Sweeney Angela, Davies Jonathon, McLaren Susan, Whittock Margaret, Lemma Ferew, Belling Ruth, Clement Sarah, Burns Tom, Catty Jocelyn, Jones Ian Rees, Rose Diana, Wykes Til
Population Health Institute, St George's University of London, London, UK.
Department of Child, Family and Community Studies, Douglas College, British Columbia, Canada.
Health Expect. 2016 Aug;19(4):973-87. doi: 10.1111/hex.12435. Epub 2015 Dec 29.
Continuity of care (COC) is central to the organization and delivery of mental health services. Traditional definitions have excluded service users, and this lack of involvement has been linked to poor conceptual clarity surrounding the term. Consequently, very little is known about the differences and similarities in the conceptualization of COC by mental health service users and professionals.
To explore and compare mental health service users' and professionals' definitions of COC.
Using an exploratory, qualitative design, five focus groups with 32 service users each met twice. Data were analysed thematically to generate a service user-defined model of COC. In a cross-sectional survey, health and social care professionals (n = 184) defined COC; responses were analysed thematically. Service user and professional definitions were conceptually mapped and compared to identify similarities and differences.
There was crossover between the service user and professional derived models of COC. Both contained temporal, quality, systemic, staff, hospital and needs-related elements of COC. Service users prioritized access, information, peer support and avoiding services; health professionals most frequently referred to staff, cross-sectional and temporal COC. Service users alone identified service avoidance, peer support and day centres as COC elements; professionals alone identified cross-sectional working.
Important similarities and differences exist in service user and professional conceptualizations of COC. Further research is necessary to explore these differences, prior to integrating service user and professional perspectives in a validated COC framework which could enable the development and evaluation of interventions to improve COC, informing policy and practice.
连续性照护（COC）是精神卫生服务组织与提供的核心。传统定义将服务使用者排除在外，这种缺乏参与的情况与该术语周围概念清晰度欠佳有关。因此，对于精神卫生服务使用者和专业人员在连续性照护概念化方面的异同了解甚少。
探索并比较精神卫生服务使用者和专业人员对连续性照护的定义。
采用探索性定性设计，五个焦点小组，每组32名服务使用者，各进行两次会面。对数据进行主题分析，以生成服务使用者定义的连续性照护模型。在一项横断面调查中，卫生和社会护理专业人员（n = 184）对连续性照护进行定义；对回答进行主题分析。对服务使用者和专业人员的定义进行概念映射并比较，以识别异同。
服务使用者和专业人员得出的连续性照护模型存在交叉。两者都包含连续性照护的时间、质量、系统、人员、医院和需求相关要素。服务使用者将可及性、信息、同伴支持和避免接受服务列为优先事项；卫生专业人员最常提及人员、横断面和时间方面的连续性照护。只有服务使用者将避免接受服务、同伴支持和日间中心确定为连续性照护要素；只有专业人员确定了横断面工作。
在服务使用者和专业人员对连续性照护的概念化方面存在重要的异同。在将服务使用者和专业人员的观点整合到一个经过验证的连续性照护框架之前，有必要进行进一步研究以探索这些差异，这可能有助于开发和评估改善连续性照护的干预措施，为政策和实践提供信息。
