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 5
The fundamentals of care framework: individual descriptions of care episodes of more negative 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
2 Nurse
6 Nurse 3 Staff 5 Doctor
3 Nurse 5 Staff 2 Doctor
“because after the 3 weeks I hadn’t been to the toilet at all and was desperate to go and said I needed to go to the toilet and they said, “You can’t, if you go to the toilet, you’ll die”. I said, “Well, I’m sorry, I just, don’t you understand, I’m going to have to go. It’s not a case of a choice, it’s just I haven’t been for 3 weeks and I need to go” and it was just going to happen. “I can’t hold on to it any longer”. They said, “You can’t go”. So I said I wanted to see the doctor because I have to be able to go to a toilet. So I ended up going to see the on call doctor, who said, “No. If you go, you’ll die” and then I asked to see the senior nurse to make a formal complaint and I did that. But in the end, they said, “No, you can’t but you can have a pad on if you want to”. I said, “No”, I said, “You’ve taken everything from me, I’ve lost everything, I don’t want to lose my dignity as well” so in the end they said, “You’ve got 2 choices, you can either have, have a pad on which is like a big nappy or we’ll get the hoist, attach you to the hoist, lift you up over your bed and suspend you from 5 or 6 feet over your bed and you can just go to the toilet on your bed”. I said, “No, that’s not acceptable. I’m not happy with that”. So in the end, I had the pad, which was pretty awful and, as I said like it took away the last of my dignity.” (Case C)
1 Staff
“My right hand was worse than it had been last week. But once it was explained to me “Well you’ve been to the gym you’ve done a lot of walking you’re tired and that’s how it affects your stroke”. So you can take that on board, accept it and know you are going to be tired and know your hand’s is going to be slow your right hand is going to be slow for a couple of days.” (Case A)
1 Nurse
“I was given an antidepressant when I was in hospital by the doctors there but no assessment or anything by anyone from, from the mental health team.” (Case C)
2 Nurse
1 Doctor
1 Nurse 4 Staff 1 Doctor
“and sometimes I felt that the, the consultants didn’t treat me as a person enough. It was more as if I were just another case or another piece of paper or another case study really, rather than me.” (Case B)
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.
