Browsing by Person "McCance, Tanya"

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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.
Being person‐centred in community and ambulatory services
(Wiley-Blackwell, 2021-02) Dickson, Caroline; Peelo‐Kilroe, Lorna; McCormack, Brendan; McCance, Tanya; Bulley, Catherine; Brown, Donna; McMillan, Ailsa; Martin, Suzanne
Chapter 6: Professionalism and practising professionally
(Wiley, 2020-12) Gibson, Caroline; MacDonald, Kath; Deirdre O’Donnell; McCormack, Brendan; McCance, Tanya; Bulley, Catherine; Brown, Donna; McMillan, Ailsa; Martin, Suzanne
Co-creating a strategy for transforming person centred cultures
(Frontiers Media, 2025-06-04) Tuqiri, Karen; Murray, Suzanne; Shaw, Dan; Hackett, Kate; McCance, Tanya
Introduction: Transforming healthcare systems to support person-centred practice reflects environments where individual values and beliefs are respected and where healthful cultures can flourish. However, there are significant challenges within healthcare systems that impact on the development of healthful workplace cultures. The nursing and midwifery professions need to play an influential role in formulating health policy and decision-making to contribute to health and social care systems that are underpinned by person-centredness. This paper reports the use of a practice development approach underpinned by the Person-Centred Practice Framework to co-create a strategy for nurses and midwives that will enable the development of person-centred healthcare practices. The key objectives are to demonstrate the processes that support co-creation to build consensus on what is strategically important to nurses and midwives; to gain an understanding of the value of external facilitation throughout the process and exploring the challenges encountered during the development of the strategy. Methods: Practice Development methodology was the approach used with skilled facilitation adopted to enable the working with values and beliefs, defining purpose and vision and establishing agreed working principles and behaviours. Consensus building methods were used to co-create draft strategy priorities further defined by wider stakeholder engagement. Results: A 5-year strategy was co-created with senior nursing and midwifery leaders, inclusive of key strategic priority areas and strategic actions. The seven priority areas align to the Person-Centred Practice Framework with underpinning shared purpose and values. (1) Developing Person-Centred Cultures, (2) Creating a Supportive Practice Environment, (3) Building Research Capacity, (4) Building a Dynamic Workforce, (5) Fostering Leadership at all Levels, (6) Enhancing Digital Informatics and New Technologies, (7) Delivering High Quality, (8) Safe Person-Centred Care. Together they provide a roadmap for implementation across the many nursing and midwifery contexts providing a solid foundation for leading and supporting person-centred practice across a large local health district with a focus on what matters most while continuing to be innovative in approaches to practice. The development of a clear shared purpose of person-centred practice and the exploration of values were critical first steps in the development of the strategy and provided a clear foundation from which the nursing and midwifery leaders could utilise for the ongoing strategic priorities and action discussions. Implications for practice: The development of nursing and midwifery strategy using Practice Development Methodology and the Person-centred Practice Framework enables critical dialogue that supports nursing and midwifery leaders identify key influences over nursing and midwifery practice. This approach not only fosters a sense of ownership and engagement among nurses and midwives but also ensures that their values, beliefs, and professional insights are integral to the strategic direction of healthcare practices. By aligning the strategy with the Person-Centred Practice Framework, nurses and midwives are better able to develop a shared understanding of person-centred practice where the individual needs and preferences of patients, families and staff are acknowledged. Overall, this strategy represents a significant step forward in supporting the professional development of nurses and midwives, enhancing the quality of patient care, and fostering a healthful culture where continuous improvement and innovation are at the forefront of the healthcare system.
Compassion in facilitating the development of person-centred health care practice
(BioMed Central, 2015-06) van Lieshout, Famke; Titchen, Angie; McCormack, Brendan; McCance, Tanya
Background Person-centred practice, which includes compassion, needs to be well facilitated in order to flourish in healthcare settings. Facilitation is known to be complex and requires expert knowing and skills. The importance of adequate facilitator support is recognised. The literature however is unclear about the nature of this support and how it can be offered to facilitators while engaging with others in real world practice contexts. Case description This paper presents a lived experience of a doctoral student working as a facilitator with clinical nurses and their leaders, to develop person-centred health care practice, through action research. Compassion with others and self is apparent throughout the experience. It illustrates a facilitator's felt need to respond to this emotion that is triggered in the engagement with others, but which often is hindered by the context and perceptions of the situation. This causes imbalance within the facilitator, which in turn challenges the achievement of synchronous working with practitioners and the development of person-centred practice. Discussion A strong interplay between contextual and facilitator characteristics in the relationship with others impacts on the development of person-centredness in practice. Therefore compassion, as one of the attributes of person-centred practice, is fragile and fluid when lived in facilitative practice. A compassionate system of support is suggested to enable an understanding of context and self, in order to become and remain a person-centred, compassionate, facilitator in dynamic health care contexts. Conclusion A compassionate system of support has the potential to help professionals to navigate the context, without losing oneself, in the process of enabling person-centred, compassionate practice to thrive. Such support suggest an 'ethic of care' for the facilitator in discovering and engaging with the emotional context of facilitating person-centred practice.
