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Table 2 Coding framework

From: An integrated approach to meet the needs of high-vulnerable families: a qualitative study on integrated care from a professional perspective

ConceptCategoryCodeFrequency of quotes per codeDescriptionLiterature
Integrated careGeneral principlesCoordinated40Coordination in the care process across professional, organizational, and system boundariesWorld Health Organization [4]
Coherent11Coherence in assessment and support, across professionals and in policiesWorld Health Organization [4]
Continuity18Continuous support over time (within and between professionals)World Health Organization [4]
Family focused42Addressing the needs of all family membersTausendfreund et al. [3]
(Lack of focus on) several life domains33(Lack of) focus on several life domains: academic, familial, social and personalTausendfreund et al. [3], Wang et al. [27]
Interprofessional collaboration (intern or extern)79 (extern)
46 (intern)
Collaboration between professionals involved in the care process
Intern: collaboration with professionals within the own care team. Extern: collaboration with professionals from other organizations
Cooper [8], Hermens et al. [12], Janssens et al. [11], Van Straten et al. [13]
ExpertiseGeneralist/Specialist expertise50Broad knowledge and approach of problems (generalist) or in-depth knowledge and approach of problems (specialist)Hoffses et al. [9]
AssessmentEarly identification/Early assessment14Timely recognition of (potential) risk factors across several life domainsBower and Gilbody [15], Linton et al. [14], Van Straten et al. [13]
Broad assessment36Assessment of a broad range of problems across multiple life domainsBower and Gilbody [15]; Linton et al. [14]; Van Straten et al. [13]
Multiple, co-occurring problems26Interaction between multiple problems that occur simultaneouslyHenderson et al. [23]; Tausendfreund et al. [3]
Service deliveryAvailability of support78Availability of support throughout the continuum of careCooper et al. [8]; Meeuwissen [16]
Continuous clinical pathways/Fragmented care48Clear, non-fragmented routes of care through the entire continuum of care (universal services to primary care to specialized secondary care)/fragmentation between services or professionalsCooper et al. [8], Hermens et al. [12]; Meeuwissen et al. [16]
Stepped careDefinitionStepped care (definition)4Offering the least restrictive support as possible that is still likely to yield significant health gain and step up to more severe care if necessaryBower and Gilbody [15], Meeuwissen [16], Bennett-Levy et al. [17]
Allocation of interventionsPredetermined sequence7Support ranked from low to high intensity in a predetermined sequenceFirth et al. [18], Meeuwissen [16], Richards [19]
Least restrictive18The least intensive support in terms of time, costs, and professional’s level of expertiseMeeuwissen [16], Van Straten et al. [13]
Intensity14Providing support by a predefined sequence of support options with increasing intensityBower and Gilbody [15], Firth et al. [18], Meeuwissen [16], van Straten et al. [13]
Assessment and evaluationReflexive monitoring/(ir)regular monitoring15Progress and outcomes are monitored by collecting data to assess if support must be alteredMeeuwissen [16], Richards [19], Bower and Gilbody [15]
(standardized and systematic) Evaluation42Periodically and systematically evaluate progress in a care process and collaborationVan Straten et al. [13], Meeuwissen [16], Firth et al. [18], Bower and Gilbody [15]
Goal efficiency14Working efficiently towards concrete goalsMeeuwissen [16]
Disadvantage stepped careFocus on individuals/single problems3Focus on individuals and single problems, omitting the complex interaction of problemsCross and Hickie [25]
Variety in steps5Stepped care support is heterogeneous with different numbers of steps, intensity, and treatment componentsVan Straten et al. [13], Bower and Gilbody [15]
Lack of predefined criteria/guidelines41Lack of predefined criteria and (clinical, practical, or evidence-based) guidelines for monitoring and evaluation of support hinder stepped careMeeuwissen [16]; Van Straten et al. [13]
Under treatment33Inappropriate support or inefficient allocation of resources leading to an exacerbation of family’s problemsLinton et al. [14], Lovell and Richards [22]
Risk of drop out10Families refusing further supportSeekles et al. [26]
Matched careDefinitionMatched care (definition)16Allocation of support is based (matched) on families’ characteristics, preferences, risks, and needsVan Straten et al. [13], Linton et al. [14]
Allocation of interventionsTailored52Family’s needs and preferences are central in the allocation of supportVan Straten et al. [13], Linton et al. [14]
Disadvantage matched careLack of prognostic determinants2Lack of clear prognostic determinants to match families to the available supportBower and Gilbody [15]; Van Straten et al. [13]
Variety of interventions18Support may vary across families regarding intensity, setting, and type of professionalLinton et al. [14]; Van Straten et al. [13]
Overtreatment13Families receiving too many support, leading to inappropriate allocation of servicesLovell and Richards [22]
Decision makingDecision makingShared decision making27Shared decision making is based on collaboration between professionals and families, taking families’ preferences into account and jointly decide the type and intensity of supportMeeuwissen [16]; Van Straten et al. [13]
Intuitive decision making27Intuitive decision making, not based on reflexive monitoring, evaluation, or predefined determinantsMeeuwissen [16], Van Straten et al. [13]
Quality of servicesService deliveryUser friendliness10Satisfaction with- and user friendliness of supportWorld Health Organization [4]
Safety26Professionals paying attention to a family’s safetyWorld Health Organization [4]
Open codingFreedom of professional28A professional’s freedom to make her/his own decisions in the care process 
Solution focused approach/therapy16Support that focuses on solutions rather than problems 
Familiarity50Familiarity with other services or professionals (often affects the feeling of availability) 
Trust30Trust between professionals 
Early consultation37Early consultation function of professionals in for example schools to provide early support 
Care plan18Care plan with goals for the entire family 
Clinical case discussion35Clinical case discussions within multidisciplinary care teams to discuss and evaluate the care process 
Stepping up52Step up to more intensive support if needed 
Scale down46The opposite of stepping up, the provision of less restrictive support after intensive support 
Integrated care definition/in general29Definition of integrated care, general aspects of integrated care 
Warm handoff14The gradual transfer from one professional to another