A concept analysis of poor care using Rodgers’ evolutionary cycle

Date28 March 2019
Pages111-125
Published date28 March 2019
DOIhttps://doi.org/10.1108/JAP-07-2017-0028
AuthorDenise Shanahan
Subject MatterHealth & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse
A concept analysis of poor care using
Rodgersevolutionary cycle
Denise Shanahan
Abstract
Purpose The purpose of this paper is to examine and explicate the concept of poor care by
exploring what it is and what contributes to its occurrence in practice with a particular focus on the care of
older people.
Design/methodology/approach The results of systematically searched published literature were
analysed using an inductive, descriptive, thematic approach as part of Rodgersevolutionary concept
analysis method.
Findings The concept of poor care is understood in the context of the antecedents of vulnerability, use of
healthcare services and interaction with healthcare personnel. Its defining characteristics involve
individuals personal traits, interpersonal dynamics, an endangered self, misconceptions or organisational
constraints.
Research limitations/implications Further research is needed to explore the recognition of poor care
and reporting thresholds. In addition, the role of the zone of toleranceof expectations in the delivery and
receipt of interpersonal care and attention for older people needs to be better understood.
Originality/value Understanding the continuum and mapping the structures of poor care in contemporary
UK healthcare practice can help sensitise practitioners to the widespread range and potential for instances of
poor care. This concept analysis uniquely demonstrates consequences not only for the patient but also for
healthcare staff and other individuals.
Keywords Older people, Safeguarding, Legal, Neglect, Adult at risk, Conceptual model, Concept analysis,
Poor care
Paper type Conceptual paper
Aims and objectives
Given the intense media coverage and plethora of poor practice reports, this paper aims to
examine the concept of poor care by exploring what it is and what contributes to its occurrence
in practice with a particular focus on the care of older people. This understanding is developed by
undertaking an inductive, descriptive, thematic concept analysis of published literature using
Rodgersevolutionary methods. The findings are discussed in the context of neglect, abuse and
expectations of care.
Background
Good standards in healthcare should be a given. Standards of care can be difficult to articulate,
but we experience healthcare which we may perceive as not good enough. There is a plethora of
media coverage of poor care, with several published reports in the UK exposing poor care for
adults who may be vulnerable, particularly older people (Andrews and Butler, 2014; Care Quality
Commission, 2015; Department of Health and NHS Commissioning Board, 2012; Flynn, 2015;
Gosport Independent Panel, 2018). The concept of poor care spans the developing and western
world (Pillemer et al., 2016; World Health Organization, 2002), and persists despite the practices
that measure quality, service user satisfaction, inspection processes and quality improvement
having been mainstreamed throughout healthcare services.
Received 3 July 2017
Revised 5 November 2018
4 December 2018
Accepted 17 December 2018
Denise Shanahan is based at
the Primary Community
Intermediate Care Clinical
Board, Cardiff and Vale
University Health Board,
Cardiff, UK and Department of
Healthcare Sciences, Cardiff
University, Cardiff, UK.
DOI 10.1108/JAP-07-2017-0028 VOL. 21 NO. 2 2019, pp. 111-125, © Emerald Publishing Limited, ISSN 1466-8203
j
THE JOURNAL OF ADULT PROTECTION
j
PAG E 11 1

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT