title: Developing community based rehabilitation for cancer survivors: organizing for coordination and coherence in practice.
abstract: BACKGROUND
  Increasing incidences of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation in Denmark and to provide insights relevant for other contexts.
  
  
  METHODS
  Twenty-seven rehabilitation managers across 15 municipalities in Denmark comprised the sample. The study was designed with a combination of data collection methods including questionnaires, individual interviews, and focus groups. A Grounded Theory approach was used to analyze the data.
  
  
  RESULTS
  A lack of shared cultures among health care providers and systems of delivery was a primary barrier to collaboration which was essential for establishing coordination of care. Formal multidisciplinary steering committees, team-based organization, and informal relationships were fundamental for developing coordination and coherence.
  
  
  CONCLUSIONS
  Coordination and coherence in community-based rehabilitation relies on increased collaboration, which may best be optimized by use of shared frameworks within and across systems. Results highlight the challenges faced in practical implementation of community rehabilitation and point to possible strategies for its enhancement.
authors.affiliation: Research Initiative of Activity Studies and Occupational Therapy, Research Unit Health, Man and Society, Institute of Public Health, University of Southern Denmark, J, B, Winsløws Vej 9, 5000 Odense, Denmark. klacour@health.sdu.dk.
authors.forename: Karen
authors.initials: K
authors.lastname: la Cour
authors.forename: Malcolm P
authors.initials: MP
authors.lastname: Cutchin
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D003718:Denmark; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007373:Interinstitutional Relations; D009369:Neoplasms / Q000534:rehabilitation*; D015279:Organizational Culture; D016730:Program Development; D012047:Rehabilitation Centers / Q000458:organization & administration*; D017741:Survivors