Browsing by Person "Dewing, Jan"

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A Kaleidoscope of Hope: Exploring Experiences of Hope Among Service Users and Informal Carers in Health Care Contexts
(SAGE, 2017-07-06) McCormack, Brendan; Borg, Marit; Cardiff, Shaun; Dewing, Jan; Jacobs, Gaby; Titchen, Angie; van Lieshout, Famke; Wilson, Valerie
Background: There is a large and diverse literature on the concept of hope in health care. This literature covers a broad spectrum of perspectives, from philosophical, conceptual, and theoretical analysis through to attempts at measuring the concept of hope with differing health care users. Aims: To explore the concept of hope through the secondary analysis of existing data sets, with the intention of understanding hope in the context of person-centeredness. Research Question: What is the experience of hope among service users and informal carers in different health care contexts? Method: Secondary analysis of data derived from three research studies. Findings: We identified four key themes that together illustrate what we describe as a kaleidoscope of hope, reinforcing the view that there is no one presentation of hope and that practitioners must engage authentically with service users to determine the most effective and appropriate intervention strategies. Conclusions: Hope is not a singular phenomenon, and in the context of person-centered practice there is a need for practitioners to engage authentically with service users and listen carefully to what may bring hope for them. 2016, The Author(s) 2016.
A realist inquiry to identify the contribution of Lean Six Sigma to person-centred care and cultures
(MDPI, 2021-10-03) Teeling, Sean Paul; Dewing, Jan; Baldie, Deborah
A lack of fidelity to Lean Six Sigma’s (LSS) philosophical roots can create division between person-centred approaches to transforming care experiences and services, and system wide quality improvement methods focused solely on efficiency and clinical outcomes. There is little research into, and a poor understanding of, the mechanisms and processes through which LSS education influences healthcare staffs’ person-centred practice. This realist inquiry asks ‘whether, to what extent and in what ways, LSS in healthcare contributes to person-centred care and cultures’. Realist review identified three potential Context, Mechanism, Outcome configurations (CMOcs) explaining how LSS influenced practice, relating to staff, patients, and organisational influences. Realist evaluation was used to explore the CMOc relating to staff, showing how they interacted with a LSS education Programme (the intervention) with CMOc adjudication by the research team and study participants to determine whether, to what extent, and in what ways it influenced person-centred cultures. Three more focused CMOcs emerged from the adjudication of the CMOc relating to staff, and these were aligned to previously identified synergies and divergences between participants’ LSS practice and person-centred cultures. This enabled us to understand the contribution of LSS to person-centred care and cultures that contribute to the evidence base on the study of quality improvement beyond intervention effectiveness alone.
An Exploration of Person-Centredness in Practice
(American Nurses Association, 2011-05) McCance, Tanya; McCormack, Brendan; Dewing, Jan
Person-centredness' is a term that is becoming increasingly familiar within health and social care at a global level; it is being used to describe a standard of care that ensures the patient/client is at the centre of care delivery. In this article we explore the relevance of person-centredness in the context of nursing, taking account of the ongoing critical debate and dialogue regarding developments in this field. Person-centredness is recognised as a multidimensional concept. The complexity of the concept contributes to the challenge of articulating its shared meaning and describing how it can be applied in practice. The aim of this paper is to explore some of the issues pertaining to language and conceptual clarity, with a view to making connections and increasing our shared understanding of person-centred care in a way that can impact nursing practice. We begin by describing the development of the concept of person-centredness, after which we discuss the synergies with patient-centredness and other related terms, and consider how nurses can operationalise person-centredness in their practice.
Assuring care: are we ready to move beyond compliance measurement against targets?
(Foundation of Nurisng Studies, 2015-11-18) Dewing, Jan
Can we talk about it? A qualitative study exploring occupational therapists’ decision making in judging when to ask an older person about drinking alcohol
(Cambridge University Press, 2020-08-03) Maclean, Fiona; Dewing, Jan; Kantartzis, Sarah; Breckenridge, Jenna; McCormack, Brendan
Older people now currently drink alcohol more frequently than previous generations, indicating a need to understand how this influences health and wellbeing in older adults. However, knowledge and awareness of the changing role alcohol plays in the lives of older people is not necessarily widely understood by allied health professionals in acute hospital contexts. In turn, conversations about drinking alcohol in later life may not be routinely addressed as part of practice, limiting an older person's choice to make informed decisions about their drinking. This paper qualitatively examines when occupational therapists (N = 17) in an acute hospital setting will initiate a conversation with older people (65+ years) about their drinking, guided by a theoretical lens that encompasses both person-centredness and collective occupation. Adopting a qualitative methodology, this study illustrates a typology of reasoning describing how, and in what circumstances, therapists ask older people about their alcohol use. Three themes were generated that provide further insight into the typology, these being ‘hesitancy in practice’, ‘failure to link life transitions to alcohol use’ and ‘challenges of focusing on healthfulness’. These findings provide a potentially useful tool for therapists, services and organisations to self-assess their approach to asking older people about alcohol use; a necessary element of professional health-care practice as social trends in alcohol use continue to increase.