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 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.
Development of a model of situational leadership in residential care for older people
(Wiley, 2011-11) Lynch, Brighide; McCormack, Brendan; McCance, Tanya
Aim The aim of the present study was to present the process used to develop a composite model of situational leadership enacted within a person-centred nursing framework in residential care. Background Transforming the culture of the residential unit from a restrictive institution to a vibrant community of older adults requires transformational leadership. Situational leadership is one form of transformational leadership, which claims that there is not one leadership style that works in all situations.Method A model of situational leadership in residential care was developed through a series of systematic steps that identified direct linkages between situational leadership and the main constructs of the Person-Centred Nursing Framework. The process included reviewing the evidence, undertaking a comparative analysis, identifying key concepts, connecting the concepts and developing a model.Conclusion A conceptual model is presented which integrates person-centredness with leadership thinking in order to effectively impact on the follower's performance in managing the care environment and delivering person-centred care.Implications for Nursing Management Currently the model is being utilized in an action research study to evaluate the role of leaders in the practice setting of long-term care. While some of the connecting concepts have been identified in the present study, more work needs to be done to unravel these connections in further study of leaders in practice.
Examining the theoretical relationship between constructs in the person-centred practice framework: A structural equation model
(MDPI, 2021-12-13) McCance, Tanya; McCormack, Brendan; Slater, Paul; McConnell, Donna
Research relating to person-centred practice continues to expand and currently there is a dearth of statistical evidence that tests the validity of an accepted model for person-centred practice. The Person-centred Practice Framework is a midrange theory that is used globally, across a range of diverse settings. The aim of this study was to statistically examine the relationships within the Person-centred Practice Framework. A cross sectional survey design using a standardized tool was used to assess a purposive sample (n = 1283, 31.8%) of multi-disciplinary health professionals across Ireland. Survey construct scores were included in a structural model to examine the theoretical model of person-centred practice. The results were drawn from a multi-disciplinary sample, and represented a broad range of clinical settings. The model explains 60.5% of the total variance. Factor loadings on the second order latent construct, along with fit statistics, confirm the acceptability of the measurement model. Statistically significant factor loadings were also acceptable. A positive, statistically significant relationship was observed between components of the Person-centred Practice Framework confirming it’s theoretical propositions. The study provides statistical evidence to support the Person-centred Practice Framework, with a multidisciplinary sample. The findings help confirm the effectiveness of the Person-Centred Practice Index for-Staff as an instrument that is theoretically aligned to an internationally recognised model for person-centred practice.
Identifying key performance indicators for nursing and midwifery care using a consensus approach
(2011) McCance, Tanya; Telford, Lorna; Wilson, Julie; MacLeod, Olive; Dowd, Audrey
Aims.- The aim of this study was to gain consensus on key performance indicators that are appropriate and relevant for nursing and midwifery practice in the current policy context. Background.- There is continuing demand to demonstrate effectiveness and efficiency in health and social care and to communicate this at boardroom level. Whilst there is substantial literature on the use of clinical indicators and nursing metrics, there is less evidence relating to indicators that reflect the patient experience. Design.- A consensus approach was used to identify relevant key performance indicators. Methods.- A nominal group technique was used comprising two stages: a workshop involving all grades of nursing and midwifery staff in two HSC trusts in Northern Ireland (n = 50); followed by a regional Consensus Conference (n = 80). During the workshop, potential key performance indicators were identified. This was used as the basis for the Consensus Conference, which involved two rounds of consensus. Analysis was based on aggregated scores that were then ranked. Results.- Stage one identified 38 potential indicators and stage two prioritised the eight top-ranked indicators as a core set for nursing and midwifery. The relevance and appropriateness of these indicators were confirmed with nurses and midwives working in a range of settings and from the perspective of service users. Conclusions.- The eight indicators identified do not conform to the majority of other nursing metrics generally reported in the literature. Furthermore, they are strategically aligned to work on the patient experience and are reflective of the fundamentals of nursing and midwifery practice, with the focus on person-centred care. Relevance to clinical practice.- Nurses and midwives have a significant contribution to make in determining the extent to which these indicators are achieved in practice. Furthermore, measurement of such indicators provides an opportunity to evidence of the unique impact of nursing/midwifery care on the patient experience.
