{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T15:00:24Z","timestamp":1782313224073,"version":"3.54.5"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["180345"],"award-info":[{"award-number":["180345"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat&amp;#65533;Care"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Approaches to measuring continuity of care are underdeveloped for the end-of-life context, yet important for understanding the quality of end-of-life care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Our objective was to develop a grounded theory of continuity of care at end-of-life through the distillation and synthesis of interviews with bereaved family caregivers, which focused on perceptions and experiences of continuity of care at end-of-life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This qualitative study is phase III of a four-phase mixed-methods sequential explanatory study with the aim of determining which aspects of continuity of care matter most to patients and family caregivers and, accordingly, to develop a novel continuity of care index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Family caregivers completed one 60-min audio-recorded semi-structured virtual interview. Interview questions explored perceptions and experiences through four categories of questions: Patients\u2019 end-of-life experiences, family caregivers\u2019 desires for end-of-life care, family caregivers\u2019 perceptions of prior quantitative findings, and patients\u2019 and family caregivers\u2019 experiences of continuity of care at end-of-life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-one family caregivers completed interviews; 33% were aged 19\u201344, 90% identified as women, 85% lived in urban settings, and 19% identified as a visible minority. Our theory focuses on patterns of continuity and discontinuity of care at end-of-life. Following Corbin and Strauss\u2019 grounded theory method, we identified causes, contextual\/intervening conditions, strategies, and consequences. Causes included health-human resource supply and system integration; conditions included tension between preferences and system capacity, and personal resources. Strategies involved aligning care with cultural or religious considerations, identifying a single point of contact, and delivering information appropriately. Consequences included patients and caregivers feeling educated and prepared, a comprehensive approach to care, and the provision of high-quality, consistent care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Combined with prior work, these findings will inform a continuity index for use as a system-level end-of-life care indicator.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26323524251415403","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T06:14:46Z","timestamp":1770704086000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Continuity and discontinuity of end-of-life care: A grounded theory study of bereaved family caregivers\u2019 experiences"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2781-9572","authenticated-orcid":false,"given":"Taylor","family":"Shorting","sequence":"first","affiliation":[{"name":"Bruy\u00e8re Health Research Institute, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2373-6192","authenticated-orcid":false,"given":"Hannah","family":"Millward","sequence":"additional","affiliation":[{"name":"Bruy\u00e8re Health Research Institute, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6742-2118","authenticated-orcid":false,"given":"Aria","family":"Wills","sequence":"additional","affiliation":[{"name":"Bruy\u00e8re Health Research Institute, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuaib","family":"Hafid","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, McMaster University, Hamilton, ON, Canada"},{"name":"Department of Health Research Methods, Evidence and Impact, Health Sciences Centre (HSC), McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6059-5366","authenticated-orcid":false,"given":"Sarina R.","family":"Isenberg","sequence":"additional","affiliation":[{"name":"Bruy\u00e8re Health Research Institute, Ottawa, ON, Canada"},{"name":"Division of Palliative Care, Department of Medicine, University of Ottawa, ON, Canada"},{"name":"The Ottawa Hospital Research Institute, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7425.1219"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.4082\/kjfm.2017.38.5.242"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08023-0"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.46747\/cfp.6709679"},{"key":"e_1_3_3_6_2","unstructured":"Alberta Health Services. What is continuity of care? https:\/\/www.albertahealthservices.ca\/Blogs\/lrp-calgary\/256.aspx (2017)."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/109662103322654794"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20210039"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20210294"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/spcare-2023-004357"},{"issue":"1","key":"e_1_3_3_11_2","first-page":"463","article-title":"Claims-based measures of continuity of care have non-linear associations with health: data linkage study","volume":"3","author":"Tran B","year":"2018","unstructured":"Tran B, Falster M, Jorm L. Claims-based measures of continuity of care have non-linear associations with health: data linkage study. 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