1
|
Rodrigues CD, Lorenzini E, Romero MP, Oelke ND, Winter VDB, Kolankiewicz ACB. Care transitions among oncological patients: from hospital to community. Rev Esc Enferm USP 2023; 56:e20220308. [PMID: 36718767 PMCID: PMC10111385 DOI: 10.1590/1980-220x-reeusp-2022-0308en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/30/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To analyze the transition of care from the perspective of cancer patients, in a Southern Brazil hospital, correlating perspectives with sociodemographic and clinical characteristics. METHOD Cross-sectional study using the Care Transitions Measure (CTM) with cancer patients undergoing clinical or surgical treatment following hospital discharge. Data collection was completed by telephone, between June and September 2019. Data analysis was performed using descriptive and inferential statistics. RESULTS The average CTM score was 74.1, which was considered satisfactory. The CTM factors: understanding about medications (83.3) and preparation for self-management (77.7) were deemed satisfactory; while: secured preferences (69.4) and care plan (66.1) were unsatisfactory for an effective and safe care transition. No statistically significant difference was found between sociodemographic variables and the CTM. Among the clinical variables, primary cancer and the secured preferences factor showed a significant difference (p = 0.044). CONCLUSION The transition from hospital care to the community was considered satisfactory in the overall assessment.
Collapse
Affiliation(s)
- Caroline Donini Rodrigues
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Programa de Pós Graduação Strictu Sensu em Atenção Integral à Saúde, Ijuí, RS, Brazil
| | - Elisiane Lorenzini
- Universidade Federal de Santa Catarina, Departamento de Enfermagem, Florianópolis, SC, Brazil
| | - Manuel Portela Romero
- Universidade de Santiago de Compostela, Faculdad de Medicina, Ciencias de la Salud, Santiago de Compostela, Spain
| | | | - Vanessa Dalsasso Batista Winter
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Programa de Pós Graduação Strictu Sensu em Atenção Integral à Saúde, Ijuí, RS, Brazil
| | - Adriane Cristina Bernat Kolankiewicz
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Programa de Pós Graduação Strictu Sensu em Atenção Integral à Saúde, Ijuí, RS, Brazil
| |
Collapse
|
2
|
Acosta AM, Lima MADDS, Marques GQ, Zucatti PB, Silveira CDS, Oelke ND. Development of a measurement instrument to assess patient safe transition at hospital discharge. Rev Gaucha Enferm 2023; 43:e20220222. [PMID: 36888817 DOI: 10.1590/1983-1447.2022.20220222.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/18/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE To develop and validate the content of a measurement instrument to assess the quality of care transitions and patient safety at hospital discharge from the nurses' perspective. METHODS A methodological study developed in southern Brazil between April 2019 and January 2022, in three stages: integrative review and semi-structured interviews with six nurses for construction of the instrument; content validation with a committee of 14 experts; and a pre-test with 20 nurses. A Content Validity Index above 0.80 was employed. RESULTS A measurement instrument with 37 items organized into six domains was developed, as follows: structure; discharge planning; care education; referral for continuity of care; safety culture, and care transitions results. The general Content Validity Index reached 0.93. CONCLUSIONS The measurement instrument presented content validation and will contribute to understanding transitional care in the Brazilian context, proposing changes to qualify and strengthen patient safety at hospital discharge.
