title: Patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode: a multi-stage qualitative case study.
abstract: OBJECTIVE
  To explore how patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode.
  
  
  BACKGROUND
  Acute abdominal pain is one of the most common conditions to present in the acute care setting. Little is known about how patients' fundamental care needs are managed from presentation to post discharge.
  
  
  METHODS
  A multi-stage qualitative case study using the Fundamentals of Care framework as the overarching theoretical and explanatory mechanism.
  
  
  METHODS
  Repeated reflective interviews were conducted with five adult patients over a 6-month period in 2013 at a university hospital in Sweden. The interviews (n = 14) were analysed using directed content analysis.
  
  
  RESULTS
  Patients' experiences across the acute care episode are presented as five patient narratives and synthesized into five descriptions of the entire hospital journey. The patients talked about the fundamentals of care and had vivid accounts of what they meant to them. The experiences of each of the patients were influenced by the extent to which they felt engaged with the health professionals. The ability to engage or build a rapport was identified as a central component across the fundamental care elements, but it varied in visibility.
  
  
  CONCLUSIONS
  Consistent pain management, comfort, timely and accurate information, choice and dignity and relationships were identified as essential fundamental care needs of patients experiencing acute abdominal pain regardless of setting, diagnosis, or demographic variables. These were variously achieved and the patients' narratives raised areas for improvement in several areas.
authors.affiliation: Department of Surgical Sciences, Uppsala University, Sweden.|Department of Surgery, Uppsala University Hospital, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Jangland
authors.affiliation: School of Nursing, University of Adelaide, South Australia, Australia.|Central Adelaide Local Health Network, Australia Green Templeton College, Adelaide, South Australia, Australia.|University of Oxford, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Kitson
authors.affiliation: School of Nursing, University of Adelaide, South Australia, Australia.|Department of Medical Sciences and Department of Public Health and Caring Sciences, Uppsala University, Sweden.|Department of Emergency Care, Uppsala University Hospital, Sweden.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Muntlin Athlin
mesh_terms: D000006:Abdomen, Acute / Q000523:psychology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D003142:Communication; D004636:Emergency Service, Hospital / Q000592:standards; D017050:Episode of Care; D005260:Female; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D017060:Patient Satisfaction; D013548:Sweden
keywords: acute abdominal pain; acute nursing; emergency care; fundamentals of care; person-centred care; qualitative; relationship; surgical care; surgical nursing