Measuring fundamental care using complexity science: A descriptive case study of a methodological innovation

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13 Citations (Scopus)


Aims and objectives
This paper presents an exploratory account of an innovative methodology to record and evaluate fundamental care. Fundamental care is defined as the care required by everyone for survival, health and welfare.

Fundamental care has been informed by the development and testing of the Fundamentals of Care Framework, which describes how fundamental care is complex and multidimensional and consists of three interrelated dimensions and 38 elements. This accords with a broader re-examination of care provision as part of a complex adaptive system in which existing linear models of cause and effect are inadequate to describe the totality of activity.

Informed by graph theory and complexity science, this paper presents a novel methodological innovation. It uses the Fundamentals of Care Framework to create a Matrix to quantify the relationships between different elements within the Framework.

We use a Matrix methodology to process care recipient narratives to generate three outputs: a heat map, a summary table and a network analysis.

The three outputs serve to quantify and evaluate fundamental care in a multidimensional manner. They capture different perspectives (care recipients and their families, direct care providers and care managers) to improve care outcomes. The future aim is to advance this exploration into digitalising and operationalising the Matrix in a user-friendly manner for it to become a real-time mechanism to evaluate and potentially predict patterns of fundamental care.
Original languageEnglish
Pages (from-to)2903-2912
Number of pages10
JournalJournal of Clinical Nursing
Issue number11-12
Early online date16 Jun 2021
Publication statusPublished - Jun 2023


  • complexity science
  • fundamentals of care
  • network analysis
  • complex adaptive systems
  • nursing


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