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Qualitative Analyses
You have been provided with excerpts from transcripts evaluating the  experience of being hospitalized. You are to code the transcripts and identify the common themes that emerge. With the themes identified, you are to write up your qualitative findings remembering to tell the story- describe what the theme is, how it appeared and give illustrations supporting what you are describing. This assignment will develop your skills in data coding and categorization in order to describe the essence or meaning from qualitative data. You are being given short responses from multiple individuals – the actual data set would be much larger. This is a qualitative study looking at the phenomenon of the “patient experience” while being hospitalized. The purpose of the study is to gather information as to how patients view the experience- what do they perceive as excellent and what do they perceive as problematic. The overall research question is “What is the experience of quality care for adult patients hospitalized in an acute care facility? This assignment has three components and can be submitted in a single WORD document. 

 

Question:

This assignment has three components and can be submitted in a single 
WORD document. 
The three components of this assignment are worth a total of 25 points. 
#1 In Vivo coding. Within each Transcript (5 points)
 Read the transcripts at least once with no coding at all- get familiar with 
the data.
 Complete line by line in-vivo coding of your data; use the transcript file 
itself. Use highlighting, and comments to provide the in-vivo coding. 
#2 A Diagram. Across Transcripts (5 points)
ï‚· Look for similar findings across transcripts…these represent patterns in 
your data
ï‚· Collapse common codes together into categories and themes
 Present your themes making sure that you attach illustrations to theme 
as well as your own conceptual discussion.

#3 A Narrative. Tell the Story (12 points)
 The paper is to be a presentation of the major findings from your 
analysis. 
 It is to combine your personal analysis (themes, categories and codes) 
with extracted illustrations to support your analysis. 
 It should be written making sure you are answering the research 
question(s).
 

 

 

 

 

I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.

First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent?

I guess excellent care was when people listened and did something after hearing me.

Can you describe something that actually happened.

Yes the nurse came in and asked how I was doing. I told her as well as can be expected. Except she didn’t stop there. She asked me what I meant by as “well as can be expected”… “Like what was happening now”. I told her about the pain I was having and that I was sure it would get better.

She asked me more questions. She wanted to know like what kind of pain I was having, how bad it was, what I had been taking for it at home. She then called my doctor and talked about the pain plan. My medications were changed. I guess that’s what made it excellent. I didn’t ask for it and the nurse realized that something needed to be done.

 

Are there other examples of what you thought was excellent care?

 

Not that I can think of although things were really pretty good. I guess what stands out is that people really listened. They would come in and they would ask if they could help and they would remind me that they had time. I guess that made me think that it would be all right to ask things. Like one time I asked if they would walk me as I was having stiffness in my legs. Another time I requested that they explain something to my wife about my new medicines. I’m not sure I would’ve asked if they hadn’t said they had time.

 

Another good thing was how they told me about my medicines.

 

Can you tell me more about that? What kind of instructions were you receiving?

 

I was told I was going home on Coumadin. The nurse who brought me the Coumadin started to explain what it was and why I was getting it. I had hip surgery and they were worried about a possible blood clot. The doctor had said I would go home on it.

So every morning when the nurse brought in the medicine she would explain to me what it is, why I am getting it and what I needed to do once I get home like I needed to watch if I had any bleeding and I’ll have to get my blood checked for the Coumadin level.

 

Can you provide any examples of when you were not satisfied or not happy with the care you were receiving

Well probably most upsetting was the noise at night. I had a roommate who cried and cried. I think he was senile. And he made so much noise that I could not sleep. I guess it was no one’s fault but it sure made the whole experience difficult.

The other hard thing was knowing that I had treatments but not knowing when I would be getting them. I needed to go to physical therapy twice a day. I would get myself ready in the morning and then I would wait and I would wait and I would wait and sometimes they never came until close to noon and I’m supposed to have a twice a day and because I would just be getting back at 1:30 they never made it back to get me for the second time. I want to make sure my rehab goes well. I should’ve been getting my physical therapy.

