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 4
The fundamentals of care framework: individual descriptions of care episodes of more positive interactions with staff.
Fundamentals of care matrix
Number of healthcare professionals involved in the described interactions with the patient
Example of quotation
Case A
Case B
Case C
7 OT 4 PT 2 Nurse 1 Staff
1 OT 1 PT 4 Nurse 4 Doctor
5 OT 4 PT 3 Nurse 1 Staff 2 ST
“One of the, the physios in the hospital had said, it, it’s helpful to some people to do that because obviously at first you, I was told, “Don’t be too hard on yourself and don’t push yourself and wait until your body tells you that you can do it” but then rather than it all get on top of you and it’d be totally out of hand, be sensible and sit down and work out your limitations and what you can actually achieve without being totally wiped out and exhausted, so that you’ve still got something left afterwards… When you’ve done that thing, that is such a sense of achievement that you’ve done that and you then move on to the next and it makes you realise very, very small little steps get you a long way and the sense of achievement is huge when, when you, you feel you haven’t, you can’t, you know, literally you can’t get out of bed.” (Case B)
n/a
n/a
n/a
Not detected in cases
1 Nurse
1 Doctor
“I was very, very angry. I wanted to come home when I knew I wasn’t well enough to come home and I was still very, very shocked because it, it couldn’t happen, you know, things like this just don’t, don’t happen to people who are fit. And the consultants were very, very, very, very helpful [em] but they’d no idea how I was feeling inside [em].” (Case B) “I did stay exactly the 3 weeks, my hair was sticking to my head, so I said, “I need, I need to have a bath and wash my hair”. “No”, they said, “You’ll die” and I said, “No, I need to wash my hair, I’ll risk it”. So one nursing assistant did agree that she would wash my hair for me so we did that and I didn’t die.” (Case C)
1 Nurse
“if you’re not used to asking people and you’re used to being, being totally independent. I think that is the problem, you know. People are sometimes frightened to ask, you know, but nurses and doctors, nurses obviously in particular said, “We do this every day, you’re not the first, we’ve, we’ve seen it and we do this every day. We’ve been doing it for years and we’ll do it for years, so don’t worry.” And once you can take that on board, once you can take that on board, you know [eh], that’s a big hurdle to get over. As I said, you’re, you’re going to the toilet, you know, and they’re actually cleaning you up, you know, and you’re thinking to yourself, “God, this is terrible”, you know. But they’re actually saying at the time, “Don’t worry, this is, this is our job, we do this every day” (Case A)
Staff: ward staff, nurse: registered nurse and nurse assistant, PT: physiotherapist, OT: occupational therapist, ST: speech therapist. n: number of the combination for all three cases.