Caring for people with multiple sclerosis who use cannabis for symptom control
(MA Healthcare, 2019-06-05) Daly, Laura; Gibson, Caroline; Dewing, Jan
Research to-date suggests a large proportion of people living with MS are using cannabis as a way to self-manage symptoms, and, if not, believe that there are potential benefits in using this drug. Community nurses are frontline caregivers; therefore, it is likely they will come into contact with people who use cannabis for MS within the home setting. The literature base surrounding this topic is largely driven by quantitative research examining the effectiveness of cannabis as a medicine. This review has found that qualitative research exploring the experiences of people who use cannabis for MS is lacking around the world and is completely absent within UK nursing literature. Persons using cannabis for MS, in some cases, do not feel safe in discussing this with healthcare professionals through fear of being judged. This literature review discusses how people perceive the effectiveness of cannabis in helping symptoms associated with MS while also drawing upon stigma and legal concerns people face. Community nurses will gain more understanding of social/ political issues and how this influences the decision to use cannabis. The findings from this review will help community nurses inform their practice and enhance person-centred relationships between nurses and persons living with MS.
Clinical leadership and pre-registration nursing programmes: A model for clinical leadership and a prospective curriculum implementation and evaluation research strategy
(Elsevier, 2016-04-08) Brown, Angela; Dewing, Jan; Crookes, Patrick
Aim: To present for wider debate a conceptual model for clinical leadership development in pre-registration nursing programmes and a proposed implementation plan. Background: Globally, leadership in nursing has become a significant issue. Whilst there is continued support for leadership preparation in pre-registration nursing programmes, there have been very few published accounts of curriculum content and/or pedagogical approaches that foster clinical leadership development in pre-registration nursing. A doctoral research study has resulted in the creation of an overarching model for clinical leadership. Design: A multi-method research study using theoretical and empirical literature 1974-2015, a focus group, expert opinion and a national on-line survey. Discussion: A conceptual model of clinical leadership development in pre-registration nursing programme is presented, including the infinity loop of clinical leadership, an integral curriculum thread and a conceptual model: a curriculum-pedagogy nexus for clinical leadership. In order to test out usability and evaluate effectiveness, a multi method programme of research in one school of nursing in Australia is outlined. Conclusion: Implementation of the proposed conceptual model for clinical leadership development in pre-registration nursing programmes and a programme of (post-doctoral) research will contribute to what is known about curriculum content and pedagogy for nurse academics. Importantly, for nursing students and the profession as a whole, there is a clearer expectation of what clinical leadership might look like in the novice registered nurse. For nurse academics a model is offered for consideration in curriculum design and implementation with an evaluation strategy that could be replicated. 2016 Elsevier Ltd.
Clinical leadership development in a pre-registration nursing curriculum: What the profession has to say about it
(Elsevier, 2015-08) Brown, Angela; Crookes, Patrick; Dewing, Jan
Background: In the last decade literature, inquiries and reports into the short comings in health services have highlighted the vital role of leadership in clinical practice and the impact on patient care and effective workplace culture. Whilst there is an abundance of literature on leadership and the registered nursing workforce, an international literature review revealed there is very little known on leadership development in pre-registration nursing programmes. Objective: To identify what the profession's views are on proposed indicative curriculum content suggested for clinical leadership development in a pre-registration nursing degree in Australia. Design: This is a multi-method research study. This paper presents the development and results of one aspect of the study, a national online survey. Participants: Nurses: clinicians, managers and academics. Methods: In the absence of a strong evidence base in the literature review, additional pre-requisite curriculum content was augmented from the work of two published frameworks of leadership and management. From this a 67-item survey was designed to ask the profession whether the aggregated content is a reasonable view of what should be included in a pre-registration programme to develop clinical leadership. The survey sought the views of nurses on whether the proposed content was relevant (yes/no) and their opinion on whether it is significant via a 5-point Likert scale. Descriptive and chi-square analyses were performed in SPSS v.19. Results: A total of 418 nurses completed the survey; there was consensus amongst the profession on what is considered relevant and important in a pre-registration nursing programme. Conclusions: The content identified could be considered indicative and pre-requisite to include in a pre-registration nursing programme. Members of the nursing profession in Australia have clear views about this. The next step is to design and evaluate a purposeful pedagogical approach and curriculum, leading to the development of clinical leadership knowledge, skills and behaviours in newly graduating nurses. 2015 Elsevier Ltd.
