Continuity Of Care Experience Research Articles

Impact of women’s feedback on midwifery student learning: A thematic analysis of students’ reflections

ProblemLittle is known about the educational impact of providing routine, online feedback from women on midwifery student learning and clinical practice. BackgroundFeedback on students’ clinical performance has historically been provided by lecturers and clinical supervisors. Women’s feedback is not routinely collected or evaluated for impact on student learning. AimTo evaluate the impact of women’s feedback about continuity of care experiences with a midwifery student on learning and practice. DesignDescriptive, exploratory qualitative study. MethodsAll second-and third-year Bachelor of Midwifery students undertaking clinical placement between February and June 2022 at one Australian university, submitted formative, guided written reflections on de-identified women’s feedback they received through their ePortfolio. Data were analysed using reflexive thematic analysis. FindingsForty-four of the 69 eligible students (64%) submitted reflections on feedback received. Three themes emerged: 1) Confidence boosting, 2) Deeply integrating Midwifery Metavalues, and 3) Enhancing commitment to continuity. Three subthemes: connection, future practice and advocacy were identified. Women’s feedback positively impacts student learning and places the woman in the educational feedback loop. ConclusionThis study is an international first evaluating the impact of feedback from women on midwifery students’ learning. Students reported greater confidence in their clinical practice, a deeper understanding of their midwifery philosophy, and an intention to advocate for, and work in, midwifery continuity models after graduation. Routine feedback about women’s experiences should be embedded into midwifery education programs.

Learning ‘With Woman’ Alongside a Privately Practising Midwife

A midwifery degree consists of an even mix between theoretical load and student placement in an appropriate facility.1 I spent two years with a private practising midwife, completing my entire antenatal and postnatal placement hours with her, as well as most of my continuity of care experiences. In this article, I am taking you on my journey through long-term student placement with a private practising midwife.

Learning through relationships: The transformative learning experience of midwifery continuity of care for students: A qualitative study

BackgroundMidwifery curricula in Australia incorporate ‘Continuity of care experiences’ (CoCE) as an educational strategy based on an assumption that midwifery students will learn skills and knowledge about woman-centred care that they may not learn in the typical fragmented care system. However, exactly what skills and knowledge they are expected to ‘learn’ and how these can be assessed have never been specifically identified. AimTo explore midwifery students’ continuity of care learning experiences within pre-registration midwifery education. MethodsFocus groups were conducted with first, second and third year Bachelor of Midwifery students (n = 12), who were undertaking CoCE in rural and regional tertiary hospitals in NSW, Australia. FindingsThe overarching theme, ‘Learning through relationships’, was made up of three interrelated themes: Meeting women and making connections, Being known, and Understanding holistic care. DiscussionThe findings from this study contribute to understanding the educational effects of CoCE. The CoCE relationship provided safety and freedom to learn which was seen as foundational for midwifery students’ vision of their future practice and can be seen as a self-determined transformational approach to learning. ConclusionThis study adds insight into midwifery students’ experience of CoCE, and demonstrates that transformative learning occurs through developing a relationship with both the woman and the midwife. For midwifery to develop as a profession and maintain its focus on woman-centredness, it is important that this aspect of midwifery education remains embedded within midwifery program philosophies and learning outcomes.

O31 - Clinical outcomes for women participating in continuity of care experiences with pre-registration midwifery students

Midwifery students in Australia are required to care for a minimum of 10 women in a continuity of care experience (CoCE) as part of their pre-registration midwifery program. Clinical outcomes for women receiving care from midwifery students may be documented by students in portfolios or ePortfolios but are rarely reported. The extent to which students value add to women’s care is unknown. This novel study used a retrospective descriptive design to evaluate the routinely collected clinical outcomes of women who had participated in a CoCE with a midwifery student (n = 5972 during pregnancy and n = 3933 during labour and birth) in one Australian BMid program between 2015 and 2020. The clinical outcomes collected and reported by students were compared with the National Core Maternity Indicators. Clinical outcomes were analysed for (1) women in a CMC primary model and who had a CoCE; (2) women in fragmented primary model of care and who had a CoCE; and (3) a comparison of clinical outcomes for women according to their model of care. The analyses revealed that women who had a CoCE with a midwifery student experienced equal to, or better clinical outcomes than national outcomes. In particular, tobacco smoking after 20 weeks of pregnancy, fourth degree tears and episiotomy rates were reduced for women who had CoCE with a midwifery student. Greatest benefit of CoCE with midwifery students was achieved when care began earlier in pregnancy. It is recommended that midwifery students commence CoCE as early as possible in pregnancy and that pre-registration midwifery programs extend and develop CoCE to maximise benefits for students and women.

