Nursing
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24
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Item Implementation of learning into person-centred practice: evidence of impact from community nursing preparation programmes(Frontiers Media S.A., 2025-08-08) Tyagi, Vaibhav; Churchill, Julie; Dickson, CarolineIntroduction: There has been a global move towards personalising and “humanising” healthcare and promoting caring cultures. Education is addressing this agenda by incorporating person-centred principles into teaching and learning. The aim of this research was to explore the implementation of person-centred learning into healthcare practice. More specifically, this study aims to explore community nurses' implementation of learning about person-centredness in their practice and to demonstrate the impact of person-centred curriculum. Methods: A cross-sectional quantitative survey design was used with community nursing graduates and current students who engaged with person-centred curricula. Results: Significant improvements were found in three constructs of person-centred practice—clarity of beliefs and values, knowing self and developed interpersonal skills. Discussion: These findings provide support for the development of pre-requisites of person-centred practice, rather than person-centred processes in pre-registration curricula. With key pre-requisites for person-centred practice such as leadership attributes of knowing self and of advanced communication skills, learners and graduates will be able adopt healthful leadership practices which are vital in developing others and in creating person-centred cultures.Item Becoming a person-centred facilitator of learning in a hospital setting: Findings from a participatory action-oriented study with hospital-based educators(Elsevier, 2024-12-13) Robinson, Betty Ann; McCormack, Brendan; Dickson, CarolineAim Investigate the experience of hospital-based educators becoming person-centred facilitators of learning. Background Hospital-based educators working with staff are not well-prepared for their role. No person-centred pedagogical approaches exist specifically for use in hospital settings. Educators are positioned to advance person-centredness in clinical practice. To do so they need knowledge and skills in person-centred approaches. Little is known about how educators transform from teacher-centred approaches to person-centred facilitation. This study investigated how educators learn about and use person-centred principles to acquire educational theory and become person-centred facilitators. Design Participatory, action-oriented research Methods Guided by four person-centred principles blending relational inquiry and practice development, 10 educators participated in group and individual sessions over 18 months. Data were analyzed using relational inquiry and critical creative hermeneutics. Results Becoming person-centred facilitators was enabled through three principles: starting with self, developing community and belonging and bumping against culture and inviting transformation. Participants became person-centred facilitators through intrapersonal, interpersonal and contextual transformations during moments of discovery, reconciliation and action. Competence developed by experiencing and using four methodological principles of taking a relational stance; using active learning to learn in and from practice; being collaborative, inclusive and participatory; and linking creativity with cognition. This model resulted in improved trust, strengthened relationships and more meaningful and robust learning outcomes. Conclusions Hospital-based educators can be enabled to become person-centred facilitators by providing them with person-centred learning opportunities. The four methodological principles, as a model for person-centred education, provided an effective preparation and orientation to educational and person-centred theory.Item Women's experiences of the transition to motherhood and self-compassion(Mark Allen Group, 2024-09-20) Hunter, Stephanie; Dickson, CarolineHealth visitors have a pivotal role in supporting women in their transition to motherhood, equipping them with the necessary skills and knowledge to help them cope and thrive. This review was conducted to appraise the current literature around the role of self-compassion in the transition to motherhood and women's experiences of this, as well as the effectiveness of self-compassion on women's psychological wellbeing in this transition. Databases were searched against an inclusion criterion and 11 studies were selected for review. Review findings give insights into how self-compassion practices can aid the transition to motherhood by mitigating psychological challenges and promoting maternal wellbeing and mother–infant bonding. Self-compassion training opportunities should be provided to health visitors and other health professionals working with women from pregnancy, to competently deliver and facilitate such interventions.Item Building an Inclusive Research Culture(Springer, 2020-12-23) Baldie, Debbie; Dickson, Caroline; Sixsmith, Judith; Sixsmith, Andrew; Sixsmith, Judith; Mihailidis, Alex; Fang, Mei LanItem Unpacking and Developing Facilitation(Wiley-Blackwell, 2021-05) Middleton, Rebekkah; Kelly, Margaret; Dickson, Caroline; Wilson, Valerie; van Lieshout, Famke; Hirter, Kathrin; Boomer, Christine; Manley, Kim; Wilson, Valerie J.; Oye, ChristineItem 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, SuzanneItem Leadership practices that enable healthful cultures in clinical practice: A realist evaluation(2023-12-06) Dickson, Caroline; Merrell, Joy; Mcilfatrick, Sonja; Westcott, Liz; Gleeson, Nigel; McCormack, BrendanAim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. ‘Knowing self’ as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution.Item Embedding storytelling in practice through CAKE – a recipe for team wellbeing and effectiveness(Foundation of Nursing Studies (FONS), 2023-05-24) Dickson, Caroline; MacDonald, KathBackground: CAKE, an interactive resource to promote individual and team wellbeing and effectiveness through storytelling was co-designed with community nurses in 2020. In Phase 1 of this project, CAKE comprised seven slices that guided teams through a process of connecting, storytelling, reflecting and action planning to promote wellbeing. It was developed in response to an increasing awareness of psychological harm experienced by nurses and other healthcare professionals. Levels of stress in the workplace are currently contributing to