Clinical leadership in pre-registration nursing programmes - an international literature review
(Taylor & Francis, 2015-10-22) Brown, Angela; Crookes, Patrick; Dewing, Jan
Background: Clinical leadership and the safety, quality and efficiency of patient/client care are inextricably linked in government reports, major inquiries and the professional literature. Objectives: This review explores the literature on clinical leadership development within preregistration nursing programmes. Method: The literature retrieved from a scoping review was evaluated to identify what is already published on the development of clinical leadership within pre-registration nursing programmes. Twenty-seven publications matched the inclusion criteria and were included in this review, 14 journal articles, one thesis and 11 chapters within one book were analysed and three themes were identified: clinical leadership; curriculum content and pedagogy. Results and main outcomes: This review identified a paucity of literature specifically relating to clinical leadership and pre-registration nursing programmes and what is available is inconclusive and unconvincing. Conclusions: Academics, curriculum development leaders and accreditation bodies have a responsibility to influence how nurses are prepared for the profession as such clinical leadership and the new graduate should be considered an area of greater importance. 2015 Taylor & Francis.
Creative reflections on Enhancing Practice 16: New explorations, insights and inspirations for practice developers
(Foundation of Nurisng Studies, 2016-11-11) Baldie, Deborah; Brown, Angela; Dewing, Jan; Dickson, Caroline; none
It began two years ago, then Arriving in Edinburgh the enthusiasm abounds. The first day arrives - oozing anticipation. Great to gather old friends, new friends; Clans and clever creativity, having fun Energy in the room, creating, innovating, Creative ways transforming minds, creating impact. The International Practice Development Collaborative (IPDC) is loose network of practice developers, academics and researchers who are committed to working together to develop healthcare practice. The IPDC believes that the aim of practice development is to work with people to develop person-centred cultures that are dignified, compassionate and safer for all. One of its four pillars of work is a biennial Enhancing Practice conference. Moving round the world, the IPDC members take it in turns to host the conference; in early September 2016 it was the turn of Queen Margaret University (QMU) in Edinburgh. This article has been created collaboratively by a number of the people who attended this three-day conference. The IPDJ team invited participants to offer 'the line of a poem' that captured or reflected their experience and/or learning. These were then collected and shared, and together we created a series of poems and a collection of haiku (a three-line Japanese poem with 17 syllables, 5-7-5). Other participants have subsequently offered reflections, which we would also like to share with you here. We offer this article to you, as a celebration of our time together; our learning, connections and creating, in the hope that there might be some learning in here for you and that you may consider joining us at our next conference in Basel, Switzerland in 2018.
Developing facilitation skills amongst undergraduate nursing students to promote dementia awareness with children in a higher education institution (innovative practice)
(Sage, 2018-11-17) Gibson, Caroline; Rennie, Karen; Dewing, Jan; McKinlay, Lesley
Final year students on a BSc Hons Nursing programme in Scotland were supported to become Dementia Friends facilitators and develop interactive dementia awareness sessions for children from local schools. The children were invited to indicate phrases and images they associated with ‘dementia’ at the outset and end of the session. Analysis of the responses suggested that there were positive changes in the children’s values and beliefs when thinking about a person living with dementia during the sessions. We suggest that peer learning is a valuable strategy to increase public and professional awareness about dementia and supports the development of graduate attributes.
Developing new methods for person-centred approaches to adjudicate context−mechanism−outcome configurations in realist evaluation
(MDPI, 2022-02-18) Teeling, Sean Paul; Dewing, Jan; Baldie, Deborah
Realist evaluation provides a general method of evaluating the application of interventions including policy, legislation, projects, and new processes in social settings such as law enforcement, healthcare and education. Realist evaluation focuses on what about interventions works, for whom, and in what circumstances, and there is a growing body of work using realist evaluation to analyse interventions in healthcare organizations, including those using Lean Six Sigma improvement methodologies. Whilst realist evaluation facilitates the analysis of interventions using both qualitative and quantitative research, there is little guidance given on methods of data collection and analysis. The purpose of this study is to address this lack of guidance through detailing the use of innovative person-centred methods of data collection and analysis in a realist evaluation that enabled us to understand the contribution of Lean Six Sigma to person-centred care and cultures. This use of person-centred principles in the adjudication of identified program theories has informed novel methods of collecting and analysing data in realist evaluation that facilitate a person-centred approach to working with research participants and a way of making the implicit explicit when adjudicating program theory.