Collapse
Affiliation(s)
- Aline Marques Acosta
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Departamento de Assistência e Orientação Profissional. Porto Alegre, Rio Grande do Sul, Brasil
| | - Maria Alice Dias da Silva Lima
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Paula Buchs Zucatti
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Cristhiane de Souza Silveira
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Nelly Donszelmann Oelke
- University of British Columbia (UBC), Okanagan Campus, Faculty of Health and Social Development. SchoolofNursing. Kelowna, British Columbia, Canadá
| |
Collapse
|
3
|
Cechinel-Peiter C, Lanzoni GMDM, de Mello ALSF, Acosta AM, Pina JC, de Andrade SR, Oelke ND, dos Santos JLG. Quality of transitional care of children with chronic diseases: a cross-sectional study. Rev Esc Enferm USP 2022; 56:e20210535. [PMID: 35404992 PMCID: PMC10081595 DOI: 10.1590/1980-220x-reeusp-2021-0535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/17/2022] [Indexed: 04/16/2023] Open
Abstract
Abstract Objective: To analyze which factors may be associated with the quality-of-care transition of children with chronic diseases from the hospital to their home. Method: A cross-sectional, quantitative study, carried out in two hospitals in Southern Brazil, from February to September 2019. Participants included 167 family members of children with chronic disease. Data collection took place through a demographic questionnaire, and the use of the Brazilian version of the Care Transitions Measure (CTM-15). Results: The average score for the quality of care transition was 90.1 (sd = 19.5) (0–100). Factor 1, “Health management preparation”, was the one with the highest self-perceived average, 92.3 (sd = 11.6), while Factor 4, “Care plan”, had the lowest average, 86.3 (sd = 21.3). The quality of care transition was higher for patients living in municipalities belonging to health regions other than the hospital’s. Conclusion: The quality of care transition for children with chronic diseases, perceived by the children’s family members, in the discharge process from the hospital to home, was considered high. Living in a health region other than the hospital’s region was associated with better perception of the quality of care transition.
Collapse
|
4
|
Acosta AM, Lima MADDS, Marques GQ, Zucatti PB, Silveira CDS, Oelke ND. Construção de instrumento de avaliação da transição segura do paciente na alta hospitalar. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20220222.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
RESUMO Objetivo: Construir e validar o conteúdo de um instrumento de avaliação da qualidade da transição do cuidado e da segurança do paciente na alta hospitalar na perspectiva de enfermeiros. Métodos: Estudo metodológico, desenvolvido no Sul do Brasil entre abril de 2019 e janeiro de 2022, em três etapas: revisão integrativa e entrevistas semiestruturadas com seis enfermeiros para construção do instrumento; validação de conteúdo por comitê de 14 especialistas; e pré-teste com 20 enfermeiros. Empregou-se Índice de Validade de Conteúdo acima de 0,80. Resultados: Desenvolvido instrumento com 37 itens organizados em seis domínios: estrutura; planejamento de alta; orientações sobre cuidados; encaminhamento para continuidade de cuidados; cultura de segurança, e resultado da transição do cuidado. O Índice de Validade de Conteúdo geral foi 0,93. Conclusões: o instrumento apresentou validação de conteúdo e contribui para a compreensão da transição do cuidado no contexto nacional, propondo mudanças para qualificar e fortalecer a segurança do paciente na alta hospitalar.
Collapse
|
5
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
|
6
|
Lima MADDS, Magalhães AMMD, Oelke ND, Marques GQ, Lorenzini E, Weber LAF, Fan I. Care transition strategies in Latin American countries: an integrative review. ACTA ACUST UNITED AC 2018; 39:e20180119. [PMID: 30517436 DOI: 10.1590/1983-1447.2018.20180119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/12/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To identify and analyze available literature on care transition strategies in Latin American countries. METHODS Integrative literature review that included studies indexed in PubMed, LILACS, Web of Science Core Collection, CINAHL, SCOPUS databases, and the Scientific Electronic Library Online (SciELO), published in Portuguese, Spanish or English, between 2010 and 2017. RESULTS Eleven articles were selected and the strategies were grouped into components of care transition: discharge planning, advanced care planning, patient education and promotion of self-management, medication safety, complete communication of information, and outpatient follow-up. These strategies were carried out by multidisciplinary team members, in which nurses play a leading role in promoting safe care transitions. CONCLUSIONS Care transition activities are generally initiated very close to patient discharge, this differs from recommendations of care transition programs and models, which suggest implementing care transition strategies from the time of admission until discharge.
