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Le Ho Thi QA, Pype P, Wens J, Nguyen Vu Quoc H, Derese A, Peersman W, Bui N, Nguyen Thi Thanh H, Nguyen Minh T. Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam. BMC Public Health 2024; 24:34. [PMID: 38166740 PMCID: PMC10763071 DOI: 10.1186/s12889-023-17522-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Vietnam is undergoing a rapid epidemiological transition with a considerable burden of non-communicable diseases (NCDs), especially hypertension and diabetes (T2DM). Continuity of care (COC) is widely acknowledged as a benchmark for an efficient health system. This study aimed to determine the COC level for hypertension and T2DM within and across care levels and to investigate its associations with health outcomes and disease control. METHODS A cross-sectional study was conducted on 602 people with T2DM and/or hypertension managed in primary care settings. We utilized both the Nijmegen continuity of care questionnaire (NCQ) and the Bice - Boxerman continuity of care index (COCI) to comprehensively measure three domains of COC: interpersonal, informational, and management continuity. ANOVA, paired-sample t-test, and bivariate and multivariable logistic regression analysis were performed to examine the predictors of COC. RESULTS Mean values of COC indices were: NCQ: 3.59 and COCI: 0.77. The proportion of people with low NCQ levels was 68.8%, and that with low COCI levels was 47.3%. Primary care offered higher informational continuity than specialists (p < 0.01); management continuity was higher within the primary care team than between primary and specialist care (p < 0.001). Gender, living areas, hospital admission and emergency department encounters, frequency of health visits, disease duration, blood pressure and blood glucose levels, and disease control were demonstrated to be statistically associated with higher levels of COC. CONCLUSIONS Continuity of primary care is not sufficiently achieved for hypertension and diabetes mellitus in Vietnam. Strengthening robust primary care services, improving the collaboration between healthcare providers through multidisciplinary team-based care and integrated care approach, and promoting patient education programs and shared decision-making interventions are priorities to improve COC for chronic care.
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Affiliation(s)
- Quynh-Anh Le Ho Thi
- Family Medicine Center, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Peter Pype
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Johan Wens
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Huy Nguyen Vu Quoc
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Anselme Derese
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Wim Peersman
- Research Group Social and Community Work, Odisee University of Applied Sciences, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Nhon Bui
- Phu Vang District health center, Thua Thien Hue province, Hue, Vietnam
| | - Huyen Nguyen Thi Thanh
- Family Medicine Center, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Tam Nguyen Minh
- Family Medicine Center, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
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Boyer L, Fernandes S, Brousse Y, Zendjidjian X, Cano D, Riedberger J, Llorca PM, Samalin L, Dassa D, Trichard C, Laprevote V, Sauvaget A, Abbar M, Misdrahi D, Berna F, Lancon C, Coulon N, El-Hage W, Rozier PE, Benoit M, Giordana B, Caqueo-Urizar A, Yon DK, Tran B, Auquier P, Fond G. Development of the PREMIUM computerized adaptive testing for measuring the access and care coordination for patients with severe mental illness. Psychiatry Res 2023; 328:115444. [PMID: 37677894 DOI: 10.1016/j.psychres.2023.115444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
Severe mental illness (SMI) patients often have complex health needs, which makes it difficult to access and coordinate their care. This study aimed to develop a computerized adaptive testing (CAT) tool, PREMIUM CAT-ACC, to measure SMI patients' experience with access and care coordination. This multicenter and cross-sectional study included 496 adult in- and out-patients with SMI (i.e., schizophrenia, bipolar disorder, or major depressive disorder). Psychometric analysis of the 13-item bank showed adequate properties, with preliminary evidence of external validity and no substantial differential item functioning for sex, age, care setting, and diagnosis, making it suitable for CAT administration. A post-hoc CAT simulation demonstrated that the tool was efficient and accurate, with an average of seven items, compared to the full item bank administration. Its use by clinicians can contribute to optimizing patient care pathways and transitioning towards more person-centered healthcare.
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Affiliation(s)
- Laurent Boyer
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France.
| | - Sara Fernandes
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
| | - Yann Brousse
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
| | - Xavier Zendjidjian
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
| | - Delphine Cano
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
| | - Jeremie Riedberger
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
| | - Pierre-Michel Llorca
- CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), University Clermont Auvergne, Clermont-Ferrand, France
| | - Ludovic Samalin
- CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), University Clermont Auvergne, Clermont-Ferrand, France
| | - Daniel Dassa
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
| | | | - Vincent Laprevote
- Department of Addictology and Psychiatry, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Anne Sauvaget
- CHU Nantes, Movement - Interactions - Performance, Nantes Université, MIP, UR 4334, Nantes F-44000, France
| | - Mocrane Abbar
- Department of Psychiatry, CHU Nîmes, Univ Montpellier, Nîmes, France
| | - David Misdrahi
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Fabrice Berna
- University Hospital of Strasbourg - Department of Psychiatry, INSERM U1114, FMTS, University of Strasbourg, France
| | - Christophe Lancon
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
| | - Nathalie Coulon
- Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Wissam El-Hage
- CHRU de Tours, Clinique Psychiatrique Universitaire, Tours F-37000, France
| | | | - Michel Benoit
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | - Bruno Giordana
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | | | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Bach Tran
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France; Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Pascal Auquier
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
| | - Guillaume Fond
- AP-HM, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
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Navein A, Gonzalez-Viana E, Mehmeti A, Hargreaves D, Elvins R, Churchill R. Barriers and facilitators to continuity and co-ordination of healthcare for under 18 years old: a systematic review. Arch Dis Child 2023; 108:783-788. [PMID: 36650031 DOI: 10.1136/archdischild-2022-324456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 01/04/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To determine views and experiences of babies, children and young people relating to continuity of their healthcare. DESIGN Qualitative systematic review. SETTING Primary research from UK settings where NHS-commissioned or local authority-commissioned healthcare is provided. Systematic reviews from UK and non-UK high-income countries. POPULATION Babies, children and young people under 18 years old with experience of healthcare. Parental and/or carer perspectives only included if children are under 5 years old or unable to express their own view. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Thematic analysis of the benefits and facilitators to continuity of care for babies, children and young people. RESULTS 20 047 abstracts were screened; 186 full-text articles were reviewed; 11 papers fulfilled the review criteria. From these, four main themes and 14 subthemes were identified. The theme 'individuals' had four subthemes: 'knowledge of healthcare system', 'support', 'personal lives' and 'results'. The theme 'healthcare professionals' had four subthemes: 'interservice communication', 'collaboration with babies, children and young people', 'communications' and 'relationships with healthcare professionals'. The theme 'practical' had four subthemes: 'colocation', 'appointment times', 'referrals' and 'waiting times'. The theme 'technological' had two subthemes: 'ease of use' and 'complements current healthcare management'. CONCLUSIONS Continuity of healthcare for babies, children and young people can enhance clinical outcomes but requires active facilitation by healthcare providers and services, especially in circumstances where individuals or their families are less able to advocate for themselves. A range of barriers and facilitators were identified together with recommendations for enhancing continuity of care. PROSPERO REGISTRATION NUMBER CRD42019145566.
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Affiliation(s)
- Alice Navein
- National Institute for Health and Care Excellence, London, UK
| | - Eva Gonzalez-Viana
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Agnesa Mehmeti
- National Institute for Health and Care Excellence, London, UK
| | - Dougal Hargreaves
- Mohn Centre for Children's Health & Wellbeing, School of Public Health, Imperial College, London, UK
| | - Rachel Elvins
- Child and Adolescent Mental Health CSU, Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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Gray DP, Sidaway-Lee K, Whitaker P, Evans P. Which methods are most practicable for measuring continuity within general practices? Br J Gen Pract 2023; 73:279-282. [PMID: 37230786 PMCID: PMC10229170 DOI: 10.3399/bjgp23x733161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Affiliation(s)
| | | | - Philippa Whitaker
- Queen Mary University of London, London; Barts and The London School of Medicine and Dentistry, London
| | - Philip Evans
- St Leonard's Research Practice, Exeter; Professor of Primary Care Research, Faculty of Health and Life Sciences, University of Exeter, Exeter
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Lampe D, Grosser J, Gensorowsky D, Witte J, Muth C, van den Akker M, Dinh TS, Greiner W. The Relationship of Continuity of Care, Polypharmacy and Medication Appropriateness: A Systematic Review of Observational Studies. Drugs Aging 2023; 40:473-497. [DOI: 10.1007/s40266-023-01022-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
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Zhang T, Wang X. Association of Continuity of General Practitioner Care with Utilisation of General Practitioner and Specialist Services in China: A Mixed-Method Study. Healthcare (Basel) 2021; 9:healthcare9091206. [PMID: 34574980 PMCID: PMC8465206 DOI: 10.3390/healthcare9091206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/31/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Continuity of general practitioner (GP) care, widely known as the core value of high-quality patient care, has a positive association with health outcomes. Evidence about the relationship between continuity and health service utilisation has so far been lacking in China. This study aimed to analyse the association of continuity of GP care with utilisation of general practitioner and specialist services in China. Method: A cross-sectional mixed methods study was conducted in 10 urban communities in Hangzhou. Quantitative data were collected from a random sample of 624 residents adopting the self-developed questionnaire. Measurement of continuity of GP care included informational continuity (IC), managerial continuity (MC) and relational continuity (RC). With adjustment for characteristics of residents, multivariate regression models were established to examine the association of continuity of GP care with the intention to visit GP, frequency of GP and specialist visitations. Qualitative data were collected from 26 respondents using an in-depth interview, and thematic content analysis for qualitative data was conducted. Results: Quantitative analysis showed that the IC was positively associated with the intention to visit GP and frequency of GP visitations. Those people who gave a high rating for RC also used GP services more frequently than their counterparts. MC was negatively associated with frequency of specialist visitations. Qualitative analysis indicated that service capabilities, doctor-patient interaction and time provision were regarded as three important reasons why patients chose GPs or specialists. Conclusions: Overall, high IC and RC are independently associated with more GP service utilisation, but a high MC might reduce specialist visitations. Continuity of GP care should be highlighted in designing a Chinese GP system.
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Schalet BD, Lim S, Cella D, Choi SW. Linking Scores with Patient-Reported Health Outcome Instruments:A VALIDATION STUDY AND COMPARISON OF THREE LINKING METHODS. PSYCHOMETRIKA 2021; 86:717-746. [PMID: 34173935 DOI: 10.1007/s11336-021-09776-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 03/03/2021] [Accepted: 05/19/2021] [Indexed: 06/13/2023]
Abstract
The psychometric process used to establish a relationship between the scores of two (or more) instruments is generically referred to as linking. When two instruments with the same content and statistical test specifications are linked, these instruments are said to be equated. Linking and equating procedures have long been used for practical benefit in educational testing. In recent years, health outcome researchers have increasingly applied linking techniques to patient-reported outcome (PRO) data. However, these applications have some noteworthy purposes and associated methodological questions. Purposes for linking health outcomes include the harmonization of data across studies or settings (enabling increased power in hypothesis testing), the aggregation of summed score data by means of score crosswalk tables, and score conversion in clinical settings where new instruments are introduced, but an interpretable connection to historical data is needed. When two PRO instruments are linked, assumptions for equating are typically not met and the extent to which those assumptions are violated becomes a decision point around how (and whether) to proceed with linking. We demonstrate multiple linking procedures-equipercentile, unidimensional IRT calibration, and calibrated projection-with the Patient-Reported Outcomes Measurement Information System Depression bank and the Patient Health Questionnaire-9. We validate this link across two samples and simulate different instrument correlation levels to provide guidance around which linking method is preferred. Finally, we discuss some remaining issues and directions for psychometric research in linking PRO instruments.
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Affiliation(s)
- Benjamin D Schalet
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N Michigan Ave, 21st Floor, Chicago, IL, 60611, USA.
| | - Sangdon Lim
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX, 78712-1289, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N Michigan Ave, 21st Floor, Chicago, IL, 60611, USA
| | - Seung W Choi
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX, 78712-1289, USA
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Pakrad F, Ahmadi F, Grace SL, Oshvandi K, Kazemnejad A. Traditional versus extended hybrid cardiac rehabilitation based on the continuous care model for coronary artery bypass surgery patients in a middle-income country: A Randomized Clinical Trial. Arch Phys Med Rehabil 2021; 102:2091-2101.e3. [PMID: 34175270 DOI: 10.1016/j.apmr.2021.04.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/23/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare traditional (1-month supervised) versus hybrid cardiac rehabilitation (CR; usual care) with an additional 3 months offered remotely based on the continuous care model (CCM; intervention), in coronary artery bypass graft (CABG) patients. DESIGN randomized controlled trial, with blinded outcome assessment. SETTING A major heart center in a middle-income country. PARTICIPANTS Of 107 eligible patients that were referred to CR during the period of study, 88 (82.2%) were enrolled (target sample size). Participants were randomly assigned 1:1 (concealed; 44 per parallel arm). There was 92.0% retention. INTERVENTION After CR, participants were given an app and communicated biweekly with the nurse from months 1-4 to control risk factors. MAIN OUTCOME MEASURES Quality of life (QoL; SF-36; primary outcome), functional capacity (treadmill test), depression, anxiety and stress (DASS-21) were evaluated pre-CR, after one month, and three months after CR (end of intervention), as well as re-hospitalization. RESULTS The analysis of variance interaction effects for the physical and mental component summary scores of QoL were <.001, favoring intervention (per protocol); there were also significant increases from pre-CR to 1 month, and from 1 month to the final assessment in the intervention arm (p-values<.001), with change in the control arm only to 1 month. The effect sizes were 0.115 and 0.248, respectively. Similarly, the interaction effect for functional capacity was significant (p<.001), with a clinically-significant 1.5 MET increase in the intervention arm. There were trends for group effects for the psychosocial indicators, with paired t-tests revealing significant increases in each at both assessment points in the intervention arm. At 4 months, there were 4 (10.3%) re-hospitalizations in the control arm, and none in intervention (p=.049). Intended theoretical mechanisms were also impacted by the intervention. CONCLUSION Extending CR in this accessible manner, rendering it more comprehensive, was effective in improving outcomes.
