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Tanaka MC, Bernardino FBS, Braga PP, Alencastro LCDS, Gaíva MAM, Viera CS. Weaknesses in the continuity of care for preterm infants discharged from the neonatal unit. Rev Esc Enferm USP 2024; 58:e20230228. [PMID: 38497778 PMCID: PMC10946336 DOI: 10.1590/1980-220x-reeusp-2023-0228en] [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: 07/25/2023] [Accepted: 01/31/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE To identify weaknesses in the continuity of care for preterm infants discharged from a neonatal unit, based on the perspective of professionals in the family health strategy. METHOD Qualitative research, carried out with 16 professionals from four health regions in a capital city in the center-west of Brazil. Data collection took place from October to December 2020, through semi-structured, individual, and in-person interviews. Data underwent content analysis, supported by the concept of continuity of care. RESULTS The analysis consisted of three categories: Challenges for care in the unit and referral to specialized services; weak interactions between the preterm baby's family and health professionals; Information: essential aspect for the connection between health professionals and the family of the preterm newborn. CONCLUSION Health services are shown to be fragile in terms of the dimensions of continuity of care, contributing to the discontinuity of care for preterm children.
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Rodrigues CD, Lorenzini E, Onwuegbuzie AJ, Oelke ND, Garcia CF, Malkiewiez MM, Kolankiewicz ACB. Care Transition From the Perspectives of Oncological Patients and the Multiprofessional Care Team: A Mixed Methods Study. Cancer Nurs 2024; 47:E47-E56. [PMID: 36076317 DOI: 10.1097/ncc.0000000000001160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Integration into the health system is essential for safe care and efficient use of resources. OBJECTIVES The aims of this study were to analyze the transition of care from the perspective of adult patients with neoplasia of the digestive tract and the multiprofessional care team, identify factors that influence the transition of care, and, collectively with professionals, create actions to improve the transition of care at the study site. METHODS The Care Transitions Measure-15 was administered in a mixed methods study, with a QUAN→QUAL sequential explanatory approach. The principles of deliberative dialogue were used as a knowledge translation strategy, and data integration was carried out. RESULTS The average score of the Care Transitions Measure-15 considered satisfactory was 74.3. The care plan factor had an unsatisfactory score of 66. Strategies to improve the care transition were listed by the focus group participants, such as supplementary care protocol for patients with neoplasms of the digestive tract, and providing a single discharge plan containing all information relevant to the treatment and continuity of patient care. CONCLUSION The low score for the care plan factor indicates weakness in the care transition. IMPLICATIONS FOR PRACTICE The integrated analysis results indicated that the care transition can be improved by an educational process during discharge planning, implementation of protocols for patients with neoplasia of the digestive tract, and identification of a reference caregiver to help patients navigate the healthcare system.
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Affiliation(s)
- Caroline Donini Rodrigues
- Author Affiliations: Science of Life Department, Northwestern Regional University of the State of Rio Grande do Sul (Ms Rodrigues and Dr Kolankiewicz); and Nursing Department, Federal University of Santa Catarina (Dr Lorenzini and Ms Malkiewiez), Florianópolis, Brazil; Faculty of Education, University of Cambridge (Dr Onwuegbuzie), United Kingdom; School of Nursing, University of British Columbia, Okanagan Campus (Dr Oelke), Kelowna, Canada; and Serviço de Educação Continuada, Associação Hospital de Caridade Ijuí (Ms Garcia), Ijuí, Brazil
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Rojas Manzano KL, Toro Delgado N, Eraso Riascos DJ, Mondragón-Sánchez EJ. Percepción de los profesionales de enfermería sobre la aplicabilidad del proceso de continuidad de cuidados. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Highlights:
La Continuidad de Cuidados (CC) no se transmite como conocimiento epistemológico en los planes de estudios en Colombia, situación que se transforma en un motivo de dificultad en su aplicabilidad en el territorio.
La práctica de la CC es parcial por tres grandes motivos: la carencia de claridad de la CC, la desarticulación entre APS y Atención Especializada y los limitantes administrativos.
Siendo fragmentada y empírica la práctica de la CC, se observa alguna mejora en la salud del paciente; si la CC se practicara integralmente, se podrían obtener mejores resultados.
La investigación le apunta al aterrizaje de la necesidad de la implementación de la CC en la práctica enfermera colombiana, dados los beneficios de su uso.
