How do neurorehabilitation patients perceive their fundamental care needs? Findings from a qualitative study

BACKGROUND: The Fundamentals of Care (FoC) framework provides a structured model to support the delivery of person-centered nursing care by integrating physical, psychosocial, and relational dimensions. Although the framework has been widely applied in acute care, little is known about its relevance in long-term neurorehabilitation settings, where patients often face complex, prolonged, and multidimensional care needs. OBJECTIVE: To explore how individuals with neurological disorders perceive their fundamental care needs during inpatient rehabilitation. DESIGN: A qualitative secondary analysis. SETTING: A rehabilitation hospital in Italy with a total capacity of 109 beds. PARTICIPANTS: We recruited individuals aged 18 years and older with a diagnosis of stroke, multiple sclerosis, or Parkinson disease, or who had undergone neurosurgical intervention for oncological conditions. METHODS: A deductive content analysis was performed, using the FoC framework to guide coding and thematic development. FINDINGS: The analysis identified care experiences across the three FoC dimensions. In the physical dimension, patients valued hygiene, toileting, mobility, and comfort not only as technical tasks but also as meaningful acts that contributed to dignity and recovery. The psychosocial dimension emphasized the importance of respectful communication, emotional support, privacy, and being informed, factors that fostered agency and trust. In the relational dimension, patients highlighted empathy, continuity, and presence as central to feeling emotionally safe and supported. Health care assistants emerged as key figures in delivering comfort-focused and relational care. Across all dimensions, fundamental care was perceived as deeply interconnected and resistant to rigid, task-based models. CONCLUSIONS: This study underscores the value of the FoC framework in capturing the multidimensional nature of care as experienced by neurorehabilitation patients. The findings reinforce the need for nurses and assistants to provide care that extends beyond physical tasks to include relational presence and person-centered responsiveness.