Developing Person-Centred Care: addressing contextual challenges through practice development
(American Nurses Association, 2011-05) McCormack, Brendan; Dewing, Jan; McCance, Tanya
Developing person-centred care is not a one-time event; rather it requires a sustained commitment from organisations to the ongoing facilitation of developments, a commitment both in clinical teams and across organizations. Contextual factors pose the greatest challenge to person-centredness and the development of cultures that can sustain person-centred care. We will begin with a general comment on 'context' and its meaning before exploring three particular factors that influence the practice context, namely, workplace culture, learning culture, and the physical environment. Next we explore a particular approach to developing person-centred care through emancipatory practice development. We highlight the importance of facilitation through emancipatory practice development programmes and describe how person-centred care can be developed through the presentation of a case study that illustrates the principles and processes of emancipatory practice development as well as the outcomes achieved. We conclude with an application to clinical practice. A key consideration for all organisations in the development of person-centred care is to move from what we suggest are 'person-centred moments' (individual, ad hoc experiences of person-centredness) to 'person-centred care' as an underpinning culture of teams and organisations.
Developing person-centred practice: nursing outcomes arising from changes to the care environment in residdential settings for older people
(Wiley, 2010-06) McCormack, Brendan; Dewing, Jan; Breslin, L.; Coyne-Nevin, A.; Kennedy, K.; Manning, M.; Peelo-Kilroe, L.; Tobin, C.; Slater, P.
Aim. To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people.Design. The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the 'Person-Centred Nursing Index'.Findings. Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on 'technical' aspects of care, to one where 'intimate' aspects of care were more highly valued.Relevance to clinical practice. The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships.
Developing philosophical and pedagogical principles for a pan-European person-centred curriculum framework
(Foundation of Nursing Studies, 2020-09-30) Dickson, Caroline; van Lieshout, Famke; Kmetec, Sergej; McCormack, Brendan; Skovdahl, Kirsti; Phelan, Amanda; Cook, Neal F.; Cardiff, Shaun; Brown, Donna; Lorber, Mateja; Magowan, Ruth; McCance, Tanya; Dewing, Jan; Štiglic, Gregor
Background: In the associated article in this special issue of the International Practice Development Journal, Phelan et al. (2020) offer an analysis of the global positioning of person-centredness from a strategic policy perspective. This second article, an international person-centred education curriculum development initiative, builds on that foundational work. It outlines the systematic, rigorous processes adopted by academics from five European countries to analyse stakeholder data, theoretically frame the data, and thereby identify philosophical and pedagogical principles to inform the development of person-centred curriculum frameworks.
A discussion of the synergy and divergence between Lean Six Sigma and person-centred improvement sciences
(Science Publications, 2020-04-13) Teeling, Sean Paul; Dewing, Jan; Baldie, Deborah
Background: This paper discusses if and how the improvement sciences of Lean Six Sigma and person-centred approaches can be melded or blended in the health care context. The discussion highlights the relationship between each approach to improvement science in terms of their respective purposes, intentions and probable outcomes; positioning these as either synergies or divergences. Comparison of the key theoretical and methodological principles underpinning each approach to improvement is also considered and implications for future practice, policy and research are drawn out. The discussion is informed by part of the findings of a realist review of relevant literature.
Editorial: Privilege and the call of the appeal
(Wiley, 2020-07-24) Dewing, Jan
Editorial: Tell me, how do you define person-centredness?
(Wiley, 2017-04-23) Dewing, Jan; McCormack, Brendan
Exploring mediating effects between nursing leadership and patient safety from a person-centred perspective: A literature review
(Wiley, 2020-12-27) Wang, Meini; Dewing, Jan
Aims: To evaluate the mechanism through which nursing leadership impacts patient safety.
Exploring person-centredness: a qualitative meta-synthesis of four studies
(Wiley, 2010-09) McCormack, Brendan; Karlsson, Bengt; Dewing, Jan; Lerdal, Anners
Person-centredness as a concept is becoming more prominent and increasingly central within some research literature, approaches to practice and as a guiding principle within some health and social care policy. Despite the increasing body of literature into person-centred nursing (PCN), there continues to be a 'siloed' approach to its study, with few studies integrating perspectives from across nursing specialties. The purpose of this paper is to present the results of a study undertaken to explore if the secondary analysis of findings from four different and unrelated research studies (that did not have the main aim of researching person-centredness) could inform our understanding of person-centred nursing. A qualitative meta-synthesis was undertaken of the data derived from the four unrelated research studies undertaken with different client groups with long-term health conditions. A hermeneutic and interpretative approach was used to guide the analysis of data and framed within a particular person-centred nursing framework. Findings suggest 'professional competence' (where competence is understood more broadly than technical competence) and knowing 'self' are important prerequisites for person-centred nursing. Characteristics of the care environment were also found to be critical. Despite the existence of expressed person-centred values, care processes largely remained routinised, ritualistic and affording few opportunities for the formation of meaningful relationships. Person-centred nursing needs to be understood in a broader context than the immediate nurse-patient/family relationship. The person-centred nursing framework has utility in helping to understand the dynamics of the components of person-centredness and overcoming the siloed nature of many current perspectives.