How unique is continuity of care? A review of continuity and related concepts

Uijen, Annemarie; Schers, Henk; Schellevis, François G.; Bosch, W.J.H.M. van den

doi:10.1093/fampra/cmr104

Cited by 136 publications

(157 citation statements)

References 93 publications

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“…Patient, or person-centric models of communication that give the patients and family caregivers a voice will be increasingly important as advanced care moves more and more into the patient's home. Our study suggests that Choice might serve as a facilitator of teamwork, link teams of professionals together, and promote "team continuity of care" [38]. As such, Choice might challenge existing values and routines about how to perform and organize patient care.…”

Section: Compatibilitymentioning

confidence: 90%

“…Many nurses regarded good delivery of care to entail a "continuous caring relationship" between an individual patient and an identified health care professional [38] and expressed reluctance to hand over tasks to the next shift, or to follow up on an assessment initiated by colleagues. However, the complexity that characterizes cancer care, with a multitude of professionals and stakeholders involved in delivery of a safe and coordinated care [39], calls for new models of communication.…”

Section: Compatibilitymentioning

confidence: 99%

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Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Børøsund

Ruland

Moore

et al. 2014

International Journal of Medical Informatics

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Please cite this article in press as: E. Børøsund, et al., Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation, Int. J. No. of Pages 12 i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s x x x ( 2 0 1 3 ) xxx-xxx j o u r n a l h o m e p a g e : w w w . i j m i j o u r n a l . c o m Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation Objective: To explore nurses' experiences of the benefits of and barriers to using an ITPA called Choice, in cancer care one year after its implementation. ARTICLE IN PRESSMethods: This investigation is a part of a larger study examining the use of Choice in cancer care. Four focus group interviews were conducted with 20 nurses experienced in using the Choice application. The data were analyzed using qualitative content analysis.Results: Three themes and nine sub-themes emerged: (1) "Choice as facilitator for shared understanding and engagement in patients' own care," with three sub-themes: preparing both patient and nurse for communication, shared engagement in care planning, and giving the patients a voice; (2) "enhancing the patients' strengths," with two sub-themes: releasing patient's internal strengths and confirming "normalcy" for the patient; and (3) "new challenges for the nurse," with four sub-themes: organizational challenges, interactions with technology, a need for training in communication skills, and new ethical challenges. Conclusions: Findings suggest that, from nurses' perspectives, integration of ITPAs suchas Choice in clinical practice offers many benefits that can contribute to patient-centered care. However, to reap these benefits, use of such tools must receive equal priority as other routines, and require sufficient time, space and competence. Choice also challenged nurses' professional roles and created dilemmas such as nurses' ambivalence regarding patients' levels of disclosure of sensitive issues and the nurses' ability to respond to

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Section: Compatibilitymentioning

confidence: 90%

Section: Compatibilitymentioning

confidence: 99%

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Børøsund

Ruland

Moore

et al. 2014

International Journal of Medical Informatics

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“…[9,10] Common themes within these terms are personal relationship between patient and care provider and communication and co-operation between providers. [10] Continuity of care has a positive influence on the outcome of patient care, the commitment to care and patients' experience of security, confidence and satisfaction. It enhances health care professionals' communication skills, trust, empathy and shared understanding with their patients.…”

Section: Informational Continuitymentioning

confidence: 99%

Continuity of nursing care in Finnish primary health care settings: A 15-year follow-up

Raivio

Paavilainen

Mattila

2018

CNS

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Objective: Continuity is an essential part of high-quality nursing care. This study is the first systematic follow-up of Finnish primary health care patients assessing continuity of health centre nursing staff. The aim was to ascertain how longitudinal interpersonal continuity of care is related to patients' characteristics, their consultation experiences, and how continuity had changed over the 15-year study period.Methods: A questionnaire survey was conducted among patients attending the health centres in the Tampere University Hospital catchment area from 1998 to 2013. A total of 157,549 patients responded out of 363,464 in almost 60 health centres. We analysed the opinions of patients (n = 47,470) who had visited a nurse during the survey weeks. Opinions on the continuity of care were assessed with the question: "When visiting the health centre, do you usually see the same nurse", the alternatives being "yes" or "no". A binary logistic regression model was used.Results: Almost two thirds of the respondents had met the same nurse when visiting their health care centre. Longitudinal interpersonal continuity of care decreased by 15 percentage (67%-52%) during the study years. Continuity was connected to patient-related items such as a visit in the preceding 12 months (OR 1.32, 95% CI 1.17-1.49) and non-urgency of the visit (OR 1.44, 95% CI 1.27-1.63). The most prominent factor contributing to the sense of continuity of care was how attentively nurses had listened to their patients' problems and shown an interest in them and a willingness to answer their questions (OR 1.31, 95% CI 1.120-1.43). Conclusions:In the past 15 years patient-reported longitudinal interpersonal continuity of nursing care has declined. However continuity of care proved to enhance the experienced quality of primary health care. Continuity was best realized in nursing care when nurses had listened to their patients' problems, showed interest toward them and a willingness to answer their questions.

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“…[1][2][3][4] Continuity of care is, nowadays, considered a multidimensional concept. [5][6][7][8] It comprises providers' knowledge of the patient as a person, the development of an ongoing relationship (personal continuity), and communication and collaboration between care providers to connect care. For this last dimension, slightly different concepts of informational continuity, management continuity, or team/cross-boundary continuity are used in the literature, although they have proven difficult to differentiate for patients.…”

Section: Introductionmentioning

confidence: 99%

Measuring continuity of care: psychometric properties of the Nijmegen Continuity Questionnaire

Uijen

Schers²,

Schellevis³

et al. 2012

Br J Gen Pract

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BackgroundRecently, the Nijmegen Continuity Questionnaire (NCQ) was developed. It aims to measure continuity of care from the patient perspective across primary and secondary care settings. Initial pilot testing proved promising. AimTo further examine the validity, discriminative ability, and reliability of the NCQ. DesignA prospective psychometric instrument validation study in primary and secondary care in the Netherlands. MethodThe NCQ was administered to patients with a chronic disease recruited from general practice (n = 145) and hospital outpatient departments (n = 123) (response rate 76%). A principal component analysis was performed to confirm three subscales that had been found previously. Construct validity was tested by correlating the NCQ score to scores of other scales measuring quality of care, continuity, trust, and satisfaction. Discriminative ability was tested by investigating differences in continuity subscores of different subgroups. Test-retest reliability was analysed in 172 patients. ResultsPrincipal factor analysis confirmed the previously found three continuity subscales -personal continuity, care provider knows me; personal continuity, care provider shows commitment; and team/cross-boundary continuity. Construct validity was demonstrated through expected correlations with other variables and discriminative ability through expected differences in continuity subscores of different subgroups. Test-retest reliability was high (the intraclass correlation coefficient varied between 0.71 and 0.82). ConclusionThis study provides evidence for the validity, discriminative ability, and reliability of the NCQ. The NCQ can be of value to identify problems in continuity of care. Keywordscontinuity of patient care; factor analysis, statistical; healthcare surveys; questionnaires; reproducibility of results.

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How unique is continuity of care? A review of continuity and related concepts

Cited by 136 publications

References 93 publications

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Continuity of nursing care in Finnish primary health care settings: A 15-year follow-up

Measuring continuity of care: psychometric properties of the Nijmegen Continuity Questionnaire

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