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Development and pilot evaluation of a complex intervention to improve experienced continuity of care in patients with cancer

Development and pilot evaluation of a complex intervention to improve experienced continuity of care in patients with cancer
Development and pilot evaluation of a complex intervention to improve experienced continuity of care in patients with cancer
High experienced continuity of care in patients with cancer is associated with lower needs for care, better quality of life and better psychological outcomes. We developed and evaluated an intervention to improve experienced continuity. The intervention, consisted of (1) a 17-item patient-completed continuity assessment; (2) feedback to clinical nurse specialists and action to address the needs identified. Multidisciplinary team meetings and oncology outpatient clinics were observed, and patients and staff were interviewed. After qualitative work and reliability testing, the intervention was evaluated in a feasibility trial. Sixty-one patients provided data for analysis. No statistically significant differences were found in patients' experienced continuity between the trial arms, but important trends were seen in measures of needs for care in favour of those receiving the intervention. Feeding back findings from the continuity assessment to clinicians reduced patients' needs for care. Our results indicate that an intervention to target patients' experiences of continuity can reduce their subsequent needs for care. However, overcoming barriers to organisational change and addressing some patients' hesitation to report their continuity difficulties must be considered when implementing such an intervention. A phase III trial targeting patients with inadequate experienced continuity of care is recommended.
continuity of care, complex intervention, feasibility trial
0007-0920
274-280
King, M.
aba8e88c-72f5-402a-9c29-0212b60351b4
Jones, L.
b873ef7a-7df0-4411-9287-b35c45663770
McCarthy, O.
d2004129-4a8e-4654-be18-a302c3ecc45d
Rogers, M.
d94fdd17-c224-49ec-b686-1d0b8d71861a
Richardson, A.
3db30680-aa47-43a5-b54d-62d10ece17b7
Williams, R.
49181762-00c1-4043-9247-a9bcddbd04f7
Tookman, A.
e30b9cc3-77f3-4e6e-b2aa-82865f9d0d42
Nazareth, I.
7272539e-1090-4a10-9421-9d7afd68c568
King, M.
aba8e88c-72f5-402a-9c29-0212b60351b4
Jones, L.
b873ef7a-7df0-4411-9287-b35c45663770
McCarthy, O.
d2004129-4a8e-4654-be18-a302c3ecc45d
Rogers, M.
d94fdd17-c224-49ec-b686-1d0b8d71861a
Richardson, A.
3db30680-aa47-43a5-b54d-62d10ece17b7
Williams, R.
49181762-00c1-4043-9247-a9bcddbd04f7
Tookman, A.
e30b9cc3-77f3-4e6e-b2aa-82865f9d0d42
Nazareth, I.
7272539e-1090-4a10-9421-9d7afd68c568

King, M., Jones, L., McCarthy, O., Rogers, M., Richardson, A., Williams, R., Tookman, A. and Nazareth, I. (2009) Development and pilot evaluation of a complex intervention to improve experienced continuity of care in patients with cancer. British Journal of Cancer, 100 (2), 274-280. (doi:10.1038/sj.bjc.6604836).

Record type: Article

Abstract

High experienced continuity of care in patients with cancer is associated with lower needs for care, better quality of life and better psychological outcomes. We developed and evaluated an intervention to improve experienced continuity. The intervention, consisted of (1) a 17-item patient-completed continuity assessment; (2) feedback to clinical nurse specialists and action to address the needs identified. Multidisciplinary team meetings and oncology outpatient clinics were observed, and patients and staff were interviewed. After qualitative work and reliability testing, the intervention was evaluated in a feasibility trial. Sixty-one patients provided data for analysis. No statistically significant differences were found in patients' experienced continuity between the trial arms, but important trends were seen in measures of needs for care in favour of those receiving the intervention. Feeding back findings from the continuity assessment to clinicians reduced patients' needs for care. Our results indicate that an intervention to target patients' experiences of continuity can reduce their subsequent needs for care. However, overcoming barriers to organisational change and addressing some patients' hesitation to report their continuity difficulties must be considered when implementing such an intervention. A phase III trial targeting patients with inadequate experienced continuity of care is recommended.

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More information

Published date: January 2009
Keywords: continuity of care, complex intervention, feasibility trial
Organisations: Health Sciences

Identifiers

Local EPrints ID: 69380
URI: http://eprints.soton.ac.uk/id/eprint/69380
ISSN: 0007-0920
PURE UUID: 860e987a-5f24-4827-ab13-3f383af20e10
ORCID for A. Richardson: ORCID iD orcid.org/0000-0003-3127-5755

Catalogue record

Date deposited: 10 Nov 2009
Last modified: 14 Mar 2024 02:55

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Contributors

Author: M. King
Author: L. Jones
Author: O. McCarthy
Author: M. Rogers
Author: A. Richardson ORCID iD
Author: R. Williams
Author: A. Tookman
Author: I. Nazareth

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