Translating the patient perception of integrated care survey to measure integrated care in The Netherlands : Combining equivalence and contextualization approaches for optimal results

Introduction: An increase in initiatives to improve integration of care provides the need for instruments that assess the degree of integrated care as perceived by patients across cultural contexts. This article aims to explain the relevance of equivalence and contextualization approaches in translating and adapting the Patient Perception of Integrated Care Survey developed in the US for use in the Netherlands. Theory and methods: The World Health Organization guidelines guided the translation and adaptation, including a forward-backward translation and patient-feedback through informal contacts (N4) and cognitive interviews (N14). Results: The forward-backward translation produced a Dutch version of the Patient Perception of Integrated Care Survey with minor adaptations. Patients evaluated the survey as very relevant. Alterations resulted from structural and cultural differences and specificities of patients with chronic conditions. Conclusions and discussion: A context-sensitive translation process is key to developing instruments for cross-cultural health research. Our results show that equivalence- and contextualization methods provide equally relevant, yet substantially different contributions to the translation outcome and should both be incorporated when translating instruments for different cultural contexts. The results support the applicability of the Patient Perception of Integrated Care Survey in the Netherlands and are promising for its adoption in other cultural contexts

Can organisational culture of teams be a lever for integrating care? An exploratory study

Introduction: Organisational culture is believed to be an important facilitator for better integrated care, yet how organisational culture impacts integrated care remains underspecified. In an exploratory study, we assessed the relationship between organisational culture in primary care centres as perceived by primary care teams and patient-perceived levels of integrated care. Theory and methods: We analysed a sample of 2,911 patient responses and 17 healthcare teams in four primary care centres. We used three-level ordered logistic regression models to account for the nesting of patients within health care teams within primary care centres. Results: Our results suggest a non-linear relationship between organisational culture at the team level and integrated care. A combination of different culture types—including moderate levels of production-oriented, hierarchical and team-oriented cultures and low or high levels of adhocracy cultures—related to higher patient-perceived levels of integrated care. Conclusions and discussion: Organisational culture at the level of healthcare teams has significant associations with patient-perceived integrated care. Our results may be valuable for primary care organisations in their efforts to compose healthcare teams that are predisposed to providing better integrated care