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Kiran RP. Commentary on Young et al. Colorectal Dis 2014; 16:25-7. [PMID: 24330434 DOI: 10.1111/codi.12400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Ravi P Kiran
- Division of Colorectal Surgery, Columbia University and the New York Presbyterian Hospital, New York, NY, USA.
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Young JM, Masya LM, Solomon MJ, Shepherd HL. Identifying indicators of colorectal cancer care coordination: a Delphi study. Colorectal Dis 2014; 16:17-25. [PMID: 24034416 DOI: 10.1111/codi.12399] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 07/16/2013] [Indexed: 02/03/2023]
Abstract
AIM Care coordination is an important aspect of the quality of cancer care but is difficult to evaluate due to the lack of valid and reliable measures. This study was conducted to identify a set of objective measures of colorectal cancer care coordination that could be included in a medical record audit tool. METHOD A two-stage Delphi study was conducted to gain consensus among a national panel of experts about the validity of 41 potential indicators of colorectal cancer care coordination that had been identified during a literature review. The expert panel comprised 20 members from the National Health and Medical Research Colorectal Cancer Guidelines Working Party plus representatives from cancer nursing/coordination, general practice and cancer consumers. RESULTS Consensus was reached on the validity of 15 of 41 potential indicators, including those that focused on practical aspects of communication (legibility, clarity, content and timeliness of hospital discharge letters, documentation of outcomes of multidisciplinary team meetings) and appropriateness (documentation of preoperative consultation with a stoma therapist, discussions and referrals for adjuvant therapy for appropriate patients, and treatment by an experienced colorectal surgeon). There was lack of consensus on the validity of indicators relating to access to and efficiency of services. CONCLUSION The study has identified a core set of measures considered to be valid indicators of colorectal cancer care coordination. A medical record audit based on these measures could be used to monitor adequacy of cancer care coordination and will complement subjective measures based on self-reported experiences of patients and carers.
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Affiliation(s)
- J M Young
- Cancer Epidemiology and Cancer Services Research Group, Sydney School of Public Health, University of Sydney and Cancer Institute NSW, Sydney, New South Wales, Australia; Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia
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A tool for assessing continuity of care across care levels: an extended psychometric validation of the CCAENA questionnaire. Int J Integr Care 2013; 13:e050. [PMID: 24363638 PMCID: PMC3860582 DOI: 10.5334/ijic.1160] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 10/08/2013] [Accepted: 10/15/2013] [Indexed: 11/20/2022] Open
Abstract
Background The CCAENA questionnaire was developed to assess care continuity across levels from the patients’ perspective. The aim is to provide additional evidence on the psychometric properties of the scales of this questionnaire. Methods Cross-sectional study by means of a survey of a random sample of 1500 patients attended in primary and secondary care in three health care areas of the Catalan health care system. Data were collected in 2010 using the CCAENA questionnaire. To assess psychometric properties, an exploratory factor analysis was performed (construct validity) and the item-rest correlations and Cronbach's alpha were calculated (internal consistency). Spearman correlation coefficients were calculated (multidimensionality) and the ability to discriminate between groups was tested. Results The factor analysis resulted in 21 items grouped into three factors: patient–primary care provider relationship, patient–secondary care provider relationship and continuity across care levels. Cronbach's alpha indicated good internal consistency (0.97, 0.93, 0.80) and the correlation coefficients indicated that dimensions can be interpreted as separated scales. Scales discriminated patients according to health care area, age and educational level. Conclusion The CCAENA questionnaire has proved to be a valid and reliable tool for measuring patients’ perceptions of continuity. Providers and researchers could apply the questionnaire to identify areas for health care improvement.