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Affiliation(s)
- Fatemeh Pakrad
- PhD Candidate of Nursing, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Sherry L Grace
- Faculty of Health, York University, Toronto, Canada; KITE- Toronto Rehabilitation Institute, & Peter Munk Cardiac Centre, University Health Network, University of Toronto, Canada
| | - Khodayar Oshvandi
- Department of Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Hopstaken JS, van Dalen D, van der Kolk BM, van Geenen EJM, Hermans JJ, Gootjes EC, Schers HJ, van Dulmen AM, van Laarhoven CJHM, Stommel MWJ. Continuity of care experienced by patients in a multi-institutional pancreatic care network: a pilot study. BMC Health Serv Res 2021; 21:416. [PMID: 33941181 PMCID: PMC8094517 DOI: 10.1186/s12913-021-06431-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Over the past decades, health care services for pancreatic surgery were reorganized. Volume norms were applied with the result that only a limited number of expert centers perform pancreatic surgery. As a result of this centralization of pancreatic surgery, the patient journey of patients with pancreatic tumors has become multi-institutional. To illustrate, patients are referred to a center of expertise for pancreatic surgery whereas other parts of pancreatic care, such as chemotherapy, take place in local hospitals. This fragmentation of health care services could affect continuity of care (COC). The aim of this study was to assess COC perceived by patients in a pancreatic care network and investigate correlations with patient-and care-related characteristics. Methods This is a pilot study in which patients with (pre) malignant pancreatic tumors discussed in a multidisciplinary tumor board in a Dutch tertiary hospital were asked to participate. Patients were asked to fill out the Nijmegen Continuity of Care-questionnaire (NCQ) (5-point Likert scale). Additionally, their patient-and care-related data were retrieved from medical records. Correlations of NCQ score and patient-and care-related characteristics were calculated with Spearman’s correlation coefficient. Results In total, 44 patients were included (92% response rate). Pancreatic cancer was the predominant diagnosis (32%). Forty percent received a repetition of diagnostic investigations in the tertiary hospital. Mean scores for personal continuity were 3.55 ± 0.74 for GP, 3.29 ± 0.91 for the specialist and 3.43 ± 0.65 for collaboration between GPs and specialists. Overall COC was scored with a mean 3.38 ± 0.72. No significant correlations were observed between NCQ score and certain patient-or care-related characteristics. Conclusion Continuity of care perceived by patients with pancreatic tumors was scored as moderate. This outcome supports the need to improve continuity of care within multi-institutional pancreatic care networks. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06431-2.
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Affiliation(s)
- J S Hopstaken
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands.,Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands
| | - D van Dalen
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands
| | - B M van der Kolk
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands
| | - E J M van Geenen
- Department of Gastroenterology, Radboud university medical center, Nijmegen, the Netherlands
| | - J J Hermans
- Department of Medical Imaging, Radboud university medical center, Nijmegen, the Netherlands
| | - E C Gootjes
- Department of Medical Oncology, Radboud university medical center, Nijmegen, the Netherlands
| | - H J Schers
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, the Netherlands
| | - A M van Dulmen
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, the Netherlands.,Nivel (Netherlands institute for health services research), Utrecht, the Netherlands
| | - C J H M van Laarhoven
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands
| | - M W J Stommel
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands.
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Shamsalinia A, Moradi M, Rad RE, Ghadimi R, Farahani MA, Masoudi R, Rabiei L, Ghaffari F. Design and psychometric evaluation of epilepsy-related apathy scale (E-RAS) in adults with epilepsy: a sequential exploratory mixed methods design. BMC Neurol 2021; 21:121. [PMID: 33731045 PMCID: PMC7967960 DOI: 10.1186/s12883-021-02139-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/05/2021] [Indexed: 12/03/2022] Open
Abstract
Background Apathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient’s ability to perform social functions and participate in self-care and rehabilitation programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy–related apathy scale (E-RAS) in adults with epilepsy. Methods This study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct [exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200)], convergent and divergent Validity and reliability (internal consistency and stability) were investigated. Results The results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach’s alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P < 0.001). Conclusion E-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02139-2.
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Affiliation(s)
- Abbas Shamsalinia
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Reza Ebrahimi Rad
- Department of Medicine, Islamic Azad University, Tonekabon Branch, Tonekabon, Mazandaran, Iran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mansoureh Ashghali Farahani
- Nursing Care Research Center and School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Masoudi
- Community-Oriented Nursing Midwifery Research Center, Department of Adult and Geriatric Nursing, Nursing and Midwifery School, Shahr-e-Kord University of Medical Sciences, Shahr-e-Kord, Iran
| | - Leili Rabiei
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fatemeh Ghaffari
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Latina R, Salomone K, D’Angelo D, Coclite D, Castellini G, Gianola S, Fauci A, Napoletano A, Iacorossi L, Iannone P. Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228634. [PMID: 33233824 PMCID: PMC7699889 DOI: 10.3390/ijerph17228634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 12/14/2022]
Abstract
Clinical or care pathways are developed by a multidisciplinary team of healthcare practitioners, based on clinical evidence, and standardized processes. The evaluation of their framework/content quality is unclear. The aim of this study was to describe which tools and domains are able to critically evaluate the quality of clinical/care pathways. An overview of systematic reviews was conducted, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using Medline, Embase, Science Citation Index, PsychInfo, CINAHL, and Cochrane Library, from 2015 to 2020, and with snowballing methods. The quality of the reviews was assessed with Assessment the Methodology of Systematic Review (AMSTAR-2) and categorized with The Leuven Clinical Pathway Compass for the definition of the five domains: processes, service, clinical, team, and financial. We found nine reviews. Three achieved a high level of quality with AMSTAR-2. The areas classified according to The Leuven Clinical Pathway Compass were: 9.7% team multidisciplinary involvement, 13.2% clinical (morbidity/mortality), 44.3% process (continuity-clinical integration, transitional), 5.6% financial (length of stay), and 27.0% service (patient-/family-centered care). Overall, none of the 300 instruments retrieved could be considered a gold standard mainly because they did not cover all the critical pathway domains outlined by Leuven and Health Technology Assessment. This overview shows important insights for the definition of a multiprinciple framework of core domains for assessing the quality of pathways. The core domains should consider general critical aspects common to all pathways, but it is necessary to define specific domains for specific diseases, fast pathways, and adapting the tool to the cultural and organizational characteristics of the health system of each country.
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Affiliation(s)
- Roberto Latina
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Katia Salomone
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Daniela D’Angelo
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Daniela Coclite
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (G.C.); (S.G.)
| | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (G.C.); (S.G.)
| | - Alice Fauci
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Antonello Napoletano
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Laura Iacorossi
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
- Correspondence:
| | - Primiano Iannone
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
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12
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Toward Sustainable ICT-Supported Neighborhood Development—A Maturity Model. SUSTAINABILITY 2020. [DOI: 10.3390/su12229319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Scientists promote the fostering of caring communities as a means of sustainably coping with demographic changes. They consider community-based technologies to have a high potential for supporting the establishment of caring communities. However, implementing community-based technologies is a complex endeavor, making sustainable adoption difficult. We have developed a maturity model aimed at standardizing the monitoring and evaluation of neighborhood projects. Based on a maturity model for integrated care, we conducted a Delphi study, to develop a maturity model for information and communication technology (ICT)-supported neighborhood development. In eight case studies, the model was validated and subsequently adapted to the specific needs and requirements of neighborhood projects. These studies emphasized the importance of at least 12 decisive dimensions and showed that the maturity model could be applied at different stages of a project. The current form of the maturity model can be used to help orient, as well as monitor and evaluate, neighborhood development projects. Future work will be necessary to further develop accompanying materials and services and to foster the exchange of best practices and experience between projects.
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13
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Facchinetti G, Piredda M, Ausili D, Angaroni V, Albanesi B, Marchetti A, Di Mauro S, De Marinis MG. Information before discharge in geriatric patients in Italy: cultural adaptation and validation of the Patient Continuity of Care Questionnaire. Eur J Ageing 2020; 18:99-107. [PMID: 33746685 DOI: 10.1007/s10433-020-00576-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Our aim is to culturally adapt the first section of the Patient Continuity of Care Questionnaire (PCCQ) for use among older Italian patients with chronic diseases and to test its psychometric properties. The PCCQ was translated, adapted to the Italian context, and completed by 236 older inpatients with chronic diseases at the point of discharge through a cross-sectional multi-centre validation study. Face and content validity were assessed. Exploratory factor analysis (EFA) with Mplus MLr estimator was conducted. Internal consistency was analysed through Cronbach's alpha and factor score determinacy coefficients. The overall content validity index of the 15-item Italian version of the questionnaire was 0.9. The EFA revealed a four-factor model yielding adequate fit indices. The factor score determinacy coefficients ranged from 0.87 to 0.94. The Cronbach's alpha coefficients ranged from 0.71 to 0.86 showing good reliability. The study provides health professionals with an instrument with adequate psychometric properties to assess patients' perception of the information received before hospital discharge.
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Affiliation(s)
- Gabriella Facchinetti
- Department of Biomedicine and Prevention, School of Nursing, Faculty of Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.,Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Beatrice Albanesi
- Department of Biomedicine and Prevention, School of Nursing, Faculty of Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy
| | - Anna Marchetti
- Department of Biomedicine and Prevention, School of Nursing, Faculty of Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.,Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Stefania Di Mauro
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
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14
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Bull KS, Hornsey S, Kennedy CR, Darlington ASE, Grootenhuis MA, Hargrave D, Liossi C, Shepherd JP, Walker DA, Morris C. Systematic review: measurement properties of patient-reported outcome measures evaluated with childhood brain tumor survivors or other acquired brain injury. Neurooncol Pract 2020; 7:277-287. [PMID: 32537177 DOI: 10.1093/nop/npz064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Survivors of childhood brain tumors or other acquired brain injury (ABI) are at risk of poor health-related quality of life (HRQoL); its valid and reliable assessment is essential to evaluate the effect of their illness on their lives. The aim of this review was to critically appraise psychometric properties of patient-reported outcome measures (PROMs) of HRQoL for these children, to be able to make informed decisions about the most suitable PROM for use in clinical practice. Methods We searched MEDLINE, EMBASE, and PsycINFO for studies evaluating measurement properties of HRQoL PROMs in children treated for brain tumors or other ABI. Methodological quality of relevant studies was evaluated using the consensus-based standards for the selection of health status measurement instruments checklist. Results Eight papers reported measurement properties of 4 questionnaires: Health Utilities Index (HUI), PedsQL Core and Brain Tumor Modules, and Child and Family Follow-up Survey (CFFS). Only the CFFS had evidence of content and structural validity. It also demonstrated good internal consistency, whereas both PedsQL modules had conflicting evidence regarding this. Conflicting evidence regarding test-retest reliability was reported for the HUI and PedsQL Core Module only. Evidence of measurement error/precision was favorable for HUI and CFFS and absent for both PedsQL modules. All 4 PROMs had some evidence of construct validity/hypothesis testing but no evidence of responsiveness to change. Conclusions Valid and reliable assessment is essential to evaluate impact of ABI on young lives. However, measurement properties of PROMs evaluating HRQoL appropriate for this population require further evaluation, specifically construct validity, internal consistency, and responsiveness to change.
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Affiliation(s)
- Kim S Bull
- Clinical and Experimental Sciences, University of Southampton, UK
| | - Samantha Hornsey
- Primary Care, Population Sciences, and Medical Education, University of Southampton, UK
| | - Colin R Kennedy
- Clinical and Experimental Sciences, University of Southampton, UK
| | | | - Martha A Grootenhuis
- Psychosocial Research and Healthcare Innovation, Princess Máxima Centre for Paediatric Oncology, Utrecht, NL
| | - Darren Hargrave
- UCL Great Ormond Street Institute of Child Health, University College London, UK.,Paediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London,UK
| | - Christina Liossi
- Psychology, University of Southampton, UK.,Pain Control Service, Great Ormond Street Hospital for Children NHS Trust, UK
| | - Jonathan P Shepherd
- Southampton Health Technology Assessments Centre, University of Southampton, UK
| | - David A Walker
- Children's Brain Tumour Research Centre, University of Nottingham, UK
| | - Christopher Morris
- The Peninsula Childhood Disability Research Unit, University of Exeter, UK
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15
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Loranger C, Fleury MJ. Factors Associated with Perceived Continuity of Care Among Patients Suffering from Mental Disorders. Community Ment Health J 2020; 56:670-679. [PMID: 31863224 DOI: 10.1007/s10597-019-00528-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022]
Abstract
This cross-sectional study identified variables associated with continuity of care among 327 patients with mental disorders receiving services from a variety of professionals in different Quebec settings. Based on the Andersen's Behavioral Model, a linear regression analysis was performed. Attention deficit and mood disorders were negatively associated with continuity of care, while substance use disorders and quality of life revealed positive associations. Consulting a psychologist was linked to weaker continuity of care whereas visiting a drug rehabilitation center, social support, and satisfaction with services were positively related. Fostering social support, comprehensive and integrated care, and facilitating access to psychologists could lead to improved continuity of care.
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Affiliation(s)
- Claudie Loranger
- Research Centre, Centre intégré de santé Et Services Sociaux de L'Outaouais, 20 rue Pharand, Gatineau, QC, J9A 1K7, Canada
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montréal, QC, Canada
- Department of Psychiatry, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Marie-Josée Fleury
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montréal, QC, Canada.