O29 - Accountability, Advocacy and Autonomy: the top intentions for midwifery student learning in the Continuity of Care Experience

Continuity of Care Experience (CoCE) is a practice-based learning experience for midwifery students in Australia. This mandated component of education leading to the registration as a midwife provides students the experience of providing continuity of care regardless of the setting the clinical practice takes place. Since implementation, no standardised learning intention or measure of learning outcome is evident. The aim of this research is to identify the common understanding of the purpose and learning objectives of the CoCE in midwifery programs from the perspective of midwifery professionals. This presentation discusses the themes identified from Australian midwifery professionals who hold expert opinion pertaining to how the CoCE is imbedded in curriculum. Two focus groups were conducted with a total of 17 midwifery professionals across Australia via virtual platform. Participants were midwifery academics, published authors on CoCE, researchers, policy makers and accreditation experts. The focus group discussions were facilitated using open-ended ‘prompt’ questions derived from themes identified from the integrative literature review. The discussion was recorded and transcribed verbatim. A thematic analysis of the qualitative data was undertaken. The analysis of the data identifying the common understanding and purpose of the CoCE exposed three themes. Three themes identified the learning objectives: accountability, autonomy, and advocacy. The CoCE afforded the midwifery student the opportunity to engage in learning underpinned by accountability of professional responsibility, advocacy for women, and autonomy in practice. The learning objectives accountability, autonomy, and advocacy are distinctive qualities the CoCE. As opposed to traditional clinical practice based model, the CoCE affords the midwifery student an engagement experience and exposure to develop a midwifery professional identity that enables woman centred care. This research identifies the intention of the CoCE learning and is an important step toward standardisation and strengthening this mandated component of curriculum.

O102 - The MIDAC CoCE Portal: connecting pregnant women with midwifery students in Victoria, Australia

In Australia all pre-registration midwifery students are required to engage and partner with a minimum of ten women in midwifery continuity of care experiences (CoCE) throughout their course of study. Around 77,000 women give birth in Victoria each year, however two out of three students report difficulties recruiting pregnant women as CoCE partners (Newton et al., 2021). On the basis of this evidence as well as the temporary additional CoCE difficulties caused by the COVID-19 pandemic, the Midwifery Academics of Victoria (MIDAC) group developed a web portal to support students to attain CoCE requirements wherein women can learn about CoCE and register to be partnered with a midwifery student from a university that works with the maternity service providing their care. The aim of this project was to facilitate midwifery students engaging in CoCE partnerships with childbearing women in the state of Victoria, Australia. A project team was convened comprising one lead and five other midwifery academics representing all universities offering pre-registration midwifery education in Victoria, Australia, as well as Information Technology staff members and students from one of those universities. The team worked together to develop the web portal's content, design and functionality over a period of 12 months. The MIDAC CoCE web portal was launched in early 2022 with an accessible, responsive design suitable for desktop and mobile devices. QR code-enabled flyers are displayed in maternity health services enabling pregnant women to easily access the website and register their interest via a simple web form. The data is securely sent to that university's Professional Practice contact, who then pairs the woman with a suitable student. Evaluation is underway.

