A Model of Continuity of Care in the Context of Women's Mental Health: An Exploratory Study of an Interprofessional Team Approach to Eating Disorders.

摘要

Objectives The overall goal of this research was to study continuity of care in the context of team based care delivery to support adolescent women's mental health issues, specifically Anorexia or Bulimia. I used the three concepts of continuity of care described by Haggerty et al. (2003): relational, managerial and informational continuity, to develop an exploratory model of continuity of care for women's mental health. To research question was how are health care professionals providing continuity of care and collaborative patient centred care in the case of adolescent/women's mental health as represented by the eating disorders, anorexia and bulimia.;Results In terms of the continuity of care and how it unfolds, the three types work in a cyclical process. It starts with informational continuity, with the team learning with and from the patient. Once all the information is put together managerial continuity begins to form, as does relational continuity. When the patient is close to discharge informational continuity increases within the team, as well as between the family and different actors in the community.;From the constructivist grounded theory analysis, fives themes emerged as dimensions that impact continuity of care: political, clinical, social, financial, and geographical.;Conclusion The professionals can better understand the process of continuity within their team. There is now empirical evidence on the interaction of the types of continuity. At the policy level, the types of remuneration played a role in the process of continuity. Next steps include clarifying the patient perspective.;Methods Data collection took place in the eating disorder program in a tertiary care paediatric hospital. The study included 36 participants including: psychiatrists, family physicians, psychologists, nurses, dietician, child and youth counsellors, medical and psychological interns and residents, and art therapist. Data sources included non participant observation of team meetings (approximately 20 hours) of inpatient, day hospital and outpatient clinics as well as 10 semi-structured interviews with health care professionals. Constructivist Grounded theory method was used to analyze the data.