Nursing
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Item Co-creating a strategy for transforming person centred cultures(Frontiers Media, 2025-06-04) Tuqiri, Karen; Murray, Suzanne; Shaw, Dan; Hackett, Kate; McCance, TanyaIntroduction: 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.Item The development and structural validity testing of the Person-centred Practice Inventory–Care (PCPI-C)(Public Library of Science, 2024-05-10) McCormack, Brendan; Slater, Paul F.; Gilmour, Fiona; Edgar, Denise; Gschwenter, Stefan; McFadden, Sonyia; Hughes, Ciara; Wilson, Val; McCance, TanyaBackground: Person-centred healthcare focuses on placing the beliefs and values of service users at the centre of decision-making and creating the context for practitioners to do this effectively. Measuring the outcomes arising from person-centred practices is complex and challenging and often adopts multiple perspectives and approaches. Few measurement frameworks are grounded in an explicit person-centred theoretical framework. Aims: In the study reported in this paper, the aim was to develop a valid and reliable instrument to measure the experience of person-centred care by service users (patients)–The Person-centred Practice Inventory-Care (PCPI-C). Methods: Based on the ‘person-centred processes’ construct of an established Person-centred Practice Framework (PCPF), a service user instrument was developed to complement existing instruments informed by the same theoretical framework–the PCPF. An exploratory sequential mixed methods design was used to construct and test the instrument, working with international partners and service users in Scotland, Northern Ireland, Australia and Austria. A three-phase approach was adopted to the development and testing of the PCPI-C: Phase 1 –Item Selection: following an iterative process a list of 20 items were agreed upon by the research team for use in phase 2 of the project; Phase 2 –Instrument Development and Refinement: Development of the PCPI-C was undertaken through two stages. Stage 1 involved three sequential rounds of data collection using focus groups in Scotland, Australia and Northern Ireland; Stage 2 involved distributing the instrument to members of a global community of practice for person-centred practice for review and feedback, as well as refinement and translation through one: one interviews in Austria. Phase 3: Testing Structural Validity of the PCPI-C: A sample of 452 participants participated in this phase of the study. Service users participating in existing cancer research in the UK, Malta, Poland and Portugal, as well as care homes research in Austria completed the draft PCPI-C. Data were collected over a 14month period (January 2021-March 2022). Descriptive and measures of dispersion statistics were generated for all items to help inform subsequent analysis. Confirmatory factor analysis was conducted using maximum likelihood robust extraction testing of the 5-factor model of the PCPI-C. Results: The testing of the PCPI-C resulted in a final 18 item instrument. The results demonstrate that the PCPI-C is a psychometrically sound instrument, supporting a five-factor model that examines the service user’s perspective of what constitutes person-centred care. Conclusion and implications: This new instrument is generic in nature and so can be used to evaluate how person-centredness is perceived by service users in different healthcare contexts and at different levels of an organisation. Thus, it brings a service user perspective to an organisation-wide evaluation framework.Item 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, DonnaResearch 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.Item The development and validation of the Person-centred Practice Inventory-Student instrument: A modified Delphi study(Elsevier, 2021-02-25) O'Donnell, Deirdre; Slater, Paul; McCance, Tanya; McCormack, Brendan; McIlfatrick, SonjaBackground Global health care policy and regulatory requirements indicate that nursing students must be prepared for person-centred practice. Despite this, there is no evidence of a theoretically derived instrument to measure students' perceptions of person-centred practice.Item 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, GregorBackground: 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.Item 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, FamkeIn 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.Item A meta-synthesis of person-centredness in nursing curricula(Foundation of Nursing Studies, 2020-09-30) O'Donnell, Deirdre; McCormack, Brendan; McCance, Tanya; McIlfatrick, SonjaBackground: 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.Item 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, BrendanAims 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.Item 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, TanyaThe 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.Item 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, BernadetteBackground: 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.