O100 - Feasibility of embedding feedback from women participating in continuity of care experiences with pre-registration midwifery students

Quality midwifery care is woman-centred in both philosophy and model of care (ICM, 2022). Assessment of midwifery student clinical learning has typically depended on preceptor/supervisor feedback, university academic feedback and self-reflection but has not routinely embedded women’s feedback to improve student learning and practice. One pre-registration midwifery program in south-east Queensland has begun to routinely seek feedback from women about their experiences with a midwifery student providing a continuity of care experience (CoCE). The aim of this study was to evaluate the feasibility of conducting a routine, online survey of women’s perceptions of satisfaction and respect during CoCE with a midwifery student. Data from the first 12 months (July 2019 – July 2020) of this online survey was analysed and reported. The online survey was found to be feasible, reliable and valid. Over half of the women invited to complete the survey did so (response rate of 57%, n = 501). Most women reported being more satisfied with their student than they had hoped; would have a midwifery student in future pregnancies; and would recommend a midwifery student to their friends and family. Students in this study cared for a larger number of women through CoCE than the prescribed minimum of 10 required by the national regulator (Nursing and Midwifery Board of Australia, 2022) (20 CoCE minimum in this BMid program). For each woman, the student provided more antenatal care, attendance at labour and birth and postnatal contacts than minimum program requirements. Women reported greater satisfaction and respect as the number of antenatal visits and postnatal contacts with their student increased. Similarly, women were more satisfied when their student attended their labour and birth. This presentation will discuss processes to routinely obtain women’s feedback (including ethical approval); survey content; approach to data analysis; findings and future directions.

In transition with attention deficit hyperactivity disorder (ADHD): children\u2019s services clinicians\u2019 perspectives on the role of information in healthcare transitions for young people with ADHD

BackgroundNational clinical guidelines emphasise the need for good communication of information by clinicians to young people and their parent/carers about what to expect during transition into adult services. Recent research indicates that of young people in need of transition for attention deficit hyperactivity disorder (ADHD), only a minority experience continuity of care into adulthood, with additional concerns about quality of transition. This qualitative analysis explored the role that information plays in the transition from child to adult mental health services for young people with ADHD, from the perspectives of clinicians working in children’s services.MethodsParticipants were recruited from National Health Service (NHS) Trusts located across the United Kingdom (UK), with varying service configurations. Twenty-two qualitative interviews were conducted with 15 paediatricians and seven psychiatrists working in child services and supporting young people with ADHD. The Framework Method was used to complete a thematic analysis of data related to the role of information in transitional care.ResultsTwo themes were identified in relation to the role of information in supporting transition and promoting continuity of care. Information for clinicians; about adult mental health services, the young person and their ADHD, and exchanged between services. Sharing information with young people; about transition processes, self-management, to support service engagement, and tailored to be accessible to young people with ADHD. Clinicians in children’s services reported variable access to information. Clear protocols and being able to communicate about ADHD as a long-term condition, were described as having a positive impact on the transition process.ConclusionsThese findings illustrate that clear information on the transition process, and communication of evidence based and up-to-date information on ADHD as a long-term condition are essential components for clinicians supporting transition into adult services. Information exchange can be supported through transition discussions with young people, and joint meetings between services Discussions should be accompanied by accessible resources for young people and parents/carers such as leaflets and websites. Further efforts should be focussed on enabling clinicians to provide timely and appropriate information to young people with ADHD to support transition.

Quality of life and quality of care as experienced by patients with advanced cancer and their relatives: A multicentre observational cohort study (eQuiPe)

AimThis study aims to assess the quality of life and quality of care as experienced by patients with advanced cancer and their relatives while taking their interdependency into account. MethodsA prospective multicentre observational study (eQuiPe study) was conducted. Quality of life scores (EORTC QLQ-C30) was compared to a matched normative population and logistic regression analyses were conducted to assess the relation between high emotional functioning (EF, measured with the EORTC QLQ-C30) and experienced quality of care (IN-PATSAT32, CQ-index PC). ResultsIn total, 1103 (65%) patients and 831 (71%) relatives completed the baseline questionnaire, including 699 unique patient-relative couples. Patients experienced lower EF than the normative population (78 versus 87, p < .001). Compared to patients, relatives reported clinically relevantly lower EF (69 versus 78, p < .001). Being more satisfied with care in general (p < .05) and clarity about the key health-care provider (p < .05) was positively associated with high EF in patients. For relatives, experienced continuity of care (p < .01) and information for the patient (p < .05) were positively associated with high EF. The EF of patients (p < .001) and relatives (p < .001) were positively associated with each other and continuity of care as perceived by relatives was positively associated with high EF in patients (p < .01). ConclusionsPatients with advanced cancer reported low levels of EF but their relatives reported even lower levels of EF. Experienced integrated organisation and satisfaction with care were positively related to EF. The interdependent relation between patients' and relatives’ EF and their care experiences suggests that a family-centred approach can optimise palliative cancer care. Trial registrationThe eQuiPe study is registered as NTR6584 in the Netherlands Trial Register.

