Compassion in facilitating the development of person-centred health care practice

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.sch_nur2pub4155pub

Person-centredness - The ‘state’ of the art

Background: Person-centred practice is now firmly embedded in the nursing and healthcare discourse. While there is a growing body of development and research activity in the field, there is increased recognition of the need for further advances in the body of existing knowledge. This is reflected in the different approaches to person-centredness being adopted by healthcare systems internationally. Aims: To provide an overview of person-centredness and ways in which person-centred practice has been adopted in healthcare systems internationally. Methods: A summary review of the evidence underpinning the concepts and theory of person-centredness, incorporating an overview of national strategic frameworks that influence the development of person-centred practice in different countries. Findings: While there have been considerable advances in the development of person-centredness, there is a lot of work to be done in the adoption of more consistent approaches to its development and evaluation. In particular, a shared discourse and measurement tools are needed. Internationally, person-centredness is gaining momentum and many countries have strategic frameworks in place to direct its development and implementation

Developing philosophical and pedagogical principles for a pan-European person-centred curriculum framework

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Background: 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.Aim: To identify key principles that have the potential to create an international curriculum framework for the education of person-centred healthcare practitioners.Methods: A hermeneutic praxis methodological approach was used, where multiple rounds of data analyses were conducted. These were initially undertaken in each country, then collaboratively with partners, while engaging with other forms of evidence.Findings: The project group generated a set of principles embedded in four philosophical dimensions: (i) transformative; (ii) co-constructed; (iii) relational; and (iv) pragmatic. The purpose of the curriculum was identified as being transformative, facilitating journeying through knowing, doing, being and becoming a competent and committed person-centred practitioner. A person-centred curriculum is built on a philosophy of pragmatism, adopts a co-constructionist approach to curriculum design and implementation, and encourages connectivity with self, other persons and contexts. Pedagogical principles, aligned to the four philosophical dimensions, identified the required learning environment, and the learning, teaching and assessment approaches required to educate person-centred healthcare practitioners.Conclusion: This article represents steps to foster a more focused and engaging way of implicitly and explicitly embedding person-centred care in curricula. Our theoretical framework has enabled us to consider the different layers of practice while staying true to the purpose of curriculum design. The presentation of the framework in this article makes it available for wider critique to those with an interest in this area of study.Implications for practice: The draft framework provides an opportunity for curriculum teams to critically reflect on and have dialogue around current curricula Person-centred curricula have the potential to improve service-user experiences of care Prepared person-centred practitioners will contribute to person-centred cultures Students and practitioners will experience person-centredness Practitioners will be bold and innovativehttps://doi.org/10.19043/ipdj.10Suppl2.00410pubpubSuppl

Review of developments in person-centred healthcare

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Tanya McCance - ORCID: 0000-0002-9787-2627 https://orcid.org/0000-0002-9787-2627In 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.https://doi.org/10.19043/ipdj.10Suppl2.00310pubpubSuppl

Taking Action for action : a study of the interplay between contextual and facilitator characteristics in developing an effective workplace culture in a Dutch hospital setting, through action research

Abstract Implementing change and transforming nursing practice is not a linear but a complex process. The evidence within practice development (PD) and participatory action research (PAR) suggests that not enough is known about the interplay between the researcher’s characteristics and the contextual factors, in the facilitation of PAR. This study aims to understand this interplay in the development of evidence-based and person-centred practice through PAR, in collaboration with nurses and management at a centre for oncology in a Dutch hospital. The study is guided by a praxis methodology in which different philosophical perspectives are used to connect theory with the practice of PAR. Emancipatory praxis guides the transformation of practice through PAR and hermeneutic praxis guides the understanding of the reality of facilitating PAR within a specific context. The research approach integrates a mix of creative, cognitive and reflective methods. A variety of data about initiating action research in a clinical setting were collected and put into the form of a story in order to engage in a reflexive analysis, inspired by Van Manen’s principles of human science. Findings emphasise the importance of the orientation phase within PAR and suggest that it is essential for facilitators, in particular those new to the methodology, to create a system of support to help them to understand the characteristics of the context. This is necessary in order to create balance in their facilitation that is acceptable both to oneself and the context and which can then achieve synchronous working with practitioners. This study adds greater clarity to the existing body of knowledge about how facilitators of PAR can be helped to engage with the complexity of cultures in different contexts. It demonstrates that there are essential conditions necessary for facilitating PAR, these are captured within a ‘compass’-model. Principles for action for researchers of PAR are explained that are assumed to contribute to the development of researchers’ expertise engaged in the facilitation of PAR.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Reflections on being and becoming a person-centred facilitator

Background: Facilitation is vital for effective practice development and is viewed as an holistic means of enabling practitioner emancipation, development of self and effective workplace cultures. Person-centredness is a core value enacted in effective workplace cultures and focuses on enabling personhood, or the ‘coming into own’ and flourishing of self and others. Combining the concept of facilitation with person-centredness implies developing connected relationships in which both facilitator and those facilitated feel acknowledged and respected as persons who are able to develop and grow. This in turn implies that the facilitator is also in a constant state of being and becoming, which can be supported and guided by principles for action. Aims and objectives: The aim of this paper is to present principles for person-centred facilitation derived from a critical and creative reflective inquiry into the authors’ experiences of facilitating participatory action research. The four key principles for developing and sustaining person-centred facilitation are illustrated in this paper using a conversational narrative. Conclusion: Individuals and relationships are continuously subjected to constant intrapersonal, interpersonal and contextual influences, so being a person-centred facilitator in everyday healthcare practice is no mean feat. It is proposed that the four principles – being other-centred without losing self, valuing a constant state of becoming, maintaining relational connectedness and consciously working with context and cultures – help sustain balance in self and relational reciprocity while facilitating practice development in a person-centred way. Relevance to practice development: Reflection in action using the four principles can support person-centred facilitation of practice development. Those supporting (novice) facilitators may also find the principles useful in formulating critical questions to guide reflection on action