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Young JM, Butow PN, Walsh J, Durcinoska I, Dobbins TA, Rodwell L, Harrison JD, White K, Gilmore A, Hodge B, Hicks H, Smith S, O'Connor G, Byrne CM, Meagher AP, Jancewicz S, Sutherland A, Ctercteko G, Pathma-Nathan N, Curtin A, Townend D, Abraham NS, Longfield G, Rangiah D, Young CJ, Eyers A, Lee P, Fisher D, Solomon MJ. Multicenter randomized trial of centralized nurse-led telephone-based care coordination to improve outcomes after surgical resection for colorectal cancer: the CONNECT intervention. J Clin Oncol 2013; 31:3585-91. [PMID: 24002519 DOI: 10.1200/jco.2012.48.1036] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To investigate the effectiveness of a centralized, nurse-delivered telephone-based service to improve care coordination and patient-reported outcomes after surgery for colorectal cancer. PATIENTS AND METHODS Patients with a newly diagnosed colorectal cancer were randomly assigned to the CONNECT intervention or usual care. Intervention-group patients received standardized calls from the centrally based nurse 3 and 10 days and 1, 3, and 6 months after discharge from hospital. Unmet supportive care needs, experience of care coordination, unplanned readmissions, emergency department presentations, distress, and quality of life (QOL) were assessed by questionnaire at 1, 3, and 6 months. RESULTS Of 775 patients treated at 23 public and private hospitals in Australia, 387 were randomly assigned to the intervention group and 369 to the control group. There were no significant differences between groups in unmet supportive care needs, but these were consistently low in both groups at both follow-up time points. There were no differences between the groups in emergency department presentations (10.8% v 13.8%; P = .2) or unplanned hospital readmissions (8.6% v 10.5%; P = .4) at 1 month. By 6 months, 25.6% of intervention-group patients had reported an unplanned readmission compared with 27.9% of controls (P = .5). There were no significant differences in experience of care coordination, distress, or QOL between groups at any follow-up time point. CONCLUSION This trial failed to demonstrate substantial benefit of a centralized system to provide standardized, telephone follow-up for postoperative patients with colorectal cancer. Future interventions could investigate a more tailored approach.
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Affiliation(s)
- Jane M Young
- Jane M. Young, Phyllis N. Butow, Jennifer Walsh, Ivana Durcinoska, Timothy A. Dobbins, Laura Rodwell, James D. Harrison, Kate White, Christopher M. Byrne, Christopher J. Young, and Michael J. Solomon, University of Sydney; Jane M. Young, Jennifer Walsh, Ivana Durcinoska, James D. Harrison, and Michael J. Solomon, Surgical Outcomes Research Centre, Sydney Local Health District; Christopher M. Byrne, Christopher J. Young, Anthony Eyers, Peter Lee, and Michael J. Solomon, Royal Prince Alfred Hospital; Alan P. Meagher, St Vincent's Hospital; Grahame Ctercteko and Nimalan Pathma-Nathan, Westmead Hospital, Sydney; Andrew Gilmore, Orange Base Hospital, Orange; Bruce Hodge and Greg Longfield, Port Macquarie Base Hospital, Port Macquarie; Henry Hicks and Stephen Jancewicz, Wagga Wagga Base Hospital, Wagga Wagga; Stephen Smith, John Hunter Hospital, Newcastle; Geoff O'Connor and Dean Fisher, Dubbo Base Hospital, Dubbo; Andrew Sutherland and Ned S. Abraham, Coffs Harbour Base Hospital, Coffs Harbour; Austin Curtin and David Townend, Lismore Base Hospital, Lismore, New South Wales; and David Rangiah, Canberra Hospital, Australian Capital Territory, Australia
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Reissmann DR, Semmusch J, Farhan D, Smeets R, Heiland M, Heydecke G. Development and validation of the Burdens in Oral Surgery Questionnaire (BiOS-Q). J Oral Rehabil 2013; 40:780-7. [DOI: 10.1111/joor.12092] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2013] [Indexed: 11/28/2022]
Affiliation(s)
- D. R. Reissmann
- Department of Prosthetic Dentistry; University Medical Center Hamburg-Eppendorf; Hamburg Germany
- Division of TMD and Orofacial Pain; Department of Diagnostic and Biological Sciences; University of Minnesota; Minneapolis MN USA
| | - J. Semmusch
- Department of Oral and Maxillofacial Surgery; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - D. Farhan
- Department of Prosthetic Dentistry; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - R. Smeets
- Department of Oral and Maxillofacial Surgery; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - M. Heiland
- Department of Oral and Maxillofacial Surgery; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - G. Heydecke
- Department of Prosthetic Dentistry; University Medical Center Hamburg-Eppendorf; Hamburg Germany
