Continuity of care in Danish peer-led patient online communities on social media. A survey study

Abstract Background Patients in the Danish healthcare system and other Western countries experience a lack of ‘continuity of care’ due to inadequate communication and sharing of clinical information. ‘Continuity of care’ is often defined as informational, managerial and relational failures. A lack of continuity is particularly problematic for patients with chronic conditions as they are often highly dependent on longitudinal and complex treatment processes. Some of these patients have formed self-organised groups on social media in order to share their personal experiences with the health care system and discuss health related problem with peers. The aim of this paper is to understand the role peer-led online communities (PLOC) play for patients with chronic conditions experiences of continuity of care. Methods The material consists of survey data from patients with chronic conditions participating in peer-led online communities on the experience of continuity of care in the Danish healthcare system. A link to the survey was posted in the public online community “Chronic Influencers” (Instagram 10,000 followers), and in the closed Facebook group “Chronic pain patients” (Facebook, 2,200 members). The questionnaire was posted three times between 10 and 30 March 2022. Results 207 respondents answered all questions in the survey of which 95% were women. Most of them (62 %) were between 36 and 55 years. 37 % live with chronic conditions for more that 20 years. 72 % of the respondent experience lack of continuity with the healthcare system, often with regard to information or communication with health professionals and they look for peers’ advices or experiences in the online groups. 68 % felt recognized by the peers in the online community in another way than in the meeting with the healthcare system. Conclusions Patients use PLOC to find and exchange experiences from other patients with chronic conditions about their treatment and especially daily life with chronic conditions. Key messages • Patients participating in peer-led online communities provide online support and recognition to each other than that provided by the healthcare system. • Patients use peer-led online communities to read about other patients’ experiences with chronic conditions and learn about their treatment and daily life.


Background:
Breast Cancer (BC) is the most common type of cancer among women in Europe, accounting for around 28% of newly diagnosed female cancers. A clinical Pathway (CP) is an effective tool able to deliver high quality care especially if linked to a Monitoring System. Still, it is essential to integrate them with the patient's perspective according to Value-Based Care. This paper aims to define and test a tool for care quality assessment in patients with breast cancer, in a value-based perspective.

Methods:
A scoping search of the main databases (PubMed, Scopus, Web of Science) and official websites of institutions and organizations (AIOM, CIPOMO, EORTC, ICHOM, Istat) was carried out. A Delphi survey was conducted to assess the tool, according to four criteria (general relevance, evidence-based, measurability, actionability). We only included indicators that achieved strong agreement. Time-points for data collection were defined and validated in relation to the different steps of the CP.

Results:
The final tool consists of 21 questions coming from the following sources: BREAST-Q and EORT QLQ-BR23 questionnaire. BREAST-Q's questions, have to be administered at T0 (first medical contact) and T12 (follow-up), while the EORT QLQ-BR23's questions have to be administered at T0 (first medical contact) T Surgery, T6 (follow-up) and T12 (follow-up). The survey will be administered to a sample of 152 BC patients (MOE 5%; CL 95%) undergoing surgery in the period June-September 2021.

Conclusions:
The present tool will give a quick view of Value provided by the CP to these patients. In light of the high volume of patients treated at our center (1008 breast cancer surgery hospitalisations in 2020), this study acquires further public health relevance. Additionally, this approach can be extended for further evaluation of other CPs. Key messages: We

Background:
Patients in the Danish healthcare system and other Western countries experience a lack of 'continuity of care' due to inadequate communication and sharing of clinical information. 'Continuity of care' is often defined as informational, managerial and relational failures. A lack of continuity is particularly problematic for patients with chronic conditions as they are often highly dependent on longitudinal and complex treatment processes. Some of these patients have formed self-organised groups on social media in order to share their personal experiences with the health care system and discuss health related problem with peers. The aim of this paper is to understand the role peer-led online communities (PLOC) play for patients with chronic conditions experiences of continuity of care.

Methods:
The material consists of survey data from patients with chronic conditions participating in peer-led online communities on the experience of continuity of care in the Danish healthcare system. A link to the survey was posted in the public online community ''Chronic Influencers'' (Instagram 10,000 followers), and in the closed Facebook group ''Chronic pain patients'' (Facebook, 2,200 members). The questionnaire was posted three times between 10 and 30 March 2022.

Results:
207 respondents answered all questions in the survey of which 95% were women. Most of them (62 %) were between 36 and 55 years. 37 % live with chronic conditions for more that 20 Background: Hospitals falls are an important challenge for healthcare systems. An early identification of patients at risk is critical, but no assessing tool has proven to be sufficiently predictive. This review aims at identifying factors associated with an increased risk of falls in hospitalized adults and at mapping them according to main international classification systems.

Methods:
We carried out a systematic literature review and metanalysis to detect risk factors positively associated with the increase of falls in hospitals, searching litterature from January 2015 to March 2022. We included studies investigating falling risk factors in patients older than 16 years. Researchers independently assessed records' eligibility and the methodological quality of included studies was assessed. When possible, data was processed using a random effects model and odds ratio (OR) with 95% confidence interval to quantify the effect. Risk factors were than classified according to ICF, ICD, and ATC classifications.

Results:
We included 40 observational studies, enrolling 3,495,552 patients. Considering ICF-factors, mental and sensory functions-pain have a strong association with falls (OR = 3.311 and 2.149, respectively). ICD-factors associated with falls were mental and behavioural disorders (OR = 2.219), diseases of the nervous system (OR = 2.974), and symptoms, signs, and abnormal clinical and laboratory findings (OR = 2.665).
Considering ATC-related factors, medications for alimentary tract and metabolism (OR = 1.978), and nervous system (OR = 1.779), showed a strong association with falls. Other factors were also associated with a moderately increased risk.

Conclusions:
The comprehensive evidence-based assessment achieved with this meta-analysis alongside with the classification according to ICF, ICD and ATC systems provides a new standardized identification of the risk factors associated with an increase of falls in hospital.
Key messages: Falls occurring in hospital are an important challenge for health care systems. Therefore the identification of risk factors associated to patients increased risk of fall is fundamental. The comprehensive evidence-based assessment achieved with this meta-analysis provides a new standardized identification of the risk factors associated with an increase of falls for hospital.
Abstract citation ID: ckac131.296 Collaboration and health promotion for the health care system -evaluation of the WOL healthcare

Background:
Health care and social services are industries with special challenges: Constant emotional demands, the shortage of skilled workers is noticeable (in Germany) and special organizational stresses, not only since the Corona pandemic. This study evaluates the Working out Loud (WOL) program for healthcare, which aims to create a learning culture for interdisciplinary collaboration and network-oriented learning and increases growth-oriented thinking at organizational level.

Methods:
The sample consists of 51 participants. From 16 persons data could be analyzed in the pre-post-design of the 10-week intervention accompanied by individual coaching. All respondents work in the health care system in Germany. Dependent variables were collected with validated scales for psychological safety, psychological flexibility, cooperative learning, emotional energy, engagement and voice behavior. Correlations are shown for psychological safety with emotional energy (r = .426, p = .012) and job satisfaction (r = .612, p = .000).

Conclusions:
The 10-week WOL Healthcare program can strengthen employees in the important area of health promotion and care. The program serves as behavioral prevention and, by empowering individuals, brings about job crafting structural prevention in the workplace. The intervention follows a bottom-up principle, it is an approach for health promotion in the healthcare sector, that can strengthen patient's safety. Key messages: Evidence for the effectiveness of a health promotion intervention for health care workers. Organizational learning promotes workers health.