Adaptation to patienthood: A grounded theory study on the contributions of Healthcare Assistants towards the patient experience

Morey, Sarah (2016) Adaptation to patienthood: A grounded theory study on the contributions of Healthcare Assistants towards the patient experience. Doctoral thesis, Northumbria University.

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Abstract

Background
The healthcare assistant (HCA) workforce delivers much of the fundamental care across both health and social care and is therefore in a unique position to influence the patient experience. To date, there has been little qualitative research that explores the HCA role from the perspective of the patient.
Research Aim
The research set out to explore, and generate a theoretical understanding of, the role of the HCA from the patient perspective within secondary care.
Research Design
This study explores patients’ perceptions of the role of the HCA within secondary care. Ethical approval was granted in May 2014. Data were collected in a large teaching hospital in North East England between 2014 and 2015. Employing constructivist grounded theory, twenty patient interviews were coded and analysed. Three later interviews were added for depth to the findings.
Findings
Four core categories emerged from the data:
 Expectation
Participants entered the healthcare environment with varying expectations but told a largely positive story about their experiences, reframing negative episodes within an overall positive narrative. This reframing may indicate participants were indirectly reinvesting in staff for their future care needs.
 Observation
Some participants worked out “who was who” through observation, often associating tasks with uniform. Where jurisdiction and performance of the HCA was not as expected, this sometimes made participants more vigilant.
 Meaningful connections
Meaningful connections involved comfort and consideration from staff and humorous interactions between participants and HCAs. These connections contributed to the patienthood experience and were employed as a trading strategy, to cement relationships and overcome difficult circumstances.
 Adaptation
Participants worked out when to ask for help, recognising their dependency on staff availability and desire not to be labelled a nuisance.
Conclusion
In conclusion, education and development for HCAs that enhances understanding of roles and performance and their impact on relationships with patients would enhance the patient experience.
Implications
Investigation of the negative patient episodes hidden within reframed positive narratives would inform future policy and educational initiatives.

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