problems with recruitment and retention, and a lack of resources have impacted on practitioners’ wellbeing, and their ability to be compassionate caregivers and to contribute to healthful teams. Aim: Phase 2 of the project sought to: 1) develop facilitators of CAKE; 2) pilot test the prototype CAKE resource in a range of contexts; and 3) create a digital version of CAKE. Methods: An evaluation approach to pilot testing, using multiple methods of data collection, involved 130 health and social care practitioners at 17 sites across the UK. Eight facilitator support sessions, underpinned by the Critical Ally model were offered and data were analysed using thematic analysis. Findings: The findings revealed two overarching themes: facilitating CAKE and experiencing CAKE. In the former, three themes emerged: preparing for CAKE, trying CAKE and embedding CAKE. The latter had two themes: giving it a go and culture change. Following the study, the number of CAKE slices was increased from seven to eight by separating reflection and action planning, and minor amendments were made around spelling and grammar. Conclusion: We propose CAKE as a novel resource to promote individual and team wellbeing and effectiveness in health and social care teams. CAKE users acknowledge the challenges in creating space to use the resource, but when it is implemented teams embed practices that create healthful teams. As facilitators use CAKE, they develop their facilitation skills but they require preparation and support.Item UK Nurses’ and Midwives’ experiences of healthful leadership practices during the COVID‐19 pandemic: A Rapid Realist Review(Wiley, 2022-09-05) Dickson, Caroline; Davies, Caitlin; McCormack, Brendan; Westcott, Liz; Merrell, Joy; Mcilfatrick, Sonja; Dewing, JanAim We aim to explore healthful leadership practices in nursing and midwifery evident within the COVID-19 pandemic in the United Kingdom, the contextual facilitators, barriers and outcomes. Background Globally, the health and care sectors are under pressure and despite nurses and other professionals, demonstrating resilience and resourcefulness in the COVID-19 pandemic; this has negatively impacted on their health and wellbeing and on patient care. Evaluation Two searches were conducted in July 2021 and December 2021. Inclusion/exclusion criteria were identified to refine the search, including papers written since the beginning of the pandemic in 2020. A total of 38 papers were included principally from the United States and United Kingdom. Ten were research papers; the others were commentaries, opinion pieces and editorials. MS Teams literature repository was created. A unique critical appraisal tool was devised to capture contexts, mechanisms and outcomes whilst reflecting more standardized tools, that is, the Critical Appraisal Skills Programme and the Authority, Accuracy, Coverage, Objectivity and Date tool for reviewing grey literature to refine the search further. Key issues Six tentative theories of healthful leadership emerged from the literature around leadership strategies, which are relational, being visible and present; being open and engaging; caring for self and others; embodying values; being prepared and preparing others; and using available information and support. Contextual factors that enable healthful leadership practices are in the main, created by leaders' values, attributes and style. The literature suggests that leaders who embody values of compassion, empathy, courage and authenticity create conditions for positive and healthful relations between leaders and others. Nurse and midwives' voices are however absent from the literature in this review. Conclusion Current available literature would suggest healthful leadership practices are not prioritized by nurse leaders. Perspectives of nurses' and midwives' about the impact of such practices on their wellbeing is also missing. Tentative theories are offered as a means of identifying healthful leadership strategies, the context that enable these and potential outcomes for nurses and midwives. These will be explored in phase two of this study. Implications for Nursing Management Nurse leaders must be adequately prepared to create working environments that support nurses' and midwives' wellbeing, so that they may be able to provide high-quality care. Ensuring a supportive organizational culture, which embodies the values of healthfulness, may help to mitigate the impact of the COVID-19 pandemic on nurses' and midwives' wellbeing in the immediate aftermath and going forward.Item Achieving congruence in ‘being and doing’ community nursing(Mark Allen Group, 2022-06-02) Dickson, CarolineConceptual and theoretical frameworks for person-centred community nursing practices have not yet been fully developed. There is a need to explore this further in order to guide future district nursing, which forms part of the community nursing discipline in the UK. The contemporary district nursing role is undergoing change, although there appears to be little consensus about the district nurse's (DN) vision across the UK, and little indication of the theoretical position underpinning this change. Meeting strategic requirements ( National Health Service (NHS), 2019 ; Scottish Government (SG), 2017a & b ), DNs have advancing clinical expertise and are recognised for their technical skills. However, one may contend that this emphasis on ‘doing’ in practice contributes to practice decisions made exclusively on task performance by strategic decision-makers, and DNs continually viewing themselves as invisible ( National Assembly for Wales,, 2019 ; Queens Nursing Institute (QNI), 2006 ; Dickson 2018 ; 2020 ). District nursing education may contribute to this lack of clarity as curricula are based on borrowed theory from other disciplines that continue to focus on ‘how to do’, with little emphasis on ‘how to be’ a DN, and the continued decrease in DN numbers across the UK may be a consequence. In this paper, I explore current evidence that underpins district nursing practice, education and research in the UK, and advocate the use of the Person-centred Practice Framework (PCPF) ( McCormack and McCance, 2017 ) as a means of unifying and guiding ‘being a person-centred DN.’ This will enable practitioners who can draw on multiple forms of evidence to inform their advancing practice. This article offers philosophical and pedagogical principles to underpin person-centred education going forward. I argue this will promote congruence between ‘doing’ and ‘being’ a DN, giving a voice to DNs, and direction to their specialism.