Development and Preliminary Testing of a Framework to Evaluate Patients' Experiences of the Fundamentals of Care: A Secondary Analysis of Three Stroke Survivor Narratives

Table 2

Eight hypothetical dimensions of the fundamental of care framework.

Dimensions of FOC	Individual experience	Likelihood in practice
Phy↑×Psy↑×Rel↑; (Orange in Figure 3)	Attention to physical, psychosocial needs and relational aspects in the majority of fundamentals of care	Likely—and aspirational. The ultimate target for patients and professionals and the goal of patient centred care
Phy↑×Psy↑×Rel↓; (Purple in Figure 3)	Attention to physical and psychosocial needs in the majority of fundamentals of care; little attention to relational aspects	Likely—in areas where more attempt is made to involve patients but staff have not been trained in terms of extending their interpersonal and relational skills or where they feel under time pressure to get the tasks done
Phy↑×Psy↓×Rel↑; (Blue in Figure 3)	Attention to physical and relational aspects in the majority of fundamental of care; little attention to psychosocial needs	Unlikely—possibly in settings where there is a superficial attempt to engage with patients but it is not authentic
Phy↑×Psy↓×Rel↓; (Red in Figure 3)	Attention to physical needs in the majority of fundamentals of care; little attention to psychosocial and relational aspects	Likely—in areas that have a biomedical approach to care and strict routines and where there are workforce shortages
Phy↓×Psy↓×Rel↓; (Yellow in Figure 3)	Majority of fundamentals of care characterised by lack of attention to physical and psychosocial needs and little empathy from staff	Likely—particularly in areas of low staffing, poor leadership, and low morale with high patient acuity
Phy↓×Psy↓×Rel↑; (Pink in Figure 3)	Lack of attention to physical and psychosocial needs but staff have demonstrated empathy and relationship building	Unlikely—but could happen in areas where there are skill and competency gaps and staff are well intentioned but inadequately prepared
Phy↓×Psy↑×Rel↓; (Turquoise in Figure 3)	Lack of attention to the majority of physical needs; more attention to psychosocial needs and little attention to the relational issues	Unlikely—may be seen in an environment that is required to implement a policy such as “dignity nurses” ref to improve patient experiences but not addressing physical needs
Phy↓×Psy↑×Rel↑; (Green in Figure 3)	Lack of attention to physical needs in the majority of fundamentals of care; good attention to psychosocial and relational aspects	Less likely—but could happen in some clinical areas where attention to physical aspects of care is a low priority and where patients’ physical self care capacity was poor or inadequately assessed