Patients’ perceptions of safety whilst in the acute phase of hospitalisation following a spinal cord injury

This thesis focuses on synthesising what is known on patients’ perceptions of safety within physical healthcare settings, and presents new research on this within a spinal cord injury setting.

The first paper is a literature review of patients’ perceptions of safety within physical health hospital settings. The aim of this literature review was to understand the main factors contributing to patients feeling psychologically safe within the physical health hospital environment. Searches were conducted during May and June 2022 and 11 studies were selected for the review. These were appraised using the CASP Qualitative Checklist Tool, and findings were analysed using thematic synthesis methods (Thomas & Harden, 2008). The review contained three main themes: ‘Communication with Staff’ (subthemes of information sharing, staff knowledge/competence, staff presence, staff attitude), ‘Connection and the Effects of This’ (support from others, isolation), and ‘Control Over the Situation and Self’ (physical environment, other patients, dependence on others, autonomy).
The second paper is an empirical study of patients’ perceptions of safety in the acute phase of hospitalisation following a spinal cord injury (SCI). This qualitative study consisted of interview data from eight participants who had experienced hospitalisation following SCI, and used Reflexive Thematic Analysis for analysis. Four themes were noted as having an impact on feelings of safety. ‘Staff Attributes and Interactions’, ‘Perceptions of Self and Autonomy’, ‘Impact of Others in the Ward’ and ‘Availability of Resources’. Clinical implications from the research include training for staff on the psychological impact of SCI, management of staff pressures to lessen dehumanising care, and trauma-informed hospital design, such as choice over shared spaces.

The third paper is an executive summary on the empirical research in Paper 2, aimed at the general population for wider dissemination of the research, including those with experience of hospitalisation following a SCI and healthcare professionals working within acute hospital settings.