OBJECTIVE: The study was aimed at exploring the current scope of hospital to home transitional care programmes for stroke survivors.
BACKGROUND: Stroke survivors face the dilemma of solving many complex problems that leave survivors at high risk for readmission as they discharge from hospital. The transitional care model has proved to be effective in reducing readmissions and mortality, thereby improving health outcomes and enhancing patient satisfaction for survivors with stroke.
METHODS: A scoping review.
METHODS: Conducted in accordance with the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews.
METHODS: A comprehensive search was conducted in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, Medline, China Knowledge Net-work, Wanfang Database and China Biomedical Literature Database (SinoMed) from January 2014 to June 2023.
RESULTS: Title and abstract screening was performed on 10,171 articles resulting in 287 articles for full-text screening. Full-text screening yielded 49 articles that met inclusion criteria.
CONCLUSIONS: This study identified transitional care programmes for stroke survivors, as well as areas for future consideration to be explored in more depth to help improve transitional care for stroke survivors as they transition from hospital to home.
UNASSIGNED: This study demonstrates that multidisciplinary collaboration becomes an integral part of the transitional care model for stroke survivors, which provides comprehensive and precise medical care to them.
UNASSIGNED: PRISMA checklist for scoping reviews.
UNASSIGNED: No patient or public contribution was part of this study.

UNASSIGNED: Both care continuity and coordination are considered essential elements of health care system. However, little is known about the relationship between care continuity and coordination. This study aimed to differentiate the concepts of care continuity and coordination by developing and testing the reliability and validity of the Combined Outpatient Care Continuity and Coordination Assessment (COCCCA) questionnaire under the universal coverage health care system in Taiwan from a patient perspective.
UNASSIGNED: Face-to-face interviews were conducted nationwide with community-dwelling older adults selected via stratified multistage systematic sampling with probability-proportional-to-size process. A total of 2,144 subjects completed the questionnaire, with a response rate of 44.67%.
UNASSIGNED: The 16 items of the COCCCA questionnaire were identified via item analysis and principal component analysis (PCA). The PCA generated five dimensions: three continuity-oriented (interpersonal, information sharing and longitudinal between patients and physicians) and two coordination-oriented (information exchange and communication/cooperation among multiple physicians). The second-order confirmatory factor analysis supported the factor structure and indicated that distinct constructs of care continuity and coordination can be identified.
UNASSIGNED: The COCCCA instrument can differentiate the concepts of care continuity and care coordination and has been demonstrated to be valid and reliable in outpatient care settings from a patient perspective.

OBJECTIVE: Patient-perceived quality of care has become an increasingly important index within the healthcare setting. We examined patient-reported overall quality of care and patient experiences in three specific domains of care (physician communication, nursing care, and care coordination) in a sample of Chinese patients with advanced cancer.
METHODS: A cross-sectional study was conducted with stage IV cancer patients (N = 202) who were recruited from a public, tertiary hospital in Beijing. Study participants completed surveys administered by a research assistant. Multivariable regression analysis was conducted to examine the extent to which patient demographic factors (age, gender, socioeconomic status), disease/treatment factors, and domain-specific care were associated with overall quality of care.
RESULTS: A majority of patients reported overall quality of care scores that we were either excellent (23%) or very good (41%). Patients reported highest ratings in the domain of nursing care (M = 87.57, SD = 31.05), followed by physician communication (M = 68.93, SD = 32.30), and care coordination (M = 66.79, SD = 25.17). Better perceived physician communication (b = 0.17, p < 0.01), care coordination (b = 0.26, p < 0.01), and higher socioeconomic status (b = 11.30, p < 0.05) were associated with higher overall quality of care.
CONCLUSIONS: A majority of patients with advanced cancer in this Chinese hospital reported positive overall quality of care. Physician communication and care coordination are potential areas to focus on to improve patient-reported overall quality of care. Understanding perceptions of care quality will allow opportunities to improve delivery of healthcare.

