地域医療と健康教育

抽象的な

Exploring Continuity of Care: The Patient Voice

Tiziano Carradori, Francesca Bravi, Silvia Foglino, Mattia Altini and Anna Marcon

Background: Oncology is one of the priorities of public health given its high incidence and prevalence. In 2010 there were 8 million deaths caused by cancer. In Italy neoplastic disease is the second highest cause of death. Considering these data, we need to guarantee appropriate, quality healthcare responses. In order to monitor the quality of cancer care pathways, we intend to explore continuity of care from patients’ perspective, identifying the dimensions that define continuity.
Methods: Semi-structured interviews with 30 cancer patients (4 colorectal and 26 breast cancer) who received treatment at different service points of the Area Vasta Network (AVR), Italy. To identify the macro-categories of continuity, all interviews were transcribed and analysed using framework analysis, assisted by a computer software package for analysis of qualitative data (N-VIVO 10). Simultaneously, a literature review was carried out using the Pubmed database to examine the continuity of care measures validated.
Results: From the narratives of 30 patients, different continuity of care’s dimensions emerged, for example the presence of a professional who knows the patient’s illness history and takes him/her from initial diagnosis to followup care, guaranteeing him/her accurate information; a multi-professional team. The same aspects result central and transversal to 5 questionnaires identified in literature.
Conclusions: The analysis allows us to identify 3 central and transversal dimensions of continuity of care: informational, organizational and relational; confirming the continuity of care model produced by Haggerty et al. It follows that in order to cater to the needs of cancer patients; we need to focus simultaneously on these three dimensions along the cancer care pathway. In line with these results, we are developing the first Italian patients experience continuity of care tool.