- Department of Psychiatry, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
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16
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Scaioli G, Schäfer WLA, Boerma WGW, Spreeuwenberg PMM, Schellevis FG, Groenewegen PP. Communication between general practitioners and medical specialists in the referral process: a cross-sectional survey in 34 countries. BMC FAMILY PRACTICE 2020; 21:54. [PMID: 32183771 PMCID: PMC7079351 DOI: 10.1186/s12875-020-01124-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/09/2020] [Indexed: 11/29/2022]
Abstract
Background The communication of relevant patient information between general practitioners (GPs) and medical specialists is important in order to avoid fragmentation of care thus achieving a higher quality of care and ensuring physicians’ and patients’ satisfaction. However, this communication is often not carried out properly. The objective of this study is to assess whether communication between GPs and medical specialists in the referral process is associated with the organisation of primary care within a country, the characteristics of the GPs, and the characteristics of the primary care practices themselves. Methods An analysis of a cross-sectional survey among GPs in 34 countries was conducted. The odds ratios of the features that were expected to relate to higher rates of referral letters sent and communications fed back to GPs were calculated using ordered logistic multilevel models. Results A total of 7183 GPs from 34 countries were surveyed. Variations between countries in referral letters sent and feedback communication received did occur. Little of the variance between countries could be explained. GPs stated that they send more referral letters, and receive more feedback communications from medical specialists, in countries where they act as gatekeepers, and when, in general, they interact more with specialists. GPs reported higher use of referral letters when they had a secretary and/or a nurse in their practice, used health information technologies, and had greater job satisfaction. Conclusions There are large differences in communication between GPs and medical specialists. These differences can partly be explained by characteristics of the country, the GP and the primary care practice. Further studies should also take the organisation of secondary care into account.
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Affiliation(s)
- Giacomo Scaioli
- Department of Public Health Sciences, University of Turin, Piazza Polonia, 94, 10126, Torino, Italy
| | - Willemijn L A Schäfer
- Department of Surgery, Northwestern University, Feinberg School of Medicine, 633 N. St Clair Street, Chicago, IL, 60611, USA
| | - Wienke G W Boerma
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, Utrecht, 3500BN, The Netherlands
| | - Peter M M Spreeuwenberg
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, Utrecht, 3500BN, The Netherlands
| | - François G Schellevis
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, Utrecht, 3500BN, The Netherlands.,Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, the Netherlands
| | - Peter P Groenewegen
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, Utrecht, 3500BN, The Netherlands. .,Department of Sociology and Department of Human Geography, Utrecht University, P.O. Box 80.115, Utrecht, 3508 TC, The Netherlands.
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17
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Valaker I, Fridlund B, Wentzel-Larsen T, Nordrehaug JE, Rotevatn S, Råholm MB, Norekvål TM. Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention. BMC Health Serv Res 2020; 20:71. [PMID: 32005235 PMCID: PMC6993348 DOI: 10.1186/s12913-020-4908-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
AIMS Complexity of care in patients with coronary artery disease is increasing, due to ageing, improved treatment, and more specialised care. Patients receive care from various healthcare providers in many settings. Still, few studies have evaluated continuity of care across primary and secondary care levels for patients after percutaneous coronary intervention (PCI). This study aimed to determine multifaceted aspects of continuity of care and associations with socio-demographic characteristics, self-reported health, clinical characteristics and follow-up services for patients after PCI. METHODS This multi-centre prospective cohort study collected data at baseline and two-month follow-up from medical records, national registries and patient self-reports. Univariable and hierarchical regressions were performed using the Heart Continuity of Care Questionnaire total score as the dependent variable. RESULTS In total, 1695 patients were included at baseline, and 1318 (78%) completed the two-month follow-up. Patients stated not being adequately informed about lifestyle changes, medication and follow-up care. Those experiencing poorer health status after PCI scored significantly worse on continuity of care. Patients with ST-segment elevation myocardial infarction scored significantly better on informational and management continuity than those with other cardiac diagnoses. The regression analyses showed significantly better continuity (P ≤ 0.034) in patients who were male, received written information from hospital, were transferred to another hospital before discharge, received follow-up from their general practitioner or had sufficient consultation time after discharge from hospital. CONCLUSION Risk factors for sub-optimal continuity were identified. These factors are important to patients, healthcare providers and policy makers. Action should be taken to educate patients, reconcile discharge plans and organise post-discharge services. Designing pathways with an interdisciplinary approach and shared responsibility between healthcare settings is recommended.
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Affiliation(s)
- Irene Valaker
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Svanehaugvegen 1, 6812 Førde, Norway
| | - Bengt Fridlund
- Department of Heart Disease, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway
- Centre for Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, 351 95 Växjö, Sweden
| | - Tore Wentzel-Larsen
- Centre for Clinical Research, Haukeland University Hospital, Haukelandsveien 28, 5009 Bergen, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484 Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugveien 1, 0484 Oslo, Norway
| | - Jan Erik Nordrehaug
- Department of Clinical Science, Faculty of Medicine, University of Bergen, P.O box 7804, 5020 Bergen, Norway
- Department of Cardiology, Stavanger University Hospital, Gerd-Ragna Bloch Thorsens gate 8, 4011 Stavanger, Norway
| | - Svein Rotevatn
- Department of Heart Disease, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway
- Norwegian Registry for Invasive Cardiology, 5021 Bergen, Norway
| | - Maj-Britt Råholm
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Svanehaugvegen 1, 6812 Førde, Norway
| | - Tone M. Norekvål
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Svanehaugvegen 1, 6812 Førde, Norway
- Department of Heart Disease, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, P.O box 7804, 5020 Bergen, Norway
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18
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Pascual López JA, Gil Pérez T, Sánchez Sánchez JA, Menárguez Puche JF. [Questionnaires of person centered care in primary care. A systematic review]. Aten Primaria 2019; 52:738-749. [PMID: 31883783 PMCID: PMC8054285 DOI: 10.1016/j.aprim.2019.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 10/11/2019] [Accepted: 11/18/2019] [Indexed: 12/30/2022] Open
Abstract
Objetivo Pese a la importancia de la «atención centrada en la persona» (ACP), hay evidentes limitaciones para valorarla y medirla, debidas probablemente a la dificultad para definirla. El objetivo del estudio fue identificar herramientas validadas que midiesen la ACP o algunos de sus aspectos en el ámbito de la atención primaria. Diseño Revisión sistemática. Fuentes de datos MEDLINE, Embase, Cochrane, PSYCinfo, IME-Biomedicina, LILACS y TESEO hasta del 31 de mayo de 2018. Selección de estudios Los criterios de inclusión fueron: a) estudios de validación de cuestionarios, revisiones sistemáticas sobre estudios de validación u otros estudios descriptivos, b) realizados todos ellos en el ámbito de la atención primaria y c) que midieran aspectos de la ACP en profesionales y/o pacientes. Dos investigadores revisaron de forma independiente los artículos y sus discrepancias fueron resueltas por un tercer investigador. Extracción de datos Se recogieron datos sobre los aspectos de la ACP medidos, población a la que se dirige, tipo de cuestionario, y datos sobre validez y fiabilidad. Resultados Se localizaron 1.415 artículos a los que se añadieron 54 referencias adicionales identificadas a través de referencias de los artículos de la revisión sistemática. Tras una depuración finalmente fueron 75 los artículos que cumplieron todos los criterios y 39 las herramientas identificadas y clasificadas según las dimensiones analizadas. Conclusiones Debido a la dificultad de medir la ACP en su conjunto, la mayor parte de los artículos hacen referencia solo a alguno de sus aspectos o dimensiones, predominando la perspectiva del paciente frente a la del profesional. Estas herramientas son, no obstante, un importante punto de partida para futuros cuestionarios que intenten valorar de forma integral la ACP.
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Affiliation(s)
| | - Trinidad Gil Pérez
- Centro de Salud docente Mariano Yago, Servicio Murciano de Salud, Yecla, Murcia, España
| | - Juan Antonio Sánchez Sánchez
- Grupo de Trabajo de Medicina Basada en la Evidencia, Sociedad Murciana de Medicina de Familia y Comunitaria (SMUMFyC), Murcia, España
| | - Juan Francisco Menárguez Puche
- Grupo de Trabajo de Medicina Basada en la Evidencia, Sociedad Murciana de Medicina de Familia y Comunitaria (SMUMFyC), Murcia, España; Centro de Salud docente Profesor Jesús Marín, Molina de Segura, Murcia, España
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19
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Scaioli G, Schäfer WLA, Boerma WGW, Spreeuwenberg P, van den Berg M, Schellevis FG, Groenewegen PP. Patients' perception of communication at the interface between primary and secondary care: a cross-sectional survey in 34 countries. BMC Health Serv Res 2019; 19:1018. [PMID: 31888614 PMCID: PMC6937702 DOI: 10.1186/s12913-019-4848-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/17/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor communication between general practitioners (GPs) and medical specialists can lead to poorer quality, and continuity, of care. Our study aims to assess patients' perceptions of communication at the interface between primary and secondary care in 34 countries. It will analyse, too, whether this communication is associated with the organisation of primary care within a country, and with the characteristics of GPs and their patients. METHODS We conducted a cross-sectional survey among patients in 34 countries. Following a GP consultation, patients were asked two questions. Did they take to understand that their GP had informed medical specialists about their illness upon referral? And, secondly, did their GP know the results of the treatment by a medical specialist? We used multi-response logistic multilevel models to investigate the association of factors related to primary care, the GP, and the patient, with the patients' perceptions of communication at the interface between primary and secondary care. RESULTS In total, 61,931 patients completed the questionnaire. We found large differences between countries, in both the patients' perceptions of information shared by GPs with medical specialists, and the patients' perceptions of the GPs' awareness of the results of treatment by medical specialists. Patients whose GPs stated that they 'seldom or never' send referral letters, also less frequently perceived that their GP communicated with their medical specialists about their illness. Patients with GPs indicating they 'seldom or never' receive feedback from medical specialists, indicated less frequently that their GP would know the results of treatment by a medical specialist. Moreover, patients with a personal doctor perceived higher rates of communication in both directions at the interface between primary and secondary care. CONCLUSION Generally, patients perceive there to be high rates of communication at the interface between primary and secondary care, but there are large differences between countries. Policies aimed at stimulating personal doctor arrangements could, potentially, enhance the continuity of care between primary and secondary care.
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Affiliation(s)
- Giacomo Scaioli
- Department of Public Health Sciences, University of Turin, Piazza Polonia, 94, 10126, Torino, Italy
| | - Willemijn L A Schäfer
- Department of Surgery, Northwestern University, Feinberg School of Medicine, 633 N. St Clair Street, Chicago, IL, 60611, USA
| | - Wienke G W Boerma
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BN, Utrecht, The Netherlands
| | - Peter Spreeuwenberg
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BN, Utrecht, The Netherlands
| | - Michael van den Berg
- Department of Public Health, Amsterdam Public Health Research Institute, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - François G Schellevis
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BN, Utrecht, The Netherlands.,Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands
| | - Peter P Groenewegen
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BN, Utrecht, The Netherlands. .,Department of Sociology, P.O. Box 80.115, 3508 TC, Utrecht, The Netherlands. .,Department of Human Geography, Utrecht University, P.O. Box 80.115, 3508 TC, Utrecht, The Netherlands.
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20
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Gagnier JJ, Shen Y, Huang H. Psychometric Properties of Patient-Reported Outcome Measures for Use in Patients with Anterior Cruciate Ligament Injuries: A Systematic Review. JBJS Rev 2019; 6:e5. [PMID: 29634589 DOI: 10.2106/jbjs.rvw.17.00114] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Despite the high costs of anterior cruciate ligament (ACL) injuries to patients and society, we are not aware of any systematic reviews that have been performed on patient-reported outcome instruments designed for this patient population. The purpose of the present review is to identify currently available patient-reported outcome questionnaires for patients with ACL injuries, to appraise and assess the methodological quality and psychometric evidence of the evaluations of identified instruments, and to summarize the overall evidence for each included questionnaire. METHODS A computerized literature search was performed to identify articles appropriate for inclusion in this systematic review. Search terms were related to outcome instruments, ACL injuries, and psychometric properties. Two independent reviewers assessed the suitability of articles for inclusion. The methodological quality of instrument evaluation was assessed with use of the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) checklist. Psychometric properties were assessed with use of the quality criteria established by Terwee et al. The 2 assessments were synthesized to obtain an overall rating of the psychometric evidence for each questionnaire. RESULTS Forty-one studies investigating 24 instruments were included. The International Knee Documentation Committee (IKDC) Form and the Knee injury and Osteoarthritis Outcome Score (KOOS) were the most frequently assessed instruments. The ACL-Return to Sport after Injury (ACL-RSI) scale had 6 properties with positive evidence and was the highest-quality instrument overall. CONCLUSIONS Many of the included studies had low COSMIN ratings. The ACL-RSI is a reliable and valid scale to measure outcomes for patients with ACL injuries. Further assessments with improved methodological quality are needed to determine the psychometric properties of other instruments.
