Transitional Cancer Care Program from Hospital to Home in the Health Care System of Iran

Document Type : Research Articles

Authors

1 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Department of Health Care Sciences, Palliative Research Center, Ersta Sköndal Bräcke University College, Campus Ersta, Stockholm, Sweden.

3 Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Objectives: Transitional care program refers to the health care continuity during transferring from one health care setting to another or to home. This is an essential program for cancer patients and reduces the risk of unnecessary hospital admissions as well as the complications of the disease. The aim of this study was to develop a transitional cancer care program from hospital to home in the health care system of Iran. Methods: This study is a health policy and system research. It was conducted in four stages from October 2019 to January 2020. The first stage was a qualitative study. The qualitative data were collected through semi-structured interviews with 24 participants and a focus group with eight experts. In the second stage, a literature review of transitional care models was carried out. The initial version of the transitional cancer care program was developed based on the qualitative results and the literature review in the third stage. The validity and feasibility of the program were assessed using the Delphi study in the fourth stage. Results: Six major categories were extracted from the qualitative results, consisting of “integrated services for the continuity of care”, “holistic care”, “care standardization”, “the use of telemedicine”, “the transparency of rules” and “the care process provision”. Using these results and extracted the three common models of transitional care, the initial program was developed in three phases of pre-discharge, post-discharge, and transitional care with six protocols. The content validity of the program (98.7%) and its feasibility (95.8%) were approved by experts in the Delphi rounds. Conclusions: It is necessary to revise hospitals’ discharge program, and home health care center’s plan for admission and delivering health care services for cancer patients. Also, a pilot program is necessary to find the system advantages and disadvantages.
 

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