# Territorial Continuity of Care for Patients with Spinal Cord Injury: A Focus Group Study
## 2 Materials and Methods  
This was an observational monocentric study with a qualitative design conducted at the Department of Rehabilitative Medicine--AUSL Piacenza, performed by a research group composed of 7 members, of whom two had a Master's Degree in qualitative research and had already conducted/participated in studies with a qualitative design (Focus Group--FG, ethnography and grounded theory). Two further researchers underwent a training course about FG conduction and analysis. The study was based on the Focus Group Discussion method (FDG) [10]. FDG represents a qualitative research technique involving a small group of participants guided to discuss a specific theme [11]. A moderator facilitates and guides the discussion, aided by a semi-structured interview or a thematic guide, while an observer takes notes of non-verbal issues. The research query was framed through the SPIDER framework, a tool for planning and reporting qualitative evidence synthesis studies:  
* S (sample) = Chronic (more than 6 months by onset) SCI patients discharged from the Spinal Unit for at least 18 months; professionals specializing in the rehabilitation and assistance of patients with SCI (physiotherapists/nurses with specialization in autonomous dysfunction management/occupational therapists/technical coordinators of rehabilitation area);PI (phenomenon of interest) = Continuity of territorial/home care in SCI patients;
* D (design) = Monocentric qualitative observational study;
* E (evaluation) = Facilitators and obstacles to territorial care;
* R (research type) = Focus Group Discussion. The theoretical reference profile for the study was chronic SCI patients with a long-term disease history, in a territorial setting to access or visit diagnostic services/autonomous dysfunction re-evaluation and training/rehabilitation. Regarding professionals, we aimed to include well-trained experts with a long service in SCI assistance/rehabilitation (at least 18 months of employment at the Piacenza ASL Service and a minimum of three years of total work experience.) A convenience sampling strategy, based on inclusion criteria, was conducted: professionals were initially contacted for participation through company e-mail by study P.I. (G.C. and E.R. ), and then a short explanatory meeting was scheduled for those who wanted to participate in the survey. Patients were instead contacted from the database of the Spinal Unit; moreover, local association of para/tetraplegic patients (Associazione Paratetraplegici Piacenza) helped to promote participation in the study. A short explanatory meeting was scheduled for those who agreed to participate. According to [PERSON] and [PERSON]'s approach [12], the number of participants was set at 5/8 for each Focus Group (FG). Four FGs were conducted: two with healthcare professionals, on 9 July 2024 and on 29 July 2024, and two with the patients on 24 July 2024 and on 10 September 2024. The first group of healthcare professionals involved 4 subjects and the second involved 6 subjects, while the first group of patients involved 6 subjects and the second involved 7 subjects. Informed consent was obtained from all participants before starting the meetings. Each Focus Group lasted about 90-120 min and was moderated by a research team member with high-level training in qualitative research (University Master's Degree) using a predefined thematic guide (Table 1). A thematic guide is a central tool for ensuring consistency, depth, and comparability in FGs, facilitating the systematic exploration of key issues [13; 14]. It allows the moderator to keep the discussion focused while still enabling the emergence of spontaneous themes. In our study, after topic presentation, an initial ice-breaking was performed (recognizing picture of patients/health professional).