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Affiliation(s)
- Joel J Gagnier
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Ying Shen
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Hsiaomin Huang
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
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21
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Valentijn PP, Pereira F, Sterner CW, Vrijhoef HJM, Ruwaard D, Hegbrant J, Strippoli GFM. Validation of the Rainbow Model of Integrated Care Measurement Tools (RMIC-MTs) in renal care for patient and care providers. PLoS One 2019; 14:e0222593. [PMID: 31536548 PMCID: PMC6752779 DOI: 10.1371/journal.pone.0222593] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 09/03/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Integrated service delivery is considered to be an essential condition for improving the management and health outcomes of people with chronic kidney disease (CKD). However, research on the assessment of integrated care by patients and care providers is hindered by the absence of brief, reliable, and valid measurement tools. OBJECTIVE The aim of this study was to develop survey instruments for healthcare professionals and patients based on the Rainbow Model of Integrated Care (RMIC), and to evaluate their psychometric properties. DESIGN The development process was based on the US Food and Drug Administration guidelines. This included item generation from systematic reviews of existing tools and expert opinion on clarity and content validity, involving renal care providers and chronic kidney patients. A cross-sectional, multi-centre design was used to test for internal consistency and construct validity. SETTING Outpatient clinics in a large renal network. PARTICIPANTS A sample of 30.788 CKD patients, and 8.914 renal care providers. METHODS AND ANALYSIS Both survey instruments were developed using previous qualitative work and published literature. A multidisciplinary expert panel assessed the face and content validity of both instruments and following a pilot study, the psychometric properties of both instruments were explored. Exploratory factor analysis with principal axis factoring and with promax rotation was used to assess the underlying dimensions of both instruments; Cronbach's alpha was used to determine the internal constancy reliability. RESULTS 17.512 patients (response rate: 56.9%) and 8.849 care providers (response rate: 69.5%) responded to the questionnaires. Factor analysis of the patient questionnaire yielded three internally consistent (Cronbach's alpha > 0.7) factors: person-centeredness, clinical coordination, and professional coordination. Factor analysis of the provider questionnaire produced eight internally consistent (Cronbach's alpha > 0.7) factors: person-centeredness, community centeredness, clinical coordination, professional coordination, organisational coordination, system coordination, technical and cultural competence. As hypothesised, care coordination patient and providers scores significantly correlated with questions about quality of care, treatment involvement, reported health, clinics' organisational readiness, and external care coordination capacity. CONCLUSION This study provides evidence for the reliability and validity of the RMIC patient and provider questionnaires as generic tools to assess the experience with or perception of integrated renal care delivery. The instruments are recommended in future applications testing test-retest reliability, convergent and predictive validity, and responsiveness.
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Affiliation(s)
- Pim P. Valentijn
- Department of Patient and Care, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Integrated Care Evaluation, Essenburgh, Hierden, The Netherlands
| | | | | | - Hubertus J. M. Vrijhoef
- Department of Patient and Care, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Family Medicine, Vrije Universiteit Brussel, Brussels, Belgium
- Panaxea, Amsterdam, The Netherlands
| | - Dirk Ruwaard
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Jörgen Hegbrant
- Diaverum Medical Scientific Office, Diaverum Sweden AB, Lund, Sweden
| | - Giovanni F. M. Strippoli
- Diaverum Medical Scientific Office, Diaverum Sweden AB, Lund, Sweden
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
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22
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Wyngaerden F, Nicaise P, Dubois V, Lorant V. Social support network and continuity of care: an ego-network study of psychiatric service users. Soc Psychiatry Psychiatr Epidemiol 2019; 54:725-735. [PMID: 30758541 DOI: 10.1007/s00127-019-01660-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 01/21/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE For severely mentally ill (SMI) users, continuity of care requires consistency between the supports provided by the members of their social support network. However, we know little about their network cohesion and its association with continuity of care. We set out to investigate this association and hypothesised that it would depend on the severity of the user's situation and on his/her living arrangements. METHODS We conducted face-to-face interviews with 380 SMI users recruited in outpatient and inpatient mental health services in three areas in Belgium. Data regarding users' social networks were collected using an ego-network mapping technique and analysed with social network analysis. The cohesion indicators were density (frequency of connections between network members), centralisation (having a small number of central people), and egobetweenness (the user's centrality in his/her own network). Participants' perception of continuity of care was measured by the Alberta Continuity of Services Scale. RESULTS Results show that cohesion indicators were associated with continuity of care only for users with high-severity problems, regardless of their living arrangements. The numbers of network members, professionals, and services in the network were all negatively associated with continuity of care for all the users. CONCLUSIONS Satisfactory continuity of care requires fewer professionals or services in a user's network and a dense network for users with the most severe problems. This implies that those providing care must not only be able to increase cohesion within a network, but also to adapt their interventions to support the transition to a different, individualised network structure when severity decreases.
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Affiliation(s)
- François Wyngaerden
- Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, B1.30.15, 1200, Brussels, Belgium.
| | - Pablo Nicaise
- Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, B1.30.15, 1200, Brussels, Belgium
| | - Vincent Dubois
- Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, B1.30.15, 1200, Brussels, Belgium
| | - Vincent Lorant
- Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, B1.30.15, 1200, Brussels, Belgium
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23
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Valaker I, Fridlund B, Wentzel-Larsen T, Hadjistavropoulos H, Nordrehaug JE, Rotevatn S, Råholm MB, Norekvål TM. Adaptation and psychometric properties of the Norwegian version of the heart continuity of care questionnaire (HCCQ). BMC Med Res Methodol 2019; 19:62. [PMID: 30885143 PMCID: PMC6423885 DOI: 10.1186/s12874-019-0706-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/11/2019] [Indexed: 11/17/2022] Open
Abstract
Background Continuity of cardiac care after hospital discharge is a priority, especially as healthcare systems become increasingly complex and fragmented. There are few available instruments to measure continuity of cardiac care, especially from the patient perspective. The aim of this study was (1) to translate and adapt the Heart Continuity of Care Questionnaire (HCCQ) to conditions in Norway, and (2) to determine its psychometric properties in self-report format administered to patients after percutaneous coronary intervention (PCI). Methods The HCCQ was first translated into Norwegian from the original English version, following a widely used cross-cultural adaptation process. Data were collected before hospital discharge and in a follow-up after 2 months. To assess psychometric properties, a confirmatory factor analysis (CFA) was performed and three aspects of construct validity were evaluated: structural validity, hypotheses testing and cross-cultural validation. Internal consistency of the HCCQ subscales was calculated using Cronbach’s alpha, while intra-class correlation (ICC) was used to assess test-retest reliability. Additionally, socio-demographic and patient-reported data were collected to correlate with HCCQ scores. Results Of those included at baseline, 436 (76%) completed the questionnaires after 2 months. CFA suggested that the fit of the HCCQ data to a 3-factor model was modest (RMSEA = 0.11, CFI = 0.90, TLI = 0.90). However, convergent validity was satisfactory, based on existing research. Internal consistency was good, as indicated by its Cronbach’s alphas: total continuity of care (0.95); informational (0.93), relational (0.87), and management (0.89) continuity. The ICC for the total HCCQ score was 0.80 (95% CI [0.71, 0.87] p < 0.001). As indicated by negative care experiences (rated as 1 or 2 on the five-point scale), patients seemed to have limited knowledge about medical treatment, lifestyle modification and follow-up after PCI. Participation in cardiac rehabilitation and longer consultations with the general practitioner after hospital discharge were positively correlated with better continuity of care. Conclusions Implementation of the HCCQ will likely support healthcare providers and researchers in identifying problem areas of continuity of cardiac care and in evaluating interventions aimed at improving continuity of care.
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Affiliation(s)
- Irene Valaker
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway.
| | - Bengt Fridlund
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden
| | - Tore Wentzel-Larsen
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern, Oslo, Norway.,Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | | | - Jan Erik Nordrehaug
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Svein Rotevatn
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,Norwegian Registry for Invasive Cardiology, Bergen, Norway
| | - Maj-Britt Råholm
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Tone M Norekvål
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
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24
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Loranger C, Bamvita JM, Fleury MJ. Typology of patients with mental health disorders and perceived continuity of care. J Ment Health 2019; 29:296-305. [PMID: 30862205 DOI: 10.1080/09638237.2019.1581329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: While multiple socio-demographic, clinical and service use variables have been associated with continuity of care (CoC) in patients diagnosed with mental health disorders (MHDs), little is known about how these variables may inform clinical practice and service planning.Aim: This article identified profiles of patients with MHDs to better understand their perceptions of CoC.Method: The sample for this cross-sectional study comprised 327 patients recruited by staff or self-referred from four local health networks in Quebec (Canada). Data were collected using standardized instruments, and patient medical records. A three-factor conceptual framework based on Andersen's Behavioral Model was used, integrating predisposing, needs and enabling factors.Results: Cluster analyses identified five patient profiles. Profiles that included relatively more patients with common MHDs reported less continuity than those with patients primarily affected by severe MHDs.Conclusions: Service planning and delivery should be better adapted to patient profiles in order to improve CoC, and increased access to services prioritized.
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Affiliation(s)
- Claudie Loranger
- Research Centre, Centre intégré de santé et services sociaux de l'Outaouais, Gatineau, Québec.,Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montréal, Québec.,Department of Psychiatry, McGill University, Montréal, Québec
| | - Jean-Marie Bamvita
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montréal, Québec.,Department of Psychiatry, McGill University, Montréal, Québec
| | - Marie-Josée Fleury
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montréal, Québec.,Department of Psychiatry, McGill University, Montréal, Québec
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25
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Meiqari L, Al-Oudat T, Essink D, Scheele F, Wright P. How have researchers defined and used the concept of 'continuity of care' for chronic conditions in the context of resource-constrained settings? A scoping review of existing literature and a proposed conceptual framework. Health Res Policy Syst 2019; 17:27. [PMID: 30845968 PMCID: PMC6407241 DOI: 10.1186/s12961-019-0426-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/14/2019] [Indexed: 01/11/2023] Open
Abstract
Background Within the context of the growing burden of non-communicable diseases (NCDs) globally, there is limited evidence on how researchers have explored the response to chronic health needs in the context of health policy and systems in low- and middle-income countries. Continuity of care (CoC) is one concept that represents several elements of a long-term model of care. This scoping review aims to map and describe the state of knowledge regarding how researchers in resource-constrained settings have defined and used the concept of CoC for chronic conditions in primary healthcare. Methods This scoping review adopted the modified framework for interpretive scoping literature reviews. A systematic literature search in PubMed was performed, followed by a study selection process and data extraction, analysis and synthesis. Extracted data regarding the context of using CoC and the definition of CoC were analysed inductively to identify similar patterns; based on this, articles were divided into groups. MaxQDA was then used to re-code each article with themes according to the CoC definition to perform a cross-case synthesis under each identified group. Results A total of 55 peer-reviewed articles, comprising reviews or commentaries and qualitative or quantitative studies, were included. The number of articles has increased over the years. Five groups were identified as those (1) reflecting a change across stages or systems of care, (2) mentioning continuity or lack of continuity without a detailed definition, (3) researching CoC in HIV/AIDS programmes and its scaling up to support management of NCDs, (4) researching CoC in NCD management, and (5) measuring CoC with validated questionnaires. Conclusion Research or policy documents need to provide an explicit definition of CoC when this terminology is used. A framework for CoC is suggested, acknowledging three components for CoC (i.e. longitudinal care, the nature of the patient–provider relationship and coordinated care) while considering relevant contextual factors, particularly access and quality. Electronic supplementary material The online version of this article (10.1186/s12961-019-0426-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lana Meiqari
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands. .,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Tammam Al-Oudat
- Médecins Sans Frontières, Operational Centre Geneva (MSF-OCG), Geneva, Switzerland
| | - Dirk Essink
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Fedde Scheele
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Pamela Wright
- Guelph International Health Consulting, Amsterdam, The Netherlands
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26
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Qiu C, Chen S, Yao Y, Zhao Y, Xin Y, Zang X. Adaption and validation of Nijmegen continuity questionnaire to recognize the influencing factors of continuity of care for hypertensive patients in China. BMC Health Serv Res 2019; 19:79. [PMID: 30696430 PMCID: PMC6352379 DOI: 10.1186/s12913-019-3915-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 01/17/2019] [Indexed: 12/05/2022] Open
Abstract
Background Continuity of care (COC) has become a primary point of concern for care providers in both developed and developing countries, which is regarded as the “cornerstone of care” and an “essential element” of good health care. A robust and proper instrument is of necessity to identify problems and evaluate intervention aimed at improving continuity of care. This study aimed to adapt Nijmegen continuity questionnaire (NCQ) into a Chinese version (NCQ-C) and to delineate the status of COC as well as explore its influencing factors for hypertensive patients in China. Methods A forward-back-translation procedure was adopted for the determination of the adaption of NCQ. Then a total of 448 patients completed questionnaires and 24-h ambulatory blood pressure monitoring (ABPM). Proper indexes were calculated to test the reliability and validity of NCQ-C. Logistic analysis were used to detect the influencing factors of COC. Results The NCQ-C had excellent intraclass correlation coefficient of 0.855 and internal consistency of seven dimensions varied from 0.907 to 0.944. The item-content validity index ranged from 0.71 to 1.00. For construct validity, seven-factor structure was confirmed as original questionnaire and all the fit indices indicated acceptable levels. Gender, education level, medical insurance and frequency of family visits, blood pressure level, depression status as well as general health perception were demonstrated to be statistically related to COC. Conclusions In addition, all the parameters of ABPM were negatively significant with COC. The NCQ-C has shown acceptable level of reliability and validity. The related factors of COC should arouse care providers’ attention.
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Affiliation(s)
- Chen Qiu
- School of Nursing, Tianjin Medical University, Qixiangtai Road, Heping District, Tianjin, China
| | - Shixiang Chen
- School of Nursing, Tianjin Medical University, Qixiangtai Road, Heping District, Tianjin, China
| | - Ying Yao
- Department of Emergency, Tianjin Medical University General Hospital, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Qixiangtai Road, Heping District, Tianjin, China
| | - Yi Xin
- Department of Cardiology, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaoying Zang
- School of Nursing, Tianjin Medical University, Qixiangtai Road, Heping District, Tianjin, China.
