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Nursing

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24

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    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, Caroline
    Aim 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.
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    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.
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    ‘It’s a nice place, a nice place to be’. The story of a practice development programme to further develop person-centred cultures in palliative and end-of-life care
    (Foundation of Nursing Studies (FoNS), 2018-05-16) Dickson, Caroline; Smith, Tracy; Ford, Hilary; Ludwig, Steffi; Moyes, Rhona; Lee, Laura; Adam, Elaine; Paton, Tracy; Lydon, Brigid; Spiller, Juliet; McCormack, Brendan
    Background Palliative and end of life care services need to be person-centred. However, it cannot be assumed that such services are ‘naturally’ person-centred as in reality they face the same pressures and challenges as any other service. This is the case in the practice development research reported in this paper. Whilst the service had good patient and family feedback/satisfaction, the context of care provision for staff did not reflect these same levels of satisfaction. This contrast poses challenges for organisations in the context of staff well-being and the sustainability of person-centred care. The work undertaken in this project aimed to address this issue. Aim To implement a programme of practice development to further the development of a culture of person-centred practice in the Marie Curie Care (MCC) Edinburgh Hospice. Methods The programme was theoretically informed by The Person Centred Practice Framework of McCormack and McCance (2017) and operationalised through the methodology of Transformational Practice Development. Thirteen multidisciplinary team members formed a project group and participated in 10 x 4 hour workshops of learning and development, spread over a 12-month period. Practice development activities were planned in-between the workshops to be undertaken by the group members. Evaluation data were collected prior to the practice development work commencing, as a continuous process throughout the 12-months and at the end of the project period. Data collected included patient and staff stories, practice observations, creative expressions and routinely collected data. These data were analysed through a participatory approach with the group members and theorised through the lens of human flourishing. Findings The findings are located within a framework for exploring the conditions for human flourishing. They illustrate the tension between person-centred care and person-centred cultures. Key findings demonstrate the need for all persons to be ‘known’ in order for effective person-centred relationships to exist, the significance of shared values, the importance of addressing ‘small’ practice changes as well as the need to ensure the hearing of different voices. Findings fromn routine collected data further demonstrate the relationship between the development of a person-centred culture with patient and staff outcomes. Conclusions and Implications for Practice This project is one of the first to explicitly use a framework for human flourishing to analyse the relationship between person-centred culture and care provision. The programme demonstrates the importance of person-centred cultures for sustainable person-centred care. Implications for practice include: 1. Practice settings need to be clear about the difference between patient and person-centredness. 2. The engagement of a multidisciplinary team in interdiscioplinary systematic transformational practice development has the potential to transform the culture and context of care and produce sustaiunable outcomes. 3. Human flourishing is an appropriate focus to adopt in exploring how practice settings embrace the principles of person-vcentredness for all persons.
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    From root to fruit – flourishing in change. Evaluation of a development programme for practice development facilitators in end-of-life care
    (Foundation of Nursing Studies (FoNS), 2018-05-16) Dickson, Caroline; Legg, Melanie; Penman, Pam; Smith, Tracy; Marie Curie
    Background: This paper outlines the structure, processes and outcomes of a 12-month development programme for nurses who were transitioning from a practice-based training role to a practice development role. The programme was part of organisational commitment to develop a person-centred culture. A new team of Practice Development Facilitators across the UK was formed at Marie Curie. Marie Curie, a UK-based charity supporting people with palliative and end of life care needs. Aims and Objectives: The overall aim of the programme was to enable PDFs to engage with the theory and practice of practice development to develop as enablers in the delivery of person-centred practice. Methods: A co-designed multi-method evaluation of the programme that adopted emancipatory practice development and active learning methodologies. Data collection included 4th Generation evaluation, reflective writing, participant stories and examples of practice change. Findings: The programme supported a change in focus of their role from technical to emancipatory. The team identified new ways of engaging together which enabled them to embody person-centredness. By experiencing active learning they came to understand themselves and their practice. Throughout the programme the team experienced a range of organisational challenges which impacted on their progress throughout the programme. Development of their facilitation skills and a strong community of practice will assure embeddedness and sustainability of their new role. Conclusions: Facilitators of Practice Development are a catalyst in developing person-centred cultures which are indicative of flourishing organisations but this needs to be included in organisational strategy. Experiencing flourishing creates a sense of well-being and renewed commitment to develop practice in ways that keep person-centred care at its heart. Key messages: • Making explicit values and beliefs at the beginning of a programme enable social learning and innovation in practice • Investment in PD can be a catalyst to developing person-centred cultures • Role-modelling person-centredness has an impact on staff well-being and person-centred practices • Embedding communities of practice will main momentum in new ways of working