Innovative Ways of Analysing Data with Practitioners as Co-Researchers: Dancing outside the ballroom

Conducting research as part of a PhD study offers students a unique opportunity to explore new methods and methodologies. Although we each based our PhD studies on a more traditional participatory action research (PAR) methodology, we also took the opportunity to experiment with a new data analysis method. Working from a critical social science paradigm (Fay, 1987) that translates into critical and collaborative research practice with an emancipatory intent, our scope of freedom as to how to process data, perform the analyses, then synthesise and report the results, became restricted. We felt that if we were to be genuine in involving practitioners in data analysis, as co-researchers, we needed to adopt approaches that allowed the expression of all ways of knowing. Using the creative arts proved to be an innovative way of working and learning, facilitating the complex interpretation of narrative data, identifying patterns, themes and connections. As in all qualitative research, in order to enhance process and outcome rigour, the (learning) strategies and methods used by researchers should be congruent with the principles characteristic of the chosen methodology. In this chapter, we want to offer you, the reader, a deeper insight into the key principles underlying this method for data analysis, before describing how we "danced" with them in each of our studies. Building on the original work of Boomer and McCormack (2010), who used the key principles of practice development, namely participation, inclusion and collaboration,i we developed a "critical and creative data analysis framework". This framework rests on the three main philosophical principles of hermeneutics,criticality, and creativity. Applying these principles to data analysis we have learned that multiple perspectives usually show more similarities than differences, which we express visually and poetically in Figure 22.1. The interface between two perspectives is not a juxtaposition but a fluid transition, where the sky meets the sea and the sea meets the sand. Each is separate and yet part of the whole, bigger picture

Lecturer-Practitioner: een nieuwe rol voor verpleegkunde

De theorie-praktijk kloof is al menige jaren onderwerp van discussie zowel in de literatuur als op de werkvloer, in Nederland en in het buitenland. Sinds het beëindigen van de in-service opleiding voor verpleegkundigen in de jaren '90 lijkt de discussie alleen maar toegenomen te zijn. Met het herontwerpen van haar curriculum heeft Fontys Hogeschool Verpleegkunde getracht expliciet aandacht te besteden aan de zogenoemde theorie-praktijk kloof. De noodzaak hiervoor werd bevestigd gedurende studiedagen in 2004 waarbij Fontys Hogeschool Verpleegkunde contact had met partners vanuit de praktijkinstellingen. Naast een grondige herziening van het 'bachelor' curriculum werd besloten om, onder leiding van het lectoraat 'Implementeren en Evalueren van Evidence Based Practice', een (nieuwe) rol te ontwikkelen middels actieonderzoek, die de interactie tussen theorie en praktijk zal moeten gaan bevorderen: de rol van Lecturer-Practitioner (LP). Als leden van de experimentgroep, werkzaam zowel in onderwijs -als praktijk instelling, beschrijven de auteurs van dit artikel de LP rol op basis van buitenlandse literatuur en vanuit eigen ervaringen. Zodoende hopen zij een constructieve discussie te openen over deze (voor Nederland) nieuwe rol

Actieonderzoek: Principes en onderzoeksmethoden voor participatief veranderen

Het landschap van zorg, welzijn en educatie verandert voortdurend. Als professional moet je dagelijks kunnen werken met deze veranderende werkelijkheid. Hoe kun jij invulling geven aan nieuw beleid, goed inspelen op veranderende vragen van burgers, en actuele (maatschappelijke) gebeurtenissen? Op een manier die impact heeft en doorwerkt in meerdere domeinen, zoals de wetenschap, de beroepspraktijk, het onderwijs en de samenleving? Het antwoord is te vinden in nieuwe manieren van (samen)werken, leren en onderzoeken. Actieonderzoek is hierbij een niet meer weg te denken methodologie. Actieonderzoek vertrekt vanuit een kwestie die speelt in de praktijk en zoekt daar samen met de betrokkenen een antwoord op. De opgedane inzichten worden vertaald in acties in de praktijk. Door dit te onderzoeken wordt de kennis over en kwaliteit van praktijkvoering bevorderd. Vaak gaat het om complexe vraagstukken waar geen eenvoudige oplossing voor is. Actieve inbreng van diverse betrokkenen is noodzakelijk tijdens alle fasen. Tegelijkertijd ontwikkelen de betrokkenen zich doorgaans ook persoonlijk en professioneel. De taak van de onderzoeker is om deze ontwikkelingen te faciliteren, door onderzoek en verandering te integreren. Actieonderzoek biedt studenten en professionals handvatten om systematisch en methodisch de sociale praktijken te onderzoeken en te ontwikkelen. Het boek geeft inzicht in een participatieve benadering van actieonderzoek, met acht principes – waaronder participatie, persoonsgerichtheid en reflexiviteit – die helpen richting te geven aan het onderzoeks- en ontwikkelproces. Bijpassende onderzoeksmethoden en voorbeelden van actieonderzoeken bieden de lezer ideeën om een actieonderzoek vorm te geven, te bekritiseren en te faciliteren. Deze tweede, herziene editie bevat recente bronnen, nieuwe inzichten, onderzoeksmethoden en voorbeelden. Daarnaast staat deze editie meer stil bij de toepassing van de genoemde acht kernprincipes en bij de uitdagingen waar je als onderzoeker voor komt te staan. Ook is er specifieke aandacht voor rapporteren over actieonderzoek