Collapse
Affiliation(s)
- Maria Alice Dias da Silva Lima
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós- Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Ana Maria Müller de Magalhães
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós- Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | | | | | - Elisiane Lorenzini
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Núcleo de Estudos sobre Gestão em Enfermagem (NEGE), Porto Alegre, Rio Grande do Sul, Brasil
| | - Luciana Andressa Feil Weber
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós- Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Iris Fan
- University of British Columbia (UBC), Okanagan Campus, School of Nursing. Kelowna, Canada
| |
Collapse
|
7
|
Abstract
RESUMO Objetivo: este estudo visa discutir e refletir sobre concepções teóricas e metodológicas no uso do diálogo deliberativo e sua contribuição para prática, política e pesquisa em enfermagem. Método: foi realizado estudo teórico e reflexivo sobre a abordagem metodológica do processo de deliberação e suas concepções teóricas. O artigo também fornece uma descrição geral das principais características e passos fundamentais que podem ser utilizados para guiar o desenvolvimento uma sessão de deliberação. Resultados: diálogo deliberativo envolve conversações propositadas e facilitadas entre pessoas interessadas para alcançar consenso sobre prioridades em serviços de saúde e decidir coletivamente sobre estratégias para ação utilizando síntese de evidências de pesquisas e experiência contextual. É uma estratégia de translação de conhecimento que envolve indivíduos, comunidades e instituições no uso de conhecimento científico para realizar mudanças fundamentadas. As principais características desse método são seleção cuidadosa dos participantes, elaboração de documento de leitura com síntese de evidências, facilitação neutra e habilidosa, uso de abordagens inovadoras para atividades grupais e análise de dados com métodos integrados. Conclusão: princípios de diálogo deliberativo têm sido utilizados para a tomada de decisão política, com pouco uso nos cuidados de enfermagem. Seu uso pode ser uma experiência única para o campo de enfermagem, contribuindo para mudanças nas práticas e políticas. Também pode ser utilizado como estratégia para coleta dados em pesquisa qualitativa, como uma nova forma de construir conhecimento científico. Diálogo deliberativo é uma abordagem inovadora que pode proporcionar enfermeiros mais críticos-reflexivos, mais práticas baseadas em evidências e melhores resultados de saúde.
Collapse
|
8
|
Lorenzini E, Oelke ND, Marck PB, Dall'Agnol CM. Contributions of the sandwich doctoral program to methodological approaches: an experience report. Rev Gaucha Enferm 2016; 37:e58244. [PMID: 27253599 DOI: 10.1590/1983-1447.2016.02.58244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/25/2016] [Indexed: 11/22/2022] Open
Abstract
Objective To share our experience on theoretical and methodological insights we have gained as researchers working together during the Sandwich Doctoral Program. Method This is a descriptive experience report. Results We have incorporated restoration thinking into a study on patient safety culture and will enhance knowledge translation by applying principles of deliberative dialogue to increase the uptake and implementation of research results. Conclusion Incorporating new approaches in Brazilian nursing research plays a key role in achieving international participation and visibility in different areas of nursing knowledge.
Collapse
Affiliation(s)
- Elisiane Lorenzini
- Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | | | | | - Clarice Maria Dall'Agnol
- Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| |
Collapse
|
9
|
Oelke ND, Lima MADDS, Acosta AM. Knowledge translation: translating research into policy and practice. Rev Gaucha Enferm 2015; 36:113-7. [DOI: 10.1590/1983-1447.2015.03.55036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/14/2015] [Indexed: 11/22/2022] Open
Abstract
Objective: This paper provides a theoretical-reflective study of knowledge translation concepts and their implementation processes for using research evidence in policy and practice.Results: The process of translating research into practice is iterative and dynamic, with fluid boundaries between knowledge creation and action development. Knowledge translation focuses on co-creating knowledge with stakeholders and sharing that knowledge to ensure uptake of relevant research to facilitate informed decisions and changes in policy, practice, and health services delivery. In Brazil, many challenges exist in implementing knowledge translation: lack of awareness, lack of partnerships between researchers and knowledge-users, and low research budgets.Conclusions: An emphasis on knowledge translation has the potential to positively impact health outcomes. Future research in Brazil is needed to study approaches to improve the uptake of research results in the Brazilian context.
Collapse
|