Abstract
Introduction and Aim:There are four quality paradigms, of which the Empirical and Reference paradigm fit best in stable circumstances, and the Reflective and Emergence paradigms, which fit best in unstable circumstances. This study aims to explore the use of the four quality paradigms in integrated care, and to shed light on the different paradigmatic commitments and different perspectives on quality.Methods:Peer-reviewed articles from the International Journal of Integrated care published between January 2015 and December 2019 were included in this study. For each article was determined in which paradigm it belonged. Additionally, the role of the patient and domain of impact in research, policy or practice in relationship to the paradigms were investigated.Results:In total, 255 articles were assessed based on the four quality paradigms. 55 (21.6%) of the articles were placed in the Empirical paradigm, 147 (57.6%) in the Reference paradigm and 45 (17.6%) in the Reflective paradigm. The Emergence paradigm occurred the least (n = 8, 3.1%).Discussion and conclusion:Of all reviewed studies, 80% were placed in the Empirical and Reference paradigm. This raises the question if the used research approaches are consistent with the complexity and contexts in the field of integrated care and support a personalised care approach. More awareness of all four paradigms and reflection on the used epistemologies is needed.
Highlights
IntroductionIntroduction and AimThere are four quality paradigms, of which the Empirical and Reference paradigm fit best in stable circumstances, and the Reflective and Emergence paradigms, which fit best in unstable circumstances
Introduction and AimThere are four quality paradigms, of which the Empirical and Reference paradigm fit best in stable circumstances, and the Reflective and Emergence paradigms, which fit best in unstable circumstances
Article Selection All peer-reviewed articles published in the International Journal of Integrated Care (IJIC) between January 2015 and December 2019 were identified through literature searches in PubMed (Medline)
Summary
Introduction and AimThere are four quality paradigms, of which the Empirical and Reference paradigm fit best in stable circumstances, and the Reflective and Emergence paradigms, which fit best in unstable circumstances. This study aims to explore the use of the four quality paradigms in integrated care, and to shed light on the different paradigmatic commitments and different perspectives on quality. The history of the International Foundation of Integrated Care (IFIC) goes back to 2000, which means this year is the 20th anniversary of this movement. In the last twenty years, there was a shift from institution-centred to community-based integrated care, with more emphasis on a multi-sectoral approach. The focus shifted from economic arguments for integration towards arguments for enhancing the quality of care to clients. There is an increased focus on a person-centred approach, where the client is seen as a partner [1]. The implementation and evaluation of integrated care require person-centred goals and measures. People and communities have to be supported to take an active role in their health [2, 3]
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