Towards a conceptual consensus of continuity in mental healthcare: focused literature search and theory analysis
Article first published online: 10 JUN 2013
© 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute
International Journal of Evidence-Based Healthcare
Volume 11, Issue 2, pages 94–109, June 2013
How to Cite
Digel Vandyk, A., Graham, I. D., VanDenKerkhof, E. G., Ross-White, A. and Harrison, M. B. (2013), Towards a conceptual consensus of continuity in mental healthcare: focused literature search and theory analysis. International Journal of Evidence-Based Healthcare, 11: 94–109. doi: 10.1111/1744-1609.12024
- Issue published online: 10 JUN 2013
- Article first published online: 10 JUN 2013
- ADV through the Primary Health Care System Research Fellowship from the Ontario Ministry of Health and Long-term Care
- continuity of patient care;
- mental health;
- systematic review;
- theoretical models
While continuity of care is an important component in the provision of mental health services, a universally accepted definition is missing. There is a need to identify areas of consensus and discrepancy in continuity theory and provide a foundation for advancing measurement capabilities. The purpose of this study was to systematically identify and examine scholarship on continuity in mental healthcare.
Using a focused literature review modelled on the Joanna Briggs Methodology for systematic reviews, MEDLINE, CINAHL, Embase, PsycINFO and Health STAR were searched from 1950 to 2011 for articles on the theoretical nature of continuity in mental healthcare. Included conceptualisations were subject to a theory analysis to critically examine similarities and differences. Next, a content analysis on the extracted data was used to identify a global understanding and set of theoretically defined concepts for the whole. Finally, the identified global concepts were compared with the original documents and to items identified on existing quantitative measurement tools to assess areas of consensus and discrepancy.
Seven documents describing the conceptualisation of continuity in mental healthcare were identified. From these, a deductive theoretical summary is proposed and theoretical consensus exists to support nine global concepts of continuity in mental healthcare. These global concepts include Longitudinality, Input & Individuality, Comprehensiveness, Flexible Consistency, Stability & Relationship, Accessibility, Information & Sharing, Realities, and Responsibility/Accountability. The original theories proposed by Dr Bachrach and colleagues and Dr Joyce and colleagues, as well as the ACSS-MH measurement tool, provide the best coverage of the proposed concepts.
Consensus exists across conceptualisations of continuity in mental healthcare, yet it is obscured by inconsistent use of language. Existing tools capture many of the associated concepts and elements, but none do so entirely. Further tool development and psychometric testing is needed. This study provides the foundational work required to advance research priorities in this area.