Continuity and coordination of care in highly selected chronic cancer patients treated with multiple repeat radiation therapy

Introduction and backgroundAs cancer is developing into a chronic disease due to longer survival, continuity and coordination of oncological care are becoming more important for patients. As radiation oncology departments are an integral part of cancer care and as repeat irradiation becomes more commonplace, the relevance of continuity and coordination of care in operating procedures is increasing. This study aims to perform a single-institution analysis of cancer patients in which continuity and coordination of care matters most, namely the highly selected group with multiple repeat course radiotherapy throughout their chronic disease.Materials and methodsAll patients who received at least five courses of radiotherapy at the Department of Radiation Oncology at the University Hospital Zurich from 2011 to 2019 and who were alive at the time of the initiation of this project were included into this study. Patient and treatment characteristics were extracted from the hospital information and treatment planning systems. All patients completed two questionnaires on continuity of care, one of which was designed in-house and one of which was taken from the literature.ResultsOf the 33 patients identified at baseline, 20 (60.6%) participated in this study. A median of 6 years (range 3–13) elapsed between the first and the last visit at the cancer center. The median number of involved primary oncologists at the radiation oncology department was two (range 1–5). Fifty-seven percent of radiation therapy courses were preceded by a tumor board discussion. Both questionnaires showed high levels of experienced continuity of care. No statistically significant differences in experienced continuity of care between groups with more or less than two primary oncologists was found.Discussion and conclusionPatients treated with multiple repeat radiation therapy at our department over the past decade experienced high levels of continuity of care, yet further efforts should be undertaken to coordinate care among oncological disciplines in large cancer centers through better and increased use of interdisciplinary tumor boards.

Feasibility of a novel framework to routinely survey women online about their continuity of care experiences with midwifery students

AimThis study describes a novel framework used to evaluate the feasibility of an online survey to routinely collect women’s feedback about their continuity of care experiences with Bachelor of Midwifery students during the clinical practicum. BackgroundThe extent to which secure online platforms can efficiently distribute surveys and collect routine feedback from women receiving continuity of midwifery care experiences by Bachelor of Midwifery students needs to be effectively assessed and evaluated. MethodsUsing a co-design approach, the teaching team, program software developers, information technology and cybersecurity experts, students, consumers and clinical placement officers were consulted in development of survey content and processes. ResultsA novel framework for evaluating online surveys was developed with a focus on survey content, processes, web technology and outcomes. ConclusionsThe online survey was found to be reliable, valid, reproducible, efficient and easy to access by women with a response rate of 56% achieved. Only 0.4% of surveys were opened and not completed. Accuracy of electronic addresses was increased by adding two text-match fields in the consent form and sending a confirmation email when first completed. Application of this novel framework is recommended when developing and evaluating online surveys for educational and research purposes.

\u2018One feels somewhere that one is insignificant in that system\u2019 \u2013 older multimorbid patients\u2019 between lifeworld and system in healthcare