And I guess overall it is hard being in the hospital. There is really nothing people can do to make it better I guess. But why do so many people come in to do things to you and never introduce themselves or even ask your permission- it’s like another world. Come in do what they want. Speak about you to others as if you aren’t even there and walk out the door.

 

 

 

I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.

First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent?

 

I can tell you what excellent care is but it sure didn’t happen here. Excellent care would be when there was care. It was like I never saw a nurse. They would come in give me medications and then be gone. I put my call light on and this voice would come over the intercom and say “someone will be right in” and of course no one came right in. It was very frustrating. I couldn’t ambulate on my own. I needed assistance to even feed myself. They would bring in my trays for meals and it would sit on my table. Having had a stroke I couldn’t feed myself. I couldn’t take the lids off. My meal would sit there and get colder and colder and colder. Then the nursing assistant would come in and say I’m here to feed you and would try feeding me cold food. I probably wouldn’t of liked it hot either

as it was puréed.

 

I sound like a crabby old lady don’t I? But it was a very scary time. My room was at the end of the hall. I felt alone and I was scared. And when people did come in they really were more interested in my tubes in my weakness.

They did not care about who I was or how I was feeling after having a stroke. People would come in do what they had to do sometimes never even say who they were. It was like I just had to lay there and do whatever they wanted. Or they would just do what they wanted and ignore me.

Can you provide any examples of when you were not satisfied or not happy with the care you were receiving?

I guess it was hard when it seemed like no one communicated with each other. One nurse did not know what another nurse had done. It doesn’t make you feel comfortable when you think they don’t know what is going on. The doctors are even worse…they clearly never talk with other nurses and doctors. How are you supposed to feel secure when you don’t think those who are supposed to take care of you know what they need to know about you or the care.

 

 

I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.

First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent?

 

Excellent care was when people were kind. I had gotten some bad news about uterine cancer. The nurse, her name is Josie, she sat next to me, took my hand, and asked how I was doing.I felt like  she really cared. It also helped. To share my fear with someone who could give me information. Information… that really helped. This was my first time being sick and finding out that you needed surgery and chemotherapy was very difficult.

 

I was angry at first as the doctor came in and told me the diagnosis and told me that I would be scheduled for surgery the next day and then I would need chemotherapy afterwards. He didn’t even give me a choice. It was Josie who told me that I could ask the doctor about options. That I did have a right to make my own choice. I didn’t know how to ask the doctor. So she made him come back to see me. She told him that I wanted to know what my options were. He really was very nice. We all sat and talked for a very long time about what the different approaches could be with the pros and cons. I did choose to go ahead with surgery. But I felt better about it after having been given the information. Don’t treat me as if I can’t think for myself. It’s my body. Josie understood that.

I hated when Josie was not there. She saw me for who I was. Other nurses would just come in and out and they were pleasant but they really didn’t take the time to find out what was happening with me. I felt comfortable when Josie was around. She would leave when her shift was over and I would be more anxious.

 

What other things did Josie do that made you feel like you were getting excellent care?

 

Gee I don’t know. She treated me as an individual. She asked me what I wanted. She told me I got to make decisions. And she gave me information. I was overwhelmed. She would give me information in small doses. Then she would come back. I never felt I was a bother. And I guess another thing was how she talked to my husband. She told him that she knew it was a difficult time for me but that it was likely hard for him as well. And that she was there to answer his questions. And not to feel uncomfortable asking. I think that make him feel more relaxed. He always looked for her

I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.

First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent?

What was excellent? I think everyone paid a lot of attention to my wound and how it was healing. They measured it every day. They examined it. They asked me about it. They would share their thoughts about how it was doing. That helped. I wanted to know about how I was progressing. I wanted information and they shared information about the wound, the treatment and all. Yes, I think I would say it was excellent- they knew not just what was happening at the time but how it was from the previous few days.