Implementing person‐centred key performance indicators to strengthen leadership in community nursing: A feasibility study
(Wiley, 2020-08-13) McCance, Tanya; Dickson, Caroline; Daly, Laura; Boomer, Christine; Brown, Donna; Lynch, Brighide; MacArthur, Juliet; Mountain, Kristina; McCormack, Brendan
Aims To explore the utility and feasibility of implementing eight person‐centred nursing key performance indicators in supporting community nurses to lead the development of person‐centred practice.
A meta-synthesis of person-centredness in nursing curricula
(Foundation of Nursing Studies, 2020-09-30) O'Donnell, Deirdre; McCormack, Brendan; McCance, Tanya; McIlfatrick, Sonja
Background: Person-centred approaches to practice are synonymous with effective healthcare. It is therefore important that the nursing workforce values, recognises and demonstrates person-centred practice. This has implications for nursing education and how curricula prepare students for person-centred practice.
Patients' experiences of in-hospital care when nursing staff were engaged in a practice development programme to promote person-centredness: A narrative analysis study
(Elsevier, 2015-05-11) Laird, Elizabeth A.; McCance, Tanya; McCormack, Brendan; Gribben, Bernadette
Background: The drive towards person-centred approaches to care delivery has been increasingly promoted. This is in response to the significant challenges within health and social care organisations, which impact on the care experience for patients and their families. Objective: The aim of this paper is to illuminate the experiences of patients of care received in hospital wards during the intervention phase of a programme to develop person-centred practice. Design: A narrative enquiry study was conducted which is a particular way of exploring complex cultural or social patterns. Structural narrative analysis was used to generate explanation and interpretation of in-hospital patients' care experience. Setting: Recruitment was from four different hospital sites in one health care organisation, focussing on patients who were admitted to the nine wards/units where the nursing teams were participating in a practice development programme that had the intention of promoting person-centredness. Participants: Participants were people aged over 18 and receiving care and treatment in the identified wards/units. Twenty-six patients were recruited. Methods: Narrative interviews were audio-recorded at four month intervals and transcribed. The records were subjected to a process of structural analysis. Results: The findings offer insight into patients' experiences of care in a range of clinical settings in which an explicit intervention to promote person-centred practice was underway. There was one overriding theme formulated: Vulnerability at the junctures of systems, care processes and nurses' responses. From this main theme, we derived four sub-themes: (1) confronting vulnerability, (2) experiencing exemplary care, (3) experiencing misalignments in systems, care processes and nurses' responses, and (4) sharing in a sense of belonging with ward nurses. Conclusions: In-hospital patients are exposed to vulnerability in the care experience. They placed value on exemplary care. Experiences of misalignments in systems, care processes and nurses' responses disempower patients and heighten a sense of vulnerability. The ward nursing teams were generating a family like atmosphere. Patients responded by sharing a sense of belonging with ward nurses. These findings confirm components that have influenced the development of person-centred practice, such as the importance of the context and culture of care. They also offer new insights that may contribute to on-going practice development work. 2015 Elsevier Ltd.
Perceived caring attributes and priorities of pre-registration nursing students throughout a nursing curriculum underpinned by person-centredness
(Wiley, 2018-03-08) Cook, Neal F.; McCance, Tanya; McCormack, Brendan; Barr, Owen; Slater, Paul
Aim This paper explores pre-registration nursing students' caring attributes development through a person-centred focused curriculum.
Person-centred community nursing
(Wiley-Blackwell, 2016-07) Dickson, Caroline; McCormack, Brendan; McCance, Tanya
Person-centred community nursing
(Wiley Blackwell, 2016-08) Dickson, Caroline; McCance, Tanya; McCormack, Brendan
Person-centred Leadership: a relational approach to leadership derived through action research
(Wiley-Blackwell, 2018-04-09) Cardiff, Shaun; McCormack, Brendan; McCance, Tanya
Aims & Objectives: How does person-centred leadership manifest in clinical nursing. Background: Person-centred practice fosters healthful relationships and is gaining increasing attention in nursing and healthcare, but nothing is known about the influence of a person centred approach to leadership practice. Most leadership models used in nursing were originally developed outside of nursing. Design: A three year participatory action research study where participant leaders planned, researched and learned from their practice development. Methods: After an orientation phase, four action spirals focused on: critical and creative reflective inquiries into leadership practice change; leading the implementation and evaluation of a new nursing system; facilitating storytelling sessions with staff and annually reflecting on personal leadership change. Multiple data gathering methods offered insight into leadership development from several perspectives. Results: Critical and creative thematic data analysis revealed a set of attributes, relational processes and contextual factors that influenced the being and becoming of a person-centred leader. Comparing the findings with nursing leadership literature supports a conceptual framework for person-centred leadership. Conclusions: Person-centred leadership is a complex, dynamic, relational and contextualised practice that aims to enable associates and leaders achieve self-actualisation, empowerment and wellbeing.
