Journal of Clinical Nursing, volume 32, issue 11-12

Measuring fundamental care using complexity science: A descriptive case study of a methodological innovation

T Conroy 1, 2
Alexandra Mudd 3
Merle Mitchell 4
A. Kitson 1, 2
Publication typeJournal Article
Publication date2021-06-16
scimago Q1
SJR1.235
CiteScore6.4
Impact factor3.2
ISSN09621067, 13652702
PubMed ID:  34137100
General Medicine
General Nursing
Abstract
AIMS AND OBJECTIVES This paper presents an exploratory account of an innovative methodology to record and evaluate fundamental care. Fundamental care is defined as the care required by everyone for survival, health and welfare. BACKGROUND Fundamental care has been informed by the development and testing of the Fundamentals of Care Framework, which describes how fundamental care is complex and multidimensional, and consists of three interrelated dimensions and 38 elements. This accords with a broader re-examination of care provision as part of a complex adaptive system in which existing linear models of cause and effect are inadequate to describe the totality of activity. DESIGN Informed by graph theory and complexity science, this paper presents a novel methodological innovation. It uses the Fundamentals of Care Framework to create a Matrix to quantify the relationships between different elements within the Framework. METHODS We use a Matrix methodology to process care recipient narratives to generate three outputs: a heat map, a summary table and a network analysis. CONCLUSIONS The three outputs serve to quantify and evaluate fundamental care in a multidimensional manner. They capture different perspectives (care recipients and their families, direct care providers and care managers) to improve care outcomes. The future aim is to advance this exploration into digitalising and operationalising the Matrix in a user-friendly manner for it to become a real-time mechanism to evaluate and potentially predict patterns of fundamental care.
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