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Maximising comfort: how do patients describe the care that matters? A two-stage qualitative descriptive study to develop a quality improvement framework for comfort-related care in inpatient settings

Wensley, Cynthia, Botti, Mari, McKillop, Ann and Merry, Alan F 2020, Maximising comfort: how do patients describe the care that matters? A two-stage qualitative descriptive study to develop a quality improvement framework for comfort-related care in inpatient settings, BMJ open, vol. 10, no. 5, pp. 1-18, doi: 10.1136/bmjopen-2019-033336.

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Title Maximising comfort: how do patients describe the care that matters? A two-stage qualitative descriptive study to develop a quality improvement framework for comfort-related care in inpatient settings
Author(s) Wensley, Cynthia
Botti, MariORCID iD for Botti, Mari orcid.org/0000-0002-2782-0987
McKillop, Ann
Merry, Alan F
Journal name BMJ open
Volume number 10
Issue number 5
Article ID e033336
Start page 1
End page 18
Total pages 18
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2020-05-18
ISSN 2044-6055
2044-6055
Keyword(s) comfort
compassion
patient experience
person and family centred care
qualitative research
quality in health care
Summary Objective To develop a multidimensional framework representing patients’ perspectives on comfort to guide practice and quality initiatives aimed at improving patients’ experiences of care. Design Two-stage qualitative descriptive study design. Findings from a previously published synthesis of 62 studies (stage 1) informed data collection and analysis of 25 semistructured interviews (stage 2) exploring patients’ perspectives of comfort in an acute care setting. Setting Cardiac surgical unit in New Zealand. Participants Culturally diverse patients in hospital undergoing heart surgery. Main outcomes A definition of comfort. The Comfort ALways Matters (CALM) framework describing factors influencing comfort. Results Comfort is transient and multidimensional and, as defined by patients, incorporates more than the absence of pain. Factors influencing comfort were synthesised into 10 themes within four inter-related layers: patients’ personal (often private) strategies; the unique role of family; staff actions and behaviours; and factors within the clinical environment. Conclusions These findings provide new insights into what comfort means to patients, the care required to promote their comfort and the reasons for which doing so is important. We have developed a definition of comfort and the CALM framework, which can be used by healthcare leaders and clinicians to guide practice and quality initiatives aimed at maximising comfort and minimising distress. These findings appear applicable to a range of inpatient populations. A focus on comfort by individuals is crucial, but leadership will be essential for driving the changes needed to reduce unwarranted variability in care that affects comfort.
Language eng
DOI 10.1136/bmjopen-2019-033336
Indigenous content off
Field of Research 1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30139046

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.