Introducción: La Continuidad de Cuidados se comprende a partir de la adaptación del sujeto de cuidado y su red de apoyo a la nueva situación de salud-enfermedad. Objetivo:Comprender la percepción de los profesionales de enfermería sobre la aplicabilidad del proceso de continuidad de cuidados. Materiales y métodos: Estudio con abordaje cualitativo, fenomenológico, los sujetos de estudio se conformaron por profesionales de enfermería coordinadores de área, realizando entrevistas semiestructuradas, para el análisis de los datos se utiliza el software AtlasT. Resultados: Se encontró que la continuidad de cuidados se aplica parcialmente por los participantes, esto debido a la carencia de claridad del concepto, la desarticulación entre atención primaria en salud, atención especializada y los limitantes administrativos; así mismo, esta es practicada de forma desorganizada y de forma empírica. Discusión: Es evidente la necesidad de la aplicación de estrategias en pro de la comunicación entre los diferentes niveles de atención, para fortalecer el trabajo en equipo y favorecer el autocuidado de los pacientes, dado que a consideración de los participantes la información no es compartida entre los diferentes niveles de atención y esto dificulta la continuidad de cuidados individual de los pacientes. Conclusión: La aplicación de la Continuidad de Cuidados es fragmentada y desordenada, además de esto, se reconoce que, con base en la evidencia de otros países, si dicho proceso se aplicara en Colombia mejoraría la calidad del servicio y así mismo la calidad de vida de los pacientes.
Como citar este artículo: Rojas-Manzano Karen Liseth, Toro-Delgado Nicolay, Eraso-Riascos Deysi Johana, Mondragón-Sánchez Edna Johana. Percepción de los profesionales de enfermería sobre la aplicabilidad del proceso de continuidad de cuidados. Revista Cuidarte. 2023;14(1):e2210.http://dx.doi.org/10.15649/cuidarte.2210
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Santos MTD, Halberstadt BMK, Trindade CRPD, Lima MADDS, Aued GK. Continuity and coordination of care: conceptual interface and nurses' contributions. Rev Esc Enferm USP 2022; 56:e20220100. [PMID: 35951450 PMCID: PMC10111392 DOI: 10.1590/1980-220x-reeusp-2022-0100en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
This is a theoretical-reflective study, with the objective of discussing the concepts of continuity and coordination of care, its conceptual interface and nurses' actions for its effectiveness in health services, based on international and national scientific publications. The concepts have been studied for decades and, although they are interrelated, they are used in a similar way, indicating a lack of conceptual understanding. The concept of continuity underwent paradigm shifts and began to adopt patients' perspectives. Currently, it involves interpersonal, longitudinal, management and informational domains. Coordination consists of establishing connections between the possible elements involved in care. It is classified as horizontal and vertical and is organized into categories: sequential, parallel and indirect. Nurses stand out through actions aimed at coordination and continuity at different levels of care, which contributes to strengthening a cohesive and people-centered care. The interface between concepts indicates that, in order to achieve integrated and continuous services, continuity and coordination of care need to be interconnected and act together.
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Affiliation(s)
- Mariana Timmers Dos Santos
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Enfermagem, Porto Alegre, RS, Brazil
| | | | | | | | - Gisele Knop Aued
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
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da Silva OBM, Bernardino E, Encarnação P. Strengths-based Nursing and Healthcare in maternities: rethinking practices and continuity of care. Rev Esc Enferm USP 2022; 56:e20210597. [PMID: 35666983 PMCID: PMC10081581 DOI: 10.1590/1980-220x-reeusp-2021-0597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/01/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify elements of the Strengths-Based Nursing and Healthcare in the maternity nurses care practice in a perspective of continuity of care. METHOD Qualitative exploratory-descriptive study. A focus group was used for data collection, seven meetings were held with 18 nurses between August 2019 and January 2020, starting from a priori categories: "problem-based nursing care" and "strengths-based nursing and healthcare". RESULTS In the first category, nurses' care is centered on problems identified in women; they keep a hierarchical relationship and a prescriptive posture based on a biomedical model. In the second category, care is focused on singularity, empowerment, self-determination, learning, collaborative partnership, and promotion of women's health, based on a holistic nursing model. CONCLUSION Although nurses use the biomedical model in their care practice, many of them already use the framework elements empirically. Applying this theoretical framework allows nurses to shift the focus of their attention from the disease to the person/family, promoting health and the continuity of care in a holistic way.