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Kesselring S, Osborne C, Bever A, Salters K, Cui Z, Chia J, Moore DM, Parashar S, Kaida A, Samji H, Duddy J, Gabler K, Howard T, Nash D, McCandless LC, Patterson TL, Corneil T, Montaner JSG, Hogg RS. Factors associated with delayed and late ART initiation among people living with HIV in BC: results from the engage study. AIDS Care 2018; 31:885-892. [PMID: 30466303 DOI: 10.1080/09540121.2018.1549722] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We examined correlates of late and delayed initiation of antiretroviral therapy (ART) in British Columbia, Canada. From December 2013 to December 2015 we recruited treatment-naïve people living with HIV who initiated ART within the previous year. 'Late initiation' was defined as CD4 cell count ≤500 cells/µL at ART initiation and 'delayed initiation' as ≥1 year between HIV diagnosis and initiation. Multivariable logistic regression assessed independent correlates of late and delayed initiation. Of 87 participants, 44 (51%) initiated late and 22 (26%) delayed initiation. Delayed initiation was positively associated with older age (adjusted odds ratio [AOR]: 1.06 per year, 95% confidence interval [95% CI]: 1.01-1.12) and inversely associated with wanting to start ART at diagnosis (AOR: 0.06, 95% CI: 0.02-0.21). Variables associated with late initiation were older age (AOR: 1.09 per year, 95% CI: 1.03-1.15) and medical reason(s) for initiation (AOR: 5.00, 95% CI: 1.41-17.86). Late initiation was less likely among those with greater perceived ART efficacy (AOR 0.94, 95% CI: 0.90-0.98) and history of incarceration (AOR: 0.12, 95% CI: 0.03-0.56). Disparities in timing of initiation were observed for age, perceived ART efficacy, and history of incarceration. Enhanced health services that address these factors may facilitate earlier treatment initiation.
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Affiliation(s)
- Sarah Kesselring
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada
| | - Charles Osborne
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada
| | - Andrea Bever
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada
| | - Kate Salters
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada
| | - Zishan Cui
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada
| | - Jason Chia
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada
| | - David M Moore
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada.,b University of British Columbia , Vancouver , British Columbia , Canada
| | - Surita Parashar
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada.,c Simon Fraser University , Burnaby , British Columbia , Canada
| | - Angela Kaida
- c Simon Fraser University , Burnaby , British Columbia , Canada
| | - Hasina Samji
- c Simon Fraser University , Burnaby , British Columbia , Canada.,d British Columbia Centre for Disease Control , Vancouver , British Columbia , Canada
| | - Janice Duddy
- e Pacific AIDS Network , Vancouver , British Columbia , Canada
| | - Karyn Gabler
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada
| | - Terry Howard
- f Engage Study Knowledge User , Vancouver , British Columbia , Canada
| | - Denis Nash
- g City University of New York School of Public Health , New York , NY , USA.,h City University of New York Institute for Implementation Science in Population Health , New York , NY , USA
| | | | | | - Trevor Corneil
- j Interior Health Authority , Kelowna , British Columbia , Canada
| | - Julio S G Montaner
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada.,b University of British Columbia , Vancouver , British Columbia , Canada
| | - Robert S Hogg
- a Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , British Columbia , Canada.,c Simon Fraser University , Burnaby , British Columbia , Canada
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28
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Wei Y, McGrath P, Hayden J, Kutcher S. The quality of mental health literacy measurement tools evaluating the stigma of mental illness: a systematic review. Epidemiol Psychiatr Sci 2018; 27:433-462. [PMID: 28462747 PMCID: PMC6999021 DOI: 10.1017/s2045796017000178] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/26/2017] [Indexed: 01/08/2023] Open
Abstract
AIMS Stigma of mental illness is a significant barrier to receiving mental health care. However, measurement tools evaluating stigma of mental illness have not been systematically assessed for their quality. We conducted a systematic review to critically appraise the methodological quality of studies assessing psychometrics of stigma measurement tools and determined the level of evidence of overall quality of psychometric properties of included tools. METHODS We searched PubMed, PsycINFO, EMBASE, CINAHL, the Cochrane Library and ERIC databases for eligible studies. We conducted risk-of-bias analysis with the Consensus-based Standards for the Selection of Health Measurement Instruments checklist, rating studies as excellent, good, fair or poor. We further rated the level of evidence of the overall quality of psychometric properties, combining the study quality and quality of each psychometric property, as: strong, moderate, limited, conflicting or unknown. RESULTS We identified 117 studies evaluating psychometric properties of 101 tools. The quality of specific studies varied, with ratings of: excellent (n = 5); good (mostly on internal consistency (n = 67)); fair (mostly on structural validity, n = 89 and construct validity, n = 85); and poor (mostly on internal consistency, n = 36). The overall quality of psychometric properties also varied from: strong (mostly content validity, n = 3), moderate (mostly internal consistency, n = 55), limited (mostly structural validity, n = 55 and construct validity, n = 46), conflicting (mostly test-retest reliability, n = 9) and unknown (mostly internal consistency, n = 36). CONCLUSIONS We identified 12 tools demonstrating limited evidence or above for (+, ++, +++) all their properties, 69 tools reaching these levels of evidence for some of their properties, and 20 tools that did not meet the minimum level of evidence for all of their properties. We note that further research on stigma tool development is needed to ensure appropriate application.
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Affiliation(s)
- Y. Wei
- Faculty of Graduate Studies, Interdisciplinary PhD, Dalhousie University, Halifax, Nova Scotia, Canada
| | - P. McGrath
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - J. Hayden
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - S. Kutcher
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Cohen Castel O, Dagan E, Keinan-Boker L, Shadmi E. Reliability and validity of the Hebrew version of the Nijmegen Continuity Questionnaire for measuring patients' perceived continuity of care in oral anticancer therapy. Eur J Cancer Care (Engl) 2018; 27:e12913. [PMID: 30238665 DOI: 10.1111/ecc.12913] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/11/2018] [Accepted: 08/14/2018] [Indexed: 12/14/2022]
Abstract
To assess the validity and reliability of the Nijmegen Continuity Questionnaire in Hebrew (NCQ-H) for measuring patients' perceived continuity of care in the multiprovider setting of oral anticancer therapy (OACT). Following forward-backward translation of the original instrument into Hebrew, the NCQ-H was administered to adult cancer patients in five oncology centres in Israel, 2-3 months after initiation of OACT (either targeted, hormonal or chemotherapy). Confirmatory factor analysis and Cronbach's alpha were used to assess the validity and reliability of the NCQ-H respectively. A total of 135 patients completed the questionnaire. The postanalysis models for measuring "personal continuity with care provider" (eight items for each provider: the oncology specialist and the primary care physician), and "team/cross-boundary continuity" (four items for each setting: within the oncology team, and between the oncology specialist and the primary care physician) showed good fit for the observed data (root-mean-square error of approximation (RMSEA) = 0.02; RMSEA = 0.015; for each model respectively). Cronbach's alpha was 0.79-0.95 for all subscales. Conclusions. This study provides preliminary evidence for the reliability and validity of the NCQ-H in assessing cancer patients' experience with continuity of care and for its usability in the context of OACT.
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Affiliation(s)
- Orit Cohen Castel
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Efrat Dagan
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Lital Keinan-Boker
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Efrat Shadmi
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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30
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Hustoft M, Biringer E, Gjesdal S, Aβmus J, Hetlevik Ø. Relational coordination in interprofessional teams and its effect on patient-reported benefit and continuity of care: a prospective cohort study from rehabilitation centres in Western Norway. BMC Health Serv Res 2018; 18:719. [PMID: 30223847 PMCID: PMC6142375 DOI: 10.1186/s12913-018-3536-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 09/12/2018] [Indexed: 11/21/2022] Open
Abstract
Background Rehabilitation services depend on competent professionals who collaborate effectively. Well-functioning interprofessional teams are expected to positively impact continuity of care. Key factors in continuity of care are communication and collaboration among health care professionals in a team and their patients. This study assessed the associations between team functioning and patient-reported benefits and continuity of care in somatic rehabilitation centres. Methods This prospective cohort study uses survey data from 984 patients and from health care professionals in 15 teams in seven somatic rehabilitation centres in Western Norway. Linear mixed effect models were used to investigate associations between the interprofessional team communication and relationship scores (measured by the Relational Coordination [RC] Survey and patient-reported benefit and personal-, team- and cross-boundary continuity of care. Patient-reported continuity of care was measured using the Norwegian version of the Nijmegen Continuity Questionnaire. Results The mean communication score for healthcare teams was 3.9 (standard deviation [SD] = 0.63, 95% confidence interval [CI] = 3.78, 4.00), and the mean relationship score was 4.1 (SD = 0.56, 95% CI = 3.97, 4.18). Communication scores in rehabilitation teams varied from 3.4–4.3 and relationship scores from 3.6–4.5. Patients treated by teams with higher relationship scores experienced better continuity between health care professionals in the team at the rehabilitation centre (b = 0.36, 95% CI = 0.05, 0.68; p = 0.024). There was a positive association between RC communication in the team the patient was treated by and patient-reported activities of daily living benefit score; all other associations between RC scores and rehabilitation benefit scores were not significant. Conclusion Team function is associated with better patient-reported continuity of care and higher ADL-benefit scores among patients after rehabilitation. These findings indicate that interprofessional teams’ RC scores may predict rehabilitation outcomes, but further studies are needed before RC scores can be used as a quality indicator in somatic rehabilitation. Electronic supplementary material The online version of this article (10.1186/s12913-018-3536-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Merethe Hustoft
- Centre for Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway. .,Department of Global Health and Primary Health Care, University of Bergen, Bergen, Norway.
| | - Eva Biringer
- Section of Research and Innovation, Helse Fonna Local Health Authority, Haugesund/Stord, Norway
| | - Sturla Gjesdal
- Department of Global Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Jörg Aβmus
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Øystein Hetlevik
- Department of Global Health and Primary Health Care, University of Bergen, Bergen, Norway
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Sugavanam T, Fosh B, Close J, Byng R, Horrell J, Lloyd H. Codesigning a Measure of Person-Centred Coordinated Care to Capture the Experience of the Patient: The Development of the P3CEQ. J Patient Exp 2018; 5:201-211. [PMID: 30214927 PMCID: PMC6134538 DOI: 10.1177/2374373517748642] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Person-centred coordinated care (P3C) is a priority for stakeholders (ie, patients, carers, professionals, policy makers). As a part of the development of an evaluation framework for P3C, we set out to identify patient-reported experience measures (PREMs) suitable for routine measurement and feedback during the development of services. METHODS A rapid review of the literature was undertaken to identity existing PREMs suitable for the probing person-centred and/or coordinated care. Of 74 measures identified, 7 met our inclusion criteria. We critically examined these against core domains and subdomains of P3C. Measures were then presented to stakeholders in codesign workshops to explore acceptability, utility, and their strengths/weaknesses. RESULTS The Long-Term Condition 6 questionnaire was preferred for its short length, utility, and tone. However, it lacked key questions in each core domain, and in response to requests from our codesign group, new questions were added to cover consideration as a whole person, coordination, care plans, carer involvement, and a single coordinator. Cognitive interviews, on-going codesign, and mapping to core P3C domains resulted in the refinement of the questionnaire to 11 items with 1 trigger question. The 11-item modified version was renamed the P3C Experiences Questionnaire. CONCLUSIONS Due to a dearth of brief measures available to capture people's experience of P3C for routine practice, an existing measure was modified using an iterative process of adaption and validation through codesign workshops. Next steps include psychometric validation and modification for people with dementia and learning difficulties.
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Affiliation(s)
- Thavapriya Sugavanam
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
- NIHR CLAHRC South West Peninsula (PenCLAHRC), Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, United Kingdom
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Rehabilitation Research in Oxford, University of Oxford, Oxford, United Kingdom
| | - Ben Fosh
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
- NIHR CLAHRC South West Peninsula (PenCLAHRC), Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, United Kingdom
| | - James Close
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - Richard Byng
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
- NIHR CLAHRC South West Peninsula (PenCLAHRC), Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, United Kingdom
| | - Jane Horrell
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
- NIHR CLAHRC South West Peninsula (PenCLAHRC), Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, United Kingdom
| | - Helen Lloyd
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
- NIHR CLAHRC South West Peninsula (PenCLAHRC), Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, United Kingdom
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van Melle MA, van Stel HF, Poldervaart JM, de Wit NJ, Zwart DLM. Measurement tools and outcome measures used in transitional patient safety; a systematic review. PLoS One 2018; 13:e0197312. [PMID: 29864119 PMCID: PMC5986135 DOI: 10.1371/journal.pone.0197312] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 04/29/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Patients are at risk for harm when treated simultaneously by healthcare providers from different healthcare organisations. To assess current practice and improvements of transitional patient safety, valid measurement tools are needed. AIM AND METHODS To identify and appraise all measurement tools and outcomes that measure aspects of transitional patient safety, PubMed, Cinahl, Embase and Psychinfo were systematically searched. Two researchers performed the title and abstract and full-text selection. First, publications about validation of measurement tools were appraised for quality following COSMIN criteria. Second, we inventoried all measurement tools and outcome measures found in our search that assessed current transitional patient safety or the effect of interventions targeting transitional patient safety. RESULTS The initial search yielded 8288 studies, of which 18 assessed validity of measurement tools of different aspects of transitional safety, and 191 assessed current transitional patient safety or effect of interventions. In the validated measurement tools, the overall quality of content and structural validity was acceptable; other COSMIN criteria, such as reliability, measurement error and responsiveness, were mostly poor or not reported. In our outcome inventory, the most frequently used validated outcome measure was the Care Transition Measure (n = 9). The most frequently used non-validated outcome measures were: medication discrepancies (n = 98), hospital readmissions (n = 55), adverse events (n = 34), emergency department visits (n = 33), (mental or physical) health status (n = 28), quality and timeliness of discharge summary, and patient satisfaction (n = 23). CONCLUSIONS Although no validated measures exist that assess all aspects of transitional patient safety, we found validated measurement tools on specific aspects. Reporting of validity of transitional measurement tools was incomplete. Numerous outcome measures with unknown measurement properties are used in current studies on safety of care transitions, which makes interpretation or comparison of their results uncertain.