BackgroundWhen older multimorbid people are acutely hospitalized, continuity of care is a fundamental goal in the healthcare process. However, some acute hospitalized older multimorbid patients do not experience continuity of care. This phenomenon is explored using the theoretical framework of Jürgen Habermas “Theory of communicative action”.MethodsAcutely hospitalized patients over the age of 65 with two or more chronic conditions and who received home care services were invited to participate in two interviews: one at the emergency department and the other 4–12 weeks after discharge. These interviews formed the basis for an evaluation of patient experience of continuity of care, and the content of the interviews was analyzed using a structured matrix.ResultsFifteen patients participated with seven patients evaluated to have continuity of care in their healthcare process. Eight patients were evaluated as not having experienced continuity of care in their healthcare process. The categories from the matrix highlighted a healthcare system that interfered with a patient’s lifeworld with a lack of communication, different expectations, frustration regarding care, strained relations to health care providers and feelings of being objectified.ConclusionsWe conclude that mutual understanding based on communicative action is essential when it comes to patients’ experiences of continuity of care. Our results justify improving the mutual understanding between patients and professionals in transition between healthcare sectors. Future research should target whether an enhanced focus on communicative action and mutual understanding in particular between non-healthcare professionals and patients will improve the patients’ perception of continuity of care.

Continuity of care experiences: A national cross-sectional survey exploring the views and experiences of Australian students and academics

BackgroundContinuity of Care Experiences (CoCEs) are a component of all entry-to-practice midwifery programs in Australia and facilitate an understanding of the central midwifery philosophy of woman-centred care and continuity of the therapeutic relationship. The aim of this research was to explore how CoCEs are viewed and experienced by students and academics across Australia. MethodsStudents enrolled in Australian midwifery programs and academics who teach into these programs were invited to participate in a cross sectional, web-based survey. Data were analysed using descriptive statistics and free text responses were analysed using content analysis. FindingsFour hundred and five students and 61 academics responded to the survey. The CoCE was viewed as a positive and unique learning experience, preparing students to work in midwifery-led continuity models and developing confidence in their midwifery role. Challenges in recruitment, participation in care, and balancing the workload with other course requirements were evident in reports from students, but less understood by academics. Significant personal impact on finances, health and wellbeing of students were also reported. DiscussionThe value of CoCEs as an experiential learning opportunity is clear, however, many students report being challenged by elements of the CoCE within current models as they try to maintain study-work-life balance. ConclusionInnovative course structure that considers and embeds the CoCE requirements within the curricula, in addition to a collective commitment from regulatory bodies, the maternity care sector and Universities to facilitate CoCEs for students may address some of the significant student impacts that are reported by this research.

Clinical outcomes for women who had continuity of care experiences with midwifery students

BackgroundPre-registration midwifery students in Australia are required to engage in a minimum of ten continuity of care experiences (CoCE). Students recruit and gain consent of each woman to provide CoCE under direct supervision of a registered health professional, usually a midwife. Clinical outcomes for women who had CoCE with a midwifery student placed in a continuity of midwifery care (CMC) or fragmented models are rarely reported. Aims1. analyse clinical outcomes for women experiencing CMC with CoCE by students; 2. analyse clinical outcomes for women in a fragmented care model with CoCE by students; and 3. compare clinical outcomes according to women’s primary model of care. MethodsStudents undertaking a Bachelor of Midwifery program at one Australian university recorded clinical outcomes for women experiencing CoCE during pregnancy [n=5972] and labour and birth [n=3933] in an e-portfolio. A retrospective, cohort design compared student recorded maternal data with National Core Maternity Indicators and Queensland Perinatal Data. ResultsMidwifery students providing CoCE reported better or equal clinical outcomes for women compared to population data. Women receiving CoCE had reduced likelihood of tobacco smoking after 20 weeks of pregnancy, episiotomy, and third and fourth degree tears. ConclusionsClinical outcomes for women in fragmented models of care and receiving CoCE by undergraduate, pre-registration midwifery students are equal to or better than State data across 12 variables. CoCE should be offered to all women early in their pregnancy to ensure optimal benefits. Acknowledging midwifery students’ potential to make positive impacts on women’s clinical outcomes may prompt more health services to reconceptualise and foster CoCE.

