Patients', Relatives' and Healthcare Professionals' Experiences and Perceptions of Raising Concerns About Acute Deterioration: A Qualitative Case Study.

Authors

Aidín McKinney, Donna Fitzsimons, Bronagh Blackwood, Jennifer McGaughey

Published in

Journal of advanced nursing. Jul 08, 2026. Epub Jul 08, 2026.

Abstract

To explore adult patients', relatives', and healthcare professionals' experiences of acute deterioration and perceptions of patient/family involvement in raising concerns.
A collective case study underpinned by implementation science.
Individual and focus group semi-structured interviews were conducted with patients, relatives and healthcare professionals who had experience of deterioration across two urban hospitals. The interview schedule was informed by the Theoretical Domains Framework of behaviour change and a concurrent review of patient notes was undertaken to contextualise the deterioration experience. Data was analysed using thematic analysis.
Between March and October 2019, 12 patients, 11 relatives, and 32 healthcare professionals were interviewed. Findings revealed that patients and relatives can detect deterioration, and they highlighted challenges and benefits in their involvement in raising concerns. Perspectives from all stakeholders highlighted an urgent need to provide better support and mechanisms for patients and relatives in escalating deterioration. These include the need to co-design innovative interventions that focus on informing patients/relatives of the main signs of deterioration, key steps to take when calling for help, and their role in the process.
Understanding the perceived challenges and benefits of patient and family-initiated care escalation provides a strong theoretical and practical foundation for designing and implementing an effective intervention.
The findings highlight key processes and intervention components essential for developing a patient and family-initiated escalation of care intervention.
This insight will support the co-design and implementation planning of an intervention aimed at preventing or reducing deterioration by empowering patients and their families to escalate concerns.
The COREQ checklist was used as a guide for reporting the study.
Patients, relatives and healthcare professionals were involved in the co-design of the study.

PMID:
42417095
Bibliographic data and abstract were imported from PubMed on 08 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.