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Affiliation(s)
- Marije A van Melle
- Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Henk F van Stel
- Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Judith M Poldervaart
- Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Niek J de Wit
- Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Dorien L M Zwart
- Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht, the Netherlands
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Harris MG, Sparti C, Scheurer R, Coombs T, Pirkis J, Ruud T, Kisely S, Hanssen-Bauer K, Siqveland J, Burgess PM. Measurement properties of the Health of the Nation Outcome Scales (HoNOS) family of measures: protocol for a systematic review. BMJ Open 2018; 8:e021177. [PMID: 29678991 PMCID: PMC5914766 DOI: 10.1136/bmjopen-2017-021177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 02/08/2018] [Accepted: 02/19/2018] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION The Health of the Nation Outcome Scales (HoNOS) for adults, and equivalent measures for children and adolescents and older people, are widely used in clinical practice and research contexts to measure mental health and functional outcomes. Additional HoNOS measures have been developed for special populations and applications. Stakeholders require synthesised information about the measurement properties of these measures to assess whether they are fit for use with intended service settings and populations and to establish performance benchmarks. This planned systematic review will critically appraise evidence on the measurement properties of the HoNOS family of measures. METHODS AND ANALYSIS Journal articles meeting inclusion criteria will be identified via a search of seven electronic databases: MEDLINE via EBSCOhost, PsycINFO via APA PsycNET, Embase via Elsevier, Cumulative Index to Nursing and Allied Health Literature via EBSCOhost, Web of Science via Thomson Reuters, Google Scholar and the Cochrane Library. Variants of 'Health of the Nation Outcome Scales' or 'HoNOS' will be searched as text words. No restrictions will be placed on setting or language of publication. Reference lists of relevant studies and reviews will be scanned for additional eligible studies. Appraisal of reliability, validity, responsiveness and interpretability will be guided by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Feasibility/utility will be appraised using definitions and criteria derived from previous reviews. For reliability studies, we will also apply the Guidelines for Reporting Reliability and Agreement Studies to assess quality of reporting. Results will be synthesised narratively, separately for each measure, and by subgroup (eg, treatment setting, rater profession/experience or training) where possible. Meta-analyses will be undertaken where data are adequate. ETHICS AND DISSEMINATION Ethics approval is not required as no primary data will be collected. Outcomes will be disseminated to stakeholders via reports, journal articles and presentations at meetings and conferences. PROSPERO REGISTRATION NUMBER CRD42017057871.
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Affiliation(s)
- Meredith G Harris
- School of Public Health, The University of Queensland, Brisbane, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Claudia Sparti
- School of Public Health, The University of Queensland, Brisbane, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Roman Scheurer
- School of Public Health, The University of Queensland, Brisbane, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Tim Coombs
- Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Steve Kisely
- School of Medicine, The University of Queensland, Brisbane, Australia
- Metro South Addiction and Mental Health Service, Brisbane, Australia
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johan Siqveland
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division for Health Services at the Norwegian Institute of Public Health, Oslo, Norway
| | - Philip M Burgess
- School of Public Health, The University of Queensland, Brisbane, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia
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Giese-Davis J, Sisler J, Zhong L, Brandelli Y, McCormick JL, Railton C, Shirt L, Lau H, Hao D, Chobanuk J, Walley B, Joy AA, Taylor A, Carlson L. Alberta CancerBridges development of a care plan evaluation measure. ACTA ACUST UNITED AC 2018; 25:e59-e72. [PMID: 29507497 DOI: 10.3747/co.25.3766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background No standardized measures specifically assess cancer survivors' and healthcare providers' experience of Survivor Care Plans (scps). We sought to develop two care plan evaluation (cpe) measures, one for survivors (cpe-s) and one for healthcare providers (cpe-p), examine initial psychometric qualities in Alberta, and assess generalizability in Manitoba, Canada. Methods We developed the initial measures using convenience samples of breast (n = 35) and head and neck (n = 18) survivors who received scps at the end of active cancer-centre treatment. After assessing Alberta's scp concordance with Institute of Medicine (iom) recommendations using a published coding scheme, we examined psychometric qualities for the cpe-s and cpe-p. We examined generalizability in Manitoba, Canada, with colorectal survivors discharged to primary care providers for follow-up (n = 75). Results We demonstrated acceptable internal consistency for the cpe-s and cpe-p subscales and total score after eliminating one item per subscale for cpe-s, two for cpe-p, resulting in revised scales with four 7-item and 6-item subscales, respectively. Subscale scores correlated highly indicating that for each measure the total score may be the most reliable and valid. We provide initial cpe-s discriminant, convergent, and predictive validity using the total score. Using the Manitoba sample, initial psychometrics similarly indicated good generalizability across differences in tumour groups, scp, and location. Conclusions We recommend the revised cpe-s and cpe-p for further use and development. Studies documenting the creation and standardization of scp evaluations are few, and we recommend further development of patient experience measures to improve both clinical practice and the specificity of research questions.
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Affiliation(s)
- J Giese-Davis
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - J Sisler
- Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba
| | - L Zhong
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - Y Brandelli
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - J L McCormick
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - C Railton
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta
| | - L Shirt
- Palliative Consult Service-Calgary Zone Urban, Alberta Health Services, Calgary, Alberta
| | - H Lau
- Department of Radiation Oncology, Head and Neck Tumour Group, Tom Baker Cancer Center, Calgary
| | - D Hao
- Department of Radiation Oncology, Head and Neck Tumour Group, Tom Baker Cancer Center, Calgary
| | - J Chobanuk
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta
| | - B Walley
- Comprehensive Breast Care Program (cbcp), Community Oncology, Alberta Health Services-Cancer Care, Edmonton, Alberta
| | - A A Joy
- Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta; and
| | - A Taylor
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta.,Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta; and
| | - L Carlson
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
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Grooten L, Borgermans L, Vrijhoef HJM. An Instrument to Measure Maturity of Integrated Care: A First Validation Study. Int J Integr Care 2018; 18:10. [PMID: 29588644 PMCID: PMC5853880 DOI: 10.5334/ijic.3063] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 11/28/2017] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Lessons captured from interviews with 12 European regions are represented in a new instrument, the B3-Maturity Model (B3-MM). B3-MM aims to assess maturity along 12 dimensions reflecting the various aspects that need to be managed in order to deliver integrated care. The objective of the study was to test the content validity of B3-MM as part of SCIROCCO (Scaling Integrated Care into Context), a European Union funded project. METHODS A literature review was conducted to compare B3-MM's 12 dimensions and their measurement scales with existing measures and instruments that focus on assessing the development of integrated care. Subsequently, a three-round survey conducted through a Delphi study with international experts in the field of integrated care was performed to test the relevance of: 1) the dimensions, 2) the maturity indicators and 3) the assessment scale used in B3-MM. RESULTS The 11 articles included in the literature review confirmed all the dimensions described in the original version of B3-MM. The Delphi study rounds resulted in various phrasing amendments of indicators and assessment scale. Full agreement among the experts on the relevance of the 12 B3-MM dimensions, their indicators, and assessment scale was reached after the third Delphi round. CONCLUSION AND DISCUSSION The B3-MM dimensions, maturity indicators and assessment scale showed satisfactory content validity. While the B3-MM is a unique instrument based on existing knowledge and experiences of regions in integrated care, further testing is needed to explore other measurement properties of B3-MM.
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Affiliation(s)
- Liset Grooten
- Department of Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, B-1090 Brussels, BE
| | - Liesbeth Borgermans
- Department of Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, B-1090 Brussels, BE
| | - Hubertus JM Vrijhoef
- Department of Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, B-1090 Brussels, BE
- Department Patient and Care, Maastricht University Medical Center, Maastricht, NL
- Panaxea B.V., Amsterdam, NL
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Hetlevik Ø, Hustoft M, Uijen A, Aßmus J, Gjesdal S. Patient perspectives on continuity of care: adaption and preliminary psychometric assessment of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ-N). BMC Health Serv Res 2017; 17:760. [PMID: 29162089 PMCID: PMC5698962 DOI: 10.1186/s12913-017-2706-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 11/07/2017] [Indexed: 11/18/2022] Open
Abstract
Background Continuity of care is regarded as a core quality element in healthcare. Continuity can be related to one or more specific caregivers but also applies to collaboration within a team or across boundaries of healthcare. Measuring continuity is important to identify problems and evaluate quality improvement of interventions. This study aimed to assess the feasibility and psychometric properties of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ). Methods The NCQ was developed in The Netherlands. It measures patients’ experienced continuity of care across multiple care settings and as a multidimensional concept regardless of morbidity. The NCQ comprises 28 items categorised into three subscales; two personal continuity scales, “care giver knows me” and “shows commitment”, asked regarding the patient’s general practitioner (GP) and the most important specialist; and one “team/cross boundary continuity” scale, asked regarding primary care, specialised care and cooperation between GP and specialist, with a total of seven factors. The NCQ was translated and adapted to Norwegian (NCQ-N) and distributed among patients referred to somatic rehabilitation (N = 984, response rate 34.5%). Confirmatory factor analyses (CFA), Cronbach’s alpha, intra-class correlation (ICC) and Bland–Altman plots were used to assess psychometric properties. Results All patients (N = 375) who had responded to all parts of the NCQ-N were included in CFA. The CFA fit indices (CFI 0.941, RMSEA 0.064 (95% CI 0.059–0.070), SRMR 0.041) support a seven-factor structure in the NCQ-N based on the three subscales of the original NCQ. Cronbach’s alpha showed internal consistency (0.84–0.97), and was highest for the team/cross-boundary subscales. The NCQ-N showed overall high reliability with ICC 0.84–91 for personal continuity factors and 0.67–0.91 for team factors, with the lowest score for team continuity within primary care. Conclusions Psychometric assessment of the NCQ-N supports that this instrument, based on the three subscales of the original Dutch NCQ, captures the concept of “continuity of care” among adult patients with a variety of longstanding medical conditions who use healthcare on a regular basis. However, its usefulness among varied patient groups, including younger people, patients with acute disorders and individuals with mental health problems, should be further evaluated. Electronic supplementary material The online version of this article (10.1186/s12913-017-2706-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Øystein Hetlevik
- Department of Global Health and Primary Health Care, University of Bergen, PO-box 7804, N-5020, Bergen, Norway.
| | - Merethe Hustoft
- Department of Global Health and Primary Health Care, University of Bergen, PO-box 7804, N-5020, Bergen, Norway.,Centre for Habilitation and Rehabilitation in Western Norway, Bergen Local Health Authority, Bergen, Norway
| | - Annemarie Uijen
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Jörg Aßmus
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Sturla Gjesdal
- Department of Global Health and Primary Health Care, University of Bergen, PO-box 7804, N-5020, Bergen, Norway
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Denman D, Speyer R, Munro N, Pearce WM, Chen YW, Cordier R. Psychometric Properties of Language Assessments for Children Aged 4-12 Years: A Systematic Review. Front Psychol 2017; 8:1515. [PMID: 28936189 PMCID: PMC5594094 DOI: 10.3389/fpsyg.2017.01515] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/21/2017] [Indexed: 01/30/2023] Open
Abstract
Introduction: Standardized assessments are widely used by speech pathologists in clinical and research settings to evaluate the language abilities of school-aged children and inform decisions about diagnosis, eligibility for services and intervention. Given the significance of these decisions, it is important that assessments have sound psychometric properties. Objective: The aim of this systematic review was to examine the psychometric quality of currently available comprehensive language assessments for school-aged children and identify assessments with the best evidence for use. Methods: Using the PRISMA framework as a guideline, a search of five databases and a review of websites and textbooks was undertaken to identify language assessments and published material on the reliability and validity of these assessments. The methodological quality of selected studies was evaluated using the COSMIN taxonomy and checklist. Results: Fifteen assessments were evaluated. For most assessments evidence of hypothesis testing (convergent and discriminant validity) was identified; with a smaller number of assessments having some evidence of reliability and content validity. No assessments presented with evidence of structural validity, internal consistency or error measurement. Overall, all assessments were identified as having limitations with regards to evidence of psychometric quality. Conclusions: Further research is required to provide good evidence of psychometric quality for currently available language assessments. Of the assessments evaluated, the Assessment of Literacy and Language, the Clinical Evaluation of Language Fundamentals-5th Edition, the Clinical Evaluation of Language Fundamentals-Preschool: 2nd Edition and the Preschool Language Scales-5th Edition presented with most evidence and are thus recommended for use.