The Experiences of Midwifery Student in Learning Model of CoC (Continuity of Care)

Introduction:Midwife student in the continuity of care experience is an innovative midwifery education strategy in facilitating learning for midwifery students. But students also identified a number of challenges they faced, one of which was in recruiting women. Purpose: The purpose of this scoping review is to find out the experience of midwife students in the continuity of midwifery care with the CoC learning model. Methods: In this scoping review, the authors identify studies that explain the experience of midwife students in the continuity of care with the CoC learning model from three databases (PubMed, Science Direct, and Pro-quest). Searches are limited to studies published in English and present data for the 2009-2018 period. The identified study was reviewed using the PRISMA Flowchart. Studies with a qualitative design related to continuity of care with the CoC learning model are then selected for review. Results: From A total of 5 journals were found, then analyzed in the form of scoping reviews. Then classify them in the theme of the process of implementing midwifery student learning, the benefits, impacts and challenges in the continuity of care with the CoC learning model. Conclusion: From the results of a journal review, it can be concluded that the experience through CoC is intended to enable students to experience continuously with a woman throughout the period of pregnancy, childbirth and childbirth, where the care desired by women can be provided through a continuous midwifery care model. Equally beneficial between midwifery and female students, it can provide insight into the experience of midwife students to support, facilitate learning, provide a unique opportunity to build strong relationships with women by developing a range of skills and knowledge for midwifery students.

Evaluation of a student-led midwifery group practice: A woman's perspective

Background. ObjectiveTo evaluate women's experiences of a student-led midwifery group practice. DesignA mixed methods design was used to examine women's experiences and level of satisfaction about a student-led midwifery model of care. An on-line survey elucidated women's levels of satisfaction and experiences with the student-led midwifery group practice. The online survey was sent to all women (n = 25) who were receiving care from third year Bachelor of Midwifery students in 2018 via email up to 6 weeks postnatally. The online survey was distributed in the first instance to obtain baseline information about the importance of this student-led midwifery group practice and so the survey information was linked to the in-depth interview in the analysis for the purpose of identifying if the women were primiparous or multiparous. Women (n = 9) were invited to participate in an in-depth interview by self-opting on the survey and this extra data provided a richer understanding about the level of satisfaction about woman-centred care led by midwifery students.Retrospective data were also collected from the Maternity database - E-Maternity about birth outcomes. SettingA tertiary teaching public hospital in New South Wales (NSW). ParticipantsFifteen women participated in an online survey. Five primiparous and four multiparous women opted to be involved in the in-depth interviews on the online survey. Measurements and findingsAnalysis in SPSS provided descriptive statistics including frequencies and percentages of data including birth outcomes. Simple correlations enabled associations to be established between levels of satisfaction, individualised care, quality of care, benefits and anxiety during pregnancy. The overarching themes from the qualitative findings identified the students’ presence for the women as the most important component of the women's journey. The four main themes that emerged from the study included: familiarity of the caregiver, staying informed on the journey, feeling supported and reassured by their expertise, and control and decisions over birth events. Key conclusionsFor a variety of reasons, women valued the presence of the students throughout their childbearing journey, including valuing the woman's private space during labour and her time with her partner. This combination of pedagogical approaches provides an alternative to the current placement approach, which includes working shifts in all areas of maternity. This approach will better support midwifery students to achieve the skills necessary to provide a continuity of care experience (CoCE) amongst a small team by a student-led midwifery group practice that is supported by a registered midwife in the antenatal clinic. The midwifery student is able to develop a relationship with the woman as a component of the CoCE under the guidance of a registered midwife and this is an important underpinning of the philosophy of woman-centred care. Implications for practiceThis model of care provides evidence that women do value the students’ support and presence throughout their experience and that the benefits of this model should be offered to all women as a normal component of their midwifery care.

In transition with ADHD: the role of information, in facilitating or impeding young people\u2019s transition into adult services