Can you provide any examples of when you were not satisfied or not happy with the care you were receiving?

I was there for the wound so I shouldn’t complain as the wound care was good. But it’s not easy being a patient in the hospital. No, it’s not easy. One thing that bothered me is that they called me “Pops”. I guess because I am older. I wanted to say- I’m not your Pops. It was people trying to be nice but Pops? Really? And some people didn’t call me by name or call me Pops they just came in and did what they had to do. Like I wasn’t even there. And of course they would automatically talk loud- I think they looked at me and said well he’s an old man so I will just shout so he can hear me. There was one day when I was not doing well and the nurse told my daughter that I was a little out of it- she asked what he meant and he told her- you know confused but that comes with being in your 80s. She was not pleased with him- explained to him that I was not normally confused that something must be happening- later that day they found that I was septic and they started antibiotics by IV. No one stops to find out who you are.

 

 

 

I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving. First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent?

The nurses in ICU were excellent. They were so professional. They knew what was      happening with me- were constantly checking me and reassuring me and telling me what was happening. I had a mild stroke and I was of course scared. And the ICU was scary but the nurses explained what the machines were. What the sounds were coming from the machines and what the machines were monitoring. I got to the point that I felt safe with the machines- it was a little scary to have them take off the machines but the nurses were so attentive – and they told me about how coming off the machine was a sign of my progress. I felt good about that- made me feel hopeful. I felt very comfortable asking questions to them and I have not always felt that way when I have been in the hospital before.  When I was in the hospital the last time (somewhere else) I felt that no one listened to me.

The other thing they did was that when my husband and children would visit, the nurses would update them on how I was doing. They would ask them if they saw anything that they were concerned about or if they had questions. I think my kids are more scared then I am so that was really excellent. And they were so accommodating- they let my children visit whenever they wanted. Bobby works long hours so he might not get to the hospital until after 10 at night- they let him come in – he would just sit there if I was sleeping. The nurses filled him in on how I was doing. It was so reassuring to me to have my family present. 

 

Can you provide any examples of when you were not satisfied or not happy with the care you were receiving?

Well, when I left ICU everything was different. It was like being thrown from a secure situation to being alone. I was alone a lot. I was in a room by myself which was good- but it was like no one checked on me. I didn’t realize how hard it was going to be to do things for myself but I had to force myself because there was no staff there to help me. Even when they did come to the room they were so busy, so rushed that it was hard to ask them questions- I’m sure there were sicker people then me. But it was a little bit like being abandoned.

 

 

I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.

First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent?

This is the first time I was at this hospital and it was a different experience. Everyone was so professional- from the physicians to nurses to the nursing assistants. It was as if they really cared about who I was and what I wanted. When I came in they asked me if I wanted to wear a hospital gown or would I be more comfortable in my own clothes- have you ever heard such a thing? I of course did not want the hospital gown- I hate that feeling of flapping in the wind- it is humiliating. But right from the beginning they asked me- what was I expecting from the hospitalization. Was there anything they could do for me that would ease the experience for me? I told them – I just want to make sure that I was not in a lot of pain. I can’t tell you how many times nurses came in and asked me about my pain. Whether it was being managed to my expectations. They included me in the conversation about how I was doing. I never suffered.

Another thing that was excellent was that I rarely had to ask for information- it was routinely given. When nurses made rounds, when they came in to give medications- they were always giving me information- one nurse she explained my blood results and told me what it meant in terms of my condition- like what did it mean that my hemoglobin was going down- she explained it in relation to the bleeding I was having and how they would be watching it to see if I needed blood.  I never had to ask about what was happening as it was automatically shared. That is so different- usually you have to beg to be listened to and get the information you need.

 

Can you provide any examples of when you were not satisfied or not happy with the care you were receiving?

Not really. But I would suggest… knock on the door before you come in- people would come into my room day and night and it feels like I was being invaded. 

SCIENCE
HEALTH SCIENCE
NURSING
NRS 206

 

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