Complexity Science and its Relevance for Primary Health Care Research

Griffiths, Frances

doi:10.1370/afm.727

Cited by 19 publications

(13 citation statements)

References 3 publications

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“…24 Likewise, exploration of the biopsychosocial model of care and the consultation showed that they are better understood as emergent, dependent on the individuals involved and the conditions at the time of presentation. Given this fact, models of care need to account for circular causalities, whereby feedback loops, either self-balancing (stabilizing) or self-rein- [23][24][25][26][27][28][29] Applying complexity science principles to the function of medical practice 23 and the understanding of the biopsychosocial model 28 Family practices are local professional complex adaptive systems 24 Understanding and managing in complex adaptive systems 26 Constructing a complexity model of continuity of care and illustrating its veracity using previously published outcomes data 27 Understanding the interconnected issues affecting the primary care workforce crisis 29 The function of medical practice Healing is the process of reestablishing wholeness 30,45,47,49 Consultation dynamics 31,45,46 and outcomes 32,46 Care team development, practice development, and dynamics 35,57,58 Health systems and health system reform [36][37][38]43,44,50,[52][53][54] Toward an integrated understanding of health 37,47,49 and disease 41,…”

Section: Defining the Discipline Of General/family Practicementioning

confidence: 99%

Systems and Complexity Thinking in the General Practice Literature: An Integrative, Historical Narrative Review

Sturmberg

Martin

Katerndahl

2014

The Annals of Family Medicine

105

112

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PURPOSE Over the past 7 decades, theories in the systems and complexity sciences have had a major influence on academic thinking and research. We assessed the impact of complexity science on general practice/family medicine. METHODSWe performed a historical integrative review using the following systematic search strategy: medical subject heading [humans] combined in turn with the terms complex adaptive systems, nonlinear dynamics, systems biology, and systems theory, limited to general practice/family medicine and published before December 2010. A total of 16,242 articles were retrieved, of which 49 were published in general practice/family medicine journals. Hand searches and snowballing retrieved another 35. After a full-text review, we included 56 articles dealing specifically with systems sciences and general/family practice. RESULTSGeneral practice/family medicine engaged with the emerging systems and complexity theories in 4 stages. Before 1995, articles tended to explore common phenomenologic general practice/family medicine experiences. Between 1995 and 2000, articles described the complex adaptive nature of this discipline. Those published between 2000 and 2005 focused on describing the system dynamics of medical practice. After 2005, articles increasingly applied the breadth of complex science theories to health care, health care reform, and the future of medicine.CONCLUSIONS This historical review describes the development of general practice/family medicine in relation to complex adaptive systems theories, and shows how systems sciences more accurately reflect the discipline's philosophy and identity. Analysis suggests that general practice/family medicine first embraced systems theories through conscious reorganization of its boundaries and scope, before applying empirical tools. Future research should concentrate on applying nonlinear dynamics and empirical modeling to patient care, and to organizing and developing local practices, engaging in community development, and influencing health care reform. 2014;66-74. doi:10.1370/afm.1593. Ann Fam Med INTRODUCTIONC omplex adaptive systems are defined as collections of many different components (agents) interacting in nonlinear ways in the absence of any external supervisory influence. The behaviors of a complex adaptive system cannot be explained by the behavior of specific agents (reductionism); instead, complex adaptive systems show emergent behaviors. Table 1 provides definitions for core terms from systems sciences and their characteristic effects on system behaviors. 1Complex systems theories emerged during the second half of the 19th century as physicists, mathematicians, chemists, and others searched for better explanatory models to describe and predict the behavior of phenomena under study. The reductionist model, dominant since the 17th century, had led to important discoveries of human physiology and pathophysiology, laying the foundation for an extraordinary rise in diagnostic and therapeutic effectiveness. These developments, coupl...

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Section: Defining the Discipline Of General/family Practicementioning

confidence: 99%

Systems and Complexity Thinking in the General Practice Literature: An Integrative, Historical Narrative Review

Sturmberg

Martin

Katerndahl

2014

The Annals of Family Medicine

105

112

View full text Add to dashboard Cite

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“…Emergence in complexity science thinking demonstrates that large-scale consequences can arise from small triggers: Cohen and Stewart (1994) and argue that emergence is a rule, rather than an exception; see also Morowitz (2002). The generation of data from commissioned research or evaluation (Griffiths, 2002) through the interaction of researchers and research subjects (Kvale and Brinkmann, 2008) may not be what research commissioners or researchers had expected. Researchers who disregard or remove 'disconfirming observations' (Stewart, 1998, 22) during data collection or analysis can determine different findings and outcomes.…”

Section: Complexity Science: Key Conceptsmentioning

confidence: 99%

Complexity Science: Understanding Research Processes and Improving Research Practice

Cox

2012

Journal of Social Service Research

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ABSTRACT.Reflecting on experiences of co-researching with young people aged thirteen to fifteen in evaluating a government-funded initiative within their own communities, the author explores both some of the consequences of this endeavour and learnings from reflections on research processes therein. Reflections upon lessons learned are analysed through applying some key concepts from complexity science to the research. It is argued that complexity science assists in reflection and in reaching more in-depth understandings of research processes. The author outlines how these concepts could be applied in research more generally and concludes that learnings from this experience are relevant to researchers everywhere.

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“…Leykum et al [2] pick up on the fact that the identification of effective ways to improve care of patients with chronic disease has been difficult because the non-linear nature of practice has not been recognized and systematically addressed. Griffiths [3] recognizes that the dynamic interaction of patients with their social and environmental context influences patient health, but this is poorly documented in available health care data. Finally, Singhal [4] reviews the complex factors, which affect the provision of high-quality care of nursing homes and points out the importance of the quality of the relationships between nursing home staff members.…”

Section: Definitionsmentioning

confidence: 99%

Outcomes from the workshop ‘Putting Complexity to Work – Supporting the Practitioners’: implications for health care

Beautement¹,

Broenner²

2011

Evaluation Clinical Practice

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Complexity Science and its Relevance for Primary Health Care Research

Cited by 19 publications

References 3 publications

Systems and Complexity Thinking in the General Practice Literature: An Integrative, Historical Narrative Review

Systems and Complexity Thinking in the General Practice Literature: An Integrative, Historical Narrative Review

Complexity Science: Understanding Research Processes and Improving Research Practice

Outcomes from the workshop ‘Putting Complexity to Work – Supporting the Practitioners’: implications for health care

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