Transitions between care settings after enrolment in a palliative care service in Italy: A retrospective analysis

Registered Nurse and PhD student, EV is Assistant Professor.
International journal of palliative nursing 03/2013; 19(3):110-5. DOI: 10.12968/ijpn.2013.19.3.110
Source: PubMed


This study was a retrospective analysis of prospectively collected data that aimed to map patients' care transitions following admission to a specialist palliative care service in Italy called Antea Centre. Patients' data was extracted from the Antea local database from 2007 to 2011. External transitions were defined as a change in the setting of care, with the patient no longer being cared for by Antea staff. Internal transitions were defined as a change in the setting of care, with the care still being provided by Antea staff. A total of 1123 patients out of 5313 admitted to the palliative service (21%) experienced transitions. Patients who experienced no transitions after their admission to the palliative care service were more likely to have a Karnofsky Performance Scale Index <30, to have been referred by a hospital physician, to have a shorter survival time, and to have home as their place of death (P<0.001). Although the patients with no transitions had worse clinical conditions, organisations should pay attention to reducing the possible negative effects of transitions, such as discontinuity of care and poor coordination.

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    ABSTRACT: Mucositis is a frequent side-effect of chemotherapy and radiotherapy. Assessment of oral cavity is important to detect alterations in the mouth and plan appropriate interventions. A reliable tool can help to have a better assessment of mucositis and a major knowledge about this phenomenon. Since no valid and reliable tool for the assessment of mucositis is still available in Italy, the aim of this study was to establish the validity and reliability of the Italian version of the Oral Assessment Guide (OAG). A panel of health care experts established the content validity of the tool both for the items and the descriptors. To establish the reliability of the tool, a sample of 14 inpatients with haematological diseases were recruited. Couples of dental hygienists separately performed 60 pairs of assessments (for a total of 120 assessments) on the sample. The Italian version of OAG was found to have an acceptable Content Validity Index (CVI) for items and related descriptors ranging between 0.67 and 1. Cronbach's alpha was 0.84, agreement of assessment ranged between 0.87 and 0.65 with Cohen's Kappa coefficient ranging from good to very good. This study showed that the Italian version of the OAG has good psychometric properties of validity and reliability to assess mucositis in patients undergoing chemotherapy. This tool will have a great importance to carry out future research in Italy aimed to improve the patient's outcomes particularly in terms of functional ability and quality of life.
    Full-text · Article · Jul 2013 · Professioni infermieristiche