BACKGROUND: Patients\' views on the optimal model for care coordination between primary care providers (PCPs) and oncologists in the context of cancer and multiple chronic conditions (MCC) are unclear. Thus, the purpose of this systematic review is to evaluate the perceptions of patients with both cancer and MCC regarding their care coordination needs.
METHODS: Following PRISMA guidelines, the literature was systematically searched through PubMed, CINAHL, and PsycINFO for articles pertaining to patients\' perspectives, experiences, and needs regarding care coordination between PCPs and oncologists during the cancer care continuum, in the context of patients with cancer and MCC. English-language articles were included if they met the following criteria: 1) published between 2008 and 2018; 2) peer-reviewed study; 3) patients aged 18 years or older diagnosed with any type or stage of cancer; 4) patients have one or more chronic comorbid condition; 5) inclusion of patient perceptions, experiences, or needs related to care coordination between PCPs and oncologists; and 6) ability to extract results. Data extraction was performed with a standardized form, and themes were developed through qualitative synthesis. A grounded theory approach was used to qualitatively evaluate data extracted from articles and create a framework for providers to consider when developing patient-centered care coordination strategies for these complex patients. Risk of bias within each study was assessed independently by two authors using the Mixed Methods Appraisal Tool.
RESULTS: A total of 22 articles were retained, representing the perspectives of 8,114 patients with cancer and MCC. Studies were heterogeneous in the patients\' respective phases of cancer care and study design. From qualitative synthesis, four themes emerged regarding patients\' needs for cancer care coordination and were included as constructs to develop the Patient-centered Care Coordination among Patients with Multiple Chronic Conditions and Cancer (PCP-MC) framework. Constructs included: 1) Communication; 2) Defining provider care roles; 3) Information access; and 4) Individualized patient care. Care navigators served as a communication bridge between providers and patients.
CONCLUSIONS: Findings highlight the importance that patients with both cancer and MCC place on communication with and between providers, efficient access to understandable care information, defined provider care roles, and care tailored to their individual needs and circumstances. Providers and policymakers may consider the developed PCP-MC framework when designing, implementing, and evaluating patient-centered care coordination strategies for patients with both cancer and MCC.

Treating cancer and existing chronic comorbidities requires a dynamic mix of primary care and specialist providers. However, little is known regarding primary care physicians\' (PCPs) and oncologists\' comfort level prescribing for comorbid conditions.
The objectives of this study were to describe oncologists\' and PCPs\': 1) comfort-level prescribing, 2) perceptions of providers\' role in prescribing cardiometabolic and psychiatric medications in persons with cancer and comorbidity, and 3) provider factors associated with comfort-levels.
This cross-sectional online survey examined responses from practicing U.S. PCPs and oncologists. A 33-question survey was used to assess PCPs\' and oncologists\' comfort-levels for prescribing 6 classes of medications used to treat common comorbid cardiometabolic or psychiatric conditions. Using t-tests, chi-square tests, or Fisher\'s Exact tests, physicians\' own comfort and comfort with other physicians prescribing medications for shared patients were compared between PCPs and oncologists. Linear regression models were used to analyze predictors of comfort-level scale score for prescribing medications.
Oncologists were more comfortable with PCPs initiating or refilling antidiabetics, antihyperlipidemics, antidepressants, and antipsychotics, and PCPs were more comfortable initiating antihypertensives, antidiabetics, antihyperlipidemics, antidepressants, and antipsychotics themselves as opposed to having an oncologist initiate or refill these medications. Compared to oncologists, PCPs reported a 32.3% higher comfort-level for initiating cardiometabolic medications (Adjusted Coefficient (standard error) = 0.323 (0.033), p < 0.001), and a 25.0% higher comfort-level for initiating psychiatric medications in cancer patients (Adjusted Coefficient (standard error) = 0.250 (0.030), p < 0.001), after controlling for prescriber demographics and practice site characteristics.
Findings suggest that when a cancer diagnosis is made for patients with pre-existing cardiometabolic or psychiatric conditions, oncologists prefer PCPs to manage these medications. This enhanced understanding of PCPs\' and oncologists\' comfort managing these medications may help develop a standard for defining physician roles in medication therapy as part of a shared care plan for patients with cancer and comorbidities.