Literature DB >> 24445105

Systems and complexity thinking in the general practice literature: an integrative, historical narrative review.

Joachim P Sturmberg1, Carmel M Martin, David A Katerndahl.   

Abstract

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.
METHODS: We 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.
RESULTS: General 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.

Entities:  

Keywords:  complex adaptive systems; family medicine; general practice; historical review; integrative review; nonlinear dynamics; philosophy of general practice; philosophy of medicine; systems biology; systems theory

Mesh:

Year:  2014        PMID: 24445105      PMCID: PMC3896540          DOI: 10.1370/afm.1593

Source DB:  PubMed          Journal:  Ann Fam Med        ISSN: 1544-1709            Impact factor:   5.166


  50 in total

1.  Chaos and complexity.

Authors:  T Holt
Journal:  Br J Gen Pract       Date:  1999-06       Impact factor: 5.386

2.  Practice jazz: understanding variation in family practices using complexity science.

Authors:  W L Miller; R R McDaniel; B F Crabtree; K C Stange
Journal:  J Fam Pract       Date:  2001-10       Impact factor: 0.493

3.  From black box to complex adaptive system.

Authors:  Flemming Bro; Jakob Kragstrup
Journal:  Scand J Prim Health Care       Date:  2003-03       Impact factor: 2.581

4.  A complexity perspective on health care improvement and reform in general practice and primary health care.

Authors:  Barbara J Booth; Nicholas Zwar; Mark Harris
Journal:  Aust J Prim Health       Date:  2010       Impact factor: 1.307

5.  Reading and interpreting genograms: a systematic approach.

Authors:  R C Like; J Rogers; M McGoldrick
Journal:  J Fam Pract       Date:  1988-04       Impact factor: 0.493

6.  The relative complexity of primary care provided by medical specialists.

Authors:  R C Mendenhall; C J Moynihan; S E Radecki
Journal:  Med Care       Date:  1984-11       Impact factor: 2.983

7.  Changing models: the impact of Kuhn's theory on medicine.

Authors:  I R McWhinney
Journal:  Fam Pract       Date:  1984-03       Impact factor: 2.267

8.  Description of illness: limitations and approaches.

Authors:  C B Freer
Journal:  J Fam Pract       Date:  1980-05       Impact factor: 0.493

9.  Ecosystemic epistemology: critical implications for the aesthetics and pragmatics of family therapy.

Authors:  B P Keeney; D H Sprenkle
Journal:  Fam Process       Date:  1982-03

10.  Teaching the family system concept in family medicine.

Authors:  J Christie-Seely
Journal:  J Fam Pract       Date:  1981-09       Impact factor: 0.493

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  34 in total

1.  Commentary: Understanding Somatic Symptoms: From Dualism to Systems, Diagnosis to Dimensions, Clinical Judgement to Clinical Science.

Authors:  Lynn S Walker
Journal:  J Pediatr Psychol       Date:  2019-08-01

2.  A paradigm shift: from doctor-patient to payer-patient relationship.

Authors:  Anthony Heymann
Journal:  Br J Gen Pract       Date:  2018-09       Impact factor: 5.386

3.  In this issue: team-based care and information to improve practice.

Authors:  Kurt C Stange
Journal:  Ann Fam Med       Date:  2014 Jan-Feb       Impact factor: 5.166

4.  Assessing, communicating, and managing risk in general practice.

Authors:  Lyndal Trevena
Journal:  Br J Gen Pract       Date:  2014-04       Impact factor: 5.386

5.  Duly noted: Lessons from a two-site intervention to assess and improve the quality of clinical documentation in the electronic health record.

Authors:  Laura Fanucchi; Donglin Yan; Rosemarie L Conigliaro
Journal:  Appl Clin Inform       Date:  2016-07-06       Impact factor: 2.342

6.  The Challenges of Measuring, Improving, and Reporting Quality in Primary Care.

Authors:  Richard A Young; Richard G Roberts; Richard J Holden
Journal:  Ann Fam Med       Date:  2017-03       Impact factor: 5.166

7.  Criteria-Based Return to Sport Decision-Making Following Lateral Ankle Sprain Injury: a Systematic Review and Narrative Synthesis.

Authors:  Bruno Tassignon; Jo Verschueren; Eamonn Delahunt; Michelle Smith; Bill Vicenzino; Evert Verhagen; Romain Meeusen
Journal:  Sports Med       Date:  2019-04       Impact factor: 11.136

Review 8.  A conceptual model of oro-facial health with an emphasis on function.

Authors:  Martin Schimmel; Ghizlane Aarab; Lene Baad-Hansen; Frank Lobbezoo; Peter Svensson
Journal:  J Oral Rehabil       Date:  2021-09-12       Impact factor: 3.558

9.  Barriers to using eHealth data for clinical performance feedback in Malawi: A case study.

Authors:  Zach Landis-Lewis; Ronald Manjomo; Oliver J Gadabu; Matthew Kam; Bertha N Simwaka; Susan L Zickmund; Frank Chimbwandira; Gerald P Douglas; Rebecca S Jacobson
Journal:  Int J Med Inform       Date:  2015-07-19       Impact factor: 4.046

10.  Development and validation of a score to assess complexity of general internal medicine patients at hospital discharge: a prospective cohort study.

Authors:  Fabian D Liechti; Thomas Beck; Adrian Ruetsche; Marie C Roumet; Andreas Limacher; Tobias Tritschler; Jacques D Donzé
Journal:  BMJ Open       Date:  2021-05-06       Impact factor: 2.692

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