BackgroundMany national and regional clinical guidelines emphasise the need for good communication of information to young people and their parent/carers about what to expect during transition into adult services. Recent research indicates only a minority of young people in need of transition for Attention Deficit Hyperactivity Disorder (ADHD) experience continuity of care into adulthood, with additional concerns about quality of transition. This qualitative study explored the role that information plays in experiences of transition from the perspectives of parent/carers and young people.MethodsParticipants were recruited from 10 National Health Service Trusts, located across England, with varying service configurations. Ninety two qualitative interviews were conducted: 64 with young people with ADHD at different stages relative to transition, and 28 with parent/carers. Thematic analysis of data was completed using the Framework Method.ResultsInterviewees reported a range of experiences; however reliance on parent/carers to gather and translate key information, and negative experiences associated with poor communication of information, were universal. Three themes emerged: Navigating information with help from parents; Information on ADHD into adulthood; Information about the transition process. The first revealed the essential role of parent in the translation and application of information, the other two explored distinct types of information necessary for a smooth transition. Interviewees made recommendations for clinical practice similar to UK (United Kingdom) National Institute for Health and Care Excellence (NICE) guidelines, with an additional emphasis on providing nuanced information on ADHD as a potentially long term condition. It was important to interviewees that General Practitioners had a basic understanding of adult ADHD and also had access to information about service provision.ConclusionsOur findings illustrate that the availability and communication of information to young people and their parent/carers is an essential component of the transition process between child and adult ADHD services. How and when it is provided may support or impede transition. This study constitutes a substantial contribution to the evidence base, drawing on interviews from a range of participants across England and from Trusts offering different types of services.

Stories from women birthing off country

in Australia, models of maternity care that offer women continuity of care with a known midwife have been promoted. Little is known about the intentions of the future midwifery workforce to work in such models. This study aimed to explore midwifery students׳ views and experiences of caseload midwifery and their work intentions in relation to the caseload model following graduation.cross-sectional survey.Victoria, Australia.129 midwifery students representing all midwifery course pathways (Post Graduate Diploma, Bachelor of Midwifery, Bachelor of Nursing/Bachelor of Midwifery) in Victoria.midwifery students from all course pathways considered that continuity of care is important to women and indicated that exposure to continuity models during their course was very positive. Two-thirds of the students (67%) considered that the continuity experiences made them want to work in a caseload model; only 5% reported that their experiences had discouraged them from continuity of care work in the future. Most wanted a period of consolidation to gain experience as a midwife prior to commencing in the caseload model. Perceived barriers to caseload work were being on-call, and challenges in regard to work/life balance and family commitments.midwifery students in this study were very positive about caseload midwifery and most would consider working in caseload after a period of consolidation. Continuity of care experiences during students׳ midwifery education programmes appeared to provide students with insight and understanding of continuity of care for both women and midwives. Further research should explore what factors influence students׳ future midwifery work, whether or not their plans are fulfilled, and whether or not the caseload midwifery workforce can be sustained.

Continuity of care experiences following the transition from Early Intervention Teams to Primary, Community and Continuous Care Teams in Ireland: A multi-perspective case study exploring the views of caregivers’ of children with Autistic Spectrum Disorder and service providers

Continuity of care experiences following the transition from Early Intervention Teams to Primary, Community and Continuous Care Teams in Ireland: A multi-perspective case study exploring the views of caregivers’ of children with Autistic Spectrum Disorder and service providers

High experienced continuity in breast cancer care is associated with high health related quality of life

BackgroundHigh experienced continuity is known to be associated with lower needs for supportive care and most likely higher quality of life. On this background, the aim of this study was to investigate if patient-experienced continuity of care was associated with health-related quality of life (HRQoL) in breast cancer patients treated at two different-sized breast cancer units.MethodsIn 2016, two questionnaires, “Statements on experienced continuity of care” and “The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)”, were sent out to patients diagnosed between 2011 and 2014 at two different-sized breast cancer units in Sweden. Lead times and other data reflecting medical quality were collected from the patients’ medical records and from the National Swedish Breast Cancer Quality Register.ResultsOf 356 eligible patients, 231 (65%) answered the questionnaires, of whom 218 patients were included in the analyses. A statistically significant association was found between high experienced continuity and high global HRQoL (p = 0.03). Continuity was higher at the smaller unit, while no major differences between the units were found regarding medical quality or lead times.ConclusionThe study found that high experienced continuity and HRQoL was strongly associated. A statistically significant higher continuity of care was found at the smaller unit, in line with what was expected. The absence of clinically relevant differences in lead times and medical quality may indicate that continuity could be achieved without loss of quality.