Continuity of rehabilitation services in post-acute care from the ambulatory outpatients’ perspective: a qualitative study

Medina-Mirapeix, Françesc; Oliveira-Sousa, Silvana Loana de; Sobral-Ferreira, Marta; Baño-Aledo, María Elena del; Escolar-Reina, Pilar; Montilla-Herrador, Joaquina; Collins, Sean M.

doi:10.2340/16501977-0638

Cited by 20 publications

(23 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although not submitted to the same level of analysis, the recent studies did not contradict or substantially change our conclusions. 17,[63][64][65][66][67][68][69][70] Our fi ndings are highly coherent with a recent metasynthesis of 25 qualitative studies of patients' perceptions of continuity of care by Waibel and colleagues. 71 Their synthesis aimed to contribute new knowledge to the conceptualization of continuity of care, whereas we were looking for measurable dimen-* References: 4-6, 33, 44, 46, 50, 53, 55, 60. sions in the multiple clinician context.…”

Section: Discussionsupporting

confidence: 77%

Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary

Haggerty

Roberge

Freeman

et al. 2013

The Annals of Family Medicine

192

253

View full text Add to dashboard Cite

PURPOSE Continuity of care among different clinicians refers to consistent and coherent care management and good measures are needed. We conducted a metasummary of qualitative studies of patients' experience with care to identify measurable elements that recur over a variety of contexts and health conditions as the basis for a generic measure of management continuity.METHODS From an initial list of 514 potential studies (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007), 33 met our criteria of using qualitative methods and exploring patients' experiences of health care from various clinicians over time. They were coded independently. Consensus meetings minimized conceptual overlap between codes.RESULTS For patients, continuity of care is experienced as security and confidence rather than seamlessness. Coordination and information transfer between professionals are assumed until proven otherwise. Care plans help clinician coordination but are rarely discerned as such by patients. Knowing what to expect and having contingency plans provides security. Information transfer includes information given to the patient, especially to support an active role in giving and receiving information, monitoring, and self-management. Having a single trusted clinician who helps navigate the system and sees the patient as a partner undergirds the experience of continuity between clinicians.CONCLUSION Some dimensions of continuity, such as coordination and communication among clinicians, are perceived and best assessed indirectly by patients through failures and gaps (discontinuity). Patients experience continuity directly through receiving information, having confi dence and security on the care pathway, and having a relationship with a trusted clinician who anchors continuity. Ann Fam Med 2013;11:262-271. doi:10.1370/afm.1499. INTRODUCTIONC ontinuity of care is the extent to which a series of health care services is experienced as connected and coherent and is consistent with a patient's health needs and personal circumstances.1 As patients increasingly receive care from multiple professionals and organizations, improving continuity of care has become a research priority. Although continuity of care is understood differently across health disciplines, an interdisciplinary review of concepts and measures of continuity of care found all disciplines would recognize 3 types of continuity. 1,2 Relational continuity is the therapeutic relationship between a patient and 1 or more clinicians that bridges episodes of care and provides coherence through clinicians' growing comprehensive knowledge of the patient. It is most valued in primary care and family medicine. Informational continuity ensures connectedness and coherence by the uptake of information on past events and is most emphasized in the nursing sciences.3-6 Management continuity refers to consistent and coherent management by different clinicians 263 CONT INUIT Y O F C A R E WIT H MULT IPL E CLINICIANSthrough coordinated and timely delivery of complemen...

show abstract

Section: Discussionsupporting

confidence: 77%

Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary

Haggerty

Roberge

Freeman

et al. 2013

The Annals of Family Medicine

192

253

View full text Add to dashboard Cite

show abstract

“…The literature shows that the PCCQ can be used to understand the essential components of patient CoC based on the patients’ experiences (Medina‐Mirapeix et al . ). Hadjistavropoulos et al .…”

Section: Introductionmentioning

confidence: 97%

A Chinese version of the Patient Continuity of Care Questionnaire: reliability and validity assessment

Chen

2017

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…1 Delivering good healthcare is consistent with an international effort to maintain and enhance continuity of care within the entire healthcare system. 2 Despite this fact, few studies have investigated cardiac patients’ experiences of care across the interface between secondary and primary healthcare systems. 3,4 …”

Section: Introductionmentioning

confidence: 99%

Continuity of care after percutaneous coronary intervention: The patient’s perspective across secondary and primary care settings

Valaker

Norekvål

Råholm

et al. 2017

European Journal of Cardiovascular Nursing

View full text Add to dashboard Cite

Background:Although patients may experience a quick recovery followed by rapid discharge after percutaneous coronary interventions (PCIs), continuity of care from hospital to home can be particularly challenging. Despite this fact, little is known about the experiences of care across the interface between secondary and primary healthcare systems in patients undergoing PCI.Aim:To explore how patients undergoing PCI experience continuity of care between secondary and primary care settings after early discharge.Methods:The study used an inductive exploratory design by performing in-depth interviews of 22 patients at 6–8 weeks after PCI. Nine were women and 13 were men; 13 were older than 67 years of age. Eight lived remotely from the PCI centre. Patients were purposively recruited from the Norwegian Registry for Invasive Cardiology. Interviews were analysed by qualitative content analysis.Findings:Patients undergoing PCI were satisfied with the technical treatment. However, patients experienced an unplanned patient journey across care boundaries. They were not receiving adequate instruction and information on how to integrate health information. Patients also needed help to facilitate connections to community-based resources and to schedule clear follow-up appointments.Conclusions and implications:As high-technology treatment dramatically expands, healthcare organisations need to be concerned about all dimensions of continuity. Patients are witnessing their own processes of healthcare delivery and therefore their voices should be taken into greater account when discussing continuity of care. Nurse-led initiatives to improve continuity of care involve a range of interventions at different levels of the healthcare system.

show abstract

Continuity of rehabilitation services in post-acute care from the ambulatory outpatients’ perspective: a qualitative study

Abstract: This study provides evidence of gaps in different types of continuity of care within the post-acute rehabilitation services in ambulatory settings. Outpatients often perceive their experiences of rehabilitation care as non-connected or non-coherent over time.

Cited by 20 publications

References 18 publications

Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary

Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary

A Chinese version of the Patient Continuity of Care Questionnaire: reliability and validity assessment

Continuity of care after percutaneous coronary intervention: The patient’s perspective across secondary and primary care settings

Contact Info

Product

Resources

About