Nursing
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24
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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 German translation, cultural adaptation and validation of the Person-Centred Practice Inventory—Staff (PCPI-S)(BioMed Central, 2023-05-09) von Dach, Christoph; Schlup, Nanja; Gschwenter, Stefan; McCormack, BrendanBackground: The person-centred practice framework represents the cornerstone of a middle-range theory. Internationally, person-centredness has become an increasingly common topic. The measurement of the existence of a person-centred culture is complex and subtle. The Person-Centred Practice Inventory—Staff (PCPI-S) measures clinicians’ experience of a person-centred culture in their practice. The PCPI-S was developed in English. Therefore, the aims of this study were (1) to translate the PCPI-S into German and to cross-culturally adapt and test in the acute care setting (PCPI-S aG Swiss) and (2) to investigate the psychometric properties of the PCPI-S aG Swiss. Methods: The two-phase investigation of this cross-sectional observational study followed the guidelines and principles of good practice for the process of translation and cross-cultural adaptation of self-reporting measures. Phase 1 involved an eight-step translation and cultural adaptation of the PCPI-S testing in an acute care setting. In Phase 2, psychometric retesting and statistical analysis based on a quantitative cross-sectional survey were undertaken. To evaluate the construct validity, a confirmatory factor analysis was implemented. Cronbach’s alpha was used to determine the internal consistency. Results: A sample of 711 nurses working in a Swiss acute care setting participated in testing the PCPI-S aG Swiss. Confirmatory factor analysis indicated a good overall model fit, validating the strong theoretical framework, which underpins the PCPI-S aG Swiss. Cronbach’s alpha scores demonstrated excellent internal consistency. Conclusion: The chosen procedure ensured cultural adaptation to the German-speaking part of Switzerland. The psychometric results were good to excellent and comparable with other translations of the instrument.Item 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, DeborahA 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.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 The Student International Community of Practice: A critical reflection on the shared experience of being a member, using creative hermeneutics(Foundation of Nursing Studies, 2020-05-13) Sanders, Kate; Marriott-Statham, Kelly; Mackay, Maria; McMillan, Ailsa; Rennie, Karen; Robinson, Betty Ann; Teeling, Sean PaulBackground: The Student International Community of Practice is a global network of more than 30 doctoral candidates affiliated with the Centre for Person-centred Practice Research, at Queen Margaret University, Edinburgh. An ongoing challenge the community faces is its changing and growing membership; as members progress and complete their doctoral studies they leave the group, and as the centre grows new community members (doctoral candidates) join.Item German translation, cultural adaptation and testing of the Person‐centred Practice Inventory – Staff (PCPI‐S)(Wiley, 2020-05-26) Weis, Maya L. D.; Wallner, Martin; Köck‐Hódi, Sabine; Hildebrandt, Christiane; McCormack, Brendan; Mayer, HannaAim The aim of this study was to translate and culturally adapt the PCPI‐S into German and to eventually test its psychometric properties in long‐term care settings.Item Relational ethics in palliative care research: Including a person-centred approach(SAGE, 2019-12-19) Haraldsdottir, Erna; Lloyd, Anna; Dewing, JanThe traditional approach to research ethics is to ensure that all ethical issues are adhered to through the scrutiny of research proposals by research ethics committees, themselves sitting within national research governance frameworks. The current approach implies that all potential ethical issues can be considered and mitigated prior to the research. This article is a perspective piece whereby we consider how this approach, on its own, is not enough to ensure ethical practice. We draw attention to the limitations of current ethical procedures in the inherent detachment between the researcher and research participants. We argue that applying a person-centred approach to research ethics allows for contextual and situational factors and places the relationship between research participants and researcher as central.Item Using two models of workplace facilitation to create conditions for development of a person-centred culture: A participatory action research study(Wiley, 2019-04-24) Hardiman, Michele; Dewing, JanAims and objectives: To examine facilitation in workplace learning where nurses are focused on creating person-centred cultures; to provide a framework for novice and proficient facilitators/practitioners to learn in and from their own workplaces and practices; to provide the conditions where practitioners can gain an understanding of the culture and context within their own workplace. Background: Evidence suggests that person-centred cultures depend on purposeful, facilitated practice based learning activities. For person-centredness to become more meaningful to nursing leaders in their daily work, focus must be placed on their acquisition and use of facilitation skills. The facilitation framework ‘Critical Companionship’ remains an exemplar in the development of expert facilitation skills. Two sequential facilitation models were developed as ‘steps’ towards Critical Companionship, as a framework for novice and proficient facilitators and practitioners to learn in and from their own workplaces and practices. Design and Methods: This research, situated in a critical social science paradigm, drew on participatory action research to devise, explore and refine two facilitation models: Critical Allies and Critical Friends. The researcher adopted an insider approach to work with five nursing leaders, which was subsequently reported using the EQUATOR Guidelines for Best Practice in the reporting of Participatory Action Research. Results: Show the complexity of enabling facilitation within the workplace. Four themes and twelve sub-themes emerged from the data that describe the attributes needed to facilitate workplace learning and reveal that mangers can have an active role in enabling person-centred culture development. Conclusions: This research adds to the body of knowledge on developing person-centred culture. It offers practical stepping stones for novice and proficient facilitators to enable embodiment of the skills necessary to facilitate learning in person-cultures. The models offer a workplace friendly pathway with practical methods and further contribute to our understanding of how we create person-centred cultures. Relevance to Clinical Practice Facilitation of practice development and workplace learning remains the most effective methods to develop person-centred cultures. This research introduces a pathway for clinical leaders/managers to become facilitators with their own teams, maximising the impact on the culture where care is delivered.Item ‘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, BrendanBackground 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.