Continuity of rehabilitation services in post-acute care from the ambulatory outpatients’ perspective: a qualitative study
Francesc Medina-Mirapeix, Silvana Oliveira Sousa, Marta Sobral Ferreira, Maria Elena Del Baño-Aledo, Pilar Escolar-Reina, Joaquina Montilla-Herrador, Sean M. Collins
Objective: To explore ambulatory outpatient experiences and perceptions in post-acute care settings and how these experiences may have led to perceived gaps in continuity of rehabilitation care.
Subjects: Fifty-seven adults undergoing outpatient rehabilitation for musculoskeletal conditions/injuries, who had had more than 10 physiotherapy treatment sessions.
Methods: Qualitative study using a modified grounded theory approach. Data collection was carried out through 9 focus groups. Each group was recorded, transcribed literally and analyzed thematically.
Results: Participants described 3 main themes in continuity; relational, informational, and management continuity. Several factors that led to gaps in the 3 types of continuity were described. The relevant factors for relational continuity were: consistency of the multi-professional rehabilitation team; and an established provider–patient relationship. Factors for informational continuity were: transfer of information among providers; and accumulated knowledge regarding patients’ disability experiences. Factors for management continuity included: consistency of care among rehabilitation providers; flexibility of the team in adapting care to functional changes; and involvement of the team in achieving patient collaboration.
Conclusion: This study provides evidence of gaps in different types of continuity of care within the post-acute rehabilitation services in ambulatory settings. Outpatients often perceive their experiences of rehabilitation care as non-connected or non-coherent over time.
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