A person-centred observational tool: Devising the Workplace Culture Critical Analysis Tool®
(Foundation of Nursing Studies, 2020-02-12) Wilson, Val; Dewing, Jan; Cardiff, Shaun; Mekki, Tone Elin; Øye, Christine; McCance, Tanya
The Workplace Cultural Critical Assessment Tool (WCCAT) is a participant observational tool developed a decade ago to capture evidence about workplace culture that can then be used to support practice development initiatives. The WCCAT has been applied extensively across the world in a range of healthcare settings. Since its inception, practice development has progressed and it is now explicitly linked to advancing person-centred cultures. With this in mind, it seemed timely to revise the WCCAT to reflect the progress made within practice development, and strategically link the tool to person-centred practice and achieving person-centred outcomes. This revision (WCCAT®) has been undertaken by members of the International Community of Practice (the authors of this article), whose focus is person-centred practice research. This article outlines the process undertaken for the revision and for the alignment of the revised tool with the Person-centred Practice Framework. Guidance is provided on when, why and how to use the tool to capture participant observational data that highlights evidence of person-centred practice. Detailed information and cues to support the observer in collecting and analysing data are provided, along with suggestions for facilitating feedback of data and subsequent action planning to support changes in practice. The benefits and limitations of using the WCCAT® are outlined.
Phenomenological and hermeneutic approaches to person-centred nursing research
(Springer, 2021-04-27) Rennie, Karen; Gibson, Caroline; Saev, Elmira; Dewing, Jan; McCormack, Brendan; McCance, Tanya
We are Karen, Caroline and Elmira and we are three nurses who are engaged in PhDs with the Person-centred Practice Research Centre at Queen Margaret University (QMU), Edinburgh—although Elmira is registered at The University of Malta. In this chapter, we explore how phenomenological and hermeneutic approaches can offer one methodology to come to know and do person-centred research. We will take you, the reader, on a journey to show how we evolved the chapter; how we worked together, shared our experiences on how we believe phenomenological and hermeneutic approaches have strong connections to person-centred research. Within this chapter, you will hear the individual perspectives of the three of us. Yet will be able to feel how the three authors as unique individuals came together as one. We believe that three key messages emerge from this chapter. Firstly, phenomenology and person-centredness can be interwoven and intertwined through its strong connections for not only doing research, but our worldviews. Secondly, the hermeneutic process tries to see beyond what we take as obvious and straightforward. It encourages us to recognise alternative viewpoints and thus can shift our focus to what does it mean to be a person in the world. Thirdly, the process of becoming an engaged observer can help person-centred practice researchers to understand the importance of knowing who we are, knowing others, and developing practices as relationally based experience, which in turn contributes to meaning-making on the whole experience of being person-centred.
Review of developments in person-centred healthcare
(Foundation of Nursing Studies, 2020-09-30) Phelan, Amanda; McCormack, Brendan; Dewing, Jan; Brown, Donna; Cardiff, Shaun; Cook, Neal F.; Dickson, Caroline; Kmetec, Sergej; Lorber, Mateja; Magowan, Ruth; McCance, Tanya; Skovdahl, Kirsti; Štiglic, Gregor; van Lieshout, Famke
In recent years, there has been a shift in orientation towards person-centredness as part of a global move towards humanising and centralising the person within healthcare. Person-centredness, underpinned by robust philosophical and theoretical concepts, has an increasingly solid footprint in policy and practice, but research and education lag behind. This article considers the emergence of person-centredness, including person-centred care, and how it is positioned in healthcare policy around the world, while recognising a dominant philosophical positioning in Western philosophy, concepts and theories. Second, the evolution of person-centred healthcare over the past five years is reviewed. Published evidence of person-centred healthcare developments is drawn on, as well as information gathered from key stakeholders who engaged with the partner organisations in an Erasmus+ project to develop a European person-centred healthcare curriculum framework. Five themes are identified, which underpin the literature and stakeholder perspectives: Policy development for transformation Participatory strategies for public engagement Healthcare integration and coordination strategies Frameworks for practice Process and outcome measurement These themes reflect the World Health Organization’s global perspective on people-centred and integrated healthcare, and give some indication of development priorities as person-centred healthcare systems continue to be developed.