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Langbecker D, Janda M, Yates P. Health professionals' perspectives on information provision for patients with brain tumours and their families. Eur J Cancer Care (Engl) 2012; 22:179-87. [PMID: 22989208 DOI: 10.1111/ecc.12011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A significant number of patients diagnosed with primary brain tumours report unmet information needs. Using concept mapping methodology, this study aimed to identify strategies for improving information provision, and to describe factors that health professionals understood to influence their provision of information to patients with brain tumours and their families. Concept mapping is a mixed-methods approach that uses statistical methods to represent participants' perceived relationships between elements as conceptual maps. These maps, and results of associated data collection and analyses, are used to extract concepts involved in information provision to these patients. Thirty health professionals working across a range of neuro-oncology roles and settings participated in the concept mapping process. Participants rated a care coordinator as the most important strategy for improving brain tumour care, with psychological support as a whole rated as the most important element of care. Five major themes were identified as facilitating information provision: health professionals' communication skills, style and attitudes; patients' needs and preferences; perceptions of patients' need for protection and initiative; rapport and continuity between patients and health professionals; and the nature of the healthcare system. Overall, health professionals conceptualised information provision as 'individualised', dependent on these interconnected personal and environmental factors.
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Affiliation(s)
- D Langbecker
- School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
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Uijen AA, Heinst CW, Schellevis FG, van den Bosch WJHM, van de Laar FA, Terwee CB, Schers HJ. Measurement properties of questionnaires measuring continuity of care: a systematic review. PLoS One 2012; 7:e42256. [PMID: 22860100 PMCID: PMC3409169 DOI: 10.1371/journal.pone.0042256] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 07/05/2012] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Continuity of care is widely acknowledged as a core value in family medicine. In this systematic review, we aimed to identify the instruments measuring continuity of care and to assess the quality of their measurement properties. METHODS We did a systematic review using the PubMed, Embase and PsycINFO databases, with an extensive search strategy including 'continuity of care', 'coordination of care', 'integration of care', 'patient centered care', 'case management' and its linguistic variations. We searched from 1995 to October 2011 and included articles describing the development and/or evaluation of the measurement properties of instruments measuring one or more dimensions of continuity of care (1) care from the same provider who knows and follows the patient (personal continuity), (2) communication and cooperation between care providers in one care setting (team continuity), and (3) communication and cooperation between care providers in different care settings (cross-boundary continuity). We assessed the methodological quality of the measurement properties of each instrument using the COSMIN checklist. RESULTS We included 24 articles describing the development and/or evaluation of 21 instruments. Ten instruments measured all three dimensions of continuity of care. Instruments were developed for different groups of patients or providers. For most instruments, three or four of the six measurement properties were assessed (mostly internal consistency, content validity, structural validity and construct validity). Six instruments scored positive on the quality of at least three of six measurement properties. CONCLUSIONS Most included instruments have problems with either the number or quality of its assessed measurement properties or the ability to measure all three dimensions of continuity of care. Based on the results of this review, we recommend the use of one of the four most promising instruments, depending on the target population Diabetes Continuity of Care Questionnaire, Alberta Continuity of Services Scale-Mental Health, Heart Continuity of Care Questionnaire, and Nijmegen Continuity Questionnaire.
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Affiliation(s)
- Annemarie A Uijen
- Radboud University Nijmegen Medical Centre, Department of Primary and Community Care, Nijmegen, The Netherlands.
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