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Affiliation(s)
- Deborah Denman
- College of Healthcare Sciences, James Cook UniversityTownsville, QLD, Australia
| | - Renée Speyer
- College of Healthcare Sciences, James Cook UniversityTownsville, QLD, Australia
- Faculty of Health Science, Curtin UniversityPerth, WA, Australia
- Leiden University Medical CentreLeiden, Netherlands
| | - Natalie Munro
- Faculty of Health Science, The University of SydneySydney, NSW, Australia
| | - Wendy M. Pearce
- School of Allied Health, Australian Catholic UniversitySydney, NSW, Australia
| | - Yu-Wei Chen
- Faculty of Health Science, The University of SydneySydney, NSW, Australia
| | - Reinie Cordier
- Faculty of Health Science, Curtin UniversityPerth, WA, Australia
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Weaver N, Coffey M, Hewitt J. Concepts, models and measurement of continuity of care in mental health services: A systematic appraisal of the literature. J Psychiatr Ment Health Nurs 2017; 24:431-450. [PMID: 28319308 DOI: 10.1111/jpm.12387] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2017] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Care continuity is considered to be a cornerstone of modern mental health care. As community mental health services have become increasingly fragmented and complex, the crucial criterion for best quality care has become the degree to which treatment delivered by separate services and professionals is continuous and well coordinated. However, clarification of the key elements of continuity has proved challenging and a consensus has not been reached. Recent research has shown significant levels of variation in the quality of care coordination across England and Wales, with potentially detrimental consequences for individuals. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Studies on care continuity identified in this review are grouped into three categories: studies defining concepts of care continuity, studies providing models of continuity and studies describing development of questionnaires about care continuity. There are many similarities and parallels between concepts of continuity described in the studies under review. Therefore, there is potential for developing a consensus on the nature of care continuity as a multidimensional concept. The priority placed upon the patient's experience of care continuity is identified as a major focus in these studies. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A consensus on the nature of care continuity would benefit both theory and practice in mental health nursing. It would provide a firmer foundation for new research seeking to improve continuity for people using services, and enable mental health nurses working as care coordinators to have a better understanding of the elements of their role that are most effective. ABSTRACT Introduction The increased complexity of community mental health services, and associated fragmentation of traditional dividing lines between services, has underscored the centrality of care continuity and coordination in modern mental health care. However, clarification of the key features of the care continuity concept has proved difficult and a consensus has not been reached. Aim/Question This review draws together and critically examines latest evidence concerning concepts, models and scales based on a multidimensional understanding of care continuity. Method Databases ASSIA, PubMed, MEDLINE and Cochrane were searched for papers dating from January 2005 to July 2016, of which 21 articles met the inclusion criteria. These were subjected to quality appraisal based on CASP and COSMIN checklists. Studies were grouped into three thematic categories describing concepts, models and scales of care continuity. Results/Discussion Synthesis indicated correspondence between independent, multidimensional models of care continuity, providing greater clarity regarding the essential features of the concept. Association, although not causation, between care continuity factors and health outcomes is supported by current evidence. Implications for practice Clarification of care continuity in mental health services may enable nurses working as care coordinators to develop a better understanding of key elements of their role, and provide guidance for future service development.
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Affiliation(s)
- N Weaver
- Public Health, Policy and Social Sciences, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - M Coffey
- Public Health, Policy and Social Sciences, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - J Hewitt
- Public Health, Policy and Social Sciences, College of Human and Health Sciences, Swansea University, Swansea, UK
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39
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Quinn M, Robinson C, Forman J, Krein SL, Rosland AM. Survey Instruments to Assess Patient Experiences With Access and Coordination Across Health Care Settings: Available and Needed Measures. Med Care 2017; 55 Suppl 7 Suppl 1:S84-S91. [PMID: 28614185 DOI: 10.1097/mlr.0000000000000730] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Improving access can increase the providers a patient sees, and cause coordination challenges. For initiatives that increase care across health care settings, measuring patient experiences with access and care coordination will be crucial. OBJECTIVES Map existing survey measures of patient experiences with access and care coordination expected to be relevant to patients accessing care across settings. Preliminarily examine whether aspects of access and care coordination important to patients are represented by existing measures. RESEARCH DESIGN Structured literature review of domains and existing survey measures related to access and care coordination across settings. Survey measures, and preliminary themes from semistructured interviews of 10 patients offered VA-purchased Community Care, were mapped to identified domains. RESULTS We identified 31 existing survey instruments with 279 items representing 6 access and 5 care coordination domains relevant to cross-system care. Domains frequently assessed by existing measures included follow-up coordination, primary care access, cross-setting coordination, and continuity. Preliminary issues identified in interviews, but not commonly assessed by existing measures included: (1) acceptability of distance to care site given patient's clinical situation; (2) burden on patients to access and coordinate care and billing; (3) provider familiarity with Veteran culture and VA processes. CONCLUSIONS Existing survey instruments assess many aspects of patient experiences with access and care coordination in cross-system care. Systems assessing cross-system care should consider whether patient surveys accurately reflect the level of patients' concerns with burden to access and coordinate care, and adequately reflect the impact of clinical severity and cultural familiarity on patient preferences.
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Affiliation(s)
- Martha Quinn
- *University of Michigan School of Public Health †VA Ann Arbor Center for Clinical Management Research, Health Services Research and Development ‡Department of Internal Medicine, Taubman Center, University of Michigan Medical School §University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI
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Bautista MAC, Nurjono M, Lim YW, Dessers E, Vrijhoef HJ. Instruments Measuring Integrated Care: A Systematic Review of Measurement Properties. Milbank Q 2017; 94:862-917. [PMID: 27995711 DOI: 10.1111/1468-0009.12233] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Policy Points: Investigations on systematic methodologies for measuring integrated care should coincide with the growing interest in this field of research. A systematic review of instruments provides insights into integrated care measurement, including setting the research agenda for validating available instruments and informing the decision to develop new ones. This study is the first systematic review of instruments measuring integrated care with an evidence synthesis of the measurement properties. We found 209 index instruments measuring different constructs related to integrated care; the strength of evidence on the adequacy of the majority of their measurement properties remained largely unassessed. CONTEXT Integrated care is an important strategy for increasing health system performance. Despite its growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague and limited. Our systematic review aims to provide evidence on the state of the art in measuring integrated care. METHODS Our comprehensive systematic review framework builds on the Rainbow Model for Integrated Care (RMIC). We searched MEDLINE/PubMed for published articles on the measurement properties of instruments measuring integrated care and identified eligible articles using a standard set of selection criteria. We assessed the methodological quality of every validation study reported using the COSMIN checklist and extracted data on study and instrument characteristics. We also evaluated the measurement properties of each examined instrument per validation study and provided a best evidence synthesis on the adequacy of measurement properties of the index instruments. FINDINGS From the 300 eligible articles, we assessed the methodological quality of 379 validation studies from which we identified 209 index instruments measuring integrated care constructs. The majority of studies reported on instruments measuring constructs related to care integration (33%) and patient-centered care (49%); fewer studies measured care continuity/comprehensive care (15%) and care coordination/case management (3%). We mapped 84% of the measured constructs to the clinical integration domain of the RMIC, with fewer constructs related to the domains of professional (3.7%), organizational (3.4%), and functional (0.5%) integration. Only 8% of the instruments were mapped to a combination of domains; none were mapped exclusively to the system or normative integration domains. The majority of instruments were administered to either patients (60%) or health care providers (20%). Of the measurement properties, responsiveness (4%), measurement error (7%), and criterion (12%) and cross-cultural validity (14%) were less commonly reported. We found <50% of the validation studies to be of good or excellent quality for any of the measurement properties. Only a minority of index instruments showed strong evidence of positive findings for internal consistency (15%), content validity (19%), and structural validity (7%); with moderate evidence of positive findings for internal consistency (14%) and construct validity (14%). CONCLUSIONS Our results suggest that the quality of measurement properties of instruments measuring integrated care is in need of improvement with the less-studied constructs and domains to become part of newly developed instruments.
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Affiliation(s)
| | - Milawaty Nurjono
- Saw Swee Hock School of Public Health, National University of Singapore
| | - Yee Wei Lim
- Saw Swee Hock School of Public Health, National University of Singapore
| | - Ezra Dessers
- Centre for Sociological Research, KU Leuven, Leuven, Belgium
| | - Hubertus Jm Vrijhoef
- Saw Swee Hock School of Public Health, National University of Singapore.,National University Health System, Singapore.,Department of Patient and Care, University Hospital Maastricht, Maastricht, The Netherlands.,Vrije Universiteit Brussels, Brussels, Belgium
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A Systematic Review of Measurement Properties of Patient-Reported Outcome Measures Used in Patients Undergoing Total Knee Arthroplasty. J Arthroplasty 2017; 32:1688-1697.e7. [PMID: 28162839 DOI: 10.1016/j.arth.2016.12.052] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/15/2016] [Accepted: 12/27/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND While clinical research on total knee arthroplasty (TKA) outcomes is prevalent in the literature, studies often have poor methodological and reporting quality. A high-quality patient-reported outcome instrument is reliable, valid, and responsive. Many studies evaluate these properties, but none have done so with a systematic and accepted method. The objectives of this study were to identify patient-reported outcome measures (PROMs) for TKA, and to critically appraise, compare, and summarize their psychometric properties using accepted methods. METHODS MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO, and SPORTDiscus were systematically searched for articles with the following inclusion criteria: publication before December 2014, English language, non-generic PRO, and evaluation in the TKA population. Methodological quality and evidence of psychometric properties were assessed with the COnsensus-based standards for the selection of health Status Measurement INstruments (COSMIN) checklist and criteria for psychometric evidence proposed by the COSMIN group and Terwee et al. RESULTS One-hundred fifteen studies on 32 PROMs were included in this review. Only the Work, Osteoarthritis or joint-Replacement Questionnaire, the Oxford Knee Score, and the Western Ontario and McMaster Universities Arthritis Index had 4 or more properties with positive evidence. CONCLUSION Most TKA PROMs have limited evidence for their psychometric properties. Although not all the properties were studied, the Work, Osteoarthritis or joint-Replacement Questionnaire, with the highest overall ratings, could be a useful PROM for evaluating patients undergoing TKA. The methods and reporting of this literature can improve by following accepted guidelines.
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Wei Y, McGrath PJ, Hayden J, Kutcher S. Measurement properties of mental health literacy tools measuring help-seeking: a systematic review. J Ment Health 2017; 26:543-555. [PMID: 28355928 DOI: 10.1080/09638237.2016.1276532] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Mental health literacy is important to improve help-seeking behaviors. However, the quality of mental health help-seeking tools remains unknown. AIMS We conducted a systematic review to appraise the quality of such tools. METHODS We searched databases for English publications addressing psychometrics of help-seeking tools. We included help-seeking tools addressing mental health in general and tools on four mental disorders: anxiety, depression, attention deficit hyperactivity disorder (ADHD) and schizophrenia. We determined the methodological quality of studies as "excellent", "good", "fair", or "indeterminate". We ranked the level of evidence of each measurement property as "strong", "moderate", "limited", "conflicting" or "unknown". RESULTS We found 12 help-seeking tools in 24 studies that assessed related psychometrics. The methodological quality of included studies ranged from "poor" to "excellent" with four studies on the content validity, structural validity or internal consistency demonstrating "excellent" quality. Three tools demonstrated overall strong evidence (content or structural validity); eight tools demonstrated moderate evidence (internal consistency, structural or construct validity); and eight tools demonstrated limited evidence (reliability, construct validity or internal consistency). CONCLUSIONS We recommend the application of tools with strong or moderate evidence for their psychometric properties. Future research may focus on the generalizability of the tools across diverse settings.
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Affiliation(s)
- Yifeng Wei
- a Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre and Dalhousie University , Halifax , Canada
| | - Patrick J McGrath
- b IWK Health Centre, Nova Scotia Health Authority and Dalhousie University , Halifax , Canada
| | | | - Stan Kutcher
- d Department of Psychiatry , Dalhousie University , Halifax , Canada
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A systematic review of measurement properties of patient-reported outcome measures for use in patients with foot or ankle diseases. Qual Life Res 2017; 26:1969-2010. [DOI: 10.1007/s11136-017-1542-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2017] [Indexed: 12/20/2022]
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Ignatyev Y, Timm J, Heinze M, Indefrey S, von Peter S. Development and Preliminary Validation of the Scale for Evaluation of Psychiatric Integrative and Continuous Care-Patient's Version. Front Psychiatry 2017; 8:162. [PMID: 28912735 PMCID: PMC5583144 DOI: 10.3389/fpsyt.2017.00162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 08/14/2017] [Indexed: 11/13/2022] Open
Abstract
This pilot study aimed to evaluate and examine an instrument that integrates relevant aspects of cross-sectoral (in- and outpatients) mental health care, is simply to use and shows satisfactory psychometric properties. The development of the scale comprised literature research, held 14 focus groups and 12 interviews with patients and health care providers, item-pool generation, content validation by a scientific expert panel, and face validation by 90 patients. The preliminary scale was tested on 385 patients across seven German hospitals with cross-sectoral mental health care (CSMHC) as part of their treatment program. Psychometric properties of the scale were evaluated using genuine and transformed data scoring. To check reliability and postdictive validity of the scale, Cronbach's α coefficient and multivariable linear regression were used. This development process led to the development of an 18-item scale called the "Scale for Evaluation of Psychiatric Integrative and Continuous Care (SEPICC)" with a two-point and five-point response options. The scale consists of two sections. The first section assesses the presence or absence of patients' experiences with various CSMHC' relevant components such as home treatment, flexibility of treatments' switching, case management, continuity of care, cross-sectoral therapeutic groups, and multidisciplinary teams. The second section evaluates the patients' opinions about these relevant components. Using raw and transformed scoring resulted into comparable results. However, data distribution using transformed scoring showed a smaller deviation from normality. For the overall scale, the Cronbach's α coefficient was 0.82. Self-reported experiences with relevant components of the CSMHC were positively associated with the patients approval of these components. In conclusion, the new scale provides a good starting point for further validation. It can be used as a tool to evaluate CSMHC. Methodologically, using transformed data scoring appeared to be preferable because of a smaller deviation from normality and a higher reliability measured by Cronbach's α.