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Affiliation(s)
| | | | - Paula Encarnação
- Universidade do Minho, Braga, Portugal.,Pesquisadora UICISA-E, Escola de Enfermagem. Coimbra, Portugal
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Cechinel-Peiter C, Lanzoni GMDM, Neves ET, Baggio MA, Oelke ND, Santos JLGD. Continuity of care for children with chronic conditions after discharge: a constructivist grounded theory. Rev Bras Enferm 2022; 75:e20210783. [DOI: 10.1590/0034-7167-2021-0783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: to understand the meaning of continuity of care for children with chronic conditions through transitional care from hospital to home. Methods: this is a qualitative study, conducted from a Constructivist Grounded Theory perspective. Purposive and theoretical sampling were used to recruit 35 participants, including nurses, professionals from the interprofessional hospital team, and actors responsible for healthcare in the home context. The research was conducted at two large hospitals, between March and September 2019. Semi-structured interviews were conducted. Data analysis was carried out using initial and focused coding, according to constructivist grounded theory. Results: the substantive theory that emerged from this study was named “Postponing the next hospitalization”. Eight categories-concepts and 18 elements were derived from the data to support the substantive theory. Final Considerations: transitional care from hospital to home acts as a reminder for the resumption of continuity of care after discharge.
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Santos MTD, Halberstadt BMK, Trindade CRPD, Lima MADDS, Aued GK. Continuidade e coordenação do cuidado: interface conceitual e contribuições dos enfermeiros. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0100pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Estudo teórico-reflexivo, com objetivo de discutir os conceitos de continuidade e coordenação do cuidado, sua interface conceitual e ações de enfermeiros para sua efetivação nos serviços de saúde, com base em publicações científicas internacionais e nacionais. Os conceitos são estudados há décadas e, embora sejam inter-relacionados, observa-se sua utilização de maneira semelhante, indicando falta de entendimento conceitual. O conceito de continuidade teve mudanças de paradigma e passou a adotar a perspectiva dos pacientes. Atualmente, envolve domínios interpessoal, longitudinal, gerencial e informacional. Coordenação consiste em estabelecer conexões entre os possíveis elementos envolvidos no cuidado. Classifica-se como horizontal e vertical e está organizada em categorias: sequencial, paralela e indireta. Enfermeiros destacam-se por meio de ações voltadas à coordenação e continuidade nos diferentes níveis de atenção, o que contribui para o fortalecimento do cuidado coeso e centrado nas pessoas. A interface entre conceitos indica que, para o alcance de serviços integrados e contínuos, continuidade e coordenação do cuidado precisam estar interligadas e atuar em conjunto.
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Mauro AD, Cucolo DF, Perroca MG. Hospital - primary care articulation in care transition: both sides of the process. Rev Esc Enferm USP 2021; 55:e20210145. [PMID: 34545910 DOI: 10.1590/1980-220x-reeusp-2021-0145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/20/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze how the articulation between hospital and primary health care related to patient discharge and continuity of care after hospitalization takes place. METHOD Qualitative study, using the focus group technique to explore the experience of 21 nurses in hospitals (n = 10) and at primary care (n = 11) in a municipality in the northwest area of the State of São Paulo. Data collection took place between December 2019 and April 2020. Four focus groups were carried out (two in the hospital and two in the health units) and the findings underwent thematic analysis. RESULTS The categories identified were: Patient inclusion flow in the responsible discharge planning, Patient/family member/caregiver participation, Care planning, Communication between services, and Challenges in the discharge process. According to reports, the discharge process is centered on bureaucratic aspects with gaps in communication and coordination of care. CONCLUSION This research allowed understanding how nurses from different points of health care experience the discharge and (dis)articulation of the team work. The findings can equip managers in the (re)agreement of practices and integration of services to promote continuity of care.
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Affiliation(s)
- Adriéli Donati Mauro
- Faculdade de Medicina de São José do Rio Preto, Programa de Pós-graduação em Enfermagem, São José do Rio Preto, SP, Brazil
| | - Danielle Fabiana Cucolo
- Pontifícia Universidade Católica de Campinas, Programa de Pós-graduação, Campinas, SP, Brazil
| | - Marcia Galan Perroca
- Faculdade de Medicina de São José do Rio Preto, Programa de Pós-graduação em Enfermagem, São José do Rio Preto, SP, Brazil
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