the patient /citizen as active, informed participant in their own health and healthcare.
These shifts have been reflected in health care policy- person/patient centred care, personalised care and integrated care all put forward models of working that are designed to enhance patient empowerment and a shift from a bio-medical model of health care t a more holistic bio- psychosocial model of care
Although there had been active proponents of this change, especially in parts of Northern Europe it remains a fragile part of health care
Method: Unlike some health topics, although patient empowerment is often cited, for example in relation to current work on health technology including mHealth, there appears to be no overarching consensus on a strategy for local implementation, nor even how patient empowerment is defined for strategic purposes. This survey aimed to gather information which would, when collated, help to address these issues. To explore the current standing of patient empowerment at the beginning of 2021 a survey of experts including people expert in lived experience was carried out in a number of European countries (the final total was 25 responses from 14 countries)
This was followed up in 2022 by a international round table event of people of lived experience, researchers, policy makers and leading experts to explore this issue and to record the discussion as a marker for future thinking about the concept.
Results and conclusions: Despite significant activity it was clear it was very siloed and y the concept was diversely defined or interpreted in practice.
We concluded it seems that the majority of respondents from the 14 countries only use aspects of the concept with no common understanding.
. If there is such a disparate use of terminology, is it meaningful to refer to ‘empowerment’ as a definition of anything? Is there a better term to use for an umbrella concept?
These findings confirm that concepts such as person centred care, personalised care and patient empowerment have considerable variations in how they are understood.
This has significant implication for their implementation when there is such diverse understandings at all levels - Macro, Miso and Micro leading to fragmentation and a lack of a unified approach to evaluation.
The public health insurance funds as drivers for integrated care
Authors: Dhaeyre Eline Senesael , Vandeghinste Nicky , Germonpré Siska , Demyttenaere Bart , De Brandt Laura 
Published: January 2024

The public health insurance funds are a unique player in the healthcare landscape. Belgium has seven public health insurance funds that operate the reimbursement system of health care services covered by the compulsory health insurance for their members and the payment of a replacement income in case of long-term illness. Public health insurance funds are present throughout the lifespan of their members, from birth to death, they are companion and point of contact for crucial moments in life at all ages.They play a key role in the rollout and implementation of key aspects of integrated care.
Not only are they responsible for the health care reimbursement, they are the guardians of the health insurance finance as well as the administrator. They are in control of the recognition and follow up of patients in incapacity for work and guide those patient in return to work and rehabilitation and reintegration. They have lots of experience in finance mechanisms and regulation within health care.
Next to their responsibilities in reimbursement, there’s also an important social service. The social workers are there to familiarize people with care, the organization of home care and to facilitate all preconditions to make this possible, but also to determine the severity of care and to open up as many social benefits as possible for those who are entitled to it. The public health insurance funds also generate data which they can use to evaluate the health system, provide for scientific research but also use to enhance population management and to weigh on decision- or policy makers.
After a short, interactive part, we will explore these different roles and demonstrate how they contribute to integrated care. Not only from the perspective of the public health care insurance institutions, but also from the perspective of collaboration amongst formal care givers surrounding one patient and from the perspective of several informal care givers. By using various testimonials, we let informal care givers share their experience and needs about integrated care.
Despite the long history, many actors in Belgium are insufficiently aware of what exactly these different roles are. It is the task of the public health insurance funds to continue to fully focus on this and to participate in initiatives that can realize integrated care. Therefore, at least one good practice will be discussed from one of the 12 integrated care pilot projects in which the funds, together with the other care actors and the government, are looking for innovative actions to make integrated care possible.
Quality and safety for the public through domiciliary nursing in Italy: a multicentre cross-sectional descriptive observational study (The AIDOMUS-IT Protocol)
Authors: Bagnasco Annamaria , Alvaro Rosaria , Lancia Loreto , Manara Duilio Fiorenzo , Rasero Laura , Rocco Gennaro , Zega Maurizio , Sasso Loredana 
Published: January 2024

Introduction: The development of this study occurred in conjunction with the new "Regulation defining models and standards for the development of community care in the National Health Service" (Ministerial Decree no. 77/2022) with the redefinition of care in the community. Considered the increase in the elderly population, in the complexity of care and the workload for home care, it is important and urgent to describe the work environment and the Italian community care reality.
Aims: The main objective of this study is to evaluate the characteristics of nursing care and the quality of home care in the community in Italy.
Methods: This is a cross-sectional descriptive observational study using the survey method. The study uses quantitative data from three sources: 1) primary data on organizational characteristics, professional satisfaction, intention to leave home care services, and burnout; 2) secondary data on the experience of patients and their caregivers; 3) data on improper access to the emergency department, readmission to hospital, comorbidities, services offered, and users’ level of autonomy, and main and secondary diagnoses.
Data will be analyzed using descriptive and inferential statistics.
Conclusions: The systematic analysis of the different national community care contexts will enable to increase the knowledge and awareness of the need for community health care. The availability of specific data will promote and support the role of the family and community nurse in district health care contexts, in order to increase the quality of care perceived by patients and their families.
KEYWORDS (MAX 5): family and community nurses, community care realities, complexity of care, multicentre observational study.