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Affiliation(s)
- Yuriy Ignatyev
- Department of Psychiatry, Psychotherapy and Psychosomatics, Immanuel Klinik, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Jürgen Timm
- Biometry Section, Competence Center for Clinical Trials, University of Bremen, Bremen, Germany
| | - Martin Heinze
- Department of Psychiatry, Psychotherapy and Psychosomatics, Immanuel Klinik, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Sonja Indefrey
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
| | - Sebastian von Peter
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
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Ye T, Sun X, Tang W, Miao Y, Zhang Y, Zhang L. Effect of continuity of care on health-related quality of life in adult patients with hypertension: a cohort study in China. BMC Health Serv Res 2016; 16:674. [PMID: 27894298 PMCID: PMC5125036 DOI: 10.1186/s12913-016-1673-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 08/15/2016] [Indexed: 02/07/2023] Open
Abstract
Background Continuity of care is widely considered a principle of primary care that decreases healthcare utilization and mortality. However, the effect of continuity of care on health-related quality of life (HRQoL) for adult patients with hypertension remains unclear. Methods To further evaluate the effect of continuity of care, we implemented a cohort study among hypertensive patients aged over 35 years (n = 1200) in six townships in Qianjiang District, Chongqing, China, between 2012 and 2014. The study ultimately included 1079 participants. The continuity of care index was calculated using claim-based longitudinal data obtained from hypertension follow-up service records. The baseline and endline survey-based data, tested by the SF-36 scale, were used to assess HRQoL. To control selection bias and examine the effect of continuity of care, a kernel-based propensity score matching difference-in-differences (DID) method was used. Additionally, descriptive statistics, chi-squared test, and Mann–Whitney nonparametric test were used to summarize characteristics, evaluate proportional differences, and analyze statistical differences, respectively. Results Our results showed that patients in the high continuity of care group presented greater improvement in both Physical Component Summary (PCS, DID = 5.192 ± 1.970, p < 0.001) and Mental Component Summary (MCS, DID = 7.900 ± 1.815, p = 0.008) than those in the low continuity of care group. Moreover, patients in the high continuity of care group showed significant improvement in physical functioning, role-physical, general health, role-emotional, and mental health. Conclusions Our findings indicate that a long-term physician-patient relationship may improve HRQoL in patients with hypertension. However, more unified measurement tools are needed to evaluate continuity of care. Further studies should include more study settings.
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Affiliation(s)
- Ting Ye
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Xiaowei Sun
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Wenxi Tang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Yudong Miao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Yan Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China.
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Wei Y, McGrath PJ, Hayden J, Kutcher S. Measurement properties of tools measuring mental health knowledge: a systematic review. BMC Psychiatry 2016; 16:297. [PMID: 27553955 PMCID: PMC4995619 DOI: 10.1186/s12888-016-1012-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 08/18/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Mental health literacy has received great attention recently to improve mental health knowledge, decrease stigma and enhance help-seeking behaviors. We conducted a systematic review to critically appraise the qualities of studies evaluating the measurement properties of mental health knowledge tools and the quality of included measurement properties. METHODS We searched PubMed, PsycINFO, EMBASE, CINAHL, the Cochrane Library, and ERIC for studies addressing psychometrics of mental health knowledge tools and published in English. We applied the COSMIN checklist to assess the methodological quality of each study as "excellent", "good", "fair", or "indeterminate". We ranked the level of evidence of the overall quality of each measurement property across studies as "strong", "moderate", "limited", "conflicting", or "unknown". RESULTS We identified 16 mental health knowledge tools in 17 studies, addressing reliability, validity, responsiveness or measurement errors. The methodological quality of included studies ranged from "poor" to "excellent" including 6 studies addressing the content validity, internal consistency or structural validity demonstrating "excellent" quality. We found strong evidence of the content validity or internal consistency of 6 tools; moderate evidence of the internal consistency, the content validity or the reliability of 8 tools; and limited evidence of the reliability, the structural validity, the criterion validity, or the construct validity of 12 tools. CONCLUSIONS Both the methodological qualities of included studies and the overall evidence of measurement properties are mixed. Based on the current evidence, we recommend that researchers consider using tools with measurement properties of strong or moderate evidence that also reached the threshold for positive ratings according to COSMIN checklist.
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Affiliation(s)
- Yifeng Wei
- Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre, 5850 University Ave., P.O Box 9700, Halifax, NS, B3K 6R8, Canada.
| | - Patrick J. McGrath
- IWK Health Centre, Nova Scotia Health Authority and Dalhousie University, 5850 University Ave., P.O Box 9700, Halifax, NS B3K 6R8 Canada
| | - Jill Hayden
- Centre for Clinical Research, Room 403, 5790 University Avenue, Halifax, NS B3H IV7 Canada
| | - Stan Kutcher
- Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre, 5850 University Ave., P.O Box 9700, Halifax, NS B3K 6R8 Canada
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Rachas A, Lefeuvre D, Meyer L, Faye A, Mahlaoui N, de La Rochebrochard E, Warszawski J, Durieux P. Evaluating Continuity During Transfer to Adult Care: A Systematic Review. Pediatrics 2016; 138:peds.2016-0256. [PMID: 27354452 DOI: 10.1542/peds.2016-0256] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Appropriate outcomes are required to evaluate transition programs' ability to maintain care continuity during the transfer to adult care of youths with a chronic condition. OBJECTIVE To identify the outcomes used to measure care continuity during transfer, and to analyze current evidence regarding the efficacy of transition programs. DATA SOURCES PubMed (1948-2014), Web of Science (1945-2014), Embase (1947-2014), and the reference lists of the studies identified. STUDY SELECTION Screening on titles and abstracts; full-text assessment by 2 reviewers independently. DATA EXTRACTION By 2 reviewers independently, by using a Cochrane form adapted to observational studies, including bias assessment. RESULTS Among the 23 studies retrieved, all but 5 were monocentric, 16 were cohorts (15 retrospective), 6 cross-sectional studies, and 1 randomized trial. The principal disease studied was diabetes (n = 11). We identified 24 indicators relating to 2 main aspects of continuity of care: engagement and retention in adult care. As designed, most studies probably overestimated engagement. A lack of adjustment for confounding factors was the main limitation of the few studies evaluating the efficacy of transition programs. LIMITATIONS The assessment of bias was challenging, due to the heterogeneity and observational nature of the studies. CONCLUSIONS This review highlights the paucity of knowledge about the efficacy of transition programs for ensuring care continuity during the transfer from pediatric to adult care. The outcomes identified are relevant and not specific to a disease. However, the prospective follow-up of patients initially recruited in pediatric care should be encouraged to limit an overestimation of care continuity.
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Affiliation(s)
- Antoine Rachas
- Center for Research in Epidemiology and Population Health, UMR 1018, INSERM, Paris-Sud University, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France; Department of Epidemiology and Public Health, Paris-Sud University Hospital, and Paris Sud University, Le Kremlin-Bicêtre, France;
| | - Delphine Lefeuvre
- Department of Social Epidemiology, INSERM, Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Laurence Meyer
- Center for Research in Epidemiology and Population Health, UMR 1018, INSERM, Paris-Sud University, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France; Department of Epidemiology and Public Health, Paris-Sud University Hospital, and Paris Sud University, Le Kremlin-Bicêtre, France
| | - Albert Faye
- General Pediatrics, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris 7 Denis Diderot University, Sorbonne Paris Cité, Paris, France; INSERM UMR 1123, Paris, France
| | - Nizar Mahlaoui
- French National Reference Center for Primary Immune Deficiencies, and Pediatric Immuno-Hematology and Rheumatology Unit, Necker Enfants Malades University Hospital, and INSERM UMR 1163, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Elise de La Rochebrochard
- Center for Research in Epidemiology and Population Health, UMR 1018, INSERM, Paris-Sud University, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France; Institut National d'Etudes Démographiques, Paris, France
| | - Josiane Warszawski
- Center for Research in Epidemiology and Population Health, UMR 1018, INSERM, Paris-Sud University, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France; Department of Epidemiology and Public Health, Paris-Sud University Hospital, and Paris Sud University, Le Kremlin-Bicêtre, France
| | - Pierre Durieux
- Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Informatics and Public Health, Georges Pompidou European Hospital, Paris, France; and INSERM Cordeliers Research Center UMRS 872, Paris Descartes University, Paris, France
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Jowsey T, Dennis S, Yen L, Mofizul Islam M, Parkinson A, Dawda P. Time to manage: patient strategies for coping with an absence of care coordination and continuity. SOCIOLOGY OF HEALTH & ILLNESS 2016; 38:854-873. [PMID: 26871716 DOI: 10.1111/1467-9566.12404] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper examines how people with chronic illnesses respond to absences of continuity and coordination of care. Little work has been done on how the ill person might mitigate flaws in a less than optimal system. Our qualitative research, carried out among 91 participants in Australia, reveals that people with chronic illnesses create strategies to facilitate the management of their care. These strategies included efforts to improve communication between themselves and their health care practitioners; keeping personal up-to-date medication lists; and generating their own specific management plans. While we do not submit that it is patients' responsibility to attend to gaps in the health system, our data suggests that chronically ill people can, in and through such strategies, exert a measure of agency over their own care; making it effectively more continuous and coordinated. Participants crafted strategies according to the particular social and bodily rhythms that their ongoing illnesses had lent to their lives. Our analysis advances the view that the ill body itself is capable of enfolding the health system into the rhythms of illness - rather than the ill body always fitting into the overarching structural tempo. This entails an agent-centric view of time in illness experience. A Virtual Abstract of this paper can be found at: https://youtu.be/UwbxlEJOTx8.
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Affiliation(s)
- Tanisha Jowsey
- Centre for Medical and Health Sciences Education, The University of Auckland, New Zealand
- Australian Primary Health Care Research Institute, Australian National University, Australia
| | - Simone Dennis
- School of Archaeology and Anthropology, The Australian National University
| | - Laurann Yen
- Australian Primary Health Care Research Institute, Australian National University, Australia
| | - M Mofizul Islam
- Australian Primary Health Care Research Institute, Australian National University, Australia
| | - Anne Parkinson
- Australian Primary Health Care Research Institute, Australian National University, Australia
| | - Paresh Dawda
- Australian Primary Health Care Research Institute, Australian National University, Australia
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Kim CJ, Schlenk EA, Ahn JA, Kim M, Park E, Park J. Evaluation of the Measurement Properties of Self-reported Medication Adherence Instruments Among People at Risk for Metabolic Syndrome: A Systematic Review. DIABETES EDUCATOR 2016; 42:618-34. [PMID: 27352922 DOI: 10.1177/0145721716655400] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE The purpose of this study was to present a systematic review of available published studies that evaluated the measurement properties of self-reported instruments assessing global medication adherence in adults at risk for metabolic syndrome. METHODS The authors searched PubMed, EMBASE, PsycINFO, and CINAHL in January 2015 for appropriate studies. The methodological quality (based on reliability, validity, responsiveness, and interpretability) of selected studies was assessed with the COSMIN checklist (Consensus-Based Standards for the Selection of Health Measurement Instruments). RESULTS Of the 44 studies reviewed, 32 used classical test theory, and 14 used self-reported medication adherence instruments. More than half the studies included patients with hypertension, followed by diabetes, dyslipidemia, and increased body mass index. Among the measurement properties, internal consistency, hypothesis testing, and structural validity were frequently assessed items, whereas only 1 study evaluated responsiveness, and none evaluated measurement error. The MMAS-8 (Morisky Medication Adherence Scale-8 items) and the Hill-Bone scale were the most frequently used instruments. They were found to be well validated, with strong evidence for internal consistency and strong positive evidence for reliability, structural validity, hypothesis testing, and criterion validity. CONCLUSIONS The MMAS-8 and Hill-Bone scale seem to be well-validated instruments for assessing medication adherence in adults at risk for metabolic syndrome. These findings may assist clinicians with selecting the appropriate instruments for assessing medication adherence in this population. However, further studies might be needed to define concepts to better understand the dimensions of each medication adherence instrument.
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Affiliation(s)
- Chun-Ja Kim
- Ajou University College of Nursing and Institute of Nursing Science, Suwon, South Korea (Dr C. Kim, Dr J. Park)
| | - Elizabeth A Schlenk
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA (Dr Schlenk)
| | - Jeong-Ah Ahn
- Ajou University College of Nursing, Suwon, South Korea (Dr Ahn, Ms M. Kim)
| | - Moonsun Kim
- Ajou University College of Nursing, Suwon, South Korea (Dr Ahn, Ms M. Kim)
| | - Eunyoung Park
- Department of Nursing Science, Sangji University, Wonju, South Korea (Dr E. Park)
| | - JeeWon Park
- Ajou University College of Nursing and Institute of Nursing Science, Suwon, South Korea (Dr C. Kim, Dr J. Park)
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Janssens A, Rogers M, Gumm R, Jenkinson C, Tennant A, Logan S, Morris C. Measurement properties of multidimensional patient-reported outcome measures in neurodisability: a systematic review of evaluation studies. Dev Med Child Neurol 2016; 58:437-51. [PMID: 26661333 PMCID: PMC5031226 DOI: 10.1111/dmcn.12982] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 12/15/2022]
Abstract
AIM To identify and appraise the quality of studies that primarily assessed the measurement properties of English language versions of multidimensional patient-reported outcome measures (PROMs) when evaluated with children with neurodisability, and to summarize this evidence. METHOD MEDLINE, Embase, PsycINFO, CINAHL, AMED, and the National Health Service Economic Evaluation Database were searched. The methodological quality of the papers was assessed using the COnsensus-based Standards for selection of health Measurement INstruments checklist. Evidence of content validity, construct validity, internal consistency, test-retest reliability, proxy reliability, responsiveness, and precision was extracted and judged against standardized reference criteria. RESULTS We identified 48 studies of mostly fair to good methodological quality: 37 papers for seven generic PROMs (CHIP, CHQ, CQoL, KIDSCREEN, PedsQL, SLSS, and YQOL), seven papers for two chronic-generic PROMs (DISABKIDS and Neuro-QOL), and four papers for three preference-based measures (HUI, EQ-5D-Y, and CHSCS-PS). INTERPRETATION On the basis of this appraisal, the DISABKIDS appears to have more supportive evidence in samples of children with neurodisability. The overall lack of evidence for responsiveness and measurement error is a concern when using these instruments to measure change, or to interpret the findings of studies in which these PROMs have been used to assess change.
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Affiliation(s)
- Astrid Janssens
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Morwenna Rogers
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Rebecca Gumm
- Royal Devon and Exeter NHS Foundation TrustExeterUK
| | - Crispin Jenkinson
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Alan Tennant
- Department of Rehabilitation MedicineUniversity of LeedsLeedsUK
| | - Stuart Logan
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Christopher Morris
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
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