2015 | 2/2015 (53), t. 2 | 196-215
Article title

Wartości przypisywane ciągłości opieki przez pacjentów przewlekle chorych – wyniki badania jakościowego

Title variants
Chronic Patients’ Values Associated to Continuity of Care – the Results of Qualitative Study
Languages of publication
Celem niniejszego artykułu jest identyfikacja doświadczeń pacjentów przewlekłe chorych i wartości przypisywanych przez tych pacjentów ciągłości opieki w polskich podmiotach leczniczych. Autorka odpowiada na dwa główne pytania badawcze: (1) jakie czynniki pacjenci postrzegają jako istotne dla ciągłości opieki?, (2) w jaki sposób można te elementy pogrupować w celu stworzenia modelu oceny jakości opieki nad pacjentem w kontekście ciągłości opieki? Stosując analizę jakościową, przeprowadzono zogniskowany wywiad grupowy z 10 pacjentami przewlekle chorymi. Zebrane odpowiedzi pogrupowano tematycznie w wymiary ciągłości opieki. Na podstawie doświadczeń pacjentów nakreślono model oceny ciągłości opieki. Wyróżniono 8 kategorii centralnych i 36 sub-wymiarów, które umożliwiają całościową ewaluację postrzeganej jakości w opiece nad pacjentem w stanach przewlekłych. Zidentyfikowano następujące wymiary centralne: aktywacja pacjentów, wsparcie przy podejmowaniu decyzji, ciągłość relacyjna, koordynacja działań, komunikacja z pacjentem, rozwiązywania problemów, elastyczność i dostępność oraz orientacja na pacjenta. Praca stanowi wstęp do koncepcyjnego modelu oceny ciągłości opieki. Identyfikuje zarazem newralgiczne punkty braku owej ciągłości.
The aim of this paper is to identify chronic patients’ experiences and values associated to continuity in care in integrated health care settings in Poland. The author answers two major research questions: (1) what variables do patients perceive to be significant in the continuity of care?, (2) how can the isolated elements be grouped in order to establish a model of evaluating patient care quality in the respect of continuity of care? Applying the qualitative study, focus group interview with 10 chronic ill patients has been carried. Collected responses were analysed thematically and grouped into dimensions of continuity of care. A patient-based framework for evaluating continuity of care was developed. 8 central categories and 36 sub-dimensions were constructed, that allow quality of integrated health care to be examined holistically. The following central dimensions of experienced continuity of care were identified: patients’ involvement, decision-making support, cross-boundary continuity, coordination of activities, communication with the patient, problem solving, flexibility and availability, and patient-centeredness. This study develops a patient-based framework for evaluating continuity of care. Is also identifies key transition points with problems of lack of continuity.
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